These are among the top killers today. How is that possible with such advancements in medicine? To answer this question, we must look at lifestyle factors of North American people.
Unlike the flu and pneumonia, people tend to think heart disease and cancers are chronic conditions (long-standing and building up over time). Modern medicine is excellent at treating acute illnesses such as infections; however, when it comes to chronic diseases, most doctors prescribe medication to mask the symptoms associated with said condition. These prescriptions aren’t due to any fault of the physician. It’s a system based problem that values productivity versus optimization. Although there is a time and a place for this approach, most chronic conditions require lifestyle changes, and a lot of chronic diseases can also be prevented as well by lifestyle changes.
It might come as a surprise to some patients that nutrition and exercise play a massive role in disease prevention. The old saying “you are what you eat” comes to mind here, and it’s pretty darn accurate. What we feed our cells makes up who we are. So, it shouldn’t be a big shock to find out that food is fuel for our bodies. How does all this relate to heart disease and cancer? For heart disease, the most significant predictor is abdominal obesity because people who are obese almost always have elevated inflammatory levels in their system. The higher the levels, the greater the risk. However, traditional measurements are failing to address this problem on a micro, and subsequently macro level.
Traditional measures, for the most part, measuring fats, especially triglycerides, saturated fats, and cholesterol, are largely out-dated and lack sensitivity. Firstly, calculated s-LDL measurements don’t tell the entire story, even for cholesterol. Low-density lipoprotein is made mostly of large fluffy flakes which are essentially harmless. A minimal amount of minute electrically charged particles (referred to as oxidized LDL) are where the danger lies, with anything below 60 U/L acceptable. Unfortunately, specialized lab testing is required to see this picture. These small particles are what attach to the inside of blood vessels creating clots. Another measure, hs-CRP (< 1.0 mg/L) and Lp-PLA2 (<75 nmol/min/mL) measure inflammation within the walls of blood vessels. So, essentially, inflammation of the blood vessels and small LDL molecules are a better indication of clotting risk than total cholesterol and LDL alone.
We shouldn’t abandon working with our medical colleagues due to a lack of sensitivity of testing. However, we should take the time to educate our patients on all aspects of health and work diligently to encourage the lifestyle changes required to reduce heart disease risk. This education alone will go a long way to saving a lot of lives.
In the clinic, we need to shift focus from BMI to waist-hip ratio. Waist-hip ratio is the most straightforward test we can perform that will predict risk. In women, a WHR of less than 0.8, and in men, 0.9, is ideal for reducing heart disease risk.
We must encourage a simple to follow a well-balanced diet, filled with vegetables and fruits and one serving per day of white meat such as chicken or fish. Encourage your patients to shop the outskirts of the grocery store. They must also start moving. Motion is lotion, whether that means going to the gym or for a walk. Reduce stress, unplug from social media and be present for your family. Simple changes, done repeatedly over time, will generate the most significant results.
When talking about the second leading killer – cancer, diet can also play a massive role here as well. Studies have shown that an increase in vegetables can reduce your cancer risk by up to 40 per cent! There are also certain things to avoid. One of the more prominent contributors to cancer is the way we cook meat. Picture a summer barbeque, with burgers and sausages charring over the grill. This char that gathers onto the meat is just as toxic as cigarette smoke. The toxicity is due to the incomplete combustion yielding highly carcinogenic compounds including – but not limited to – benzene and nitrosamines. Pretty scary considering most of us have barbequed at some point, if not regularly. What can be done to avoid the char? Lighting only half of the barbeque can reduce the char and reduce the risk of carcinogenic compounds. Smoked meats and processed meats are just as mutagenic as the charred meats.
As for neurodegenerative conditions: The biggest problem seen among those with neurodegenerative diseases is decreased mitochondrial functioning. This decreased functioning occurs because of an increase of reactive oxidant species. To reduce said species, the first line of prevention here is the Mediterranean diet, which consists of fruits, vegetables, nuts and limited red meat. Not only does it preserve white brain matter, but it also increases cerebrovascular function and decreases the risk of cognitive impairment. Another significant factor in prevention here is exercise. Exercise has been shown to improve cognitive function and subsequently reduce the risk of dementia. Another interesting study found that those who played video games had a decreased risk of developing neurodegenerative diseases because of the increase in grey matter.
As we age, not only do our brains begin to deteriorate, our bones do too. So, what can we do to prevent diseases such as osteoporosis? Although many immediately think of calcium and vitamin D, this is not the case. Studies have shown that the required calcium is under 400mg/day yet North Americans get roughly 700mg/day. However, we have the highest fracture rates. Why? Because the key is not merely calcium, but calcium utilization. If someone is following the standard American diet, then it’s high in meat and low in plants, causing an overall acid load leading to a negative impact on calcium balance and thus a higher chance of fracture. I’m sure you’re sensing a pattern here: increase plants and decrease animal protein. Another important aspect of bone health is – you guessed it – exercise. Exercise increases bone mineral density (BMD) and therefore decreases fracture risk.
One very common disease that is often overlooked in terms of lifestyle factor prevention is Type 2 diabetes. Diabetes is one of many chronic conditions seen exclusively in North America. Once again, the standard American diet is the culprit here. Because of the high sugar intake among our population, this disease has become rampant. When the body gets a large supply of glucose, it is unable to take it all into its cells via insulin, therefore causing insulin resistance. Unfortunately for most people, this means they will be put on metformin, and then progressively insulin for the rest of their lives. However, there are lifestyle factors that can not only prevent it but also reverse it. To prevent or reverse Type 2 diabetes, patients must decrease their overall sugar intake and increase vegetable consumption. Numerous studies looked at exercise among this population and found that it increases the uptake of glucose into muscle tissue, thereby reducing insulin resistance.
Now that we’ve covered the more common chronic conditions, what do they all have in common? They are all products of chronic inflammation. Inflammation happens to everyone, and it’s a normal process. Whether it’s from an infection, or from going for a run, more times than not, our body is dealing with some sort of inflammation. It is when the inflammation does not subside where we run into issues (chronic inflammation). Chronic inflammation can be due to anything from an ongoing infection to a long-standing injury. Because chronic inflammation is such a prevalent problem today, we must modify our lifestyles early on to avoid it in the first place.
Some supplementation recommended for the prevention of the above diseases go as follows: fish oil (this decreases inflammation which can reduce conditions associated with chronic inflammation), CoQ10 (which was found to be low in almost all patients who had heart disease and/or are taking statin medications, therefore it is an essential marker for preventing this), multivitamin (that is vitamin A free) and melatonin (sleep is an excellent predictor for mortality rate, and it has been shown to decrease risks of many chronic diseases because of its ability to promote sleep). Even more important than supplementation, though is to ensure you have a diet that is rich in nutrients and low in processed foods. Implementing exercise into your daily life will also have a profound effect on your health outcome.
The elimination diet can also be used to see if certain foods are causing some of a patient’s symptoms. This diet essentially strips out sugar, processed meats, dairy, gluten, alcohol etc., resulting in a clean diet. Re-introduce after three weeks to see which foods may be causing inflammatory reactions.
Whether it be for heart disease or cancer prevention, all the way to fracture risk, patients can now understand that lifestyle factors are the key. Not only will it reduce the risk of the leading killers and chronic inflammation, but it will also improve your overall health and ultimately, your life.