How Much Longer Can You Afford
to NOT Be Healthy?
Promoting healthy longevity requires proactive efforts to be healthy. This stands in stark contrast to the medical model of “disease prevention” that turns minor elevations in disease surrogates like cholesterol, blood pressure, and blood sugar into pre-disease – increasing the legions of the “worried well”.
Nor does it bear any resemblance to end-of-life medical care that merely prolongs the dying process.
The once noble notion of “disease prevention” has morphed into another commerce-driven excuse to over-prescribe medications that often are of no value and may even pose risk of harm.
The statin drugs (Lipitor, Crestor, etc.) are the most prescribed drugs in the world, routinely prescribed for women and seniors despite there being little evidence of any benefit, and possibly harm, for both – all in the name of “prevention”.
Do You Want To Be Healthy
or Just Disease-Free?
The goal of the medical model of prevention is to be disease-free rather than to be healthy – and there’s a world of difference. It relies on medications to offset lifestyle behaviors that increase risk factors like cholesterol and blood sugar.
But medications also add another risk factor to your likelihood of disease – and hamper your efforts to be healthy.
Statin drugs, for example, are associated with muscle weakness, memory loss, increased hostility and depression, and may increase risk for obesity and type 2 diabetes. These pose problems in their own right – increasing dependence on the medical system that prescribes these drugs.
But they also create impediments to adopting upgraded lifestyle behaviors – and it is these, not “preventive” medications, that are the true route to becoming and remaining healthy.
One example is the health benefits of increased physical activity – of increasing calorie expenditure through “moving more”, not necessarily “exercising” as it’s commonly perceived.
Strength training is an integral component for preserving muscle mass that will otherwise atrophy with age – and less muscle mass means a slower metabolism and fewer calories burned while resting.
In fact, as you age physical activity is more important than how much you eat if you wish to be healthy well into your senor years. Active older adults can better regulate their calorie intake without “dieting” than sedentary older adults. Your need to maintain your optimal weight increases as you age and your risk for both chronic and acute disease increases with central (belly) obesity.
Pot Belly or Plot Belly?
Visceral abdominal fat in proximity to the pancreas disrupts metabolism and insulin response and can cause cancer and other diseases.
A study of sarcopenia (muscle wasting) in adults found muscle loss associated with insulin resistance in both obese and non-obese adults may be…
“An important causal factor in age-induced insulin resistance and type 2 diabetes”.
The combination of muscle loss and disruptive hormones released by visceral belly fat make a healthy diet essential if you wish to be healthy – not just for those who are overweight, but for anyone with excess belly fat regardless of weight.
Taking medications that weaken muscles as statin drugs do makes strength training harder. The medication may help some and harm others, but it will very likely make it more difficult for everyone to adopt and stick with the strength training required for a longer and healthier life.
Likewise, there’s compelling evidence that anger and hostility – also reported by statin users – contribute to stress-related disease, while also causing sleep deprivation that becomes an obstacle to adopting and maintaining a healthy lifestyle.
A healthful New Year’s resolution for 2013 would be to reduce and eliminate such obstacles to healthier living.
Medications generally should be reserved only for moderate-to-advanced disease where there’s solid evidence of benefit for your age, race, and gender. Rather than “asking your doctor” if you need medications you see advertised on TV, ask if you can cut back on your medications by lowering doses or even eliminating one or more.
According to Worstpills.org, for example, people on blood pressure medications whose blood pressure has been controlled for a year or more should ask their doctor about tapering off blood pressure medications that aren’t meant as a lifetime regimen.
As discussed in Our Healthcare Sucks, up to 80% of medical practice lacks evidence of effectiveness and much of it may be harmful. Those wishing to be healthy and to avoid rampant medical errors and exploitation will need to learn which is which and agree only to those treatments with solid evidence of safety and effectiveness.
Living Longer vs. Dying Slower
Most of us want to live as long as possible, but we also value our quality of life. No one wants to spend their final years with Alzheimer’s Disease, as stroke victims, or “cardiac cripples” barely able to draw breath.
The realization that there’s no effective treatment for Alzheimer’s – current medications do little to slow its progression – turns up the fear factor even more. Alzheimer’s, in particular, has caught the public’s attention as more of us witness older friends and relatives struggle with this disease that robs them of not just their memories, but their personalities – their very identities.
The medical model has no effective answer for Alzheimer’s, so it throws more ineffective drugs at the problem in hopes of buying a little time before it takes its ultimate toll.
But most of us know instinctively the difference between living longer and dying slower.
And medicine is about dying slower. It’s focused on disease, not on health. Lifestyle measures proven to control the biggest risk factors for Alzheimer’s – and to be healthy more generally – are often ignored because they’re too time-consuming for time-pressured medical practices.
Yet high blood pressure that will affect 9 out of 10 of us and elevated blood sugar, along with its close relatives – insulin resistance, pre-diabetes (metabolic syndrome), and type 2 diabetes – are major controllable risk factors for Alzheimer’s Disease.
Tackling these threats to a healthy future long beforehand is the only way to prevent Alzheimer’s from depriving us of mental clarity in our final years. And these are best tackled in our homes and workplaces, not in doctors’ offices and hospitals.
Health Promotion is the
Best Form of Disease Prevention
In the U.S., the short-term and profit-driven nature of private health insurance assures that the health promotion efforts required to be healthy – and address these threats – will remain short-changed.
Why should health insurers reduce profits to pay for health-promoting measures that extend life and mental cognition when the financial reward – reduced medical needs in the future – will be realized by Medicare and not by them? There’s no return on their investment.
Marginal healthcare reforms like those under Obamacare will do nothing to solve this problem as Medicare will still be the beneficiary of current investments in lifestyle education and support for middle-aged adults. There’s still a disconnect between the investment required and the future return in lessened medical costs.
Expecting private insurers to invest for the future financial benefit of Medicare is fiscally illogical on its face.
The ultimate answer is politically untenable in America for the foreseeable future. And that’s universal insurance coverage that not only covers everyone currently, but covers them until they die so those making the investment also reap the rewards from those investments.
Unless and until we have such universal and permanent health insurance via an expanded Medicare, there will continue to be financial disincentives for private insurers to subsidize lifestyle behaviors that reduce medical costs by reducing the future need for medical care.
This is no paranoid perception of capitalism, but a simple recognition that it’s human nature to follow one’s financial self-interests. That’s what health insurers do and will continue to do. If they’re private for-profit companies, they have a fiduciary duty to their shareholders to do just that.
This puts their financial interests and ours at odds. And health reforms that preserve the private insurance industry – as does Obamacare – won’t reverse this underlying financial dichotomy.
The continuing resistance to even the modest reforms in Obamacare prove we have no stomach for the bold measures needed to truly reform American healthcare. Indeed, the opposition to Obamacare seeks to drive us in the opposite direction by raising the eligibility age for Medicare under a pretense of fiscal responsibility that’s little more than an attempt to expand the market for private insurers.
This political failure to aggressively address our health system failings effectively guarantees American consumers will remain exploited by medical greed and insurance abuses that make perfect economic sense for them but spell premature death and bankruptcy for growing ranks of medical consumers.
Coping with such an unreformed medical system can only be eased to the extent we reduce our reliance on it. To do that, we must reform our lifestyles and resolve to be healthy for as long as possible.
The evidence clearly shows that we consumers are very much part of the problem with our unquestioning acceptance of the “more is better” mantra of American healthcare.
With the right focus, commitment, and support, however, we can become part of the solution.
 Statins Might Slightly Boost Diabetes Risk. Reuters Health Information. 10/23/09. medscape.com.
 Habitual physical activity differentially affects acute and short-term energy intake regulation in young and older adults. Int J Obes (Lond). 2007 Aug;31 (8):1277-85.
 Sarcopenia Exacerbates Obesity-Associated Insulin Resistance and Dysglycemia: Findings from the National Health and Nutrition Examination Survey III. PLos ONE. 5(5):e10805. Doi:10.1371/journal.pone.0010805. 5/10.