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Doctors' declaration of independence

About the author: 
Bryan Hubbard

Put the patient first and talk about diet and exercise instead of prescribing drugs, says a group of doctors in a bold manifesto for a new medicine.

It's time for doctors to step up and tell patients the truth about how most diseases are caused by lifestyle choices—instead of just being the paid lackeys of the pharmaceutical industry, a group of doctors has stated in what could be seen as a declaration of independence from Big Pharma.

Doctors are failing the patient by only prescribing drugs and rarely talking about lifestyle changes—and especially eating healthily, exercising and reducing stress levels—that could prevent, and even treat, most chronic diseases.

The doctors are calling for a complete overhaul of the current medical system, which views disease as the result solely of aging and its treatment exclusively with drugs or surgery. Instead, people in the West are living with a "self-inflicted death sentence" because around 80 percent of diseases are caused by poor lifestyle choices, and especially a poor diet—and the true role of the doctor should be to advise patients on eating well instead of reaching for the prescription pad when things start going wrong, they say.

The 21 doctors, led by Balazs Bodai, director of the Breast Cancer Survivorship Institute in Sacramento, California, have already integrated lifestyle medicine into their own practices, and they are now urging others to do the same. "For far too long, patients have experienced chronic illnesses because our healthcare system has not taken a proactive role in promoting healthy eating," they say. "A paradigm shift to lifestyle medicine needs urgent implementation."1

A bankrupt system

Without this fundamental shift, doctors will be the overseers of a bankrupt system, the doctors say.

The US healthcare system currently costs $3 trillion a year, and more than $500 billion of this is spent on drugs alone. One-third of these costs are spent on cancer and heart disease.

These vast sums are escalating every year, and yet throwing money at chronic diseases, such as diabetes, obesity and heart problems, isn't working. The rate of premature deaths is increasing, and chronic conditions—such as heart disease, diabetes and cancer—have become an epidemic as drug companies and food manufacturers put profits before people.

The latest figures, from 2015, reveal a decrease in Americans' life expectancy of 0.1 years, the first decline in 25 years, and two out of every three Westerners are overweight or obese, a problem that is estimated to cause an additional 500,000 deaths by 2030.

The rate of chronic conditions is also on the rise: more than 29 million Americans have the 'lifestyle disease' type 2 diabetes, and one in four deaths in the US every year is caused by cardiovascular disease. Meanwhile, 17.5 million new cases of cancer are diagnosed around the world every year, and the disease accounts for 8.7 million deaths annually.

Not only aren't pharmaceuticals the answer, they are also contributing to disease. For instance, the overuse of antibiotics that is creating the superbug is well documented, but few realize that several antibiotics—including penicillin, quinolones, sulfonamides and tetracyclines—could be linked to prostate cancer, while breast cancer rates increase when sulfonamides have been taken. It could be a direct effect, but it's just as likely that the drugs have depleted the body's gut bacteria—known as the microbiome—which acts as a first-line defense.

Every drug has the potential to cause a serious side-effect or adverse reaction—including the worsening of the very disease it is supposed to be treating, in what is known as the 'paradoxical effect.'

It's the food, stupid

The food we eat and the lives we lead have an even bigger bearing on chronic diseases, which account for 75 percent of healthcare costs. But while Big Pharma and the food industry put profits first, the information isn't always reaching the consumer, and it can also be suppressed. "Multiple forces are maintaining the status quo... special interest groups, including lobbyists, maintain barriers by spending money to influence governments and professionals," the doctors say.

The doctors point out that the US dietary guidelines have been watered down to appease the economic interests of the food industries, and food is marketed purely as a pleasure fix instead of a vital source of nutrients essential for maintaining good health.

But although there are reasons for hope—individuals are becoming more interested in good food and diet, and some medical centers are integrating some aspects of lifestyle medicine—fundamental change won't happen until there is a strategic plan in place, the doctors say.

Setting up a lifestyle medical center inside an established healthcare unit would be a good first step, and medical education needs to be overhauled so that doctors are trained in diet and nutrition. "Practitioners need to have a basic understanding of what lifestyle modifications can do to prevent, treat and even reverse chronic diseases."

Society is also playing a part in promoting knowledge of good lifestyle choices. Companies are interested in the health of their employees, community groups are helping to spread the word and, of course, the web and social media are becoming massive sources of information.

But medicine and its practitioners should be at the center of the healthcare revolution. "It is time for the medical community to intervene and provide the proper treatment when confronting preventable conditions," they say. "Creating change takes courage and a willingness to think creatively as we begin to shift our medical system from one characterized by sick care to one deserving of the label of health care."

So what's $3 trillion?

The US spends $3 trillion a year on healthcare. That's $3,000,000,000,000. In other words, it's three million million dollars.

What does $3 trillion even look like? Well:

• If you stacked three trillion dollar bills on top of each other, the pile would reach three-quarters of the way to the moon.

• If you lived 50 more years, you could splash out $162 million on yourself every day—and still leave money in the bank for the kids.

• If you're business-minded, you could buy the entire Apple company, and still have $2.25 trillion in change to buy yourself an iPad or two.

• If you prefer the products, you could buy 3.534 billion iPhone 6 handsets, enough for every man, woman and child in the US. Actually, that's not quite right; you'd be handing them nine phones each.

• If that's a little too extravagant, you could instead give an iPhone 6 to everyone in India and China (but they'd only get one each).

• If you're into classic cars, the 1963 Ferrari 250 GTO is pretty much at the top of the pile, with a value of $38 million. You could buy 78,000 of them, assuming you could find that many.

• If your interest in cars is more environmentally responsible, go for a Tesla Model S instead. Retailing at $80,000, you could buy 37.5 million of them. Ship them to China; that would sort out global warming in one stroke.

• If you're more into giving the next generation a good education, you could put around 25 million kids through private college.

• And if you're feeling patriotic, you could wipe out 18 percent of the US national debt.

Source: Fox Business

Mind-body connections

There's a close relationship between chronic disease and mental health conditions such as depression, anxiety, stress and related problems such as insomnia.

Depression is a recognized risk factor for cardiovascular disease, and research has suggested it can even double the risk. Depression increases the severity of heart problems, and the depressed patient is three times more likely to die from a heart attack.1

And it works both ways: heart problems also increase the risk of depression. The common factor could be stress; both depression and cardiovascular disease could be caused by the cumulative effects of stress on the body.2

Depression is also associated with a person's risk of developing cancer overall, and particularly in the lung and liver.3

So how do you combat depression and stress?

Strong social connections: A major study has shown that women with breast cancer who are socially active are far less likely to see their cancer recur.4

A healthy gut: Our gut—or gut microbiome—has a big impact on our mental wellbeing. Processed foods cause gut permeability, which allows toxins to enter the bloodstream, while a healthy diet coupled with exercise helps to repopulate the gut with 'good' bacteria. This in turn has a positive effect on depression and anxiety, and on heart health.5

Exercise: Physical activity helps reduce depression and anxiety; conversely, a sedentary lifestyle increases the risk of depression.6

Inflammation overload

Inflammation is the root cause of most chronic diseases. Before the era of modern sanitation, it was a vital reaction that kept us alive, but most inflammatory responses today are excessive or inappropriate, doctors say, often triggered by unhealthy food, pollution or stress.

Inflammation's most common manifestation is obesity. Obesity is an inflammatory disease that affects two out of every three Westerners. It's a vicious cycle: obese people have higher levels of inflammatory proteins—like interleukin-6, tumor necrosis factor and C-reactive protein—because of the extra fatty tissue, and these proteins compound the problems of obesity.

But although most people worry about the cardiovascular risks of being obese, few are aware that it can also cause cancer; one study estimated that obesity causes around 90,000 cases of cancer a year.1

Even with heart disease, often seen as one of medicine's great success stories, the rate of decline in new cases and survival rates has slowed in recent years. So the key to a long and healthy life is eating more foods that have an anti-inflammatory effect.


Hands of Light

Not just for Christmas

References

Main
1 Perm J, 2018; 22: 17-25

Mind-body connections

1 Eur Heart J, 2014; 35: 1365-72
2 Curr Dir Psychol Sci, 2006; 15: 269-72
3 Public Health, 2017; 149: 138-48
4 Cancer, 2017; 123: 1228-37
5 Int J Clin Pract, 2008; 62: 423-32
6 J Phys Act Health, 2017; 14: 733-9

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