I am frequently astonished by some of the stories my patients tell me about their experiences with some of their other doctors. In general, my interactions and the stories I hear support the fact that most physicians truly want to help out their patients. But there are a few where they seem to have missed the boat on some medical issues, especially as they pertain to lifestyle changes and healthy habits.
Some old-school physicians still think that medications are the only way to make us healthy. What about the side effects? Wouldn't it make more sense to clean up someone's lifestyle first and if the health issue persists, then consider drugs? You would think it's common sense, but perhaps not to all.
If you can't already tell, this is a topic I am very passionate about. There is a recent New England Journal of Medicine article that helps us all -- including the skeptics about lifestyle changes -- to see that lifestyle changes are in fact beneficial for our health.
The study in the New England Journal of Medicine was a multicenter trial done in Spain where they looked at 7,447 people ages 55-80 years old with 57 percent being women. One group was assigned the Mediterranean diet with extra-virgin olive oil, and another group got the same diet with nuts. The control group also got healthy diet training and was told to eat a diet low in saturated fat, but wasn't given the Mediterranean diet guideline or additional olive oil or nuts. They were given non-food related gifts instead of olive oil or nuts.
The outcome showed that over the course of 4.8 years on the Mediterranean-style diet, patients had 30 percent decreased risk of heart disease. This clearly shows that diet is important to our overall health and our cardiovascular health.
I will relay a story about one of my patients to help you see why I am fired up about this. One of my patients in my clinic of integrative medicine in San Jose, Calif. recently told me that despite her changing her diet and exercise habits to the point where she has now lost weight and is feeling better, her primary care doctor told her that diet and lifestyle changes don't matter, that her high cholesterol requires a statin drug, that the statin drug was the only thing that would affect her heart disease risks, and that this doctor doesn't care about her healthy lifestyle changes.
This particular patient, who in my opinion is an amazing person who wants to take responsibility for her own health, had been proudly telling her primary care doctor that she had been eating a low sugar, low saturated fat diet that is mostly Mediterranean diet based, and is working out five days a week. She mentioned that she had lost weight and was feeling less tired and achy and was sleeping better. Her primary care doctor's response was that diet and exercise don't matter and that only a statin drug could help her high cholesterol and protect her heart. I was appalled when I heard this story.
Most physicians know that diet and exercise matter, we learn that even in medical school. But this concerned me, that there are still doctors out there who don't believe in a healthy lifestyle pattern and want their patients to depend heavily on drugs to be "healthy." Healthy on drugs? Is it me, or does that not sound ludicrous? I agree that medications are needed for various disease states, but healthy lifestyle changes should be the foundation of any disease state -- then, if medications are still needed, of course then that's appropriate.
I think the key here is that the patient should eat right and exercise so that she doesn't need a statin drug. Isn't that better for her overall health? If she eats right and exercises and genetically she still needs a statin drug, then so be it and I would agree with that management. But a healthy lifestyle should always be the foundation for any disease management plan between a patient and his/her doctor.
The recent New England Journal of Medicine study, published at the end of February 2013, says that diet is in fact extremely beneficial and that this patient's primary care doctor is wrong -- that diet in fact matters when it comes to heart health.
I am a firm believer that if we create a strong, healthy foundation with our lifestyle, we can age well and in a way that is much healthier. Of course we all age, and there may come a time when medications are required no matter how great our diet and exercise habits are, but shouldn't we all start with a strong foundation of healthy lifestyle first?
To me, it is ridiculous to give someone medications and say that they can just keep living the unhealthy lifestyle that got them there as long as they take the pill. It is unfortunate that we all may come across one disease state or another, but when we do, we should first make efforts in changing the unhealthy lifestyle habits that got us there. Then, when we have done that, if we still need some help with medications or supplements, then it is of course appropriate.
To say that a healthy diet and exercise lifestyle is unimportant is absolutely ludicrous when we as health care practitioners have the job of instituting health measures for our patients.
This patient's situation is interesting because now that she has incorporated these healthy lifestyle changes, her recent cholesterol and sugar tests are back to normal. When she was eating poorly and not exercising, she was having issues with both high cholesterol and high sugar. To say that her diet and exercise change made no difference is ridiculous -- clearly the labs favorably agree with the healthy glow and high energy she carries herself with now.
In my experience, if the healthy lifestyle is implemented, not only do the labs start to look great, but so does the patient. Usually, the patient has more energy, less pain, easier time with sleep, and glowing skin, just to name a few benefits.
If you are unsure what a Mediterranean diet is, I can give you some basic guidelines. But for those of you who are cooks and enjoy learning more about food, fortunately, the Internet these days is very helpful at giving you heart-healthy, Mediterranean-style recipes. Just use the key words "Mediterranean diet" and the recipe for the type of food you want to make.
In general, stay away from pre-made, processed versions of food; and the key types of foods found in the Mediterranean diet are nuts, olive oil, avocados, fresh vegetables and fruits, fish, and moderate levels of animal meats and wine. Because the studies are very favorable for plant-based diet as far as anti-inflammation goes as well, I tend to have my patients focus more on the fresh vegetables, nuts, legumes, and olive oil.
So for those patients who are amazing and making great strides in implementing a healthy lifestyle with an anti-inflammatory, Mediterranean-type diet as well as exercising regularly, if your primary care doctor tells you that's worthless, you make sure you point them to this study. Maybe this way, you'll have saved another patient in that doctor's practice for being yelled at for eating clean and exercising (ridiculous, I know).
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