The Experts

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Dr Ross Walker
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What came first, the cholesterol or the egg?

Thursday, March 21, 2019

Just when you thought it was safe to tuck into your favourite dish of bacon and eggs on the weekend, new research was released this week, published in the highly acclaimed Journal of the American Association of Medicine, suggesting we should rethink this position.

This extensive study pooled data from six US cohorts totalling 29,615 people of whom 45% were males and 31% African Americans. The average age of the people in the study was 52 followed up to 31 years but on average 17 years. Thus, it was a very large study with a very long follow-up looking at the American population. 

The conclusion of the study was each additional intake of dietary cholesterol of 300 mg per day equated to an increase in cardiovascular events of 17% and death from any cause of 18%. In real terms, for each 1,000 people studied, those who consumed two eggs per day compared with those who didn’t, but otherwise had a similar diet, there were 32 more cardiovascular events and 4 more deaths in the egg consumers. Eggs by themselves were not really the culprit but rather dietary cholesterol, which can come from any animal source.

So, is that the end of the story? Should we never look another egg in the face or tuck into the often consumed eggs and bacon or one of my favourites, Eggs Benedict?

The clear answer here it is to drill down on the research and find out exactly how the study was done. Once you have understood this, you’ll realise what little credence this information has for your eating habits. Basically, this entire information is based on one dietary questionnaire performed at the start of the study. This questionnaire asked the participants about the food they had consumed either in the previous month or 12 months based on the particular cohort investigated. Could you remember accurately what you consumed during these periods?

There were no further questionnaires administered and basically the health and disease events were followed for the next period up to 31 years but on average 17 years. Clearly, any intelligent human being would question the validity of such a study. Many people change their dietary and life habits over such a long period of time. Many people become ill and often radically change their diets as well.

Another recent study looked at young and ageing mice and compared their vascular health pre-and post antibiotics. They found that a course of antibiotics did nothing to the vascular health of the younger mice but profoundly improved the vascular health of the older mice. The hypothesis here is that as mice age, the gut bacteria changes to become more pathogenic. Young healthy people have young healthy gut bacteria. With years of exposure to western diets, which may or may not include eggs, our gut bacteria change from the young healthy pattern to older, more pathologic bacteria and liberate toxic chemicals into the bloodstream. There has been a significant amount of work around the chemical TMAO, which has been found to have a direct toxic effect on blood vessels, making them much stiffer and more prone to atherosclerosis, the basic underlying cause of heart disease. It appears that predisposed individuals who do have a diet high in animal products may liberate more TMAO into their bloodstreams from the interaction of these animal products and defective gut bacteria.

But, over the past two years, there have been two components of a trial known as the PURE study both of which have put this cholesterol and saturated fat argument to bed. The PURE study was conducted in 50 different countries, not just America, where we all know that dietary habits for many people living in America are very poor. It may be that it is not those couple of extra eggs per day consumed with a typically poor American diet that needs radical rethinking, but the overall diet itself.

The first component of the PURE study, released in 2017, looked at 135,000 people in 50 different countries followed for nine years and showed that those with the highest carbohydrate intake had a 28% increased death risk, where as those with the highest fat intake had a 23% reduction in death and those with the highest saturated fat intake i.e. animal products, had a 14% reduction in death.

The second component of the PURE study, released in 2018 followed 220,000 people in 50 different countries again for nine years and show that those people who had three servings of high-fat dairy and 100g of red meat on a daily basis had a 25% reduction in death and cardiovascular disease.

It is my opinion, from a more global analysis of the literature, that if you enjoy eggs on a regular basis but combine this with other healthy dietary patterns, clearly not the norm in America, that the evidence or harm is non-existent. We should be more focused on our overall lifestyle and dietary patterns and maintaining healthy gut bacteria through the consumption of at least 2 to 3 pieces of fruit per day and 3 to 5 servings of vegetables per day, rather than demonising one particular food i.e. eggs. The reality is that eggs contain high-quality protein, many essential vitamins & minerals, along with lutein, which is very good for the eyes; choline, which is essential for the memory and, of course, cholesterol, which is the basic, natural chemical essential for many normal and healthy compounds produced on a daily basis.

Medical science is essential to continue to improve the health of society but it doesn’t mean that the research is always correct and shouldn’t be questioned. I certainly question this study that makes rather emphatic conclusions based on one dietary questionnaire performed at the start of the study and not any further analysis of the person’s lifestyle for the next (at least) 17 years. You make up your own mind, but , for mine, I will continue to practice healthy lifestyle principles and enjoy eggs when I feel like eating them.

 

Is there a link between some vaccinations and autism?

Thursday, March 14, 2019

For reasons only known to those bizarre human beings known as anti-vaxxers, there has been ongoing debate over the past few decades as to the benefits and potential detriments of vaccination. If you are an anti-vaxxer, please do not waste your time sending me hate mail, because I will delete it immediately. It is my opinion that vaccinations were the greatest advances in medicine of the last century, having abolished diseases such as smallpox and polio and markedly reduced the risk of serious, life-threatening complications of many other illnesses. There are not too many absolutes in medicine but this is certainly one of them.

In 1998, a British researcher, Dr Andrew Wakefield published a paper suggesting there was a link between vaccination for measles, mumps and rubella and the development of autism. Despite the fact that this gentleman falsified his research, he has since been discredited and  stripped of academic credentials, there are a bunch of extremely gullible people around the world who still believe this nonsense.

Unfortunately, when a tragedy such as autism occurs, the parents want to blame something other than a combination of genetic and a variety of environmental factors. Because speech and behaviour really starts to manifest around the same time as the MMR vaccine is administered, then the vaccination was the obvious, but not the logical, target.

A recent study from Denmark published in the Annals of Internal Medicine, looked at the Danish population registry with access to data from all children in Denmark. This involved 657,461 children with a 10-year follow up period. During this period, 6,517 children were diagnosed with autism.

The results of this study were absolute, showing no relationship between the MMR vaccine and the risk for autism. It also showed that vaccination did not trigger autism in susceptible children and also showed that there was no clustering of autism cases in the period after vaccination. Interestingly, there were also no links between other vaccines and autism.

Hopefully, this extremely large study will put to bed any inferences that vaccinations are linked to autism. In the vast majority of cases, vaccination is perfectly safe and prevents children from having the complications of, at times, life-threatening illnesses. Unfortunately, the lunacy perpetrated by anti-vaxxers will continue, despite solid scientific evidence.

 

Let’s sleep on it

Thursday, March 07, 2019

Over the past decade, there has been increasing emphasis on the place of good quality sleep as part of an excellent quality health regimen. Some studies have suggested that 7-8 hours of good quality sleep per night is as good for the body as not smoking. With the increasing stresses and pressures of the modern world, along with the ubiquitous presence of electronics, the quality and length of sleep is being constantly eroded.

On top of this is the very common diagnosis of sleep apnoea and some other less common but still very disturbing conditions of sleep that can markedly affect the quality and quantity of a good sleep habit.

Three recent studies on sleep have prompted me to revisit this issue. The first study published in Nature Genetics from Holland assessed the DNA and sleep characteristics in 1.3 million people who were part of the US based “23 and me” genetic screening program. It has been estimated that around 30% of the population suffer some degree of insomnia, where 1 in 10 people have chronic poor sleep and subsequent daytime consequences. It has been estimated that 770 million people worldwide suffer significant chronic insomnia.

Interestingly, this new study showed that there are just under 1,000 gene variants that contribute to insomnia and this appears unrelated to whether you’re a lark i.e. go to bed early, wake up early or a night owl i.e. go to bed late, wake up late; which appears to be genetically determined with a 70-30 ratio of larks to night owls. But there does appear to be a clear link between these abnormal gene variants and insomnia with depression and anxiety.

The second study published in Science Advances from the University of Rochester was performed on mice using a variety of anaesthetic regimens, one of which simulated the effects of deep non-REM sleep. This is the phase of sleep where we rejuvenate the body for the next day. Interestingly, it has been discovered that the brain has a glymphatic system. This is the part of the immune system that helps to clear waste and other toxic proteins from the brain. It appears that this system is most active during deep sleep. Thus, if we do not have good quality deep sleep, we are not clearing toxins from the brain and thus the link between poor quality sleep and the increasing risk for Alzheimer’s disease.

The final study, published in Current Biology from the University of Colorado, looked at 36 healthy volunteers aged 18-40 and monitored their food intake, exposure to light and sleep over nine nights. They split these people into three groups, with the first group sleeping nine hours each night for nine nights, the second only five hours per night for nine nights and the third, five hours per night for five days, with an unrestricted weekend and then two further days of five hours per night. The conclusion of this study was that trying to catch up for the lost sleep on weekends does not really benefit your metabolism, with anywhere between a 9-27% reduction in insulin sensitivity by this yo-yo effect on the circadian rhythm, the vital rhythm that maintains our wake-sleep cycle each day and allows the rhythmic release of a variety of body chemicals and hormones to maintain normal body balance.

The key message from all of the studies performed on sleep is that this is a vital part of your day and one that should be respected and not abused. We should be aiming for a regular, constant sleep habit that is maintained each day. With the increasing issues around all aspects of modern living, many people are cutting back on sleep or having disrupted sleep because of stress, electronics and many other factors. We hear so much about the importance of diet and exercise but it is my opinion that good quality sleep is another vital factor in the generation of good health. Sleep poorly at your peril.

 

Should you be vaccinated against influenza?

Thursday, February 28, 2019

We are approaching that time of year when we need to start thinking about getting our flu vaccine. Although influenza in 2018 was nowhere near as vicious as the previous year, there is always the chance of serious complications and occasionally death.

It is my strong advice that anyone over the age of 50; anyone with a chronic illness; pregnant women and young children should all consider having an influenza vaccine. Those vaccinated are 70% less likely to see a general practitioner with a flulike infection and also 60% less likely to be hospitalised.

Vaccinations are never 100% effective and certainly not effective against all strains of influenza. The standard quadrivalent vaccine is directed against two strains of Influenza A and two strains of Influenza B. Hopefully, this will cover the predicted strains that will infect our community over the winter months.

There are certain myths around influenza vaccination that need to be stressed every year.

1.  Having a flu vaccination protects against all other colds and viruses

2.  You can actually get the flu from the flu vaccine

3.  Is important to take antibiotics with the onset of influenza

These three statements are certainly myths. You can still catch a cold despite having had the flu vaccine. The vaccine only protects against the strains in the vaccine to which you are exposed and even then, as stated above, is never 100% effective.

You may have a reaction to the flu vaccine where you experience mild flulike symptoms but you cannot contract influenza from the vaccine.

The reality is that antibiotics are useless in treating influenza. The only reason to see your doctor would be to have specific antivirals such as Tamiflu; to obtain a work certificate and also for the doctor to check for serious complications of influenza.

Some good news around influenza has come from Doherty institute in Melbourne published in the Journal “Nature Immunology”.

T cells are specific immune cells that fight viruses and tumours. Killer cells are types of T cells active in the immune response to influenza and protect against all types of influenza. Typically Influenza A causes the pandemics that spread through the community like wildfire whereas Influenza B is typically milder but in certain cases may be very severe, especially in young children. A peptide is a small part of a protein and the influenza virus has specific common peptides which activates Killer T cells which markedly reduces the effects of the flu virus and inflammation. The group from the Doherty Institute in Melbourne identified parts of the virus that are universal to all influenza viruses that specifically activate Killer T cells, giving us universal protection against influenza. This vaccine is now patented & will soon be trialled in humans.

I believe we are not far from the day when we will all have a universal flu vaccine possibly once every 10 years, rather similar to the vaccinations we had as children protecting us for many years against what were once lethal infections that used to kill young children. This is yet another example of the vital importance of scientific research and it is exciting to see this type of work occurring in Australia. There is no doubt with the funding received by Australian medical researchers, we are punching well above our weight in this category.

Postscript: As I am not a general practitioner, I checked with my colleagues in this area & my local pharmacy. As yet, they are not expecting the first batches of flu vaccine until sometime in March.

 

Are we eating real food or lethal muck?

Friday, February 22, 2019

Just when you thought it was safe to venture into the middle aisles of a supermarket, even more evidence is merging about the damaging effects of the modern, Western diet. A new term, Ultra-processed foods, has been used to define the modern obsession with sugary drinks, breads, ready-made meals, confectioneries and processed meats. There have been a number of studies over the years showing the deleterious effects of all these foods for a variety of conditions. 

For example, the daily consumption of one soft drink has been linked to a marked increase in type 2 diabetes and obesity, osteoporosis, tooth decay, behavioural abnormalities in children and even a higher rate of cancer. The regular ingestion of processed meats, such as delicatessen meats and bacon, has been linked to a 40% increased risk for cardiovascular disease. But, there has not been a study looking at the actual incidence of death in people who have high levels of these processed foods.

A recent survey showed that, unfortunately, these foods now dominate the food supply of high income countries. For example, in the US, it is estimated that Ultra-processed foods contribute to around 60% of the daily energy intake. It is not just the fact that these foods are high in calories, fat, sugar and salt but they are also low in fibre, micronutrients and high-quality protein. But, there are a whole host of artificial ingredients in these foods, as well including additives commonly known as emulsifiers, which have been linked directly to obesity and type 2 diabetes. Also, many of these foods require cooking at high temperatures, which liberate a chemical known as Acrylamide, which is felt to be carcinogenic.

A new study published in the Journal of the American Medical Association-Internal Medicine reviewed around 44,550 people over age 45 followed up for just over seven years. This showed that with every 10% increased ingestion of Ultra-processed foods, there was a 14% increase in death rate.

Another study, published in the Proceedings of the National Academy of Sciences, discussed a little understood condition known as sepsis. This is a life-threatening condition that occurs following a severe infection that spills into the blood stream. Because of an abnormal immune response to these bacterial infections, this may lead to damage in organs and tissues, with a marked drop in blood pressure and also the potential for severe, and at times irreversible, organ damage. It is estimated that in the US alone, there are 1.7 million cases of sepsis per year, with 270,000 of these people dying. This is especially so in people over the age of 65. 

This new study was performed in mice. Half the mice were fed a Western-style diet with the other group given standard mouse food. When the mice were exposed to pathogenic bacteria, those ingesting the Western diet had much higher rates of inflammation detected in the cardiovascular system, the brain and the gut; more severe and frequent sepsis and a much higher incidence of death.

Clearly, it appears that Western style, processed packaged muck, masquerading as food, changes our immune system, making us so more susceptible to septicaemia and a higher rate of death. The next time you feel like a quick dietary fix or a swig of that soft drink, think of the consequences.

 

60 Minutes “trick or treatment?”

Thursday, February 14, 2019

On Sunday, February 10 there was a segment on 60 minutes on the Channel 9 network, “Trick or treatments”. This segment took a swipe at complementary medicine, suggesting it was not only of no scientific value but in certain cases may also cause harm.

The segment focused on three aspects of complementary medicine. The first, the natural sedative, Valerian; the second, a green tea extract and the third, a general discussion of Chinese herbs, with no specific examples of harm from these products.

60 Minutes presented a case of a woman who had allegedly taken a Blackmore’s Valerian product and at some stage after commencing this therapy there was a significant abnormality in the woman’s liver function to the point where a liver transplant was being considered. To address this issue, Valerian is used all around the world with a reasonable relief of insomnia and there have been very rare case reports of bad reactions to this herb, including some abnormalities in the liver. This is the first case where an Australian Valerian product has been linked to significant liver issues. It is important to point out that there are many other causes for liver disease and although it is possible that Valerian was the culprit, equally it may have been a number of other potential reasons that the woman had serious abnormalities with her liver, which resolved after the Valerian was ceased. She did not require a transplant.

The second case was a young man who took a weight loss product, “Hydroxy burn Elite” which has very high doses of green tea extract. He required a liver transplant. The benefits of standard dose green tea are not disputed but there have been a few rare case reports of people having severe reactions to the very high doses of green tea extracts seen in some of these products. There have been the number of cases (albeit, not huge) across the world of liver failure requiring liver transplantation related to high dose Green tea extracts.

The final portion of this segment was more a generic comment on Chinese herbal preparations, suggesting that over 90% have varied contaminants such as heavy metals, animal products and small proportions of pharmaceutical drugs.

Although there are very rare case reports of certain herbal and complementary products leading to adverse health effects, there are many more positive reports suggesting additional health benefits, when people take the appropriate and prescribed doses of natural therapies prescribed by a well-trained health professional. I have been working as an integrative cardiologist for a number of years and combine the best aspects of orthodox medicine with evidence-based complementary medicine to offer my patients an integrated service.

There is no doubt that my patients who fare the best are those who practise sound lifestyle principles, take prescribed orthodox medicine and also use appropriate complementary medicines.

It is always a tragedy when any person reacts badly to any substance, whether it be prescribed, legal or illegal. The reality is that many more people react badly to pharmaceutical medicine than the very rare reaction to complementary medicines. It is estimated that in the US alone, there are over 100,000 deaths on a yearly basis from prescribed pharmaceuticals.

I have no issues with any television network raising concerns over any form of medical therapy but at least put this into perspective. And if you are going to present any argument about complementary medicine, why not have an expert in the area explaining the benefits that far outweigh the very rare detriments? Unfortunately, this doesn’t make for good television, as human beings enjoy sensationalism over the facts.

Disclaimer: Dr Walker does own a supplement company but none of the products were mentioned in this article

 

Is this a cure for cancer?

Thursday, February 07, 2019

A group from Israel has made the rather extraordinary claim that within 12 months they will have a cure for cancer. Before you sign up for the treatment or start investing in the company, it is important to realise when you hear any news about major breakthroughs in medicine in the news media, that often it is purely hype, a push to lift the share price or the treatment has only been shown to work in the laboratory or experimental emails. In this case, it may be a cure but equally could be any of the other situations mentioned above.

At present, the standard treatments for cancer are surgery, chemotherapy and radiotherapy. Over the past decade, a new brand of therapy known as immunotherapy is also showing enormous strides in the treatment of a variety of different cancers. Also, a new therapy that has been proven successful in humans and also now being used in Australia involves more personalised therapies where a person’s own tumour is mapped and their immune system is reprogrammed to attack the tumour. This is known as CAR-T therapy.

This new Israeli treatment is being promoted by a company, Accelerated Evolution Biotechnologies and uses a somewhat similar principle to CAR-T therapy. The therapy known as MuTaTo, again takes an individual tumour, assesses the variety of receptors on the surface of the tumour and uses small clusters of amino acids, known as peptides to bind to these receptors, allowing a protein toxin to then enter the cancer cell killing the tumour. With treatment such as chemotherapy or immunotherapy, these treatments specifically target either an enzyme system within the cancer cell or in the case of immunotherapy, typically targets receptors on the surface of cancer. This makes the cancer more recognisable by the immune system but this can often lead to resistance to therapy.

The function of every living organism is to survive and cancer cells are no different. When medical therapy attacks cancer it will, at times, rapidly develop resistance to the therapy and the cancer will recur. This Israeli company is suggesting that their new therapy targets multiple receptors on the cancer cell, which prevents these cells from developing resistance to the treatment. Before any resistance can occur, the toxic protein that is tagged to the small peptide therapy kills the cells without recurrence. To date, this has worked in cancer cells in the laboratory and in experimental mice without any side effects whatsoever but has not been trialled in humans. This therapy does appear extremely promising but unfortunately I have heard these claims in the past, which did not translate into a human cure for cancer. I certainly hope that in this case I am completely wrong.

 

Pill testing: My response to an article in The Australian

Thursday, January 31, 2019

Over the Christmas break, the subject of pill testing has been paramount because of the increasing deaths occurring during the numerous dance festivals happening over this period. I mentioned in my last article on the subject a few weeks ago that I had no issues with pill testing, as long as it has been shown to save lives (which does appear to be the case from preliminary evidence from Europe) but there is no doubt that the use of illegal drugs, even if they have been tested for impurities, still have the capability of leading to death in predisposed individuals.

It is also obvious that the vast majority of people do not die acutely from the use of illegal drugs, so what’s the issue? Why not let human beings experiment with any drugs, legal or illegal, without placing such harsh restrictions and risk of the occasional adverse health event and rare death?

An article in The Australian, Monday 28 January 2019 titled “Dancing with the Devil” examined this issue. It made the very disturbing observation (in my view) when interviewing Australians who used ecstasy and other stimulants that 40% have used cannabis in the past month, 30% alcohol and just under 20% Ecstasy with less than 5% cocaine.

With this extremely frequent use of these variety of substances, it is very important to ask the question (which was not mentioned once in this article): what are these substances doing to people’s health in the long term?

We clearly know the statistics for the long-term use of cigarette smoking and alcohol because of the legality and the fact that they have been around for hundreds of years. But the evidence is now accumulating about the deleterious effects of the chronic use of illegal drugs.

There is already widespread knowledge about the devastating effects of heroin and crystal meth addiction i.e. ice, but there is less publicity given to the chronic effects of cannabis, ecstasy and cocaine. As seen from this article in The Australian, regular users of drugs are not occasional users and there are a number of studies that are our emerging suggesting chronic changes in brain structure, mental health issues, along with increasing risk for chronic medical conditions such as cardiovascular disease.

A recent very disturbing study looked at the link between very occasional use of marijuana by age 14 and its associated effect on teen brain volume. The study performed brain scans on 46 children who reported marijuana use on only one or two occasions by age 14, showing significant differences in parts of the brain associated with fear, anger and other negative emotions, along with areas of the brain important for memory development and spatial abilities.

The young brain is obviously developing to be able to cope and deal with adult responsibilities and life. It is my strong feeling from all the evidence that with increasing use of all the illegal substances I have mentioned, even falling short of heroin & ice, we will be seeing a large population of people, as they age, developing a variety of mental illnesses and premature dementia as a consequence of some of the bad habits developed earlier on in life. Human beings have been using mind altering substances for as long as they have been available, either legal or illegal, but that does not justify normalising this behaviour or condoning it. As I often state, the best treatment of any condition is prevention. Unfortunately you can’t put an old head on young shoulders.

 

Prolonging life or extending suffering and death?

Thursday, January 24, 2019

With the recent political rumblings about the aged care sector, along with the Royal Commission into this sector about to commence, I thought I’d repeat my comments around this entire issue. Firstly, without a radical rethink of the entire aged care subject, nothing will change, regardless of a Royal Commission or grand standing by any political party on this issue.

It is my opinion that the current function of aged care is to make huge amounts of money for the people running aged care institutions and not specifically for the recipients of this care, which it definitely should be. This is precisely the reason the Federal government is starting the Royal Commission. For too long, companies and financial consultants involved in the aged care sector have been making enormous amounts of money by draining the limited coffers of vulnerable people, who need some form of supervised care once they age.

Even more independent people living in retirement villages are often charged exorbitant amounts of money for the privilege, gradually draining their children’s inheritance. We have seen the horrendous behaviour of the banks affecting many unsuspecting people living in this country, even charging people who are no longer alive. Suffice to say, it’s my view that the aged care sector is no better.

This brings us to the rather thorny topic of end-of-life care. The aged care sector is, of course, divided into many areas with one of the most contentious issues being high dependency nursing homes for people who are, typically, towards the end of their life.

For anyone who has visited or been involved in this level of care for very dependent and often very ill people, these institutions leave a lot to be desired. I am not criticising the hard-working staff, who in the vast majority of cases are very dedicated, caring people, who do offer comfort to people in this miserable situation. What I am criticising is the entire philosophy behind this aspect of aged care. As a doctor with 40 years’ experience, I think it’s important that we prolong everyone’s life but no one’s death. Any sensible doctor knows when a person has entered the death phase. This is where someone has end-stage Alzheimer’s disease, where they cannot recognise their loved ones; a person with terminal cancer; a severe disabling stroke; a chronic end-stage neurologic condition, such as motor neuron disease, where a person is wheelchair bound finding it difficult to breathe or swallow or some other severe disabling chronic condition from which there is no recovery but certainly ongoing misery.

With any of these above conditions, a common practice these days is that when someone gets sick with an acute infection, they’re filled to the eyeballs with antibiotics rather than allowing the person to pass on naturally without any intervention, thus ending their misery. The other day I was driving past one of these facilities and saw an emergency ambulance in the driveway. In my view, there is no such thing as a medical emergency in a high dependency nursing home!

I saw a patient the other day in my practice whose husband (who is not my patient) fits this criteria but is still being administered cholesterol lowering pills, blood pressure treatment and blood thinning agents. It is time that the medical profession and relatives of people in these situations worked together to make the decision to end the person’s suffering as quickly as possible. I am not suggesting these people should be euthanised but am suggesting that chronic therapy for conditions such as high cholesterol, hypertension or blood thinning be stopped and the only therapy the person be administered is pain relief and sedation.

Regular morphine for these “death phase” cases takes away the terror of death and hastens the inevitable. It is my opinion that the average stay in one of these high dependency nursing homes should be, at most, less than a month, rather than the months to years that some people endure until their inevitable death. Surely the job of any good doctor is to relieve suffering. In my view, the obvious suffering of languishing in a nursing home for months to years is unacceptable and society as a whole needs a complete rethink on this issue.

 

The 5 keys to good health

Thursday, January 17, 2019

Now that our New Year’s resolutions have been firmly forgotten, only to be dusted off and brought out in another 12 months, we are now either back at work or gearing up for the start of the working year.

Just as we’re not particularly good with following New Year’s resolutions, human beings aren’t particularly good with all forms of compliance. To give you an example, if I start therapy in a group of patients, such as a particular medication, around 50% have stopped that therapy after 12 months. When I see these people in follow-up and ask them why, I received various answers, such as: “I ran out and didn’t get round to obtaining another script”; “I didn’t feel any different, so I stopped; I thought they were giving me side-effects so I thought it better that I didn’t take them anymore”; “I thought I was only on one course of pills and didn’t realise I had to take them indefinitely” etc. etc.

What most of us fail to realise, as far as our health goes, is that most forms of medications prescribed by doctors on a chronic basis typically reduce your risk for the disease by somewhere between 20% to 30%. It may come as some surprise for you to realise that following healthy lifestyle principles reduces your risks for all modern diseases, somewhere between 70% to 80%. I’ve included below a schematic that summarises these healthy lifestyle principles.

Two recently released studies have reinforced the importance of lifestyle. The first, published in the Journal of the American College of Cardiology followed just under 4,000 individuals living in Spain, as part of the Progression of early subclinical Atherosclerosis Study (PESA). Atherosclerosis is the progressive build up of fats, calcium and inflammatory tissue in the walls of arteries, which is the precursor to a heart attack and a stroke. 

This study used a device that monitors sleep for a period of seven days and found that those people who slept less than six hours every night had a 27% increased risk for atherosclerosis, when compared with those people who had the recommended seven to eight hours of sleep per night. Also, individuals who have poor quality sleep (for example, waking often during the night) had an increased risk of Atherosclerosis by 34%. Interestingly, the study also showed that people who slept for more than eight hours per night, especially women, had a high risk of atherosclerosis as well.

The second study appearing in The European Heart Journal looked at the vital importance of physical activity. This study looked at the cardio respiratory fitness of just over 4,500 people as part of a health survey known as HUNT3. All these participants were healthy with no history of pre-existing disease. Around 50% were women and 80% were deemed to be at low risk for developing cardiovascular disease over a 10-year period. At the end of the study period, 147 people suffered heart attacks or some form of coronary artery disease and the study clearly showed that those in the top 25% of fitness compared with those in the lowest 25% had half the number of cardiovascular events.

It is a great pity that only 50% of the Australian population performs any exercise and only 25% of the population performs the recommended amount of exercise, which is somewhere between three to five hours of moderate exercise every week. A study performed a few years ago known as the MORGEN trial demonstrated an 83% reduction in cardiovascular disease in those people who were the best compliers to healthy lifestyle principles.

How many times do health professionals have to stress the importance of lifestyle as opposed to much less effective medical therapy before human beings start to take on this advice? I have been practising medicine for over 40 years and the patients in my practice who do the best, despite whether I identify them at high risk or low risk for cardiovascular disease are those who firstly pick the right relatives i.e. have good genes but also follow these healthy lifestyle principles.

If I have deemed it necessary that they also take medications, whether they be orthodox pills or complementary therapies, being compliant with these treatments offers an added bonus to lifestyle. But what I’m asking you to do is to take the message into the New Year that “Lifestyle is king and always will be”.

 

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Opinion: Media Watch needs to get its medical facts straight

5 major factors that make your ticker stop ticking

Frailty - all you need to know

Myth - Calcium is essential to prevent osteoporosis

It’s extraordinary what humans will put into their bodies

Hospital complications a leading cause of death

Opinion: Solving earth's overpopulation dilemma

What causes autoimmune disease?

Should medical cannabis be legalised?

Myth: Warfarin is a poison

Is it possible to slow, stop or reverse ageing?

Is there real science behind complementary medicine?

Myth - All milk is the same

Tips for keeping healthy over the Christmas break

Myth - all alcohol is equal

The case for compassionate medicine

Heart disease – is it reversible?

Exercise - is more better?

Depression: Is it just a brain disorder?

Is healthy eating always good for you?

Myth - An elevated PSA always means cancer

Choosing wisely

How long can we really live?

Low fat is dead

Sudden death - can it be prevented?

New study another nail in the coffin for E-cigarettes

Alcohol - is it all bad?

Breast cancer: What hurts and what helps

Overdiagnosis and overtreatment

Thinking - your brain needs it!

Can air pollution increase the risk of dementia?

Prevention is better than cure

Contraceptive Microchip

Weight loss - is it all about calories?

Is low dose alcohol safe?

Aspirin for all?

Can you die of a broken heart?

3 common myths about Fibromyalgia

Statin use in older people

Doctors warned about using the word pain

Euthanasia and compassionate medicine

Are hospitals always the safest place to be?

The death of general practice

Non-alcoholic fatty liver disease

Strokecheck: does it cause more harm than good?

4 good reasons to eat your fruit and veggies

Eating ourselves to death

How do you find Doctor Right?

Myth: BPA free is a safer alternative

Medical myth: Having a life purpose is a delusion

Is there any basis for Hanson's vaccination comments?

Myth: Contraception is only for women

Medicare: our God-given right?

The dangers of overcooking your food

Myth: you can’t teach an old drug new tricks

Does an aspirin a day keep the doc away?

Diet v non-diet soft drinks

Be a health nut

Blame Mary Jane