Who wants to live forever if you are not in great shape, physically and intellectually?

But today, I’ll share how you can unlock improvements in both longevity and healthspan.

How do different exercise types relate to longevity?

A new study provides some answers.

Philosophers on Exercise

Before we turn to the provocative new study, let’s look at what some historical thinkers had to say about physical activity.

While uttered centuries ago, the words still ring true.

First, the father of modern medicine, Hippocrates:

“Without exercise, a good diet alone is not sufficient, and eventually medical treatment will be needed.”

Hippocrates presages a future of sedentary living, with a deficit of body movement owing to the advances of modern technology.

Here is Epictetus speaking on philosophy:

“Don’t explain your philosophy. Embody it.”

Blunt, but captures a lot, doesn’t it?

Rather than simply making plans for a new exercise or diet plan on New Year’s, act.

Analyzing Over Half A Million People

A new study published in JAMA Internal Medicine investigated the impact of various exercise types on mortality risk.

Dr. del Pozo Cruz’s research team analyzed data from over 500,000 tracked participants, who were followed for an average of 10 years.

The study focused on three main categories of exercise:

• Moderate aerobic activity: Activities like walking and cycling at a relaxed pace.
• Vigorous aerobic activity: Higher intensity activities such as running.
• Muscle-strengthening activity: Activities like weightlifting that focus on building muscle mass.

Study Findings

The study revealed this:

A balanced exercise regimen that included moderate and vigorous aerobic activity and strength training resulted in the greatest reduction in early mortality risk.

Here’s a closer look at the optimal exercise combinations:

• For overall mortality risk reduction: Aim for 75 minutes of moderate aerobic exercise (like brisk walking), over 150 minutes of vigorous aerobic exercise (like running), and at least two strength training sessions each week.
• To reduce cardiovascular disease-related death. Aim for at least 150 to 225 minutes of moderate aerobic activity, 75 minutes of vigorous aerobic activity, and at least two weekly strength training sessions.

I exemplify the combination approach, using walking as my base exercise and folding in treadmill running and strength training (the latter for six days weekly).

How Little Is Enough?

Let’s face it: most of us are not committed to the rigorous approach described above.

What is the least amount of exercise you can do to fight off the greatest health threats?

The answer might surprise you.

Dr. del Pozo Cruz and colleagues provide some observations in a 2022 study in the European Heart Journal:

Engaging in vigorous exercise for only two minutes a day could help slash the risk of death related to cancer or cardiovascular events.

It’s a small commitment with potentially huge benefits.

It Doesn’t Take Much Exercise to Improve Health

I am impressed with this statistic: Subjects who never did vigorous exercise had a four percent death risk within five years.

Doing less than 10 minutes of weekly vigorous activity cut this risk in half.

Moreover, doing 60 minutes of exercise dropped the risk by half again (to one percent).

Just don’t be sedentary.

Do you have a balanced approach of moderate and vigorous exercise (plus strength training)?

The post Want to Live Forever? Science Says Do These Exercises appeared first on Medika Life.

In terms of disability-adjusted life years, both cardiovascular disease (CVD) and cancer rank highest in the world’s disease burden. There is continuous discussion regarding the relative contributions of different risk and protective factors to the incidence and mortality from these conditions. In 2019, CVD was responsible for 17.9 million annual deaths, while cancer caused 9.6 million deaths in 2017.

The statistics are withering in terms of their magnitude, and we have to wonder what we might do to turn them around, even a bit; the way to do it may be within everyone’s reach. And one thing we CAN do is get off the couch or easy chair and begin working those beautiful muscles of ours.

The main motivations behind the use of many new technologies have been to increase worker productivity and decrease physical hardships and disabilities associated with jobs that require extended heavy lifting; however, the human body has evolved in such a way that the majority of its systems—such as the skeletal, muscular, metabolic, and cardiovascular systems—do not develop and function optimally without stimulation from regular physical activity.

Sadly, the unfavorable byproduct of a loss of historical physical activity levels in our modern culture is an increased risk of chronic disease. Today, machinery and other technology have replaced much of the physical activity that chose optimal gene expression for energy metabolism. Skeletal muscle insulin resistance is a major effect of inactivity, and it can lead to the development of metabolic syndrome, cardiovascular disease, and type 2 diabetes.

When compared to not exercising at all, even one hour and a quarter of moderate exercise each week—half the recommended amount—reduces the risk of cancer, heart disease, and early mortality. The results of one study provide important evidence for inactive individuals by demonstrating that modest amounts of activity provide substantial benefits for delaying mortality while also assuring very active individuals that there is no exercise-associated increase in mortality risk—with caveats regarding existing illness. The findings are informative for people at both ends of the physical activity spectrum.

Without a doubt, exercise of any type should be incorporated into everyone’s lifestyle, and it can be of high intensity, if a PCP agrees, or subtle changes that are not strenuous or intense. All results from studies over the past half-century point to exercise protecting us from a variety of illnesses and potentially prolonging our lives.

The post Exercise Could Be the New Wonder “Drug” for Health and Longevity appeared first on Medika Life.

Even in the age of advanced diagnostics, proton beam and nanotechnology treatments, and more walkathons than we can count, cancer still kills roughly one-third of those in the U.S. diagnosed with it. The numbers for low-income countries are far more shocking.

The causes of many cancers aren’t some hidden mystery. In the U.S., we can prevent two of the most dangerous forms of skin cancer by 40-50 percent by wearing sunscreen, but it’s an expensive option, and only 13 percent say they protect themselves most of the time with SPF-rated lotions. People are 15-30 times more likely to get lung cancer if they smoke; nevertheless, 1 in 10 Americans still smoke cigarettes.

You Have Cancer – or Not

We continue to lose many of the battles we should win against cancer. Billions of dollars have been spent over the years to educate the public on how they can prevent cancer; billions more have gone into treating patients. And then there’s the emotional toll that comes from hearing those three words.

There is a massive bright spot in this story, however. While the chances of preventing many forms of cancer with known interventions are frequently below 50 percent, we have a way of preventing six forms of cancer with a 90 percent effectiveness rate. It doesn’t come from adhering to daily rituals or resisting tempting vices. These cancers can be prevented by going to a doctor’s office or a pharmacy* and getting vaccinated against Human Papilloma Virus (HPV).

The catch is that the greatest chance of preventing HPV-related cancers later in life comes from vaccinating kids between 9-14. That requires parents seeing the importance of preventing HPV and many don’t, especially in southern states, where the number of pre-teens and adolescents who are fully vaccinated against HPV frequently falls below 50 percent.

Anxiety Versus Information

Many parents cite the vaccine’s safety as a leading concern, which is not based on fact. In the 17 years since the HPV vaccine has been available, more than 160 studies in multiple countries have shown no major adverse events associated with the vaccine. Instead, safety concerns have been fueled by misinformation on the Internet and skepticism among key audiences, including some healthcare professionals (HCPs).

More strikingly, however, the roots of hesitancy to vaccinate against HPV may go back to how it has been presented to patients: as a vaccine for sexually transmitted infections (STIs), not cancer. This is a major reason many parents discount the importance of getting their 10-year-old child vaccinated. In the face of such resistance, many HCPs in chronically under-vaccinated communities do not proactively recommend HPV vaccination during annual well visits.

Need to Reinform the Link Between HPV and Cancer

Reorienting this trend requires a concerted effort to flip the script on HPV vaccination discussions from STI prevention to cancer prevention. In the past year, only 22 percent of online conversations linked HPV with cancer. And in research conducted last month, FINN Partners found that only 46 percent of HCPs surveyed discuss HPV as cancer prevention.

This presents an important opportunity to close one of our generation’s most important health gaps. Healthcare professionals rank among the most trusted people in the U.S. When doctors make a vaccine recommendation with authority; most parents follow that counsel.

Flipping the script on HPV conversations tackles several significant barriers for patients: many may have omission bias, which means they believe vaccinating puts their kids in greater danger than the disease it’s supposed to prevent. And since they can’t picture their children getting an STI, they discount HPV vaccination further as a priority. But presenting that same vaccine as cancer prevention could change the nature of the conversation. Most parents understand cancer and see it as a threat. And cancer doesn’t carry the same stigma among many patient communities as sexually transmitted diseases.

The Cancer Prevention Message is Long Neglected

It’s time to make cancer prevention the dominant message in HPV vaccination decisions. More than 135 million doses of the HPV vaccine have been administered in the U.S., and we have seen a dramatic correlation in the drop in HPV cases: the prevalence of four HPV strains has declined by 88 percent among women aged 14-19. If HCPs are provided with better resources and more people are educated on HPV vaccination as cancer prevention, we have a shot at addressing misinformation about vaccine safety and continuing the upward trend of HPV vaccination.

The stakes are high for us to get this right. Because the only thing possibly worse than being told “You have cancer” is hearing that your son or daughter has HPV-related cancer later in life when it could have been prevented by a simple, safe decision to vaccinate them against HPV as an adolescent.

*HPV vaccines can be administered to adolescents at pharmacies in 22 states. Most states allow pharmacists to administer HPV to older patients.

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Sure, it is a great way to stay active and spend time outdoors. Moreover, it provides opportunities for stress relief and relaxation. But do you think about gardening as promoting overall health and a tool for managing chronic conditions such as anxiety and depression?

Whether you have a large outdoor garden or a few potted plants, incorporating gardening into your routine can positively impact your health. First, let’s look at some famous gardeners.

The first supermarket supposedly appeared on the American landscape in 1946. That is not very long ago. Until then, where was all the food? Dear folks, the food was in homes, gardens, local fields, and forests. It was near kitchens, tables, near bedsides. It was in the pantry, the cellar, and the backyard. — Joel Salatin

Famous gardeners

There have been many famous gardeners throughout history, some of whom have significantly impacted horticulture. Here are a few examples:

• Gertrude Jekyll. A British horticulturist, garden designer, artist, and writer, Gertrude Jekyll is best known for her work in the Arts and Crafts movement. She designed over 400 gardens in the UK, Europe, and the United States, and her books on gardening are still widely read today.
• Andre Le Nôtre. A French landscape architect, Andre Le Nôtre, designed the gardens at the Palace of Versailles. His style, characterized by formal symmetry and elaborate water features, became the hallmark of French garden design.
• Vita Sackville-West. An English writer and gardener, Vita Sackville-West is known for her work at Sissinghurst Castle in Kent, where she created one of the most famous English gardens of the 20th century. Her garden design incorporated a mix of formal and informal elements and has been widely emulated.
• Capability Brown. A prominent English landscape architect of the 18th century, Capability Brown is known for his naturalistic style, characterized by sweeping lawns, serpentine lakes, and artfully placed clumps of trees. He designed over 170 parks and gardens in England, many of which are still intact today.
• Piet Oudolf. A Dutch garden designer, Piet Oudolf is known for his innovative approach to planting design, which emphasizes using perennials and grasses. His work can be seen in public gardens and parks worldwide, including the High Line in New York City.

These are just a few examples of the many famous gardeners who have left their mark on horticulture.

Gardening can be a good physical activity.

Many of my patients find it difficult to embrace the idea of regular exercise. They know that physical activity is essential to optimizing physical and mental health.

My response? Committing to a workout routine can involve something other than heading to the neighborhood gym or running that upcoming 5K in your town. I offer gardening as an example of a popular hobby that can serve as a good workout.

The pastime is also a muscle-strengthening activity, according to the US Physical Activity Guidelines for Americans, and one of the physical activities with the lowest injury rates.

Gardening is good for mental health, too.

‌Gardening can improve several aspects of mental health and focus:

• Improves mood. Gardening helps me feel more content. It is a form of mindfulness. I focus on the immediate details of gardening, avoiding any negative thinking. Simply being around plants also reduces stress for me.
• Boosts self-esteem. Helping a plant to grow is an accomplishment, and you may feel a surge of pride.
• Improves attention span. Gardening can facilitate focus. The activity involves focusing on what is directly in front of you. Childcare Connection offers this about ADHD:

“A safe and calm garden helps soothe a child with attention-deficit/hyperactivity disorder (ADHD). A child with ADHD functions better in a neat and orderly environment. A garden that exhibits order and structure will be beneficial.”

Moreover, communal gardening can provide social benefits associated with lower stress, less isolation, and a lower chance of suffering from dementia.

Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Spaces.

Environment-health research has shown significant relationships between the quantity of green space in deprived urban…

www.mdpi.com

Tips on gardening for mental health

WebMD offers some helpful tips on gardening for mental health. First, don’t ignore other mental health treatments. Medicines, psychotherapy, and other tools can help manage mental health problems. If you have signs of anxiety, depression, or other issues that interfere with your life (even while you garden), please see a medical professional.

Second, consider getting involved in a community garden. These are shared spaces where people grow plants in one large area or small individual plots. Search online to see if there is one near you. They often have experienced gardeners (useful if you have questions).

Third, decide what you want to grow. Do you have a favorite flower, vegetable, or fruit? Different plants have different care and financial requirements.

Finally, consider growing plants indoors. Pots, planters, soil, and a window (or artificial sunlight source) are all you need to start.

Physical activity benefits

Moving has numerous health benefits, including:

1. Cardiovascular health. Exercise helps improve the health of your heart and blood vessels. Regular exercise reduces the risk of heart disease, stroke, and high blood pressure.
2. Weight management. Exercise can help you maintain a healthy weight or even lose weight. It increases your metabolism and burns calories.
3. Mood improvement. Exercise releases endorphins, which are natural chemicals that help to reduce stress and anxiety and improve mood.
4. Muscle strength and endurance. Exercise can help build and maintain strong muscles and improve your physical endurance.
5. Lower risk of chronic diseases. Regular exercise can reduce the risk of chronic diseases such as type 2 diabetes, cancer, and osteoporosis.
6. Better flexibility and balance. Exercise helps improve your flexibility and balance, reducing the risk of falls and injuries.
7. An immune system boost. Regular exercise can help boost your immune system, reducing the risk of illness and disease.
8. Sleep improvement. Exercise can help improve the quality of your sleep, helping you feel more rested and alert during the day.

In summary, regular exercise is an important component of a healthy lifestyle and has numerous health benefits for physical and mental well-being. Gardening can be accessible and useful as a workout.

Oh, one more thing: If you are working in your garden or yard, please bend at the knees to lift heavier objects and pace yourself. Start with a short session, progressively increasing your gardening time and intensity. Finally, warm up by taking a short stroll.

There are few things more satisfying than eating something that you have grown.

The post You Can Use Gardening As Exercise appeared first on Medika Life.

At-home monitoring, digital health advances, technology, and 5G can play a crucial role in driving the transformation of cardiac rehabilitation and improving patient outcomes. These technologies can provide patients with greater access to healthcare services and support, enable remote monitoring, and facilitate more personalized care. In recent years, there has been a growing interest in home-based cardiac rehabilitation (HBCR) programs as an alternative to traditional facility-based cardiac rehabilitation (CR) programs.  This methodology offers many potential advantages for both patient and clinician.

Remote monitoring: Digital health advances and at-home monitoring devices can allow healthcare providers to remotely monitor patients’ vital signs, medication adherence, and other health metrics. This can enable early detection of complications and prompt interventions, reducing the risk of adverse events and improving patient outcomes.

Personalized care: With the help of digital health tools, healthcare providers can tailor cardiac rehabilitation programs to individual patients’ needs, preferences, and medical histories. This can improve patient engagement and adherence to the program and increase the chances of successful outcomes.

Telehealth: Telehealth technologies, enabled by 5G networks, can facilitate remote consultations between patients and healthcare providers, eliminating the need for in-person visits. This can improve access to healthcare services for patients who live in remote or underserved areas or who have mobility issues.

Wearables: Wearable devices such as smartwatches and fitness trackers can help patients monitor their activity levels, heart rate, and other health metrics. This data can be shared with healthcare providers, enabling them to track patients’ progress and adjust their rehabilitation programs accordingly.

Health apps: Mobile health apps can provide patients with access to educational resources, medication reminders, and other support tools. They can also enable patients to track their progress, set goals, and receive feedback and encouragement from their healthcare providers.

The comfort of home. The home environment can facilitate lifestyle modifications within a patient’s own comfort zone and provide direct family support

A new study has advanced the discussion on home care and the potential role of digital health. In a large and comprehensive clinical trial conducted at the San Francisco Veterans Health Administration compared the mortality rates of patients who participated in HBCR versus those who did not. The study included 1120 patients who were referred and eligible for outpatient CR between 2013 and 2018. Of these patients, 490 chose to participate in HBCR, while 630 chose to attend facility-based CR or did not participate in CR at all.

The results of the study showed that patients who participated in HBCR had a 36% lower hazard of mortality compared to those who did not participate in any CR program. During the median follow-up of 4.2 years, 185 patients (17%) died, and mortality was significantly lower among the HBCR participants (12%) compared to the nonparticipants (20%).

HBCR programs typically involve telephonic coaching and motivational interviewing sessions over a 12-week period, allowing patients to participate in rehabilitation from the comfort of their homes.  In addition, participants received equipment on an as‐needed basis, including resistance bands, a scale, a blood pressure cuff, a pedometer, a heart rate monitoring device, an exercise peddler or stationary bike, and a dietary video. 

This type of program is particularly beneficial for patients who cannot attend traditional CR programs due to various reasons, such as transportation issues, lack of access to facilities, or personal preferences.

Although this study has limitations, it suggests that HBCR may provide a viable and effective alternative to traditional facility-based CR programs. This finding is particularly relevant in the context of the COVID-19 pandemic, which has disrupted access to healthcare services, including CR programs. HBCR programs may offer a safe and effective option for patients to continue their cardiac rehabilitation without the need for in-person visits. Future studies can build upon these insights and incorporate advancing digital health monitoring devices for added data capture and to support analytics that drive frequent physician and patient feedback.

At-home monitoring, digital health advances, technology, and 5G can play a key role in transforming cardiac rehabilitation and improving patient outcomes. These technologies can enable remote monitoring, personalized care, telehealth, wearables, and health apps, among other benefits. By harnessing these tools, healthcare providers can provide patients with more accessible, convenient, and effective cardiac rehabilitation programs, ultimately saving lives.  But more importantly, current clinical data validate this concept and offer a life-saving path, accessible, and patient-friendly path for care.

The post There’s No Place Like Home (Care) appeared first on Medika Life.

If the consumer-doctor connection is the window to early prevention, diagnostic testing is the early biological warning system for some easily treatable illnesses. But discovering fixable problems often happens after the doctor’s visit.  That’s “closing the barn door after the horse has escaped.”

The process assumes that everyone is committed – or worried enough – about their health to follow through quickly and follow their physician’s request to obtain needed diagnostic information.  It doesn’t always happen that way!  Almost 70% of medical decisions use lab test results. The problem is that 40% of physician diagnostic prescriptions are never filled.

Could a change in how consumers access diagnostic data impact the tragic trend that more than 70% of US deaths (41 million annually) are related to often treatable non-communicable diseases? In this Medika Life exclusive, we talk with health-tech innovator Pouria Sanae of ixlayer about why he is working to shake up the current “sick care” system by empowering consumers and the health system through affordable, reliable, reliable and accessible home-based testing.

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Gil Bashe: Tell me about the genesis of ixlayer and your vision to make it easier for physicians and patients to work together around the convenience of diagnostic testing. What problem did you set out to solve?

Pouria Sanae: Two stories explain how ixlayer got started. Several years before I launched ixlayer, my mother was selected to participate in a clinical trial. The clinical site’s onboarding process included diagnostics that revealed abnormal blood levels.  The follow-up testing found a malignant tumor in her neck. She was operated on a month later and is alive and healthy today. This was a time-sensitive discovery; had she missed the tumor – until even six months later – it would have been too late. After that experience, I knew I needed to do something in the health sector that could help other people and families. Survival cannot be left to serendipity. 

Our co-founder, Dr. Poorya Sabounchi, lost his father to a medical condition that could have been prevented if detected earlier. His professional passion became genomics and genetic testing, and he first joined Illumina to pursue that mission. When we met, we immediately connected on this idea that so many people are ‘hosts’ to a disease without knowing it – many people need screening but don’t get it.  How many lives are lost because the information isn’t available? That is core to why we advocate for consumer engagement in diagnostic medicine.  Ixlayer is more than a company. It is a catalyst for long-awaited change that will benefit providers, payers, and, most importantly, patients and their families.

Bashe: Unfortunately, you’re right – the stories you shared happen too often. Your and Dr. Sabounchi’s experiences – harnessing diagnostic information within us as a preventive strategy – should be the standard of care. How did you transform life-changing family experiences into ixlayer? What were the operational steps?

Sanae:  I made the change very quickly – I left my job in the tech sector and moved to the health sector. First, I joined Helix, a promising sequencing lab providing the same concept for genomics.  There, I realized that the hurdle to better, frequent diagnostic testing is the difficulty in operationalizing or shifting the process itself. This is a very fragmented market.

I was involved in launching the lab testing platform for Geisinger, Mt. Sinai, Invitae, and National Geographic. On top of Helix – they were all spending millions of dollars and 18 months on development. They were inventing the same wheel over and over! We saw what was missing: infrastructure and patient experience layer on top of the lab work.  The observation and need were the basis for ‘ixlayer.’  I for infrastructure and X for the experience.  Suppose we could equip the industry with this missing piece. In that case, we could increase lab testing volume and offer preventative options, affordability, patient experience, and in-home convenience.

Bashe: When we look across the lab testing sector, even as some assays or technologies evolved, the patient experience for diagnostic testing has remained unchanged. Would you say that’s true? 

Sanae:  Yes. There are three issues when it comes to the consumer experience of diagnostic testing. One is convenience, the second is affordability, and the third is the ease of use.

For example, if I want to go and get my thyroid checked, I first need to go to a doctor and discuss the need for the test. I need to get a requisition or “req” form. Then go to drive to a lab like LabCorp or Quest. Then, return to the doctor to discuss the results. Once the test is ordered, this clinical journey requires at least two physician visits and a lab visit. Let’s also add in the scheduling and drive time. 

Another issue is affordability. Based on my current insurance, I pay $60 for this, out of pocket – two $20 copays for the doctor visits and another $20 for the lab. It adds up.

On top of it all, consider time constraints. I don’t have the time to see a doctor. Most people don’t have the time. This system assumes you have complete power over your schedule – put the employer aside. Get someone else to handle childcare. 

So those are the three things that need to change within the system. It’s not the doctors’ or labs’ fault.  No one is to blame. The system is the system, and it is failing us.

Bashe: You mentioned a thyroid test as an example. How does a consumer access a consumer-oriented diagnostic test like this?  

Sanae: The beauty of partnering with a national retail pharmacy is that we provide something the end consumer can pick up off the shelf. CVS calls this “symptom to treatment in a box.” Once you pick up a test, scan a QR code and begin a digital experience. A telehealth physician oversees the process on the back end. You get instructions on how to collect your sample. You ship it back to the lab, which processes the test, and you get a result. If your results are abnormal, a physician calls you and explains the result and next steps. And in this case, CVS owns the process; if your results are abnormal, you’re sent back to Cvs Minute Clinic for continuity of care.

Bashe: Tell me a little bit more about the tests themselves. What types of samples are used in your tests?

Sanae: We cover everything when it comes to at-home testing. Depending on the type of test, our services support all samples for at-home tests, including saliva, blood – whether finger-prick and dried blood spot or tube – and we also do stool and urine. The first one we started with for the four Cvs tests is blood.

Bashe: There seems to be a major movement to make pharmacies more accessible in personal health management. I’m curious to get your take – with the rise of at-home testing and telehealth during the COVID-19 pandemic, do you see a behavioral shift in consumers wanting more accessible care?

Sanae: Yes. We entered the market before the pandemic, back in 2018. Initially, the feedback from the industry was that the end user – the consumer – wasn’t ready. The Covid era has changed the concept of in-home care, and people realize how easy it is to engage with their health on their terms. CVS, Walgreens, Walmart, and Amazon are entering the market and have financial models where they feel they can add value. On top of that, consumers – especially Gen Z, Millennials, and Gen X – seek improved home care.

Bashe: It sounds like you’re talking about sparking a movement of health-conscious consumers – those who say maybe I should check my thyroid function or my cholesterol proactively. Is that your hope?

Sanae: A future of at-home health testing is key to preventive care. It provides a snapshot of personal health information over time. The doctor already knows that 133 million Americans have chronic conditions that often require ongoing lab testing. But 60 million Americans have a chronic condition and don’t know it. What if we could help more of those people get diagnosed sooner – maybe even before their condition becomes a serious problem? Suppose we manage to test that individual more often. In that case, we can identify high-risk patients and hopefully, get them the treatment and support they need before their condition becomes a problem.

Through the CVS partnership and others, we can help more pharmacy and health system partners realize the significant value of empowering consumer health.

Bashe: Could you share with me a little bit about ixlayer technology itself? How does your technology differ from other systems?

Sanae: Oneof the challenges for the diagnostic space and in-home testing is that it is a very fragmented market, with different regulations for each state. We developed a technology layer, a cloud layer, that integrates into forty different services, and we keep adding services daily. This includes 27 different labs, a physician network in all 50 states, fulfillment services, picking and packaging, in-home mobile phlebotomy, insurance, Emr, and so forth. On top of that, we combined this into a very easy-to-use patient experience layer, transforming a complex, segmented ecosystem into a patient-friendly flow.

We can launch our customers within six to eight weeks. It might take years if a retail company or provider network wanted to do this themselves. We are making it possible to operationalize the shift from sick care to self-care and support the medical practice of preventive care.

Bashe: When you look at the future, share with me what you think might happen realistically a year from now.

Sanae: Consumer adoption of these tests will increase. The goal is to have lab testing be like a toothbrush. If toothbrushes were invented for the first time today, your dentist would tell you that you don’t need that thing. Come in when you have a cavity. That is what health care is today.  We wait for people to have pain instead of giving them preventive tools to monitor and maintain their health. Our vision is that lab testing can and should be like that toothbrush – the preventive care in-between visits. You should test yourself every quarter, should monitor yourself, and then, when you come in for your checkup, you can show the results and discuss them with your doctor. That’s preventive engagement.

Bashe: What are your thoughts about how physicians understand this change as a fulfillment of their vision to be healers and address the needs of people who need healing? Will the fragmented health ecosystem realize that a smarter, educated, engaged consumer is the Holy Grail of wellness?

Sanae: I’m glad you brought that up because many disagree with this industry topic. Many primary care physicians are against patient-initiated testing, where an individual patient goes to a lab on their own.  They are concerned that the patient won’t get the correct information or support without guidance from a physician. In reality, there is demand for that kind of access, and we all need to find the balance between what we do and what physicians do.

This type of service benefits providers, too. If we can work together to prevent healthy people from coming into the hospital, it may reduce physician fatigue.  That means doctors will have more time and energy for patients with pressing needs. If physicians adopt in-home testing, which they are, it reduces the cost of a hospital bed and the cost of care. ixlayer adds value to preventive care, disease management, and the chronic condition diagnosis journey.

Bashe: You have a diagnostic business model, but it feels like you also have a public health model. When people are actively engaged in conditions that could be well-managed and engaged at the earliest stages, we can improve people’s survival outcomes.

Sanae: We are an ally to public health. The public health system needs to know that this is available to make lab testing more straightforward and accessible. For example, the Netherlands provided an in-home lab test for colon cancer for every household because they realized the significant benefit of pre-screening and early detection. This is a catalyst to have consumers recognize that they have the most at stake – healthy longevity.

We are a platform that powers consumer and public health. The provider network, retailer, payer, or government agency can tap into the ixlayer platform to set up their offering. They can utilize their health system lab because we’re lab agnostic. They own the data. They own the patient relationships. ixlayer is just the pathway.

Attempting to manage a person’s health without regular diagnostic data is like putting your ear on the car’s hood to understand if the engine is functioning correctly. Suppose we get more people to check more often. In that case, our system supports the medical community that seeks longer, healthier lives for everybody.

With chronic non-communicable illnesses on the rise, detecting health issues early enables health professionals to guide the course of treatment – to adjust diet, offer medication options and engage other medical specialties.  Creating this “pre-patient” model of care empowers consumers to be better informed and engage in their health. Suppose we encourage frequent lab testing by reducing cost, access and convenience barriers. Can we also reduce obstacles to lowering system costs and shift emphasis from sick care to preventive care?  Pouria Sanae and his ixlayer team are long-awaited catalysts for these changes.

The post Can At Home-Health Dx Testing Move Primary Care Back into the Preventive Care Front-Seat? appeared first on Medika Life.

In my earlier posts in this series, I have written primarily from the perspective of what primary care physicians can do to improve their patients’ health and reduce total costs of care. Concurrently, they can reclaim their right to practice in a non-frustrating environment with a limited number of daily patient visits. Torinus approaches improving health care from the perspective of a business leader faced with rising health care costs. Here I will quote and paraphrase from Torinus’ book and, since I basically agree with his recommendations, will amplify with some of my own thoughts.

He argues that company CEOs must make health care a strategic priority since it is one of the top three costs for any company. In addition, healthcare costs can make the company noncompetitive if not managed aggressively. However, strategic priority to him also means it is essential for the company to attend proactively to the health and wellness of its employees, not just be the provider of an insurance plan.

CEOs need to consider the long term for their companies and employees. The company and the employee together spend about $16,000 per year for a family for insurance as of his 2014 book publication, obviously much greater than that today! Using his $16,000 estimate, an employee who works for a company for 25–40 years represents an insurance expenditure over a lifetime career that could be as much as $400,000 to $640,000 in 2014 dollars. This drives home the point that it only makes sense to have a long-term view of employee health, beginning with an aggressive approach to maintain wellness, actively reduce risk factors and manage disease as it occurs.

Some repetition here is worthwhile. Don’t just focus on treating disease but prevent disease and maintain wellness. Of course, that will cost some money now, but the end result will be a substantial decrease in total costs over the years. And, don’t just cover disease care but arrange for each employee and family member to have outstanding primary care to avoid unnecessary excessive specialty care.

He observes that the current health care system focuses on specialty care, whereas it needs to focus on the care recipient with high-quality primary care — the patient/consumer/employee. But to be effective, the patient/consumer/employee needs to be engaged. Instead, the current healthcare system disengages the patient — it removes responsibility because the patient is not the doctor’s customer.

In his company, expenses were rising to double digits by 2003, but with their new plan in place, it dropped to 2% or less per year.

Torinus’ “prescription” for all companies (and what his company initiated beginning in 2004) follows:

First, every company, including small companies, should self-insure with an added stop-loss catastrophic policy.

Second, employees should be offered only a consumer-directed healthcare policy (CDHP), in essence, a moderately high deductible plan (often about $2500) with either an associated health savings account (HSA) or a health-related account (HRA.) The company should prefund the account with an amount (often about $1500 or more) that the individual can use for any health care needs with the assumption that since it is now the individual’s money, he or she will spend it more wisely — employee/patient engagement.

Third, the company should insist that each provider have price transparency. Since that’s often difficult to obtain, Serigraph uses various companies like Alithias Inc to provide that for them so that they can compare one provider to another. For example, they determine the price of the all-inclusive (gastroenterologist, anesthesiologist, and facility fee) along with quality data of colonoscopies at the nearest five centers and then rank them. The employee or family member who needs the colonoscopy is told that, for example, the company sees it as appropriate preventive care and so will cover the cost, in this case up to $1,500. [His book appeared before the ACA became law, so the insurance component would cover colonoscopy now, but the principle is still valid.] This is an amount that will pay for, say, four of the five local centers, but if he or she selects a provider that charges more, they are on the hook for the remainder.

Fourth, if the company is large enough, it should provide an on-site primary care clinic at no cost to the individual. For example, at Serigraph, the clinic includes a concierge-type physician (meaning that the physician is salaried, has a low number of patients under care, and gives ample time and energy to each employee/family member patient, consistent with some of my previous posts) plus a nurse practitioner, a health coach, a dietician, and a chiropractor. On the other hand, if the company is too small to justify a full-fledged clinic, then the company can pay the retainer for a nearby direct primary care/membership/concierge physician who works with others, such as a health coach.

Fifth, the clinic, with particular attention by the health coach, gives all employees a health risk assessment annually and then works one-on-one with each employee (and family member) at no cost to maintain wellness and health, including the use of behavioral change programs around diet, nutrition, exercise, stress management, and smoking cessation.

Sixth, the clinic staff gives very intense management of chronic diseases and coordination of specialist visits when needed. (See my earlier article on care coordination by the PCP)

Seventh, Serigraph uses what Torinus calls Centers of Value for procedures beyond those that the primary care physician does. These are doctors/institutions that have outstanding quality records yet a competitive price for, say, a knee replacement. Serigraph gives their employees $2,000 toward the deductible or covers the deductible for the surgery when they use these Centers of Value.

Seventh, his company gives (and he recommends others do likewise) generic drugs for free, and all of the above prevention and wellness programs are supplied free of charge. Finally, the company makes free counseling available for developing advanced directives, and if an individual requires end-of-life care, hospice is available free of charge.

I notice that his company spends considerably on extensive/comprehensive primary care, including wellness maintenance, proactive prevention, behavioral health, and chronic care management. In return, the company is rewarded in return with lower total costs and healthier workers.

Given that healthcare has become a company strategic priority, then it needs to be managed, and that requires data. Hence, he urges all companies to develop health-related management dashboards, including both a financial dashboard (how much is the company spending) and a health dashboard (how many individuals in the company have uncontrolled blood pressure, uncontrolled asthma, uncontrolled cholesterol, have not had appropriate mammography or colonoscopy, etc. — all information collected from the clinic in an unidentified manner to protect individual privacy).

These approaches are based on fundamental principles, including individual responsibility; marketplace discipline — installing consumerism, steering business to the best quality and price (“do good work and you get our business”); proactive care — maintaining employees’ health and wellness and give extensive care to those with chronic illnesses; and sound management — putting those who pay, i.e., the employer and the employee, in charge.

Torinus suggests that there are multiple rewards for following this basic approach (I added number 2 since he implied but did not write it.)

1) The reward for business is a healthier workforce and more affordable healthcare expenditures.

2) The reward for individuals is more health and wellness, less illness, and fewer dollars spent.

3) The reward for high-value providers is more business.

4) The reward for entrepreneurs comes if they innovate with better care provided at a lower cost

5) There could be a reward for taxpayers — if governments (federal, state, and local) were to utilize these approaches.

Sound advice? I certainly think so.

The post A Business Approach To Reducing Healthcare Costs appeared first on Medika Life.

Investigators recently sought to determine if they could use a single question as a screening tool for nutrition studies. Currently, nutrition researchers commonly use detailed dietary questionnaires.

For the National Health and Nutrition Examination Survey, subjects completed detailed 24-hour dietary recall questionnaires. These study participants then rated their diets as excellent, good, fair, or poor.

Is your diet worse than you think?

What would be your answer if I asked you this simple question: How healthy is your diet? A recent online study suggests that we may not have great personal insight.

While historical research indicates that self-rated health strongly predicts morbidity and mortality, we do not know if self-rated diet quality products the actual quality of one’s diet.

The researchers used the food recall questionnaires to score each subject’s diet quality. Foods regarded to be less healthy included those with added sugars, saturated fats, or refined grains.

On the other hand, the researchers classified healthy foods like whole grains, fruits and vegetables, healthy fats, seafood, lower-fat dairy products, and plant proteins.

Self-rating diet quality: Surprising results

There appeared to be significant discordance between the researcher-calculated scores and how the study participants rated their diet. The differences are quite large:

• Eighty-five percent of subjects inaccurately assessed their diet quality. Of these, 99 percent overrated the healthfulness of their diet.
• Those who rated their diet as poor appeared the most accurate, with the researcher’s score matching the subject’s rating 97 percent of the time. For the other four rating categories, concordance ranged from one to 18 percent.

So which do you think it is: Do American adults lack an accurate understanding of what constitutes a healthy diet? Or are we more aspirational, perceiving the healthfulness of our diet as we wish it to be?

Please note that the study will be presented later this month and has not yet been peer-reviewed.

The post Is Your Diet Worse Than You Think? appeared first on Medika Life.

The Environmental Working Group is a non-profit organization that aims to improve our environment-related health. The group recently analyzed 39,000 US Department of Agriculture tests of 47 fruits and vegetables.

The bad news? Nearly 70 percent of conventional produce contains pesticide residues. Particularly striking that virtually all apples, cherries, nectarines, and peaches contained at least one pesticide.

Rather than focus on the “dirty dozen” fruits and vegetables, today, we turn to the so-called Clean 15 produce list. First, a disclosure: The Environmental Working Group receives funding from several prominent organic marketers.

Fruits and vegetables — the clean 15

Nearly 70 percent of the Clean Fifteen fruit and vegetable samples contained no pesticide residues. Can you guess the cleanest? If you offered avocados and sweet corn, you are spot on; fewer than two percent of the samples had pesticides.

I recently wrote about some of the upsides of avocado consumption:

Are Avocados A Weapon to Dodge a Heart Attack?AVOCADOS APPEAR TO BE ONE MORE TOOL to reduce your heart attack risk. A new study suggests that this fruit — known for…medium.com Could Phytochemicals in Avocados Protect Against Cancer?I love indescribable things, like the taste of an avocado or the smell of a gardenia. — Barbra Streisand.medium.com

Let’s turn to the whole list of so-called clean fruits and vegetables.

1. Avocados

2. Sweet corn

3. Pineapple

4. Onions

5. Papaya

6. Sweet peas (frozen)

7. Asparagus

8. Honeydew melon

9. Kiwi

10. Cabbage

11. Mushrooms

12. Cantaloupe

13. Mangoes

14. Watermelon

15. Sweet potatoes

Fruits and vegetables — Study methods

The Environmental Working Group analyzed over 44,000 samples taken by the United States Food and Drug Administration (FDA) and the US Drug Administration.

Before testing the produce for pesticides, the researchers prepared each fruit or vegetable like regular folks might do, including rinsing produce with edible peels and peeling those with inedible peels.

Whether the fruit or vegetable is on the clean or dirty list, I always wash produce before peeling, cutting, or eating it. Why? I am not as concerned about the pesticides as getting enough produce into my diet. My eagerness to wash is that produce can be covered in bacteria, leading to food poisoning.

Did you know that produce causes nearly half of all foodborne illnesses? By contrast, meat and poultry are responsible for 22 percent of cases in the United States.Fruits and vegetables poison more Americans than beef and chickenEvery year, millions of Americans get sick from what they eat and drink. But it’s not always the foods you’d…www.vox.com

What is your approach?

The post Don’t Be Fooled — Not all Fruits and Vegetables are “Dirty.” appeared first on Medika Life.

I am blessed: The sheer number of jaw-dropping hikes in the Pacific Northwest region of the United States is staggering. Today, I want to explore some of my favorites before turning to how you can use hiking to burn some serious calories.

Hiking in the Pacific Northwest

Hurricane Ridge is one of my favorite places to hike. Perhaps it is because I discovered the Ridge as one of my first explorations of the Pacific Northwest in 1993.

Do you want to see extraordinary sunrises or sunsets? Have a young child and don’t want a very challenging hike? Hurricane Ridge may be for you. Located in the Olympic National Park, it has easy-to-access trailheads and is fabulous for an entire family.

Go to Port Angeles (Washington State, USA) and drive about 40 minutes into the mountains. Here’s a view:

Ambitious? Given the ease of access to the Hurricane Ridge Mountain area, you might make it a stop on your Olympic Peninsula Road Trip.

Ruby Beach is next. Positioned on the Washington coast, you can get to the beach reasonably quickly by foot. Prepare yourself for towering rock formations, lots of driftwood, and your beach picnic. Here’s a peek at Ruby Beach:

Number three on my list is one I discovered earlier this year. Can you guess what it is if I tell you that it gets as much as 14 feet of rain annually? If you are from the Seattle area, you probably know that I am talking about the Hoh Rainforest in the Olympic National Park.

Here’s a pic of this wondrous, stress-dropping place:

Hiking to burn calories

I walk. On the treadmill, on the blocks around my suburban hospital, or at Seattle’s Pike Place Market. This simple exercise promotes my physical health and gives my mind a boost, too.

Walking is a low-impact cardiovascular exercise that helps me maintain a blood pressure of 110/70 and good cholesterol levels. Hiking has similar benefits. But what if you want to burn more calories than you can with walking?

Walk, and you may burn approximately 100 calories for each mile. Hiking can easily double that number, depending on the difficulty of the activity. For the ambitious of us who take on challenging and steen terrain with a heavy backpack, you may burn well over 500 calories per hour.

I sometimes do an urban or suburban hike. You can, too — find a hilly (and safe) neighborhood, load up your backpack, and go. Perhaps you can add some trekking poles.

Hiking can be strenuous and can introduce uneven terrain, so don’t hesitate to fall back to my go-to form of exercise: Walking on an even surface.

Thank you for joining me today. I hope you have a health- and joy-filled 2022. Looking forward to the acute phase of the pandemic burning out over the next two to three months, fingers crossed.

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