It's that time of the year again. Every January millions of Americans vow that this will be the year that they buckle down and live a healthier life. Cigarettes, pizza, hot dogs and French fries are sworn off and health club owners salivate as gym memberships skyrocket.
Unfortunately, statistics show that only 30 percent of those resolutions make it through the year. But don't let that discourage you from proclaiming 2005 as the year for a healthier new you. Catherine DeAngelis, pediatrician and editor-in-chief of the Journal of the American Medical Association, based in Chicago, has a forecast for the top medical concerns of the new year. It might just make you do a double-take when you pick up the phone to order a large deep-dish sausage and pepperoni pizza on January 2.
"The top health issues, if you're talking about mortality, are heart disease, cancer, stroke and dementia," DeAngelis predicts. "Then there's a whole bunch of other illnesses that will follow. If you're looking at the things that lead up to heart disease, cancer and stroke, you're talking about obesity, which I think is at least an epidemic if not a pandemic, not only in America but all over the world."
A recent study shows that middle-aged men with a high body mass index are almost two times more likely to have a stroke in comparison to their thinner counterparts. Studies also show that the risk of breast cancer after menopause is 1.5 times higher for obese women. In addition, more than 80 percent of adults with type 2 diabetes are overweight. These statistics can be quite daunting considering the fact that 64 percent of adults are overweight or obese, according to the National Center for Health Statistics.
DeAngelis says there are some simple steps that Americans need to take to win the battle of the bulge.
"If you want to decrease the risk of developing these diseases, there are two things that we have to have some control over," she explains. "Number one is nutrition. It's a very simple formula. Take in the number of calories you need to survive, which is around 2,000. And if you consume more than that, you have to exercise and get rid of the excess calories. You have to have a balanced diet so that you get a various array of the nutrients and vitamins that you need."
Think you need a special diet in order to stick to a weight-loss plan? Not so fast, says DeAngelis.
"Low-carb, low-fat, non-fat, this is all nonsense," she says. "All the data shows that it doesn't matter what you eat, it's about the calories in and the calories out. People are making and spending a lot of money on these diets, and really it's not an issue of a diet per se, it's about caloric intake."
The environment also plays an important role in maintaining a healthy body, DeAngelis says. "Environmental toxins in the air from smoke, pollutants and smog all have an effect on health," she explains. "Asthma, for example, is getting worse because of the toxins in the air. The more pollutants there are in the air, the more likely someone's airways will react to them. We simply aren't paying enough attention to the pollutants in the air. There was a time when there was a lot of smog in the air in Chicago, but 'm looking out the window now, and it's totally clear. What we don't know is that there are tons of junk in the air that we can't see. They are silent killers or at least agents that make us sick."
"One of the best things we can do is plant trees," DeAngelis says. "We have to clean the air, and the way to do it is with trees. The bigger the city, the more toxins in the air. Something as simple as planting trees on Michigan Avenue is very important. Chicago is not so much an industrialized city anymore but pollutants are still all over the place simply because we have so many people living in such a little area."
Alzheimer's disease, which is closely linked to dementia, is a growing problem for America's aging population. The National Institute on Aging reports that approximately 4.5 million people currently have the disease with the prevalence doubling every five years after the age of 65. Scientists suspect that the number of Alzheimer's patients could jump to 13.2 million by the year 2050 if no preventative treatment is found.
"Not only is there no treatment right now, but people can't even say, ?This is what causes it and this is the medicine that will help it'," says DeAngelis. "The problem is we need something to flush out the junk in our brains. Essentially it's the junk accumulating in our brain that causes dementia. Some of it is genetics, and some of it is environmental. This is where the neuro-sciences come in. It is very important to find out where in the brain this is coming from so that we can work to treat or prevent it. I don't know anyone who's over 40 who isn't faced with this in some way, either with a friend who's dealing with it or a family member who needs someone to take care of them. It is a very sorrowful problem and we don't have the answers yet to solve it."
Heart disease is another illness many middle-aged people are battling. Former President Clinton's emergency quadruple bypass surgery served as a warning for the baby-boomer generation. After hearing the news, a large number of people went running to their doctors. This increased awareness is especially important for women because heart disease is their number one killer.
"When I became editor-in-chief of JAMA in 2000, one of the things I said wanted to have an influence on was the study of women's health issues," says DeAngelis. "I wanted to make sure that the studies we received were not conclusions based solely on men. Unfortunately, not too long ago that was the case. Women's bodies were seen as functioning like men's bodies or there was just the idea that ?oh, women don't have that'. That was the case for heart disease. When investigators sent us studies and there weren't enough women subjects, I'd have them analyze the women and men separately. And sometimes you would see some interesting differences in the findings. This is again the same for heart disease. We're finding that there are a lot of men who have heart attacks, but they may just have them at an earlier age than women. Women's signs and symptoms sometimes manifest differently than men's. The causes are the same, but women feel the pain in their shoulder rather than the crunching chest pain that men get when they have heart attack." Thanks to findings like these, women and their doctors are now more able to identify the signs of an imminent heart attack.
"Doctors are being much more diligent when examining their women patients for heart disease," reports DeAngelis. "The same goes for hypertension. Women have the protection of estrogen, and it lingers longer in their bodies than in men, so they are a bit older when they experience problems like heart disease. But estrogen isn't the only difference. Women are genetically different than men. The genotype makes them different, so some diseases, for instance auto-immune diseases like rheumatoid arthritis and lupus, occur much more frequently in women than in men. It is really important for women to be aware of these differences."
Self-examination and awareness is important, but don't go overboard, DeAngelis warns.
"In the next year or two, we're not going to see the regular life span triangle with more younger [people] in the population than older people," says DeAngelis. "Now it's looking more like a Bordeaux wine bottle. It's the same all the way up until you hit over 80 then it narrows significantly. And as great as that is, we still know our life span is nowhere near what it should be considering how much we spend on healthcare. Why do we pay so much more for medicine in this country, more than in any other country? TV advertising has a lot to do with it.
"People see the commercials or ads and think they need that medicine," DeAngelis continues. "The problem is that the doctors don't tell their patients, ?You don't need this.' There is so much more that we as a public and as physicians can do to stop our health problems. We're looking beyond what's obvious. We are in a wonderful garden of flowers, and we're looking for a rose, but there are dozens of other flowers in there that we aren't paying any attention to. The bottom line is we should not be paying as much as we do for drugs; not that the individual drugs are not worth it. It's just that we have people using things that are like grenades to get rid of a problem when they only need something little like a band-aid. We have millions upon millions of people on Vioxx when an over-the-counter, non-steroidal, anti-inflammatory drug that costs pennies -- in comparison to the dollars spent on Vioxx -- and it works just as well."
It seems like the age-old adage of ?take an aspirin and call me in the morning' may still hold a hint of truth. Now it's just a matter of creating healthier eating and exercise habits. So make that resolution, and try to stick to it. If you do, DeAngelis says your body will thank you for it.
Published: December 01, 2004
Issue: Holiday 2004