In this series we explore ways medical science, and modern medicine and lifestyles have taken us to an unhealthy extreme—and what alternatives and solutions may exist.
It’s no secret that mainstream medicine in the United States is driven by money, though fewer know it’s the most expensive medical system in the world despite some of the highest per capita government funding.
Nor is it a secret that many, perhaps most, Americans are overweight, not exercising, and not in good health. So it comes as no surprise that expensive surgeries, procedures, and pills are often suggested to patients for medical problems related to unfitness, when simple lifestyle changes could work just as well—and usually better.
Obesity, poor food choices, smoking, alcohol consumption, and lack of exercise contribute to everything from cardiovascular disease and clogged arteries to diabetes, chronic pain, and depression—yet patients are seldom counseled about lifestyle changes to correct their medical conditions. And while insurance can help supply them with drugs or surgery, getting a personal trainer or nutritionist is another matter entirely.
Avoidable Heart Conditions
Heart disease is the
leading cause of death in the United States, even though 90 percent of it is preventable through lifestyle,
according to the Cleveland Clinic. Coronary bypass operations, which began in 1968, and stents, the use of which began in the mid-1980s, have become immensely popular—even a “rite of passage” for those considered at risk of a heart attack.
Yet, 2020 research
published in the New England Journal of Medicine found neither procedure is better at reducing the risk for heart attack and death in stable ischemic heart disease than lifestyle changes, along with medication. The lifestyle treatments included patient counseling about diet and exercise, and medications for blood pressure, cholesterol, and angina.
“Taken together, the quality of life and clinical results suggest that there is no need for invasive procedures in patients without symptoms,” said Dr. David Maron, the study’s lead author. “For those with angina, our results show it is just as safe to begin treating with medication and lifestyle change, and then if symptoms persist, discuss invasive treatment options.”
Dr. Joel Kahn, a cardiologist,
said the study “should lead to a major reduction in the number of stents and bypass surgeries performed,” adding that the results confirm the lifestyle medicine work of Dr. Dean Ornish.
Dr. Monica Aggarwal, director of the Integrative and Preventive Cardiology Program at the University of Florida and a
fellow of the American College of Cardiology, also
lauded the research.
“Many of us [cardiologists] who practice more conservatively believe that lifestyle modification and medications are better than [surgical] intervention, and this trial gave us validated information,” she said.
The Trouble With Diabetes Drugs
More than 37 million Americans have diabetes,
according to the Centers for Disease Control and Prevention—1 in 10 people. And yet, it’s 90 percent avoidable with adequate lifestyle changes, according to research published in the
Archives of Internal Medicine in 2009.
Newer diabetes drugs have made a huge splash on Wall Street because of the legions of diabetics and how long the drugs are taken—but some now appear to be risky.
For example, Steglatro (ertugliflozin) “may increase your risk of lower leg amputation, especially if you have had a prior amputation, a foot ulcer, heart disease, circulation problems, or nerve damage,”
according to Drugs.com. Glyxambi (empagliflozin and linagliptin) has been
linked to heart failure, Fournier’s gangrene, bullous pemphigoid, diabetic ketoacidosis, and pancreas inflammation. Sulfonylureas, one of the oldest classes of diabetes drugs, are now linked to heart attacks and heart issues, the
National Center for Health Research says.
The good news is that lifestyle changes can enable people with Type 2 diabetes to avoid medications.
The
2009 study found that getting enough exercise, eating a healthy diet, not smoking, drinking little alcohol, and maintaining a healthy body weight could prevent diabetes, and doing the opposite could lead to diabetes.
“Overall, 9 of 10 new cases of diabetes appeared to be attributable to these 5 lifestyle factors,” it concluded.
When it comes to blood sugar, exercise can be particularly important.
“When you exercise, your muscles use sugar (glucose) for energy. Regular physical activity also helps your body use insulin more efficiently,” the Mayo Clinic
notes.
When Drugs Undermine Better Habits
Statins and proton pump inhibitors changed thinking about diet and exercise for the worse.
Cholesterol-lowering statins such as Lipitor, the most successful drug class in pharmaceutical history, promised people they could ignore diet and exercise concerns, and their body would “
forgive” the bacon cheeseburger.
According to the
Mayo Clinic, statins can lower cholesterol in people with high cholesterol, reducing their chances of having a stroke or heart attack, but the drugs aren’t risk-free and can interfere with the body’s necessary supply of cholesterol. These drugs can cause muscle pain, liver damage, Type 2 diabetes, increased blood sugar, and cognitive problems such as memory loss and confusion—side effects that were underreported during statins’ heyday.
Researchers writing in
Drug Safety—Case Reports in 2016 noted correlations between statin use and violent ideation, irritability, depression, and even suicide. The problems resolved when the statins were discontinued but reoccurred when the drugs were started again—strengthening the hypothesis that the mood problems were linked to the drug.
Proton pump inhibitors (PPIs), which are
medications that reduce stomach acid production and largely replaced antacids and the related H2-receptor
antagonists, were developed in the 1980s and also became instant bestsellers. Like so many medications advertised on television, PPIs are overprescribed and overused, according to medical sources, and can have
significant side effects, especially after long-term use. Effects can be intestinal, such as nausea and diarrhea; mood-related, such as anxiety; or muscular, such as serious rhabdomyolysis.
Long-term use of PPIs can interfere with mineral absorption and could cause
bone fractures, a warning that the Food and Drug Administration has added to the drugs’ labels. The medications can also put users at
risk of the intestinal condition Clostridioides difficile (commonly called “C. diff.”), spontaneous bacterial peritonitis, bacterial or fungal overgrowth, cardiovascular problems, and possibly pneumonia.
From a lifestyle perspective, PPIs, like statins, “forgive” unhealthy eating by removing the unpleasant consequences and may discourage patients from pursuing better nutritional choices that wouldn’t necessitate the drugs.
Worse, the drugs can make a patient dependent on them, notes an article in
The Pharmaceutical Journal by Daniel Marks, a clinical pharmacologist at University College London Hospital.
“Once a patient has taken a PPI for longer than a few weeks, acid hypersecretion can occur on discontinuation. This causes rebound symptoms, and frequently establishes a vicious cycle of drug reinitiation and long-term continuation,” Marks writes.
Chronic Pain Can Be Addressed Without Drugs
As many as 20
percent of U.S. adults suffer from chronic pain conditions such as low back and neck pain, pinched nerves, spinal disorders, and more. They are often targeted with dangerous and addictive opioids and expensive procedures such as spinal fusion, disc surgery, and nerve ablation.
While it’s understandable that pain patients want quick relief, many chronic pain treatments have poor track records. For example, failed back surgery syndrome,
defined as persistent or recurrent symptoms in someone who has had spinal surgery, is relatively common.
According to Dr. Sridhar Vasudevan, a pain specialist, opioids may do more harm than good.
“I have personally treated patients who were terrified to titrate off opioids because they were afraid of returning pain, only to find they were in less pain once off the opioids,” he writes in “Multidisciplinary
Management of Chronic Pain,” a book that offers nonsurgical, non-opioid treatments for chronic pain.
Vasudevan also cites the paradox that chronic pain patients fear and resist exercise, but exercise would usually improve their pain through strengthening their muscles, reducing their mental stress, and releasing endorphins.
He urges patients to “consider and explore the possibility that relief can be found by learning to relate to their pain, rather than running from it.”
Depression Responds to Lifestyle Change
As The Epoch Times recently
reported, the “chemical imbalance” theory of depression has been irrevocably discredited, and there’s no permanent, organic brain condition that necessitates the lifelong antidepressant usage that has been so heavily marketed.
“One interesting aspect in the studies we examined was how strong an effect adverse life events played in depression, suggesting low mood is a response to people’s lives and cannot be boiled down to a simple chemical equation.” said Dr. Mark Horowitz, co-author of the Molecular Psychiatry article that discredited the chemical imbalance theory.
Since depression develops from real-life events and not a chemical imbalance, it can also be treated by addressing such events, say non-medication-oriented health
sources. Topping the list of lifestyle changes that depressed people can contemplate are better
sleep and more exercise, followed by engaging with life and people (not isolating), pursuing pleasant experiences, taking on new responsibilities and new activities, helping others, and, of course, talk therapy.
As The Epoch Times has
reported, antidepressant use has skyrocketed, and
1 in 6 Americans now take such psychiatric drugs. These drugs aren’t harmless. In addition to “discontinuation” effects—
including anxiety, pain, palpitations, and insomnia when patients try to quit—SSRI antidepressants are also linked to
bone loss, fractures, and the same C. diff.
risks seen with PPIs. The
drugs are also linked to weight gain, sexual dysfunction, and emotional numbness.
Some Doctors and Patients Disagree
Certainly, many patients lack the willpower to change their lifestyle, and doctors know this because of how frequently they encounter noncompliance with their medical advice. Moreover, many patients may prefer the quick fix of a surgery or a procedure, rather than try to summon up discipline they might not even have.
For example, not everyone prefers exercising every day or seeing a physical therapist frequently, to the prospect of spine-related surgery.
Still, health care professionals can encourage patients and affirm their lifestyle changes, and support groups can also help patients with motivation.
Certainly, we live in a time when high-tech and expensive medical procedures can seem to work miracles. But ignoring less expensive lifestyle changes that can be equally effective doesn’t help patients—it only enriches the medical establishment.
And perhaps even more critically, if people don’t gain the insight and motivation to improve their lifestyle, many of these chronic diseases will appear at earlier and earlier ages, as we’re seeing with obesity, depression,
heart disease,
cancer,
diabetes, and more.
In other words, if our lifestyle is degenerating, it’s going to affect future generations even more severely.
