To my knowledge, there is little evidence to support broad use of statins - or medicines that lower cholesterol. The goal for treating high cholesterol is to decrease risk of heart attack and early death. The research I have reviewed only showed this benefit for statin users who have been diagnosed with heart disease or who have had a heart attack. It is that group that benefits from use. The new recommendations are to give statin medications based on factors (like having diabetes) other than a persons blood cholesterol level. In a way, this removes the argument of how high the LDL level has to be before medicine is prescribed and at what dose should the statin be started, based on that LDL number. The cut off number was always arbitrary. How could there be more risk at 120 and not 119, for example. But I don't know that this is any better, because it still places an emphasis on pills over lifestyle.
I share the concerns of CNNs Dr. Sanjay Gupta who equates this shift to medication over changes in diet (and exercise) as a sign of defeat against the prevention of diseases associated with obesity. Medication is not the solution here and we shouldn't give up on prevention.
I understand that efforts to nudge people into better lifestyles has not been successful. I don't think encouraging people to rely on medicine to fix problems is better than changing the environment to provide people better options (i.e., options to be physically active and to eat in moderation). It does seem that nutrition information and nutrition guidelines are consistently and broadly misunderstood by a majority of persons. This is in large part due to the complicated and ever changing information out there. It is confusing and most people don't know what to look for when assessing a food's nutritional content and 'healthiness.'
Just recently, I walked by a man and woman at the grocery store as the man was reading the back of package nutrition label. (YAY!) I heard him say, "Oh no, this is loaded with carbohydrates." I wanted to stop, go back and ask him,"And what exactly does that mean to you? Why is that a good or bad thing?" Because if all someone told me was "its loaded in carbohydrates," I could not make an informed decision. Sugar is a carbohydrate, so are vegetables and grains!
Our education and health promotion efforts must be constant, but simplified. Americans consume diets that are high in calories and items that might lead to high cholesterol, diabetes, obesity, heart disease, etc. The main objective to improve health should be changing the diet (and increasing activity) not medicating the entire country. Using medication in this way is as foolish as providing more rescue workers to collect the drowning from the river instead of putting a rail on the bridge to keep people from falling in the river.
Showing posts with label lifestyle. Show all posts
Showing posts with label lifestyle. Show all posts
Tuesday, November 12, 2013
Tuesday, August 6, 2013
The Best Pledge We Can Make
I was at the school rec center last week when a few people were registering as guests. I overheard the staff person as he was asking them to sign a liability waiver. He said,
"This just means that you are taking responsibility for your body."I smiled when I heard it and I have thought about it ever since. What an awesome concept. What if every person, better yet, every middle school child, signed a pledge committing to take care of their body.
This commitment could be similar to those kids make about not smoking or doing drugs. DARE to be healthy, if you will.
Even better, it could be something required of us, before we get health insurance.
I hereby agree to take care of my body. I will eat well, exercise daily and avoid all forms (active and passive) of tobacco smoke. I will consume alcohol responsibly and protect myself from environmental toxins/radiation (e.g., sun, xrays, pollution, coal emissions).
(The government needs to help us out with the last few).
I do these things in order to prevent disease and to promote my healthy active life.
Now if we can find away to 'police' that... ok, enforce .. ok encourage... though my radical, nanny self wants to add,
and if I willingly break this vow, I will be responsible for my own health care bills and or higher insurance premiums and copays!
Seriously, I do pledge to do every thing in my power to live a healthy life and if by no fault of my own, I get sick.. I hope someone will take care of me :) Ok - even if its my 'fault'... I hope someone will take care of me... just saying.
Thursday, February 25, 2010
Medicine
My plan for tonight's blog does not seem to be materializing. I could use some of my ideas that I have for later in the week, or expand one of the Odds and Ends I have put aside, but I am pretty stubborn that way- and don't want to do that.
So I will explain where I was going to go with today's post first, then I will mention the article I was going to blog about before I had that "brilliant" idea that didn't pan out.. And THEN I will just call it a day.
I came across a term teaching a class last night and the meaning escaped me - which bothered me. The word was anxiolytic. It got me thinking about analgesics, antibiotics, anti inflammatories, diuretics,psychotropics, anesthetics, antiemetics etc . I know analgesics reduce pain but I couldn't for the life of me recall what an anxiolytic did. It is an anti anxiety medication or chemical - duh, but we always call them that -anti anxiety drugs- not anxiolytics. I was hoping to find a list of drugs by their scientific names and then to describe them all, but that list doesn't really exist. Surely there is a fancy name for a fever reducing drug, but I couldn't find it. Just to be thorough, since I did mention a few- I will explain them. The first is a pain reliever, the second fights bacterial infections, the next, inflammation, diuretics are fluid pills, psychotropics are drugs that can affect ones mood, anesthetics reduce consciousness and antiemetics are anti vomit medications.
So that's all I have for that thought.
Yesterday I was intrigued by a brief story regarding Medco which is a pharmacy benefits management company. In other words, a health insurance company might use Medco to review and determine what medications are on the formulary and what copayments apply to them. Medco was the company that first reported a drug interaction between a proton pump inhibitor and plavix. The company CEO has stated that they are going to spend more resources - staff and money - on independent research in the coming year. I know a lot of people get upset about benefits managers telling us which drugs we should take, especially because all those commercials we see make the newest drugs appear to be the best, but I for one am GRATEFUL for comparative research, and if it saves money that is all the much better because the country's insurance premiums seem to rise in unison.
So I will explain where I was going to go with today's post first, then I will mention the article I was going to blog about before I had that "brilliant" idea that didn't pan out.. And THEN I will just call it a day.
I came across a term teaching a class last night and the meaning escaped me - which bothered me. The word was anxiolytic. It got me thinking about analgesics, antibiotics, anti inflammatories, diuretics,psychotropics, anesthetics, antiemetics etc . I know analgesics reduce pain but I couldn't for the life of me recall what an anxiolytic did. It is an anti anxiety medication or chemical - duh, but we always call them that -anti anxiety drugs- not anxiolytics. I was hoping to find a list of drugs by their scientific names and then to describe them all, but that list doesn't really exist. Surely there is a fancy name for a fever reducing drug, but I couldn't find it. Just to be thorough, since I did mention a few- I will explain them. The first is a pain reliever, the second fights bacterial infections, the next, inflammation, diuretics are fluid pills, psychotropics are drugs that can affect ones mood, anesthetics reduce consciousness and antiemetics are anti vomit medications.
So that's all I have for that thought.
Yesterday I was intrigued by a brief story regarding Medco which is a pharmacy benefits management company. In other words, a health insurance company might use Medco to review and determine what medications are on the formulary and what copayments apply to them. Medco was the company that first reported a drug interaction between a proton pump inhibitor and plavix. The company CEO has stated that they are going to spend more resources - staff and money - on independent research in the coming year. I know a lot of people get upset about benefits managers telling us which drugs we should take, especially because all those commercials we see make the newest drugs appear to be the best, but I for one am GRATEFUL for comparative research, and if it saves money that is all the much better because the country's insurance premiums seem to rise in unison.
Friday, January 15, 2010
SES matters too
(no I didn't misspell sex!)
With regard to chronic and terminal disease, health experts are consistent and quick to say that lifestyle is the most important factor for either risk or protection (things we do or don't do make it more or less likely that we will become ill or injured). We hear most often that we should moderate our diets, exercise and not smoke. Experts say that our lifestyle is more important than our genetics or any other factor. It has the most influence. Today on Talk of the Nation (I only caught the end), which had several guests, I believe Esteban González Burchard, MD is the one who said that the two most important determinants of health were SES and lifestyle.
SES is socioeconomic status. I believe that the reason SES was mentioned is because they were discussing race and that race is important to know when doing research and forming plans for health promotion etc, because disease is NOT an equal opportunity destroyer. Dr. Burchard was saying that having more of a certain disease condition in a particular race was NOT about the race itself, and that the culture and environment had to be considered.
A person with less education (less than 12), low (minimum wage +) paying, low skilled jobs (or none) and little income has a low SES. Persons in these conditions are more often exposed to things that may lead to disease. Perhaps a person works in a factory where they are exposed to toxic chemicals, or have limited safety equipment. Or the person is forced to seek low income and inner city(pollution) or isolated rural (farm work? tobacco use?) housing where there is no access to healthy food or exercise facilities. And surely, persons with low SES have limited access to medical treatment and even less access to preventative measures, like PAP smears, colonoscopy and the like. Persons with less education may not understand messages about healthful eating, or warnings about products. They may never even hear that sunscreen is protective against skin cancer and vitamin D is a wonder drug. The exact opposite could be said of person with higher socioeconomic status and this is why the speaker noted that SES is an important determinant of health.
It is imperative that education on the lifestyle that promotes active long life be targeted to groups that would not normally be exposed to it. The promotion must also be delivered in a way that all persons can understand, accept and adopt. I hope to be involved in that kind of health promotion as soon as possible :)
With regard to chronic and terminal disease, health experts are consistent and quick to say that lifestyle is the most important factor for either risk or protection (things we do or don't do make it more or less likely that we will become ill or injured). We hear most often that we should moderate our diets, exercise and not smoke. Experts say that our lifestyle is more important than our genetics or any other factor. It has the most influence. Today on Talk of the Nation (I only caught the end), which had several guests, I believe Esteban González Burchard, MD is the one who said that the two most important determinants of health were SES and lifestyle.
SES is socioeconomic status. I believe that the reason SES was mentioned is because they were discussing race and that race is important to know when doing research and forming plans for health promotion etc, because disease is NOT an equal opportunity destroyer. Dr. Burchard was saying that having more of a certain disease condition in a particular race was NOT about the race itself, and that the culture and environment had to be considered.
A person with less education (less than 12), low (minimum wage +) paying, low skilled jobs (or none) and little income has a low SES. Persons in these conditions are more often exposed to things that may lead to disease. Perhaps a person works in a factory where they are exposed to toxic chemicals, or have limited safety equipment. Or the person is forced to seek low income and inner city(pollution) or isolated rural (farm work? tobacco use?) housing where there is no access to healthy food or exercise facilities. And surely, persons with low SES have limited access to medical treatment and even less access to preventative measures, like PAP smears, colonoscopy and the like. Persons with less education may not understand messages about healthful eating, or warnings about products. They may never even hear that sunscreen is protective against skin cancer and vitamin D is a wonder drug. The exact opposite could be said of person with higher socioeconomic status and this is why the speaker noted that SES is an important determinant of health.
It is imperative that education on the lifestyle that promotes active long life be targeted to groups that would not normally be exposed to it. The promotion must also be delivered in a way that all persons can understand, accept and adopt. I hope to be involved in that kind of health promotion as soon as possible :)
Tuesday, June 30, 2009
Lung Cancer Addendum
I want to revisit this just briefly today as I still worry over the confusion that follows a statement such as the one I read this weekend. "A majority (60%) of new lung cancer cases are in never and former smokers." It just sends the wrong message and could, if left unchallenged, derail some persons plans to quit smoking.
So again... 85% percent of lung cancer (NSCLC and SCLC) is directly related to cigarette smoking. The people who are diagnosed with lung cancer years after they quit smoking did NOT get it because they quit, but HAD IT when they quit.
Lung cancer most often begins in the bronchi or tubes of the lungs when cells change into precancerous lesions after coming into repeated contact with carcinogens in the tobacco smoke. (If you ever had a white patch in your mouth, which is referred to as leukoplakia, you can use that as a visual.
Lung tissue changes because of the assault or injury from tobacco smoke and if the cells become cancerous they will multiply incredibly fast. Cancer cells secrete or emit a chemical that creates new blood vessels that actually feed the cancer cells. NONE of this can be seen on an XRAY but it is happening just the same. When a tumor forms from these cancerous cells THEN it can be seen. Symptoms may come at that stage, but not usually before so.
The time it takes for the cells to change into cancerous cells is YEARS and because we have gone from a national smoking rate of 42% to a near 19% we have a LOT of former smokers. These people had lung damage when they stopped smoking they did not get lung damage because they quit.
In NSCLC the tumor is usually isolated and can be removed. In SCLC, the one that does not have many nonsmokers as victims, the spread is so fast and symptomless that treatment must involve drug therapy and the five year survival rate is less than 10 percent.
Many times a smoker will tell me that they had a lung scan and the doctor said that everything was just fine. Here is what I want these people to understand:
The xray or scan will show when you HAVE cancer not that your GETTING cancer.
A person who quits smoking will have at least 1/2 the risk of getting lung cancer after ten years as one who continues to smoke. I have been quit since 1997 and well, I just have to keep my fingers crossed and do everything else healthy that I possibly can.
I understand also that disease sometimes JUST happens but that means that I need to prepare my body for such a challenge by living as healthy a lifestyle that is in my power to live.
So again... 85% percent of lung cancer (NSCLC and SCLC) is directly related to cigarette smoking. The people who are diagnosed with lung cancer years after they quit smoking did NOT get it because they quit, but HAD IT when they quit.
Lung cancer most often begins in the bronchi or tubes of the lungs when cells change into precancerous lesions after coming into repeated contact with carcinogens in the tobacco smoke. (If you ever had a white patch in your mouth, which is referred to as leukoplakia, you can use that as a visual.
Lung tissue changes because of the assault or injury from tobacco smoke and if the cells become cancerous they will multiply incredibly fast. Cancer cells secrete or emit a chemical that creates new blood vessels that actually feed the cancer cells. NONE of this can be seen on an XRAY but it is happening just the same. When a tumor forms from these cancerous cells THEN it can be seen. Symptoms may come at that stage, but not usually before so.
The time it takes for the cells to change into cancerous cells is YEARS and because we have gone from a national smoking rate of 42% to a near 19% we have a LOT of former smokers. These people had lung damage when they stopped smoking they did not get lung damage because they quit.
In NSCLC the tumor is usually isolated and can be removed. In SCLC, the one that does not have many nonsmokers as victims, the spread is so fast and symptomless that treatment must involve drug therapy and the five year survival rate is less than 10 percent.
Many times a smoker will tell me that they had a lung scan and the doctor said that everything was just fine. Here is what I want these people to understand:
The xray or scan will show when you HAVE cancer not that your GETTING cancer.
A person who quits smoking will have at least 1/2 the risk of getting lung cancer after ten years as one who continues to smoke. I have been quit since 1997 and well, I just have to keep my fingers crossed and do everything else healthy that I possibly can.
I understand also that disease sometimes JUST happens but that means that I need to prepare my body for such a challenge by living as healthy a lifestyle that is in my power to live.
Thursday, June 18, 2009
Reducing Bad Blood FATS
Today is the seventh year since my father's death from a heart attack. Seems a fitting time to discuss some of the risk factors for a heart attack.
Heart disease and heart attacks are related to plaque build up within the arteries and hardening of those arteries. Arteries can get closed off or the plaque can break off and block an artery. Sometimes, as with an aneurysm, the artery walls weaken and leakage and rupture can occur.
Much of the risk for this problems comes from lifestyle. Of course genetics are involved, and if you have a family history of heart attack that means that lifestyle modification should be even MORE important to you, not less.
Eating foods high in saturated fat has long been known to raise one's "bad" blood cholesterol. While exercising helps increase one's HDL which helps the body process and eliminate the bad, or LDL low density lipoprotein.
In an article I read yesterday, the WSJ reported on the changing picture of treating heart disease and preventing fatalities. Over the last twenty years cholesterol lowering medications have become a billion dollar industry, but they have also saved lives. My father took a cholesterol lowering medicine, too. He had one of the original powders that he mixed up diligently every day, even when we went out of town. I forget the name, it came in a can.
What we didn't pay attention to those years ago but appears to be our next big challenge with regard to heart disease is triglycerides. It is high triglycerides that cardiologists consider the big risk factor for a heart attack. In the article I read, it was said that having triglycerides at 150 or above was a big indication that the person had a poor diet and limited physical activity.
The new focus is on raising HDL and lowering the other blood fat. Unfortunately, some say, blissfully I say, the best way to make the HDL go up and the tri's go down is.... drum roll please...
Become physically active, cut calories and eat more fruits and vegetables.
Triglycerides need to be monitored in much the same way total, LDL and HDL are monitored. It is said that even if the LDL stays at a decent 100, if the HDL drops below 50 and the triglycerides start trending up, something is happening and the chance for a heart attack will go up.
I am including another website for you today called CardioSmart. On this website you can complete some assessments of your risks and learn about reducing LDL and TG. TG is the abbreviation for triglycerides. I have learned from this website that it is important to eat a low saturated fat diet with lean protein and lots of fiber but NOT a low fat diet in general. So what you have heard here and what you see on my You Tube page, is correct. Include your mono and polyunsaturated fats in a calorie controlled lifestyle.
I do not think that TG were looked at much if at all in 2002 when my Dad died. I know that he had changed the way he ate after his first heart attack and tried to exercise regularly, but I also think he drank more than the recommended 2 or less alcoholic beverages a day. I know growing up that he was heavy into red meat and potatoes with lots of gravy and starchy vegetables. I am NOT faulting or blaming at all... we did not know what we know now. I am telling YOU so your kids don't sit around wondering about it.
My Dad was awesome... just had to end with that...
http://www.cardiosmart.org/default.aspx
Heart disease and heart attacks are related to plaque build up within the arteries and hardening of those arteries. Arteries can get closed off or the plaque can break off and block an artery. Sometimes, as with an aneurysm, the artery walls weaken and leakage and rupture can occur.
Much of the risk for this problems comes from lifestyle. Of course genetics are involved, and if you have a family history of heart attack that means that lifestyle modification should be even MORE important to you, not less.
Eating foods high in saturated fat has long been known to raise one's "bad" blood cholesterol. While exercising helps increase one's HDL which helps the body process and eliminate the bad, or LDL low density lipoprotein.
In an article I read yesterday, the WSJ reported on the changing picture of treating heart disease and preventing fatalities. Over the last twenty years cholesterol lowering medications have become a billion dollar industry, but they have also saved lives. My father took a cholesterol lowering medicine, too. He had one of the original powders that he mixed up diligently every day, even when we went out of town. I forget the name, it came in a can.
What we didn't pay attention to those years ago but appears to be our next big challenge with regard to heart disease is triglycerides. It is high triglycerides that cardiologists consider the big risk factor for a heart attack. In the article I read, it was said that having triglycerides at 150 or above was a big indication that the person had a poor diet and limited physical activity.
The new focus is on raising HDL and lowering the other blood fat. Unfortunately, some say, blissfully I say, the best way to make the HDL go up and the tri's go down is.... drum roll please...
Become physically active, cut calories and eat more fruits and vegetables.
Triglycerides need to be monitored in much the same way total, LDL and HDL are monitored. It is said that even if the LDL stays at a decent 100, if the HDL drops below 50 and the triglycerides start trending up, something is happening and the chance for a heart attack will go up.
I am including another website for you today called CardioSmart. On this website you can complete some assessments of your risks and learn about reducing LDL and TG. TG is the abbreviation for triglycerides. I have learned from this website that it is important to eat a low saturated fat diet with lean protein and lots of fiber but NOT a low fat diet in general. So what you have heard here and what you see on my You Tube page, is correct. Include your mono and polyunsaturated fats in a calorie controlled lifestyle.
I do not think that TG were looked at much if at all in 2002 when my Dad died. I know that he had changed the way he ate after his first heart attack and tried to exercise regularly, but I also think he drank more than the recommended 2 or less alcoholic beverages a day. I know growing up that he was heavy into red meat and potatoes with lots of gravy and starchy vegetables. I am NOT faulting or blaming at all... we did not know what we know now. I am telling YOU so your kids don't sit around wondering about it.
My Dad was awesome... just had to end with that...
http://www.cardiosmart.org/default.aspx
Sunday, June 14, 2009
Health Care Insurance
It has been a long, but productive and enjoyable Sunday for me. I hope that you also had a nice day.
Just briefly then.
I had said to my mother on Friday that I thought health insurance should be like car insurance or home owners insurance. When we get those types of insurances, we do everything we can to act in ways that will not lead to a price increase. People who do not speed or get into self caused accidents have better rates. People who live in hazardous zones pay higher premiums.
Why wouldn't we take care of our bodies? Oh, yes, likely because pharmaceutical companies tell us we do not have to as pills can fix everything. Well, they cannot. And when they can treat a condition it often comes with a real and physical price. We also spend a lot on tests, scans, procedures etc which do not change outcomes.
With my whole heart I believe that health insurance and health care is a resource to be preserved.
I found on Friday that my idea wasn't new at all as the CEO of Safeway had an article in the WSJ saying just about the same thing. I saw also that he had started a coalition.
I can not say this better so below are the links to the article and to his website.
http://online.wsj.com/article/SB124476804026308603.html
http://www.coalition4healthcare.org/
Just briefly then.
I had said to my mother on Friday that I thought health insurance should be like car insurance or home owners insurance. When we get those types of insurances, we do everything we can to act in ways that will not lead to a price increase. People who do not speed or get into self caused accidents have better rates. People who live in hazardous zones pay higher premiums.
Why wouldn't we take care of our bodies? Oh, yes, likely because pharmaceutical companies tell us we do not have to as pills can fix everything. Well, they cannot. And when they can treat a condition it often comes with a real and physical price. We also spend a lot on tests, scans, procedures etc which do not change outcomes.
With my whole heart I believe that health insurance and health care is a resource to be preserved.
I found on Friday that my idea wasn't new at all as the CEO of Safeway had an article in the WSJ saying just about the same thing. I saw also that he had started a coalition.
I can not say this better so below are the links to the article and to his website.
http://online.wsj.com/article/SB124476804026308603.html
http://www.coalition4healthcare.org/
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