• Apr17

    Two views of why heart disease prevention does not work well: one, personal responsibility is not given the attention it deserves.

    And two, physicians are not trained or incentivized to advise patients to stop smoking, improve their diet and become fit…maybe because people don’t think they can make a real difference in their own health. Which is wrong: it is *never* too late to start.

    Both of these commentaries are tragic.

    People need skills they don’t have, and don’t have easy access to: preparing, choosing and shopping for food well, improving mindset, productivity and sleep, and optimizing the home, work and mobile environments for the best lifestyle choices.

    Health care begins at home…not in the doctor’s office. Too often, it ends in the hospital, where we manage disease intensively. At which hospitals excel.

    What I want to do professionally over the next 5 years is help people like those in these videos—people at risk for or with chronic disease (heart, stroke, Alzheimer’s, diabetes, arthritis, hypertension, many cancers)–avoid the hospital. And avoid the Heart Attack Grill.

    The key is to make caring for yourself–and lifestyle–as fun as a vacation. My first step: helping men, and the women who love them Refuel.

     
  • Jan4

    The first big JAMA study of the new year (Happy New Year!) implied that you can be overweight or barely obese, and not die early because of it.

    In between the lines: yes….in that population. Why?

    Because they get medical care right away!. Because they get sicker sooner! Because their pre-diabetes, hypertension and high cholesterol gets screened for and picked up and treated!   And because being sick–like with cancer, immune disease, and heart disease–can make you less fat, because you feel sick!

    Plus, looked at internationally (as this study did), people of lower weight were often malnourished and sickly, and in some cases, starving.

    So much for “spinning the data.”

    Here is what you need to know about who is actually overweight, and why weight loss treats heart disease.

    74% of men and 68% of women in the U.S are overweight or obese, and the rest of the world is rapidly catching up.  Most men and women don’t know where they fall. You can measure your body mass index (BMI), measure your kid’s BMI, or just look below: for both men and women:

    If you’re 5-foot-10-inches, normal is 132 -167 pounds; an overweight is 172- 202 pounds, obese is 209- 236 pounds; severely obese starts at 243; morbidly obese starts at 278.

    If you’re 5-foot-5-inches, normal 114-144; overweight 150-174; obese is 180-204; severely obese starts at 210; morbidly obese starts at 240.

    Weight loss helps your heart because it lowers your blood pressure and your blood lipids including triglycerides and LDL cholesterol; it helps you metabolize sugar more efficiently; it improves insulin sensitivity; and it reduces inflammation. And inflammation probably causes heart disease.

    Not to mention makes it easier for the heart to pump blood where it needs to go!

    No one said it was easy to lose weight and keep it off: crappy, cheap, alluring high-calorie low-nutrient foods are everywhere. Produce is not as cheap or accessible as highly processed food. People often don’t have sit down meals, and motivation is a very weak leg on which to stand.  What you need is a plan, accountability, self-monitoring and the right foods for you.

     

     
  • Jun22

    Dr Oz says “break it down and make it simple”.  Dr. Roizen says “diet smart, not hard: small changes make a big difference.” They recommend in their new YOU: Losing Weight

    * Recruit your team. You need someone to cheer for you and take the fries from you.
    * Plan Your Plate.
    * Take a You-Turn. We all make mistakes: take an authorized U-turn and turn things around.
    * Keep moving! Walk just 30 minutes a day.

    They’re right, especially for women who want to lose weight.

    But for men and women, there’s something to add to this advice, which I also give often to my own patients.

    It taps into something we all care about: sex, sex drive, performance and looks. Not to mention hormones.

    I’m for it. Whatever my patients care about most will help them make the changes that are best for their energy level, heart, liver, kidneys and their family.

    Here is a clip I’ve shown at recent talks: it’s a little risque, but it’s national TV.

    When I show it to audiences, I ask people if they think it is frivolous, unprofessional, meaningful or important.

    I also ask whether it changes their view of belly fat. Does it for you?

     
  • Jan10

    No one writes down on my medical practice questionnaires that they eat because they are stressed.

    People say that they eat for a reward, or are lonely or bored, or are happy or angry or frustrated, or because they want to.

    Scientists who study workplace health group say those feelings can mean “chronic stress.”

    But senior management see those feelings as something else: as overtime pay, temporary help, quality lapses, and higher health care, drug and health plan costs.

    Inside companies, health-related lost work time is barely noticed, because it is camouflaged as wanting to eat.

    When you drill down and look at the science, you find that some (acute) stress is helpful in the workplace.  And that learning to manage chronic stress boosts productivity and saves money.

    The place between acute and chronic stress is the razor’s edge. The science of job stress tells us that individualizing help at work is part of a successful program, with evidence-based interventions.

    Medical science now studies what works in stress management: behavioral therapy, exercise, relaxation and nutrition.  A few examples:

    Relaxation: a controlled trial of one 45 minute Swedish massage versus light touch measurably reduced cortisol levels and inflammatory markers (these levels and markers which are high in obese people too).

    Exercise: a randomized controlled trial of yoga postures measurably improved mood, increased GABA levels and decreased anxiety more than calorie-equivalent walking.

    Simple behavioral changes (breathing exercises) and dietary changes (chewing gum) also have scientific theory and data.

    There are many excellent resources online for individuals and companies that want to manage stress well. I’ve just taped an instructional DVD on the subject, and it’s fascinating!

     
  • Nov3

    I am getting more calls about managing stress among employees. Thoughts impact physiology in about 1/18th second, so it’s worth preparing for them.

    What many companies, now asking employees to do with more with less, don’t know is that stress can be measured, reduced and managed.  And that their health care costs will go down, and their productivity rates will likely go up.

    Chronic stress interferes with memory, concentration, judgments and decisionmaking.  It is the most common cause of absenteeism and a prime cause of job turnover. It’s probably the most important benefit of corporate wellness.

    And it boosts health costs.  A lot.  But HeartMath has found $1200 per employee per year in correctional officers’ annual cost savings with simple training programs over time.

    Stress is a complex emotional and physiological reaction.  It is a natural feeling, one that involves hundreds of biochemical changes which are fatiguing.

    Stress can be controlled with practiced actions

    • Communicate clearly (does not mean shouting)
    • Diminish the drama (helps reduce biochemical impact)
    • Practice a positive emotion on purpose: appreciation, care, compassion or gratitude (verbalize or write these, every day)

    This looks pretty simple. And it is.

    But like eating healthfully, people know what they should do, but don’t usually have the tools or skills to do it.  That’s why teaching tools are essential.

    For example, rhythmic breathing can be relaxing.  But it doesn’t neutralize stress over the long term  What does is actively adding a positive feeling like those above.

    I’m going to be teaching on-the-job ways to manage stress around the country next year, and I can’t wait. Because effectively managing stress can:
    1. Increase resilience  – ability to prepare for, and recoup from challenge
    2. Improve blood pressure, depression, asthma
    3. Reduce fatigue, burnout, hostility, anxiety, distress and anger.
    4. Increase brain clarity, focus, attention span, accuracy and learning ability
    5. Improve decision‐making, (reduction of decision fatigue)
    6. Improve communication skills
    7. Improve work/life balance

    This means lower health care costs, better presenteeism (defined as the level of performance on the job), less abseenteeism and improved employee satisfaction.

    Learning the tools–in even a single hour, and even better, a single day–may be the ticket to less tired, less worried, less annoyed, less anxious employees.