However, it was only recently that I began targeting something deeper.

Something upstream.

Something ancient.

Inflammation.

Not the helpful kind you get after a cut or cold. That kind heals.

I’m talking about chronic inflammation — the kind that lingers quietly, damaging your blood vessels, brain, joints, and organs like a slow, internal wildfire.

Over time, I’ve come to believe that chronic inflammation is the common thread behind most chronic diseases. The evidence keeps stacking up.

The Number That Predicts How Fast You’re Aging

Most doctors ignore it. I don’t.

medium.com

The Hidden Fire Behind Disease

Dementia? Check.

Type 2 diabetes? Check.

Heart attacks. Strokes. Obesity. Cancer?

Check, check, check.

We call these conditions separate diagnoses.

But I’ve come to see them as symptoms of a deeper cause: the body’s immune system stuck in the “on” position.

Scientists have even coined a term: inflammaging — the chronic, low-grade inflammation that accelerates aging and shortens lifespan.

That realization changed the way I live.

6 Ways I’m Extinguishing the Fire

I don’t believe in silver bullets. But I do believe in stacking small daily wins. Here’s how I’m pushing back against chronic inflammation:

1. Sleep Like It’s Medicine

Sleep isn’t optional. It’s therapeutic.
Insufficient sleep increases inflammatory markers, such as C-reactive protein. But quality sleep can lower them, especially when it becomes a consistent, protected ritual.

I now aim for 7.5–8 hours per night, without apology. I treat it like an appointment; I don’t cancel.

2. Move Daily, Not Occasionally

Exercise cools inflammation, especially the aerobic kind.
Walking. Cycling. Swimming. Even light strength training. They all lower pro-inflammatory cytokines and boost your cellular resilience.
And yes, I consider walking to be medicine.

3. Eat Food That Fights for You

I’ve shifted toward a Mediterranean-style diet, which includes olive oil, vegetables, nuts, berries, and fatty fish.
I’ve also added turmeric, green tea, and fiber-rich legumes.
These foods don’t just fuel me. They protect me from the inside out.

4. Avoid the Fire-Starters

Two habits pour gasoline on inflammation:

• Smoking
• Excess alcohol

I’ve never smoked. But I do drink on occasion — and now I limit that to one glass a week, if that. Most of the time, sparkling water does the trick just fine.

5. Stay Lean for the Right Reason

Weight isn’t just cosmetic — it’s biochemical.

Visceral fat (the kind that wraps around your organs) fuels inflammation and increases risk for cancer, dementia, and heart disease.

I stay lean, not for a mirror, but for my mitochondria.

6. Take Oral Health Seriously

Inflamed gums = inflamed body.

I didn’t always take flossing seriously. But the link between periodontal disease and heart disease — even cognitive decline — is real.

Now I treat my toothbrush like a prescription.

We Can’t Stop Time — But We Can Stop the Fire

Aging is inevitable.

But how do we age?

That’s far more flexible than most people realize.

If you want more energy, sharper cognition, and a lower risk of disease, start by cooling the flame of inflammation.

It’s not glamorous. But it works.

Final Thoughts

I used to think aging was just a number. Now I think it’s a pattern.

A pattern of how we sleep. How do we move? How do we eat?

And how we treat the quiet signals our body sends us — before they become sirens.

You don’t need a prescription to start.

You just need to start.

If you’re interested in aging better, you might also enjoy This One Lab Result Predicts How Long You’ll Live.

Ready to fight inflammation? Download my free ebook here.
📘 Debunked: 7 Health Myths That Quietly Hurt You
You’ll learn the truth about common habits that silently fuel inflammation, disease, and aging — and how to reverse them.

Author bio:
Michael Hunter, MD, is a cancer doctor, writer, and wellness advocate who believes the best medicine often starts outside the hospital walls.

The post How Chronic Inflammation Accelerates Aging — And 6 Ways to Slow It Down appeared first on Medika Life.

If we can make maternal deaths as rare as they are in the healthiest countries we can save almost 300,000 mothers each year

Figures from ourworldindata.org

If you are a woman, you are going to struggle to access unbiased levels of care. If you are woman who is Black, Brown Asian, Indian or any dark skinned complexion, and poor to boot, you are really going to struggle to access any form of care. If you are unfortunate enough to live in areas where these biases or prejudices are marked, you could end up paying for this discrimination with your life.

Another often unappreciated factor in the delivery of care to women is their physiology. Women get the short end of the stick, biologically speaking, when it comes to developing conditions that require medical interventions. The ability to create life comes at a price. The female body requires preventative care from a young age, for instance the HPV vaccine, administered to young girls to prevent cervical cancers later in life.

A woman’s womb exposes her to real healthcare challenges that often require invasive, expensive and technically challenging procedures. Procedures that rely on hospitals and clinics to provide the infrastructure and qualified providers to provide the skills. In some countries, facilities are often lacking and in certain more rural location, both are absent.

The main direct causes of maternal death are severe bleeding, unsafe abortion, infection, eclampsia, and obstructed labor; the indirect causes include anemia, malaria, heart disease, and HIV. Pregnancy complications are the main cause of death for women aged 15-19. Access to proper care can dramtically impact these figures. Risks of poor outcomes during pregnancy and childbirth are exacerbated by poverty, low status of women, lack of education, poor nutrition, heavy workloads and violence.

Then there is the issue of unsafe abortions. Around 73 million induced abortions take place worldwide each year. Six out of 10 (61%) of all unintended pregnancies, and 3 out of 10 (29%) of all pregnancies, end in induced abortion. The World Health Organization estimates that 30 women die for every 100,000 unsafe abortions in developed regions, while 220 women die for every 100,000 unsafe abortions in developing regions,

It’s unacceptable that a woman in Sierra Leone is 300 to 400 times more likely to die during pregnancy or childbirth than a woman in Sweden or Finland, and we know it is possible to prevent these deaths.

In more advanced societies, the issue of accessing care is often reduced to one simple determining factor. Money. Countries like America have healthcare systems that are beleaguered by profiteering and it is a trend that is being mirrored in more and more first world world countries. Healthcare again, reflects societies that are turning their backs on disadvantaged communities. Poverty breeds indifference. Indifference that is fatal to many women and, by association, their newborn.

Infant Mortality: 18 deaths per 1,000 live births in 2021

UNICEF Data

The first 28 days of life – the neonatal period – is the most vulnerable time for a child’s survival. Children face the highest risk of dying in their first month of life at an average global rate of 18 deaths per 1,000 live births in 2021, down by 51 per cent from 37 deaths per 1,000 live births in 1990, but figures have been impacted again by the pandemic and figures, not yet released, reflect a worrying increase.

Maternal Mortality: 223 deaths per 100,000 live births

UNICEF Data

Maternal mortality refers to deaths due to complications from pregnancy or childbirth. From 2000 to 2020, the global maternal mortality ratio (MMR) declined by 34 per cent – from 342 deaths to 223 deaths per 100,000 live births, according to UN inter-agency estimates. It is widely accepted that these figures are underreported, with deaths occurring in isolated, remote areas, not accounted for.

Every 16 seconds, a baby dies. Every 2 minutes a pregnant mother dies

To put the problem into context, a few additional figures.

The UN estimates that around 385,000 babies are born each day around the world (140 million a year). This number will remain relatively stable in the 50 years from 2020 to 2070. From 2070 to 2100, the number will decline to around 356,000 (130 million a year). The five countries with the highest number of maternal deaths in 2017 were: Nigeria (67,000); India (35,000); Democratic Republic of Congo (16,000); Ethiopia (14,000); and Tanzania (11,000).https://ourworldindata.org/grapher/maternal-mortality

Of course, the chances that a woman dies from maternal causes are not only dependent on the risk per pregnancy – which the graph above shows – but also the number of pregnancies she has.

The average woman in the UK or Sweden has one or two children. In Niger, she has seven children. Not only is the risk per pregnancy higher at lower incomes, but also the number of births. Maternal mortality rates tend to be higher where women have more children. These amplify the differences in risk between high and low-income countries.https://ourworldindata.org/grapher/lifetime-risk-of-maternal-death

In 2020 in the U.S., the maternal mortality rate for non-Hispanic Black women was 55.3 deaths per 100,000 live births, 2.9 times the rate for non-Hispanic White women. Rates for non-Hispanic Black women were significantly higher than rates for non-Hispanic White and Hispanic women. The increases from 2019 to 2020 for non-Hispanic Black and Hispanic women were significant.

The CDC lists the following four roadblocks to improving maternal care in the U.S.

• Eliminate racial and ethnic disparities in maternal mortality.
• Invest in and partner with communities.
• Ensure access to care for all pregnant and postpartum persons.
• Ensure quality care for all pregnant and postpartum persons

Admirable goals, but with no clearly defined plan of action in place, articles like these are merely pandering to a patient population that, according to the CDC and others, needs to restructure the very fabric of the societies they live in to access meaningful care. It’s a common refrain, sung by the WHO and many other global health bodies and it is a cop-out of monumental proportions.

It takes generations to engender change in a society and these changes can be ephemeral, here today, gone tomorrow. Take abortion and a woman’s right to choice. Society is not where we look to resolve healthcare’s biases.

There are simple, actionable solutions to address the healthcare issues faced by women, and they all begin at the door of healthcare itself. Read this follow up article to understand how the Clinics IV Life model seeks to improve access to care for disenfranchised and disadvantaged communities across the globe. While we most certainly don’t have all the answers, we are implementing workable solutions that have an immediate and positive impact on the health outcomes of these vulnerable communities.

None of us can afford any longer to be spectators to one of healthcare’s most damning indictments.

The post Health Care and Its Deadly Biases Toward Women  appeared first on Medika Life.

“It is all about vigilance and caring. We aim to put the caring back into healthcare, and we are serious about that. Our standards are not how many patients you saw today but how much quality you dispensed today,” Dr. Greg Foti told me about the comprehensive care center, AbsoluteCare, where he works in downtown Baltimore, MD.

Individuals with multiple chronic illnesses compounded by socioeconomic issues are perhaps the most difficult to treat, and the annual expenses can be exceptionally high. Success with these patients would be a story worth telling. Here it is.

Individual doctors and doctor groups have embraced the direct primary care approach with either a fee per visit (direct pay) or a fee per month or year (membership, retainer, and concierge). Mostly, they convert an ongoing practice of 2500–3000+ plus patients to a new model that encompasses about 500 patients. Their patient group usually spans a wide range of ages and the spectrum of some with serious chronic illnesses to those who are basically healthy. I wrote earlier in this series about the advantage of an all- gerontology practice that maintains a patient panel per PCP of about 400.

But what about a panel of patients that all have serious illnesses, who are socio-economically disadvantaged and cannot afford to pay a membership? A number of companies are addressing this need with a focus on the medically most needy; here is an example.

An infectious disease practice in Atlanta initially dedicated to HIV patients later expanded to a broad primary care program for those with multiple serious chronic illnesses — just those who are among the 5% of individuals for whom 40% to almost 50% of all medical dollars are expended. The company, AbsoluteCare, opened a second program in Baltimore — a 17,000-square-foot primary care office in a new building to manage the care of “the sickest of the sick,” whose average annual claims approach $40,000 per year.

Their model has one PCP or NP per only 300 patients working with a team of case manager, medical assistant, and nurse. Other on-site professionals include a mental health therapist, psychiatrist, and social interventions. They also deploy a community-based team that cares for patients in their neighborhoods and homes. In addition to medical care, they address social issues that may impact health status, such as food, clothing, housing, and transportation. For example, they will pick up the patient, bring them to the office, and return afterward.

In essence, the center staff is providing dramatically enhanced primary care at a substantial additional cost over typical primary care but with the aim to improve health and thus lower total costs. Most of the initial patients were on Medicaid or in a Medicare Advantage plan and lived in economically stressed areas. AbsoluteCare now also has contracts with both local and national health plans and has operations in 6 cities, and continues to grow.

It is important to be repetitive here. This type of primary care costs much more than traditional primary care but the result, besides for much-improved patient health and wellness, is a major reduction in total health care costs. That’s why health plans representing Medicare and Medicaid are willing to be supportive. Good for them to have opted to give it a try, and it is working in multiple cities.

The Baltimore office, which I have visited twice, is notable for its ambiance, cleanliness, exceptionally courteous staff, the sense of fun yet seriousness, and the clear message that everyone really cares about the patients and is determined to develop a trusting healing relationship with each. Not exactly what one might expect in an inner city medical office that caters to the socially-economically disadvantaged.

A major focus is on the family and social situation — are they living alone, having transportation, or are they having difficulties with rent, phone, and heating bills?

Same-day visits are the norm; basic blood tests are done on-site, and IV therapies are available, as is an in-house pharmacy. General radiology is transmitted to a nearby tele-radiologist. In addition, the center has a cadre of specialists they tend to call upon for referrals — chosen not only for their expertise but also for their willingness to work in close coordination with the care team.

As Chief Medical Officer Dr. Greg Foti told me: “It is all about vigilance and caring. We must call the hospitalist if the patient is admitted. We must follow up with skilled nursing if needed. We must transport them here to ensure they get the care they need. We want to fully wrap our arms around all the factors that affect their health. We don’t have any magic bullets, but we can give true love and care to our ‘members.’ That will make the difference in both quality and costs.”

The Baltimore office is focused on ensuring that they provide quality care as measured by some standard parameters. “Before AbsoluteCare intervention, our traditional member population scores in the lower 30th percentile with most quality- and value-based purchasing outcomes. After Absolute Care intervention, our members have increased their quality- and value-based purchasing outcomes [such as blood pressure control, HbA1c control, etc.] into the 75thth-95th percentile. Our culture demands that success be tied to quality- and value-based purchasing performance.”

For the payor, these numbers are impressive: a sharp reduction in hospitalizations (down 50%), ER visits (down 34%), reduction in specialists visits (24%), and total costs of care by perhaps a third, a remarkable decrease for these very challenging patients.

But most important, patients have, probably for the first time, found compassionate, thorough, comprehensive, meaningful care that has had a positive impact on their health and their lives.

Many pressures are driving the need for alternative approaches to providing primary care. Enterprising physician entrepreneurs are often the drivers of paradigm change. The fundamental concept of this center and others like it is to offer expanded primary care with heavy use of resources to improve health and lower total costs. As Dr. Foti noted, “We cannot always cure these individuals of their chronic diseases, but we can make a big difference in each person’s health, in their ability to enjoy life and be productive.”

The patient gets extensive primary care not just with a doctor or nurse practitioner but also with a team including attention to social needs as well as medical and mental health requirements. The result is that the patient becomes much healthier and will be using fewer medical system resources, especially those that are exceptionally expensive, like ER visits, procedures, imaging, specialist visits, and hospitalizations.

It is time for insurers to recognize and support this type of care. It changes the payment model but will lower their total care costs.

The post Primary Care for the Sickest of the Sick appeared first on Medika Life.

The power of the painting is the gaze of the doctor on his patient. Now is the place, the time, the person – he has no other thoughts or concerns except to assist her back to health if he possibly can. We do not know the medical problem, but we can infer it is serious. And we do not know the outcome, although there may be a clue because through the window comes a faint ray of light.

I did not fully appreciate the implications of this work of art when I first received it, but I came to understand that this physician was a healer. He had listened; he was nonjudgmental; he had earned trust. He has done his best but understood that he alone would not be her cause of cure should a cure ensue. He understands that he is but a humble person entrusted with the most important of all missions – to assist others in finding health. He has done his best and, in doing so, exemplifies the characteristics of a healer.

My maternal grandfather, Leonard McClintock, MD., was a general practitioner in New York state. He graduated from Albany Medical School in 1898. He set up his practice in what was then a small town on the Hudson River, Beacon, N.Y. He built a room on the side of their home to serve as his office and used the large wraparound front porch as the waiting room. There were no appointments; you came and sat on the porch until it was your turn. Office hours lasted until the last patient had been seen. 

Initially, there was no hospital, and he cared for all patients in the office or at home, although later in his career, he helped to establish a hospital directly across the street. In his day, a physician had relatively few tools to treat someone, so the skill was to make a diagnosis and inform the patient and the family what the situation was and what the course of that illness would probably be. Yes, he could do some things, including treating pain with morphine, removing an inflamed appendix, sewing up lacerations, and delivering babies much more safely than could have been done without the assistance of a trained clinician. 

But during the course of his practice, which ended with his death in 1936, medicine began to change toward a much more scientific basis. To a large degree, this was propelled by the influence of Johns Hopkins University School of Medicine and Hospital in Baltimore, MD. Founded in the late 1800s, it instituted the concept that medicine was and should be a science. Therefore, Johns Hopkins would teach a science-based medical practice during four years of medical school. In addition, Hopkins established what we know today as the standard residency training program following medical school. 

This was a dramatic change in medical education and training and, as a result, dramatically changed the way physicians thought about medicine and patient care. During my grandfather’s practice, he began to see the beginnings of those changes. For example, insulin was discovered in the 1920s, and the first antibiotics in the 1930s. After his death and the completion of World War II, the National Institutes of Health began to develop, grow and place large sums of money across the country in various medical schools and within its own walls to conduct basic biomedical research. 

The result is that today our ability to repair, restore to function or replace an organ, tissue, or cell has moved ahead at a dramatic pace and will do so even more quickly in the coming years. Concurrently, the pharmaceutical industry also became scientific, resulting in a continual outpouring of new drugs that can relieve suffering, reverse harm and cure many diseases while extending our life span. In addition, with the advent of the science of genomics, it is increasingly possible to predict the onset of illness before it occurs and thereby create a preventive approach for the individual patient.

Soon we will have immediate access any time, any place to our medical records, which will be fully digitized, and the safety and quality of medical care will dramatically improve. All of this is because of the science base of medicine, which was introduced over 100 years ago.

Something else has happened, but it has not been appreciated. In the past, illnesses tended to be “acute,” meaning that they occurred, were treated, and got better, or the individual died. For example, if your child developed “strep throat,” the pediatrician gave an antibiotic, and it got better. If it was an inflamed gall bladder, then you were referred to a surgeon who operated, threw away the gallbladder, and you were cured. But today, most illness is chronic and complex as well. For example, if a person survives a heart attack, he may still have some damaged heart muscle and so develops heart failure. This will be with him for life and will need multiple treatments, many medications, probably multiple hospitalizations with an ICU stay or more, and might even get to the point of a heart transplant.

Now that is chronic, and that is complex! So it is also with diabetes, rheumatoid arthritis, many cancers, chronic lung disease, kidney failure, and many other diseases are frequently seen today.

This is a major shift and enormously impacts how we should [but mostly do not] organize the treatment of the patient and their disease, how we should [but mostly do not] organize the payment system for that care, how we should [but mostly do not] use technologies wisely for maintenance, and how we should [but mainly do not] assure quality and safety in patient care.

This is a profound change, but most of the “healthcare reform” approaches do not address the implications of this change to chronic, complex lifelong illnesses. Although aware of the change toward more and more chronic diseases, physicians also tend to want to preserve their current practice patterns developed over the years to handle acute illnesses, even though the current chronic, complex diseases require a different approach.

But in that same time frame of scientific advancement and the rising frequency of chronic illnesses, we also began to lose something in medicine. That loss is the genuine “connection” between the physician and the patient. Most of us feel we do not have enough time with our physician; the physician seems busy and distracted, often by the computer, and not able or willing to listen to our story in full. 

From the physician’s perspective, they feel that there is not enough time to spend with an individual patient; not enough time to learn about the family and the environment in which that patient lives, and therefore in which the patient’s disease has occurred; that there is not enough time to focus on preventive instructions or to even talk thoroughly about the plan for the care of a specific illness or problem. But all too much time is spent following mandates, filling out forms, often repeatedly, and then being paid by the insurer well under what the time and effort were worth. Physician burnout has reached epidemic proportions.

Today we need to preserve our newfound skills and techniques, drugs, and devices but also remember that patients are human and need empathy, caring, and attention, not just technology. Equally, providers need the ability (time) to give the care they were trained to provide, the care most wanted to give when they first decided on medicine as a career.

Unfortunately, rather than a true healthcare system, we currently have a dysfunctional American medical care delivery system. We need a healthcare system, but the cards are stacked against it. That said, it can be changed. Probably not by Congress, nor by the insurance companies but only by the unique interaction of doctors and patients demanding what is and could be the very best. Concurrently, one of the best ways to change the system is for companies to realize that they can secure better medical care for their employees while augmenting health and wellness, which will dramatically reduce the company’s and their employees’ costs. That is a win-win all around.

In later articles, I will outline further what patient and their doctors can do to improve care and what employers can do to create true healthcare for their employees.

The post Healthcare and Medical Care Are Not the Same – The Difference is Very Important appeared first on Medika Life.

Consider my great, great grandparents. They lived on a small farm and were largely self-sufficient. They ate two or three meals a day and never snacked. Food was locally sourced; vegetables and fruits were fresh and ripe; chickens spent the day in the fields. Fish came out of nearby streams and rivers, and meat came from animals hunted in the forests or grazed on the farm.

There were no pesticides, no foods shipped thousands of miles, no meat from animals fattened with corn and soybeans, no fish from fish farms. Candy, soda, and junk foods were almost unknown. There were no processed and packaged foods as we know them, and there were no fast-food restaurants — foods that are all heavily marketed today yet are inherently unhealthy but tasty with their ingredients of white flour, fat, sugar, and salt.

Everyone moved all day long, mostly outdoors; that was just natural. And much of that movement was hard work, the kind that kept muscles strong from lifting, bending, digging, or hoeing. The kids were sent out, if not helping with farm chores, to play, play that included lots of movement.

Of course, stress was present, but somehow, they dealt with it, allowing it to “run off their backs.” After a day of good food and plenty of movement, they slept easily and soundly from when the sun went down until the sun came up. Very few people smoked; cigarettes were not available. Alcohol was abundant, mostly homemade cider, beer, and wine, but most did not drink excessively.

Life was a constant challenge to the mind as well as the body. Families worked and played together and interacted with their neighbors. There were no radios, TVs, or video games; families interacted with each other, and grandparents were honored and part of the family.

Many people, of course, died early, especially of trauma, childbirth, and infectious diseases. Still, many also lived to a “ripe old age” yet rarely developed the chronic diseases of today — obesity, diabetes, lung cancer, stroke, Alzheimer’s, or heart disease.

We do not live like that today and there is no reason to try to go back. But is there anything you can do directly to avoid developing a chronic disease now or in the future? Yes. It is all about modifying your lifestyles.

There are seven key steps.

• Eat a healthy diet every day
• Get adequate exercise at least 6 days per week
• Manage your chronic stress
• Enhance your sleep
• Don’t smoke or overdrink alcohol; don’t get hooked on drugs
• Challenge your brain regularly
• Stay socially engaged.

Be sure to take good care of your teeth, don’t drink or text and drive. Develop a positive attitude and be sure you have thought about your purpose in life.

According to the Centers for Disease Control (CDC,) Americans consume an average of 57 pounds of added sugar annually! Packaged in 4-pound bags, imagine 14 bags on your kitchen table — four times that for a family of four. Of course, you are sure you don’t eat that much added sugar, but someone else is consuming even more to make it average out. To top it off, we eat an excessive number of foods made from white flour (e.g., cereal, cakes, pies, cookies, pastries, and pizza) — which is digested directly into sugar. And, of course, many of those foods are high in added sugar and often fats and salt.

Here is a bit more detail: For adult Americans, men consume about 19 teaspoons (76 grams) of sugar per day; women 15 (60 grams), both well above the recommendations of the American Heart Association of 9 teaspoons (38 grams) for men and 6 tsp (25 grams) for women. In addition, the World Health Organization recommends no more than 5% of a 2000-calorie diet be from added sugars (including honey, fruit juices, etc.) or 25 grams per day.

Lack of exercise and an unhealthy diet go together. Today we drive to work, stop for a pastry and latte, sit at a desk most of the day, eat a fast-food lunch, enjoy an afternoon snack, drive home, call out for pizza, watch television, and go to bed.

Stress is everywhere — you need to check your emails and texts right up to bedtime. Your stress levels are off the charts. You probably don’t smoke and that is good. You have all too little time for socializing with true friends. The alarm rings all too early, and you are up and at it again.

What can you do? Will it really make a difference? Yes, focus on these 7 keys of lifestyle modifications.

1-Prepare meals from scratch; it does not take much time. Think of it not as a diet that eliminates something but one that includes abundant nutrient-dense foods. Eat locally sourced, preferably organic vegetables and fruits in abundance.

Vegetables should be the major components of your diet with a wide variety of types, colors, and textures to obtain all of the primary nutrients. Include dark green leafies daily — spinach, collards, arugula, and kale are good choices. Nuts, seeds, and foods like avocados and olives have healthy oils, and omega-3 fatty acids are in wild-caught finfish like salmon, mackerel, and sardines. Avoid vegetable oils; use cold-pressed virgin olive oil instead.

Don’t forget to have plenty of fresh fruits every day.

Choose chickens and eggs from hens that have been free-ranged. Eat red meat sparingly and choose cuts from range-fed animals that never saw a feedlot. Finally, and very importantly, avoid sugars like the plague and dramatically reduce your intake of foods made from white flour. It follows that you will cut back on processed foods and meals from fast-food restaurants. The Mediterranean Diet is the prototype for this type of eating.

2-Get up and move. Get 30 minutes of walking every day. That alone will have a massive impact on your immediate and long-term health. Add in a few sessions per week of strengthening (“resistance”) exercises. Remember that “sitting is the new smoking.” Park your car a distance from the building entrance. Take the stairs a few flights instead of the elevator. Get up from your computer and move around for five minutes at least every half hour. Consider a stand-up desk. Spend less time sitting in a reclining chair watching TV at night.

3-We all have chronic stress, but many don’t recognize or admit it. Give some serious thought time to your pressures. Eliminate the causes where possible and, for the remainder, consider ways to tamp them down. In addition to good food and regular exercise along with adequate sleep, add in perhaps yoga, meditation, Tai Chi, coherent breathing, or just a few moments every so often to take a couple of deep breaths with the exhalation longer than the inhalation (I will explain the rationale for longer exhales in a later article.)

4-To enhance sleep, allot at least three hours between finishing dinner and bedtime so that your meal has been largely digested. This, of course, means no late-night snack before bed. No caffeine after noon. Avoid reading or watching action or horror books, TV shows, and movies before bedtime. Early in the evening, please turn off your smartphone and the texts, emails, and Facebook with it. Instead, consider some soothing music before bed. Your bedroom needs to be pitch black with all your devices turned off. Keep to a schedule, and remember that you need 7 ½ to eight hours of sleep each night. Please don’t listen to the friend that claims they can get by on 5 or 6 hours; that person is only fooling themself.

5-No tobacco. None, including vaping. And keep alcohol consumption limited.

6-Stimulate and challenge your brain. It needs to be used just like your muscles. Learn a new language or play an instrument. Learn a dance routine. Do something creative like art or writing.

7-Social engagement is critical to slow aging, prevent disease, and enhance a sense of wellness. Maintain connections with close friends and relatives.

Does all of this make a difference? Yes.

In the Nurse’s Health Study and the Health Professionals Follow-up Study totaling over 100,000 participants and observed for more than 30 years, those who followed the five “low-risk lifestyles” lived substantially longer than those who followed none. For example, a 50-year-old female could expect to live 14 added years (life expectancy rose from 29 to 43 additional years), and for a male, 12 additional years (26 rose to 38 additional years.) I will explore this and similar studies in-depth in a later article.

Whatever the exact number of added years, the direction is clear. Healthy lifestyles mean more years of healthy life. And remember, it was not just more years of life but fewer chronic illnesses for a longer “health span.” Definitely worthwhile.

Does this seem like a tall order? Perhaps, but pick one or two areas to work on at a time. Don’t try to do it all at once. Don’t set the goal too high to start. Set some intermediate goals, ones that you can achieve. Then move up to a more comprehensive goal. After a while, you’ll be doing great; you’ll have more energy, more enthusiasm for life, much better health, and a longer, healthier lifespan. And as a bonus, if you get started early in adult life, you will reap the added benefits of compounding, just like saving for retirement. What could be better than that?

The post What Can You Do To Prevent Developing a Chronic Disease? appeared first on Medika Life.

My friend Susan in the first article of this series was a good example. Presenting to her PCP with a somewhat unusual symptom, she was sent from specialist to specialist without ever learning what was causing her symptom, much less resolve it. It was a true waist of time, money and her emotions when the answer was there if only a doctor spent some time to listen to her.

To further exacerbate the problem, the doctor and patient no longer have a “contract;”. The patient and doctor are bystanders to the decision-makers. Frustration by doctors and patients is high, and physician burnout has become rampant.

 Add to this is a significant change in the common serious diseases – complex, chronic illnesses, mostly preventable, for which American medical care has not established suitable methods of prevention or adequate methods of care. In addition, what should be the role of the primary care physician has been compromised by the insurance industry (both commercial and government-sponsored) that puts the incentives in the wrong places. The result is a sicker population, episodic care, and expenses that are far greater than necessary.

Our current delivery system was designed early in the past century with the expectation that the patient would pay the doctor a reasonable fee for the effort, skill, and time involved.

Insurance developed during the past 70 years initially to pay for unexpected, highly expensive care, such as surgery or hospitalization. But over time, insurance transitioned into what is essentially prepaid medical care and along the way eliminated the financial “contract” between you and your primary care physician (PCP or Nurse Practitioner.) The contract today for both you  and the doctor is with the insurer The patient and doctor are bystanders to the decision-makers. Frustration by doctors and patients is high, and physician burnout has become rampant.

Worse yet, insurance pays primary care providers a pittance, driving them to “make it up in volume” by seeing too many patients per day, often 24 or more. Of course, this means short visits, perhaps three per hour, which translates into about 10-12 minutes of actual face time with you.

The delivery system was developed to deal with acute medical problems, where it is reasonably effective. For example, consider the pneumonia that a single internist can treat with antibiotics, an appendicitis that can be cured by the surgeon, or the fractured arm that the orthopedist can cast. But our medical care system works poorly for most chronic medical illnesses and costs far too much. Chronic illnesses include diseases like diabetes with complications, cancer, heart failure, chronic lung and kidney disease, and Alzheimer’s.

These chronic illnesses are increasing in frequency at a rapid rate and consume the bulk of health care expenditures. They are largely (although not entirely) preventable.

A century ago, the most common causes of adult death were infections – pneumonia, typhoid, and tuberculosis. Today these are uncommon and treatable. Now the most frequent causes of death are chronic illnesses – heart, cancer, and stroke, with Alzheimer’s and diabetes just behind. Other than some cancer, most others are not curable.

Most chronic diseases are related to lifestyles and are preventable. A myriad of social, environmental, financial, and personal reasons has led to non-nutritious diets, lack of exercise, chronic stress, inadequate sleep, smoking, and excess alcohol. Obesity is now a true epidemic, with one-third of Americans overweight and one-third obese. The combined result is high blood pressure, high cholesterol, and elevated blood glucose, which, combined with the long-term effects of the above behaviors, leads to diabetes, heart disease, stroke, chronic lung problems, kidney disease, and cancer.

No one pays for prevention, for maintaining health and wellness. Insurance is for disease care. Government does little (except with tobacco) to assist. As a result, as a country, we do not attend to actual healthcare and maintaining wellness, which in turn means greater pressure on the medical care delivery system. We don’t have a health care system, it is a medical care system that focuses on disease, its diagnosis, and treatment. Wellness and prevention are largely ignored. That is unfortunate because most of today’s chronic diseases could be prevented. Attention to prevention is the logical method to maintain and improve health and is much less expensive than treating a disease once it occurs.

When any of these chronic diseases develop, except for some cancers, it usually persists for life. These are complex diseases to manage and are often very expensive to treat – an expense that continues for the rest of the person’s life. Preventing them is equally complex but a lot less expensive.

Although not adequately appreciated, primary care physicians can handle most of today’s chronic illness care. They have the knowledge, experience, and skill level to do so. But this does not happen with short visits. All too frequently, the patient is referred to one or multiple  specialists when the PCP could have dealt with the problem had they had enough time. That extra time would not have cost much, but the referral, of course, means an increase in the costs of care, often substantial.

Some patients with chronic illnesses will need a team of caregivers, but the various specialists and the PCP are not a true team working in a unified manner. For example, consider a patient with lung cancer who may need a surgeon, radiation oncologist, medical oncologist, pulmonologist, pain specialist, palliative care team, nurse practitioner, and many others. Primary care physicians generally do not have the time needed to coordinate the care by the specialists. This is very unfortunate because coordination is absolutely essential to ensure good quality at a reasonable cost. You might think that one of the specialists might take on that role but that rarely occurs. More often the patient starts with a surgeon who refers him on to a radiation oncologist who then refers to a medical oncologist who then may or may not call-in others as needed. 

Any team needs a quarterback, and in general, that person is or should be the primary care physician. The PCP needs to be the orchestrator of the various specialists when needed in these complex patients. This need for a team and a team quarterback for the patient with a chronic illness is much different than the needs of the patient with an acute disease in which one physician can usually suffice. A team quarterback dramatically reduces the total costs of care if only because it means continuity and organization of care, keeping the patient’s welfare upper most in mind.

This shift to a population that has an increasing frequency of chronic illnesses mandates a shift in how medical care is delivered. Unfortunately, our delivery system has not kept up with the need. This is no way to run a railroad.

Join me with the following articles as I address more of the Whys and Hows and What to Do.

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