Mar 12, 2021
In this podcast, Dr. Nicholas Deeter a Ridgeview family medicine physician, discusses how lifestyle intervention can be utilized for treatment of most chronic diseases, and how lifestyle medicine can influence one's health and nutrition.
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Heart disease, cancer, unintentional accidents, stroke and diabetes are all in the top ten leading causes of death. All of these are impacted by lifestyle. Here are the numbers: 3 out of 5 Americans have chronic disease. Half of Americans have some form of cardiovascular disruption, 38% will be diagnosed with cancer in their lifetime, and nearly 3 in 4 Americans are overweight or obese.
Lifestyle modifications alone, can prevent 80% of heart disease, stroke and type 2 diabetes and 40% of cancers. Dr. Deeter referenced the EPIC study, with 20,000 participants, outlining four lifestyle modifications: refrained from smoking, moderate to no alcohol, regular physical activity, and consistently eating 5 or more servings of fruits and vegetables daily. Participants that did these four things, lived 14 years longer than those who did not.
Preventable disease comes down to diet. for instance, much like smoking causes lung cancer, eating processed meats is directly linked to colon cancer. Education for our patients includes eating less processed or high sodium foods and working towards a plant based diet with an increase in fiber. "Plant based on a budget", "21-day Vegan kickstart", and nutritionfacts.org are all resources that patients can be pointed to.
Plant based diets can improve vascular health, reduce cardiovascular risks and lead to better daily performance. Briefly, proinflammatory markers were discussed in relation to meat, and how animal foods lead to Trimethylamine N-Oxide (TMAO) and advanced glycation end products. Moral of the story: less meat is better.
Changing diet can be challenging, and within the current industry, food is engineered like a drug for the brain. Dr. Deeter suggests counseling patient on taking small steps in the transition to healthier eating. For those that still want to eat meat, try cutting back one day a week, controlling the portion size, and source local and organic meat when possible. Eating by stoplight colors: green is go, yellow sparingly, and avoiding red foods, is another tactic in moving towards healthier eating. Dr. Deeter points again to a couple of resources that patients can use, including an app called Dr. Gregor's Daily Dozen which has a checklist of daily foods, with the goal for an individual to gain as many check marks per day as possible.
Talking about barriers, each person, patient, individual will have their own barriers. There is a psychological component to these things. Dr. Deeter suggested the book, "Never Binge Again", that he personally found helpful in understanding the reason behind personal eating habits.
Moving on from diet to some of the other aspects of lifestyle medicine; alcohol, exercise and sleep are addressed. There is no known safe level of alcohol, and drinking any alcohol at all increases the risk of breast cancer. Current recommendations for alcohol consumption is 1 drink for females, 2 drinks for males, per day, and under limit to under four drinks in a sitting.
Smoking cessation needs to address three areas: The dopamine addiction, the nicotine addiction and the habit or physical addiction. One of the first steps is to crate mindfulness: Why are you smoking? Dr. Deeter states that some individuals are able to cut back, just by introducing awareness to when and why they smoke.
Exercise recommendations include 75 minutes a week of high intensity training or 150 minutes per week or moderate intensity training. The addition of weight training helps with bone density and as Dr. Deeter says, "Muscle is expensive tissue", and uses up more glucose. Even starting with 15 minutes will start to show benefits for the individual.
Good sleep hygiene, a basic component to a healthy lifestyle, can help avoid things like Alzheimer's disease. The suggested level of sleep is 7-9 hours a night. Waking up tired probably means it's not enough. Many have undiagnosed sleep apnea that can contribute the decreased sleep. More tips are talked about in chapter four, but are mentioned here as well: lower the temperature in the room, and limit or stop screen time at least one hour before bedtime.
In closing, Dr. Deeter gave us some tips and tricks for lifestyle modification. Small steps is the key, "don't let perfect get in the way of better". Practice good sleep hygiene including avoiding electronics an hour before bedtime, and turning down the thermostat so that the room is cooler. Exercise tips: park farther away, take the stairs, and get steps in where possible. A 10kg weight loss can lower blood pressure by 5-10 points.
Whole and plant based were discussed extensively in this podcast, but another thing to consider is looking at caloric density. Other tricks for mealtime include drinking water before a meal, or having a bowl of soup or side salad prior to meals to help with hunger satiety.
Lastly, goal setting is important. Goals need to be specific, measurable, and attainable. Finding accountability, whether it is within immediate family units or help groups is an important aspect to help an individual reach their goals.
Thank-you for listening.