Healthcare spending in the US continues to rise at an unsustainable rate, projected to reach 20% of the gross domestic product by 2015. One response to this trend has been a renewed attention in disease prevention, diagnostics, personalized medicine and disease management. The best way to save taxpayers and insurance companies is to prevent disease versus to enter into the healthcare arena with all of it’s associated cost.
Did you know that cardiovascular disease is the leading cause of death in the U.S. while heart disease; cancer, chronic lung disease, and diabetes- kill three in five Americans. According to the World Health Organization, deaths form such disease will increase by 17% over the next decade. This rate is driven by the increase use of tobacco products, excess alcohol consumption, poor quality foods, and insufficient exercise.
One of the most prevalent and preventable diseases is diabetes. This is preventable with proper weight management. One of the first signs of diabetes is not elevated blood sugar, but elevated insulin levels. An insulin level is very predictable for the diabetes. Insulin resistance is one of the most common causes for obesity. If the patient is started on an early and aggressive weight management program the loss of 10% of body weight, a decline in insulin can be seen. Insulin resistance is also associated with kidney disease, cardiovascular disease, and fatty liver disease.
Heart disease can be reduced by as much as 40% with proper medicines. Patients are afraid to start cholesterol medicines for fear of elevated liver enzymes. They are missing the main point that no one dies from elevated liver enzymes that reverse after the drug is discontinued, but heart disease is the number one killer of American men and women.
The lipid panel is a window into the coronary arteries but only a small part of the total picture. I first of all encourage all women to get their cholesterol checked if over 40 or have strong family history. I also recommend that you to have a lipid profile that evaluate the particle size and number of lipoproteins. The particle size is indicative of the risk of plaque formation and evitable heart attack. The smaller the particle size the greater the risk of plaque formation. You can have a normal lipid profile but a very abnormal particle size.
Lipoprotein Lp(a) is one of the greatest markers for atherosclerotic disease. This marker does not respond to statin medicines and requires niacin to mount and adequate response. Inflammatory markers include Lp-PLA2 and myeolperoxidase, these markers indicate the risk of plaque being instable and breaking off and causing a heart attack. These are treated with fish oils and aspirin.
The measure of fatty acid levels can predict the risk of stroke and cardiovascular risk. This is called an omega 3 index and this is a very important marker to watch. Treatment includes fish oil or 3 omega fatty acids.
Vitamin D has been shown to be an indicator of breast cancer and heart disease. Vitamin D levels should be 30 or greater. This is many times an issue in the African American population due to poor absorption of sunlight, which promotes conversion to vitamin D.
Another key to disease prevention is proper diet that is low in saturated fats and is more of a whole food diet. A whole food consists of vegetable and fruits and low in carbohydrates and processed foods. Many cancers today are felt to be a direct cause of dietary issues. The reduction in breast cancer in Japanese women is felt to be a direct correlation to dietary differences between cultures.
Maintaining ideal body weight is key for the prevention of excessive pressure on the weight bearing joints. This could have a profound impact on arthritis and many other joint conditions. The lost of 10% of your body weight will reduce the pressure on your joints by 4-6 fold. Example: A 200 pound person that loses 20 pounds they will see a 80 to 120 pound reduction on the joint! This is a huge number.
Restricting tobacco is the most important way to reduce cardiovascular disease and cancer. Risk of heart disease is 5 fold higher for those less than 50 that smoke. Smoking promotes arthrosclerosis by increasing LDL-C that promotes plaque formation.
Smoking accounts for 90% of all lung cancers, which cause 28% of all cancer deaths. The key is that we need to aggressively promote smoking cessation. Smokers state that their doctors advise was a key factor in their quitting smoking, but many health care professionals are failing to address smoking habits. The success rate for a smoker is only 7% without aid.
These are just a few of the most common associated preventable conditions. When you go to your doctor ask for an insulin level, a lipid panel with lipoprotein markers as well as clotting and inflammatory markers. Check a vitamin D level. Work to maintain ideal body weight and if you are having trouble ask for assistance. If you are a smoker by all means don’t be shy about asking for help. Prevention is the key to long and healthy life.