Health: A Second Opinion

by Dr. Chad McDill

TLC

More than $1.5 trillion is spent annually on the diagnosis and treatment of chronic illnesses in the U.S., including $60 billion for five of the top 10 classes of drugs. Fortunately, overwhelming evidence suggests simple lifestyle changes can drastically reduce your risk of developing chronic disease.

Consider the following statistics: One in three American adults is obese, and one in five children is overweight and likely to carry their health-related problems into adulthood. Twenty-one million Americans have diabetes, 6 million of whom don't even know they have it. Additionally, 1 in 5 people (54 million) has metabolic syndrome, a cluster of conditions that predisposes them to the development of type 2 diabetes, coronary heart disease, stroke and other chronic conditions. One in five people have arthritis and 7 out of 10 people die prematurely due to chronic diseases.

Those are pretty depressing statistics - and that's only in the United States. In Europe, preventable chronic diseases are responsible for 77% of all diseases and 86% of all deaths. The World Health Organization (WHO) projects that within 10 years, deaths from infectious diseases will decrease by 4%, while deaths from chronic diseases will increase by 20%.

Simple lifestyle modifications, such as healthier eating and regular moderate exercise, have the potential to significantly reduce the world's chronic disease burden. Researchers estimated that reducing salt intake by less than 1 teaspoon per day would reduce the incidence of high blood pressure by 30% and save up to $430 million per year due to a reduced need for physician visits, laboratory tests and medications. Implementing Stanford University's six-week Arthritis Self-Help Course among just 10,000 people with arthritis could save $2.6 million over four years, primarily through reduced physician visits. Reducing systolic blood pressure by as little as 12-13 mm Hg could produce a 21% reduction in coronary heart disease, a 37% reduction in stroke, and 25% reduction in total cardiovascular disease deaths and a 13% reduction in overall death rates in the U.S.

Does Your Doctor Offer TLC?

Texas A&M University attempted to discover how much time doctors spent talking to their patients about lifestyle issues by videotaping more than 100 medical encounters between primary care physicians and patients ages 65 and older. During an average 17.5-minute office visit, only 58 seconds were spent discussing physical activity and only 83 seconds were spent discussing nutrition. Less than 10% of the entire average visit was spent discussing physical activity, nutrition or smoking cessation. Start to switch your doctor visit timeline to prevention by asking questions about exercise, nutrition, and prevention of further development of your health conditions or concerns. Why is the trend in health care not oriented toward prevention and wellness?

These attitudes are entrenched in the American health care delivery and financial reimbursement systems, which lean toward the use of high-cost diagnostics, but place little emphasis on wellness and prevention. To wit: Of the $2 trillion spent annually on health care, 75% is for the diagnosis and treatment of chronic diseases. But, its name notwithstanding, the U.S. Centers for Disease Control and Prevention has allocated less than 3% of its 2008 budget to chronic disease prevention, even though its own guidelines call for therapeutic lifestyle changes and medical nutrition therapy to reduce the risk for chronic heart disease!

Fortunately, the balance has begun to shift toward a focus on promoting wellness rather than treating symptoms of disease. Medicare has begun to offer prevention-focused benefits such as a one-time physical examination, key screenings and counseling for nutrition and smoking cessation. Plus, in Georgia, Medicare often will provide free membership to the Genesis Gym for the Silver Sneakers Program to promote wellness and physical fitness.

What Can You Do

Your employer might offer wellness benefits in the form of health insurance coverage or a corporate wellness program. Additionally, ask your tax professional if you can pay for TLC using pre-tax dollars available from an employer-sponsored flexible spending account or federal health savings account.

TLC has been shown to be a powerful tool for the prevention, management, and reversal of many of our prevalent chronic diseases. Those who participate in a TLC program have the opportunity to protect or regain health for better, more enjoyable living.

Time for a Little TLC

"Professional Supervision. If you're considering a TLC program, work with a licensed health care provider who can assess your current health status, establish goals and develop a step-by-step plan for achieving those goals. Regular follow-up visits will allow progress to be tracked and any necessary adjustments to be made.

"A Team Approach. The supervising health care provider also might bring in additional team members such as dietitian, fitness trainer or other allied health professionals or staff to educate and inspire you regarding diet and lifestyle changes.

"Long-Term Health Focus. Ideal TLC eating plans go beyond merely counting calories. A sensible nutritional regimen could include lessons on how foods are metabolized, cooking classes, and how you can incorporate nutrition and exercise into your daily routines.

"Comprehensive Lifestyle Counseling. This could include things such as recommendations or referrals for dietary supplements, stress management, adequate sleep and behavior modification.

Remember that your health is your responsibility and you only get one body, so take care of it for the long haul!