February is National Heart Health Month for Women

A Blog from The Panel of Experts

By Dr. Michael L. Smith – Functional Medicine – Nutrition and Chiropractic HEALTHcare.

I remember growing up in the sixties and seventies hearing and seeing the ubiquitous Virginia Slims ads with those famous words, “You’ve come a long way, baby”. In many ways, that has proved to be true. Sadly, there continues to be a sex biased approach when it comes to identifying and treating heart disease in women versus men in this country.

Here are some facts:

• Heart disease is the leading cause of death of women in the USA, whereas, cardiovascular deaths in men have declined and  the number of cardiovascular deaths in women remains unchanged or is increasing.
• The onset of symptoms and clinical manifestations of coronary heart disease (CHD) in women start as much as 10-20 years later for myocardial infarction (heart attack (MI)) and sudden cardiac death. Despite the fact that women live longer than men, each year since 1984, more USA women than men die of cardiovascular disease (CVD). The sex gap in mortality continues to widen.
• The landmark 2001 IOM (Institute of Medicine) 2001 report clearly stated the pervasive level of sex bias in medical research. It also stated that women have been under represented in research studies. In fact much of the evidence in the medical literature for prevention, testing and treatment for (CHD) has been gathered from studies on predominantly middle aged men.
• Women have received fewer interventions to prevent and treat heart disease. Less cholesterol screening, less lipid (cholesterol and triglyceride) lowering therapies, fewer referrals to cardiac rehabilitation and fewer implantable cardioverter-defibrillators compared to men with the same recognized indications
• More women who have had heart attacks die within 1 year compared to men and 39% do not survive their first MI.
• 61% of deaths due to stroke occur in women.
• AND HERE MAY BE THE MOST IMPORTANT FACT: 60% of women who die of CHD do not have the classic symptom presentation: upper back pain or neck pain, dyspnea (difficulty breathing), palpitations, indigestion and fatigue rather than jaw, chest or arm pain are the presenting symptoms.
• 38% of women will die within the first year after a first MI vs. 25% of men.

It is imperative that women be included in all aspects of health related research and extra care should be given as to how men and women differ respectively in their expression of cardiovascular diseases and treatment strategies. It should be the responsibility of the doctor to better educate the female patient as to the importance of the prevalence of CVD as the #1 potential problem to women’s health in this country. Although 1 of 29 deaths in women is due to breast cancer, most women perceive breast cancer as their major health concern even though 1 in 2.4 deaths in the USA will result from CVD.

Changing these attitudes of women should include a comprehensive evaluation of a woman’s lifestyle that should include a program of prevention strategies to eliminate the underlying causes of cardiovascular disease. These programs should include a detailed history, identification of those patients at highest risk, implementing patient specific nutritional, dietary and exercise programs and follow up laboratory testing of causative factors that now show up as disease. Avoidance of therapies without benefits or where risks outweigh benefits.

A newer model of medicine has emerged that addresses the bodies altered processes that precede the onset of what has been named as a disease. Functional Medicine is a dynamic approach to assessing, preventing, and treating complex, chronic disease by identifying and eliminating breakdowns to the physiology and biochemistry of the human body with the primary goal of optimizing the patient’s health. Chronic disease is almost always preceded by a lengthy decline in function in many of the bodies organ systems. Returning patients to health requires reversing or improving those specific problems that have contributed to the disease. Those dysfunctions are the result of lifelong exposure with the environment, lifestyles, and our genetic background. Each patient represents a unique history that presents itself as disease or the maintenance of health. Functional Medicine tries to answer the question of why rather than treating a group of symptoms.

In honor of this month’s theme, let us continue to strive together with the goal of improving women’s health so you can look in the mirror and shout, “You’ve come a long way, baby!”

GOOD FOR THE BODY, GOOD FOR THE BRAIN!

A Blog from The Panel of Experts

By Dr. Michael L. Smith – Functional Medicine – Nutrition and Chiropractic HEALTHcare.

I recently had the pleasure of watching a multi-part TV series about the human brain hosted by Charlie Rose.  One of the things I came away with was that the mind and body are not separate entities, but rather cohesive units.  The health of the body and brain are so intimately related that if one fails, the effect on the other can be devastating. In other words, what’s good for the body is good for the brain.

Let’s take the case of exercise.  About 2,400 years ago the Greek philosopher Plato said, “In order for man to succeed in life, God provided him with two means, education and physical activity.  Not separately, one for the soul and the other for the body, but for the two together.  With these two means, man can attain perfection”.  The main reason that exercise makes us feel better is the positive effect it has on our brain functions.

Exercise can influence mood, attention, and anxiety.  The effects of exercise can also support brain growth factors and protect against negative symptoms of chronic stress that manifest as premature aging of the brain and increased inflammation.  These symptoms have recently been cited as one of a myriad of causes of cognitive decline and dementia (i.e. Alzheimer’s disease).  Therefore, to keep our brains performing at the highest levels, we need to exercise!

In the reception area of my office there is a picture of a plump, sedentary individual watching TV from a familiar recliner. In one hand is a slice of pepperoni pizza and in the other is a beer. The broadcast tells us “A new study suggests that everyday activities count as exercise…” He proudly proclaims, “Let’s see…I’m eating pizza, drinking beer and watching TV. So apparently…. I’m a tri-athlete.” Unfortunately, this scenario is far too prevalent in our country today. There is an epidemic of obesity, especially amongst children, that gravely threatens their health.  A recent study showed that if the current trend continues, our children’s generation would be the first to have a decreased life expectancy as compared to ours!
One of the most spectacular case studies I have read is a story about a revolutionary physical education program undertaken by the entire 19,000 students of the Naperville, Illinois school district. The students’ commitment to exercise not only improved their fitness levels but also helped decrease obesity levels to around 3% (the national average is over 30%). As an added benefit, an international standards test cited cognitive performances skyrocketing, with eighth graders testing first in the world in science and sixth in math.
Exercise improves our ability to absorb and process new information, thereby increasing the brain’s ability to learn. This is aided by plasticity, the process where the brain can improve upon or alter existing connections, make new ones, or help stimulate the production of new brain cells. It does this by naturally increasing BDNF (brain-derived neurotrophic factor). BDNF has been called the “super fertilizer” of the brain because it improves neuron function by helping grow and facilitate new connections while also protecting against cell death.

Exercise can also correct a major source of abnormal brain aging and prevent insulin imbalances. We’ve also known for many years that exercise influences the same chemicals produced in our brains by many common antidepressants. A study done at Duke University in 1999 called SMILE(Standard Medical Intervention and Long-term Exercise) concluded that exercise was just as effective as Zoloft for the treatment of mild depression in both the short and long term.

So get off of that recliner, use the remote less and simply start to move. Your genes, emotions, body, and brain are all dying to get physical!

Where Are All The Good Samaritans?

So here’s another angle to good health.  Try being nice!  And I mean that just as much for big corporations as I do for individuals.  Since I travel so much for business, I run into many different types of people with many different types of personalities.  As I have started a new business, I have had to be extremely frugal when choosing airline tickets.  Therefore, the most inexpensive is not always my first choice.  After many years of traveling, I must say, the one company that is consistently “nice” is JetBlue.  Unfortunately, I did not have the pleasure of flying with JetBlue this past weekend and I must say, American Airlines is consistently “not nice”.  Let me point out for anyone who works for an airline or in a service oriented business.  Try being nice!  You will be happier; therefore, I promise you will be healthier.  Might I also point out, the meaner and crankier you are makes you not so attractive.  Believe it or not, I actually had a flight attendant from American Airlines tell me that my driver’s license did not say “blind” on it – and how could I be legally blind.  I had to actually waste my time and explain to her that I began driving long before I had a rare genetic disease called Leber’s.  This kind of treatment only makes airlines like JetBlue, who I must recommend, seem all the more enticing and quite healthier for our souls.

A word to the wise – if you want to be healthy and look your best, try being nice, accommodating, and for goodness sake, put a smile on your face.  As far as Theresa from American Airlines, I hope she had a better day today than she had yesterday and I will definitely make sure that I will avoid American Airlines until they make sure that their employees are nice and healthy.