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Healthy, Wealthy and Wise 2018

A recent presentation on health and healthy living. Learn how you personal choices just may be the most powerful predictors of your personal health. Be empowered and inspired to achieve your best health in 2018.

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Healthy, Wealthy and Wise 2018

  1. 1. Healthy, Wealthy and Wise Achieving your best Health in 2018 Stephan Esser MD, USPTA
  2. 2. “Early to bed and early to rise, makes a man healthy and wealthy and wise; wise, healthy and wealthy!”
  3. 3. Esser’s Health Ranch Dr William Esser ND, DC 1911-2003
  4. 4. • Your Personal Choices may just be the most powerful influences of your health, today, tomorrow and for years to come
  5. 5. Goals • Explore the Health of America Today • Learn why what you do matters • Develop a plan of health for your life
  6. 6. A Paradigm Shift
  7. 7. “A global response to a global problem: the epidemic of overnutrition.” WHO It is estimated that by 2020 2/3rds of the global burden of disease will be attributable to chronic non-communicable diseases, most of them strongly associated with diet. The nutrition transition towards refined foods, foods of animal origin, and increased fats plays a major role in the current global epidemics of obesity, diabetes and cardiovascular diseases, among other non- communicable conditions. Sedentary lifestyles and the use of tobacco are also significant risk factors. …….. A concerted multi-sectoral approach, involving the use of policy, education and trade mechanisms, is necessary to address these matters.
  8. 8. Mortality Statistics
  9. 9. Leading Causes of Death in US
  10. 10. Top Ten Causes of Death for Men in the United States
  11. 11. “A global response to a global problem: the epidemic of overnutrition.” WHO It is estimated that by 2020 2/3rds of the global burden of disease will be attributable to chronic non-communicable diseases, most of them strongly associated with diet. The nutrition transition towards refined foods, foods of animal origin, and increased fats plays a major role in the current global epidemics of obesity, diabetes and cardiovascular diseases, among other non- communicable conditions. Sedentary lifestyles and the use of tobacco are also significant risk factors. …….. A concerted multi-sectoral approach, involving the use of policy, education and trade mechanisms, is necessary to address these matters. DiabetesDiabetes High Blood PressureHigh Blood Pressure High CholesterolHigh Cholesterol Heart DiseaseHeart Disease ObesityObesity
  12. 12. 2 of 32 of 3
  13. 13. Associated Pathology • CVD: – Hypertension – Congestive Heart Failure – PVD – Impotence – Claudication • Endocrine: – Diabetes – PCOS – Hypothyroidism – Infertility • Orthopedics: – Osteoarthritis – AVN • Hepatic: – #1 cause of liver dz in US • Obstetrics: – Gestational DM – Macrosomia – Inc. C Section rate – Inc. Perinatal Morbidity – Inc. Pre/Eclampsia • Cancer: – Prostate – Colon – Breast – Endometrial – Renal Cell – Gallbladder – Esophageal Adeno. • Other: • Hyperuricemia, Pancreatitis, Gallstones, Sleep Apnea, Alzheimer’s, Dyslipidemia, Metabolic Syndrome
  14. 14. Overweight ↑ risk of DM2 by 3 fold Obesity ↑ risk by 9 fold
  15. 15. The Problem 1:9 adults1:9 adults
  16. 16. The Problem • High Blood Pressure: – 1 in 3 adults 1:3 adults1:3 adults
  17. 17. 1:6 adults1:6 adults
  18. 18. How did this Happen?
  19. 19. ↑39% Av. of 52 tsp added sugar/person/day
  20. 20. •IOM: (UL) for salt is 5.8 g/day > 95 percent US Males 31 - 50 > 75 percent of US females 31- 50 regularly in excess of the UL. < 2 g/day< 2 g/day
  21. 21. Sodium < 2000 mg Cholesterol < 200mg Sodium < 2000 mg Cholesterol < 200mg
  22. 22. Sodium < 2000 mg Cholesterol < 200mg Sodium < 2000 mg Cholesterol < 200mg
  23. 23. Food Portion Cholesterol/mg Vegetables Unlimited 0 Fruits “ “ 0 Nuts “ “ 0 Seed “ “ 0 Grains “ “ 0 Milk (non-fat) 100g 2 Milk (whole) 100g 10 Butter 1 Tbs 31 Beef 100g 61 Salmon 100g 55 Chicken 100g 65 Shrimp 100g 126 Lobster 100g 127 Egg 100g 372 http://www.nal.usda.gov/fnic/foodcomp/search/
  24. 24. 83.9 lbs/person/year83.9 lbs/person/year ↑88%↑88% 20122012
  25. 25. US Meat Consumption ↑57 lb/capita
  26. 26. Year Bee f Pork Total Red Meat Total Chicken Turkey Total Poultry Total Red meat and Poultry Commerci al Fish and Shellfish 1965 74.7 51.5 133.9 36.9 7.6 44.4 178.4 10.9 2000 67.5 50.8 120.2 77.4 17.3 94.7 214.8 15.2 2016 Prj. 55.0 49.2 105.3 91.4 16.2 107.6 213 NA As of 9/6/15
  27. 27. ↑300% 33.533.5 20122012
  28. 28. 8% from Fruits and Vegetables 8% from Fruits and Vegetables ≈ 50% from Added fat/oil and processed flour ≈ 50% from Added fat/oil and processed flour
  29. 29. Perspective • We eat more – Sugar, Salt, Fat, Meat, Dairy – 1970-2018: • ↑ 24.5 % C/day ≈ 504K/day • We get less then ideal Physical Activity – 18.8% of adults achieved CDC reccs on Exercise – 10% of adults >65 y/o
  30. 30. Michelangelo’s David: 12 month 20 city tour of the US
  31. 31. What we Know • Americans – Eat More – Exercise Less • 2018: – Obesity – Diabetes – Metabolic Syndrome – CV Disease
  32. 32. HealthCare Spending = $2.7 trillion = 17.7% GDPHealthCare Spending = $2.7 trillion = 17.7% GDP
  33. 33. Associated Pathology • CVD: – Hypertension – Congestive Heart Failure – PVD – Impotence – Claudication • Endocrine: – Diabetes – PCOS – Hypothyroidism – Infertility • Orthopedics: – Osteoarthritis – AVN • Hepatic: – #1 cause of liver dz in US • Obstetrics: – Gestational DM – Macrosomia – Inc. C Section rate – Inc. Perinatal Morbidity – Inc. Pre/Eclampsia • Cancer: – Prostate – Colon – Breast – Endometrial – Renal Cell – Gallbladder – Esophageal Adeno. • Other: • Hyperuricemia, Pancreatitis, Gallstones, Sleep Apnea, Alzheimer’s, Dyslipidemia, Metabolic Syndrome
  34. 34. 1: Essential Hypertension 7: Diabetes Mellitus 15/17: Heart Disease 1: Essential Hypertension 7: Diabetes Mellitus 15/17: Heart Disease Top 35 leading diagnosis groups at ambulatory care clinicsTop 35 leading diagnosis groups at ambulatory care clinics
  35. 35. Number and rate of discharges from short stay hospitals 2009Number and rate of discharges from short stay hospitals 2009 2: Heart Disease 8: Strokes 11: Diabetes Mellitus 17: Essential Hypertension 2: Heart Disease 8: Strokes 11: Diabetes Mellitus 17: Essential Hypertension
  36. 36. Admission Diagnosis to Nursing Homes 2009Admission Diagnosis to Nursing Homes 2009 1: Disease of Circulatory System1: Disease of Circulatory System
  37. 37. Can WEChange this?
  38. 38. Can we Change Health through Lifestyle Or are Genetics the end of the story?
  39. 39. They did not display their parent’s susceptibility to cancer and diabetes…. ……..the effects of the agouti gene had been virtually erased.
  40. 40. Pima Indians
  41. 41. “A global response to a global problem: the epidemic of overnutrition.” WHO It is estimated that by 2020 2/3rds of the global burden of disease will be attributable to chronic noncommunicable diseases, most of them strongly associated with diet. The nutrition transition towards refined foods, foods of animal origin, and increased fats plays a major role in the current global epidemics of obesity, diabetes and cardiovascular diseases, among other noncommunicable conditions. Sedentary lifestyles and the use of tobacco are also significant risk factors. …….. A concerted multi-sectoral approach, involving the use of policy, education and trade mechanisms, is necessary to address these matters. ……if…….Lifestyle is the Problem ……if…….Lifestyle is the Problem What is the answer……..?What is the answer……..?
  42. 42. Lifestyle Medicine Physical Modalities Pharmaceuticals Surgery
  43. 43. What HAS worked?
  44. 44. • What if…….. – You ate MOREfruits, vegetables, unprocessed whole grains, nuts, seeds and beans? – You ate LESS foods of animal origin (meat, dairy, fish) and processed foods – You reduced Toxic exposures – You exercised daily
  45. 45. 12 year Cohort Study 1507 men 832 Women Ages 70-90 years Outcomes: 10 yr all cause mortality 4 Factors: More plants, Moderate EtOH, physical exercise and non-smoking were ass. w ↓ in ACM 50% ↓ in all-cause and cause specific mortality
  46. 46. “Not only do persons with better health habits survive longer, but in such persons, disability is postponed and compressed into fewer years at the end of life.” Vita, AJ et al. NEJM 1998; 338:1035-1041
  47. 47. Finnish Diabetes Prevention Trial Total 522: 172M 350W Av. age 55 Av. BMI 31 Randomized to standard of care or individualized lifestyle counseling Av. f/u 3.2 yrs Risk of Diabetes ↓ 58 % (P<0.001) N Engl J Med 2001;344:1343-50 “The reduction in the incidence of diabetes was directly associated with changes in lifestyle”
  48. 48. The calorically restricted low-fat nutrient-dense diet in Biosphere 2 significantly lowers blood glucose, total leukocyte count, cholesterol, and blood pressure in humans PNAS December 1, 1992 vol. 89 no. 23 11533-11537 • Biosphere 2 is a 3.15-acre space containing an ecosystem that is energetically open (sunlight, electric power, and heat) but materially closed, with air, water, and organic material being recycled. Since September 1991, eight subjects (four women and four men) have been sealed inside, living on food crops grown within. Their diet, low in calories (average, 1780 kcal/day; 1 kcal = 4.184 kJ), low in fat (10% of calories), and nutrient-dense, conforms to that which in numerous animal experiments has promoted health, retarded aging, and extended maximum life span. We report here medical data on the eight subjects, comparing preclosure data with data through 6 months of closure. Significant changes included: (i) weight, 74 to 62 kg (men) and 61 to 54 kg (women); (ii) mean systolic/diastolic blood pressure (eight subjects), 109/74 to 89/58 mmHg (1 mmHg = 133 Pa); (iii) total serum cholesterol, from 191 +/- 11 to 123 +/- 9 mg/dl (mean +/- SD; 36% mean reduction), and high density lipoprotein, from 62 +/- 8 to 38 +/- 5 (risk ratio unchanged); (iv) triglyceride, 139 to 96 mg/dl (men) and 114 to 78 mg/dl (women); (v) fasting glucose, 92 to 74 mg/dl; (vi) leukocyte count, 6.7 to 4.7 x 10(9) cells per liter. We conclude that drastic reductions in cholesterol and blood pressure may be instituted in normal individuals in Western countries by application of a carefully chosen diet and that a low-calorie nutrient-dense regime shows physiologic features in humans similar to those in other animal species.
  49. 49. Healthy living is the best revenge: findings from the European Prospective Investigation Into Cancer and Nutrition-Potsdam study 2009 • 23,153 participants (35 to 65yr) for about 8 years • Rates of type 2 diabetes mellitus, myocardial infarction, stroke, and cancer • 4 Variables: – Never smoking – BMI<30 – 3.5 h/wk or more of physical activity – healthy dietary principles (high intake of fruits, vegetables, and whole-grain bread and low meat consumption). If you had all 4 factors at baseline you had • 78% lower risk of developing a chronic disease • • 93% lower risk of diabetes •81% lower risk of myocardial infarction •50% lower risk of stroke, and •36% lower risk of cancer If you had all 4 factors at baseline you had • 78% lower risk of developing a chronic disease • • 93% lower risk of diabetes •81% lower risk of myocardial infarction •50% lower risk of stroke, and •36% lower risk of cancer Sign Me Up!Sign Me Up!
  50. 50. Pritikin Program • Effects of a High-Complex-Carbohydrate Diet and Daily Walking on Blood Pressure and Medication Status of Hypertensive Patients Journal of Cardiac Rehabilitation, 3: 839, 1983 • 216 adults on 3 week program • 83% were able to discontinue BP medx and had normal BP’s • 17% had their pill dosages substantially reduced
  51. 51. Pritikin Program • Pritikin et al Long-Term Use of a High-Complex-Carbohydrate, High-Fiber, Low-Fat Diet and Exercise in the Treatment of NIDDM Patients Diabetes Care 1983 – 26 day inpatient stay, 77% off Oral Hypoglycemics, 25%  in TC • Effect of Short-Term Pritikin Diet Therapy on the Metabolic Syndrome Journal of Cardio-Metabolic Disease 2006 – 12-15 day stays, BMI 3%, SBP, SG, LDL  10-15% – 37% no longer met criteria for Metabolic Syndrome
  52. 52. Duke Rice Diet Program
  53. 53. What we Know Health Comes from Healthy Living Health Comes from Healthy Living
  54. 54. We know • Health Comes from Healthy Living –MORE Color –MORE Movement – Reduce/Eliminate Toxins – Spiritual/Emotional Well-Being
  55. 55. Stages of Change (Prochaska and DiClemente) 1: Pre-contemplation 2: Contemplation 3: Preparation/planning 4: Action 5: Maintenance 6: Permanent Maintenance (Termination)
  56. 56. GROW • Goals • Reality today • Options • Will Disease Prevention Disease Reversal Medication Reduction Functional Improvements Pain Reduction Feeling Good Weight Loss Improved Energy Longevity Sexual Performance Aesthetics Disease Prevention Disease Reversal Medication Reduction Functional Improvements Pain Reduction Feeling Good Weight Loss Improved Energy Longevity Sexual Performance Aesthetics
  57. 57. Setting Goals •Specific •Measureable •Achievable •Realistic •Timely
  58. 58. Conclusion • Personal Choices are powerful Medicine • Assess YOUR Health Today • Identify your health goals • Develop a support team • Take charge of your health today!
  59. 59. Profound Simplicity
  60. 60. Thank You! Stephan Esser MD, USPTA
  61. 61. Conclusion You are the most powerful influence in your health today, tomorrow and for years to come!
  62. 62. Fingers Feet Forks the Master Levers of Health Destiny
  63. 63. Feet
  64. 64. Exercise and Physical Health • Reduces risk of – Heart Disease ≈ 40% – Obesity: ≈ 30-100% – Stroke ≈ 50% – Type 2 Diabetes ≈ 50% – Hypertension ≈ 50% – Disability delayed ≈15 years – Colon Cancer ≈ 25-40% – Breast Cancer ≈ 20%-44% – Osteoporosis ≈ 20+% • As many as 250,000 deaths per year in the United States areattributable to a lack of regular physical activity
  65. 65. Exercise and Mental Health • Regular Exercise: – Reduces risk/severity of: • Depression • Anxiety • ADD/ADHD • Alzheimers Dementia – Improves: • Mental Clarity, test scores, focus
  66. 66. Exercise and Emotional Health • Regular Exercise: – Increases Self Confidence – Teaches skills to manage adversity – Enhances Self Esteem – Develops Discipline – Encourages Goal setting and self awareness
  67. 67. Exercise means pink spandex, going to a gym, sweating with a bunch of people I don’t even know or like!
  68. 68. Categories • Leisure time Exercise: organized sports, running, gym activities, rehabilitation etc. • Lifestyle Exercise: activity incorporated into our daily pattern of life – eg: parking in the distant portion of the parking lot rather then the first bumper, taking the stairs instead of the elevator etc.
  69. 69. Present Recommendations • Cardiovascular: – 150 minutes of moderate-intensity exercise per week. – 30-60 minutes of moderate-intensity exercise (five days per week) or 20-60 minutes of vigorous- intensity exercise (three days per week).
  70. 70. Present Recommendations • Resistance Training: – 2-3 days per week – All major muscle groups – 2-4 sets of each exercise – 48 hours in between sessions http://www.acsm.org/about-acsm/media-room/news-releases/2011/08/01/acsm-issues-new-recommendations-on- quantity-and-quality-of-exercise
  71. 71. Present Recommendations • Flexibility: – 2-3 days/week to improve range of motion • Balance: – 2-3 days/week – Eg: Tai Chi, Yoga
  72. 72. All Kinds • People • Programs • Locations • Products: Pedometers, Accelerometers etc
  73. 73. Intensity of Exercise Maximal Heart Rate: 220-Age or 206.9-(0.67x age) Heart Rate Reserve (HRR): Max. HR- Resting HR = HRR Target HR=HRR x % intensity + HR @ rest Maximal Heart Rate: 220-Age or 206.9-(0.67x age) Heart Rate Reserve (HRR): Max. HR- Resting HR = HRR Target HR=HRR x % intensity + HR @ rest Talk Test: -Easy: Can Talk and Sing -Moderate: Can Talk but not sing -Intense: Can’t talk or sing Talk Test: -Easy: Can Talk and Sing -Moderate: Can Talk but not sing -Intense: Can’t talk or sing
  74. 74. Nutrition • Up to 50% of Americans are on a Diet DIEtDIEt LifestyleLifestyle
  75. 75. Nutrition • Health Promoting Nutrition: • Majority of Calories derived from Plant-Based Sources • Limited Calories from Refined Foods and Foods of Animal Origins
  76. 76. Nutrition Think more about Health and less about Weight Loss
  77. 77. GoodGood BadBad Health Promoting Health Promoting Health CompromisingHealth Compromising
  78. 78. Nutrition Think about Calorie Density and less about individual Calories
  79. 79. Toxins • Get em’ out • Get help if you need it • You can do it • You deserve it
  80. 80. Basics • Physical Activity: – Achieve 150 min of aerobic exercise and 2 sessions of strength training per week • Nutrition: – Eat a high nutrient density program – Limit/moderate lean meats, limit refined foods, fat, sodium and cholesterol • Eliminate Smoking and Limit Alcohol Consumption
  81. 81. Now What?
  82. 82. Stages of Change (Prochaska and DiClemente) 1: Pre-contemplation 2: Contemplation 3: Preparation/planning 4: Action 5: Maintenance 6: Permanent Maintenance (Termination)
  83. 83. GROW • Goals • Reality today • Options • Will
  84. 84. Setting Goals •Specific •Measureable •Achievable •Realistic •Timely
  85. 85. Break Out: 4 minutes • Set YOURSELF a SMART Goal for 1 Lifestyle Measure and share it with your neighbor! • Specific • Measureable • Achievable • Realistic • Timely Exercise Nutrition Toxins Sleep Emotional Poise(Stress) Exercise Nutrition Toxins Sleep Emotional Poise(Stress)
  86. 86. Conclusion • Personal Choices are powerful Medicine • Assess YOUR Health Today • Identify your health goals • Develop a support team • Take charge of your health today!

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