An Opinion on Health and a Matter of a Healthy Opinion

We live in a world of vast amounts of confusion about health. What is healthy? Does being healthy help to reduce susceptibility to death and disease? Here is a little piece of perspective on how healthy can be a matter of opinion.

Health can be thought to be on a spectrum ranging from poor health to good health. Health has lots of measurements such as blood test numbers, organ function, resistance to disease and fitness levels, to name a few. Most people do not fall into hard categories of "I am sick" or "I am healthy".

In the United States, the Center of Disease Control (CDC) compiles data on who is rather unhealthy. Here are some of their statistics: 

-42% of the population is obese. This finding is calculated by a formula using height and weight and is often referred to as Body Mass Index (BMI). Obesity begins at a rating of 30 BMI. Obesity is related to heart disease, diabetes, and cancer. (1)
-45% of adults from 2017 statistics have hypertension or high blood pressure. Only about a quarter of these have it under control. The CDC considers hypertension a primary cause of death. (2)
-55% of adults are currently taking a cholesterol medication. High cholesterol is associated with heart disease and stroke. (3)
-10.5% of the US population has diabetes and another 34.5% of the population has prediabetes. Diabetes is associated with an increase in death rates. (4)
-60% of the US population has one chronic disease and 40% of the US population has more than one chronic disease. Chronic disease examples are heart disease, cancer, diabetes, and stroke. (5)

It is fair to say, if you have any of the above symptoms or medications, your health could use improvement. All of these conditions are also co-associated with other conditions on this list. For example, diabetes is associated with obesity and heart disease is associated with hypertension. The translation is that if you have one of these conditions, there is a good chance that another condition will eventually follow.

I often hear people say things to me like:

-"I did have a heart attack but I do not have heart disease."
-"I don't have diabetes anymore because I take Metformin."
-"My sugar is controlled with insulin."
-"I don't have high blood pressure because I take medication."
-"My doctor says my weight is high but other than that, I am healthy."

These little clips of rationalization above are missing at least some element of the truth. The truth being the obvious concept that there is a chronic disease present or about to be a chronic disease in the future. It is potentially better to think that the medication fixed everything. Denial does not make this go away.

Medications by definition treat a condition or disease. A physician has a role to diagnose a disease or disorder and prescribe medication. If there is no disease or condition, then there is no medication. Chronic medication implies you have a chronic disease or the early symptoms of a chronic disease. The take home point is that if you are on chronic medication, your health is suffering.

Where does this denying begin? I do believe it starts in the physician's office. A typical scenario may happen something like this:

-Blood Pressure reading of a patient of 145/95.

-Dr... Your blood pressure is high Mr. Smith. You need to be on medication.
-Patient.. Oh, but I feel fine, are you sure I need it?
-Dr... Yes, you will be fine. It is a daily prescription and your blood pressure will be normal.
-Patient... OK doctor. I guess I will be normal. thanks.

This conversation is well intended and efficient. Delivering the scary truth makes for a lot of time on a doctor's tight schedule and a lot of potential coaching. However, telling a patient they are normal again does undermine the true gravity of the patient's situation which is that they have a new medication and a diagnosis and are sicker than before. If the patient continues on the path they are on, the chance that the patient will be sicker next time is very high. The patient is not good...

It is relevant to note that medications do save lives. For example, corrected blood pressure with medication does save lives and there is plenty of science to support this. However, taking a prescription medication probably does not remove all of the risk of mortality. (6,7) More action towards health will need to be done than just taking a pill to improve health and reduce the chance of mortality.

Reversing the Problem
Having poor health is ultimately still a choice for most of us. A decision must be made to take action to improve your health. If you are unsure about what you can do, it is always safest to start the journey with conversation with your physician.
Most people can walk a little or peddle a little bit on the stationary bike with reasonably low risk. Those with joint pain can find some benefit in pools walking, swimming or doing classes. These are habits that can be formed but the truth is, they are not that easy at first.

Many problems with health are often tied to excess weight, inactivity and poor food choices. Those three items are usually what someone changes when they decide to go to the gym anyway. Losing some unwanted body weight often lowers risks and symptoms for all chronic diseases and mortality when done through better food choices and exercise.

Weight loss is highly influenced by dietary measures and often more so than physical activity. Working on a reducing a few hundred calories per day is a usual primary strategy for weight loss. Some simple ideas are replacing sweetened drinks with water or unsweetened tea, increasing vegetables and lowering some processed sugar and starchy foods.

After some results have been made on weight and fitness levels, visit your physician and get a new update on blood values, blood pressure, etc. It may be possible that your medications may need adjustments. Yes, even your medications can be negotiable. Never take it upon yourself to discontinue medications as they are there for good reason. As your health begins to improve, ask your doctor if or when a particular medication may be worth a look.
For example, I had a client that had Type 2 Diabetes. He was taking the prescription Metformin to control his blood sugar. With some changes to his diet, his weight loss, and strength improvement, his blood sugar numbers began to average just under 100. I urged him to talk to his doctor to see if the dose of Metformin could be lowered. The doctor agreed and lowered the dose. There were other medications my client was on that the doctor removed.

I had a recent conversation whereby someone in their 80's asked me if they could get stronger at their age. I told him that there is pretty convincing research that it can be done. I then explained that I have personally done it many times. With a more advanced age there is still an ability to double or triple strength but I am not sure you will see any bench presses over 500lbs anytime soon. Most seniors just want to be able to walk well and keep their independence. Avoiding extra doctor visits are also on that list. The oldest client I ever trained was 90 and he continued untill he has was 95. He asked me if it was possible to actually walk 18 holes at his age, so we set a goal. A few months later, he did walk those 18 holes...

References
1) Adult Obesity Facts. (2020, February 27). Retrieved June 1, 2020, from https://www.cdc.gov/obesity/data/adult.html
2) Facts About Hypertension. (2020, February 25). Retrieved June 1, 2020, from https://www.cdc.gov/bloodpressure/facts.htm
3) High Cholesterol Facts. (2020, April 2). Retrieved June 1, 2020, from https://www.cdc.gov/cholesterol/facts.htm
4) National Diabetes Statistics Report. (2020, February 14). Retrieved June 1, 2020, from https://www.cdc.gov/diabetes/data/statistics/statistics-report.html
5) Chronic Diseases in America. (2019, October 23). Retrieved June 1, 2020, from https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
6) Andersson, O. K., Almgren, T., Persson, B., Samuelsson, O., Hedner, T., & Wilhelmsen, L. (1998). Survival in treated hypertension: follow up study after two decades. Bmj, 317(7152), 167–171. doi: 10.1136/bmj.317.7152.167
7) Asayama, K., Satoh, M., Murakami, Y., Ohkubo, T., Nagasawa, S. Y., Tsuji, I., Nakayama, T., Okayama, A., Miura, K., Imai, Y., Ueshima, H., Okamura, T., & Evidence for Cardiovascular Prevention From Observational Cohorts in Japan (EPOCH-JAPAN) Research Group (2014). Cardiovascular risk with and without antihypertensive drug treatment in the Japanese general population: participant-level meta-analysis. Hypertension (Dallas, Tex. : 1979), 63(6), 1189–1197. https://doi.org/10.1161/HYPERTENSIONAHA.113.03206