New Under the Sun:
Volume 2, Issue 1
Greetings!! As we begin a new year, some of us may wish we could wipe the slate clean and start over again. However, our personal histories (good, bad, or indifferent) are what have made us who we are. It is this history that provides us with a base from which wisdom can form. And wisdom will lead us to make better choices that will allow us to live longer, healthier, and more productive lives.
Medical Students as Future Physicians: Although medical schools do a good job of providing students with high quality technical training, physician/patient interactions are frequently given little if any attention. The University of Michigan Medical School will be instituting a program Fall 2003 which should change that for the better. At the very beginning of their medical school training, first year medical students will be paired with a family in the community who has volunteered to be part of the program. Students will not provide any medical assistance or advice. Instead, for the first two years the students will shadow the family members as they utilize medical services. The students will also spend enough time with “their” families to really learn who they are and how health/disease issues affect their daily lives. The hope is that once the students actually begin delivering medical services that they will view their patients as the complex individuals they are and not as “the diabetic/hypertensive case in room 4”. That is, that patient care will be the more personalized and individualized care we know is necessary for the most beneficial and effective health outcomes.
Comment: Medical education would be much improved if all medical schools instituted a program similar to that of the University of Michigan. One way you as a health consumer can improve the chances of this happening is by contacting the Dean of your regional medical school and recommending that he/she look into this program. For further information on the program, contact Mary Beth Reilly, firstname.lastname@example.org, or Carrie Hagen, email@example.com,(734) 764-2220 at University of Michigan Health System.
Walking and Hip Fractures: Hip fractures are a serious concern for older adults. Research involving postmenopausal women enrolled in the Nurses’ Health Study found that those women who were not taking hormones but who walked daily had a lower risk of hip fractures than did those who did not exercise and did not take hormones, and the risk was reduced as hours walked increased. The risk of hip fractures for women who walked at least eight hours each week was 55% less than for those who walked less than one hour per week. This held true even after controlling for smoking, diet, body mass index, and age. Walking duration did not have the same linear effect on those women who took hormones.Feskanich D, Willett W, Colditz G. Walking and leisure-time activity and risk of hip fracture in postmenopausal women. JAMA 2002 Nov 13;288(18):2300-6.
Preventing Hip Fractures the AnthroHealth way: Walk 2 – 3 miles each day. One of the benefits of walking outside is that, depending on season and latitude, one is exposed to UVB radiation which means that one can potentially improve one’s blood level of vitamin D, thereby also improving skeletal strength. If UVB radiation exposure is inadequate, take a vitamin D supplement daily. For postmenopausal women who wish to avoid taking hormones, daily walks along with vitamin D supplementation (as appropriate) are necessary for prevention of hip fractures.
Diuretics and Hypertension: In line with the topic discussed in the book reviewed this month (see below), researchers in a major multi-year study (over 33,000 participants from 623 different health centers in North America) found that relatively inexpensive diuretics (water pills) were more effective at lowering blood pressure than were more expensive calcium channel blockers or ACE inhibitors. In addition, the diuretics resulted in far fewer side effects than was the case with the other drug treatments. But most importantly, those on diuretics actually had fewer cases of major forms of cardiovascular disease than did those taking the other, more expensive and more side-effect-prone drugs. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002 Dec 18;288(23):2981-97.
Preventing Hypertension the AnthroHealth way: Walk 2 – 3 miles each day. Eat the AnthroHealth way. See the archived issues for more details. Get 8 – 10 hours of sleep each night. If medication is necessary, discuss the ALLHAT research described above with your physician and see if using a diuretic is an adequate solution. Read the book reviewed below.
Book Review: The purpose of AnthroHealth News is to provide information that individuals can use to best tailor their lifestyle to that for which they are biologically adapted. When this has been achieved, limited or no drug therapies may be needed. For those who do need therapeutic drug intervention, OVERDOSE: The Case Against the Drug Companies by Jay S. Cohen, MD, is a must-read.
One of the key tenets of AnthroHealth is that each individual interacts with the environment in a unique manner. A heavily-pigmented man living in Seattle will have quite different health concerns from a lightly-pigmented man living in Phoenix. A 200 pound male has different health concerns and reactions to medications than does a 100 pound woman. Should a woman who is 70 years old, of petite build, and taking several medications be given the same dosage of a new medication that is given to a 25-year-old man of large, muscular build? These concerns are raised by Cohen in his well-written, enlightening, and disturbing book. Physicians know that medical treatment should be individualized, but given their time crunch, they often ignore individuality and substitute a fictitious “average” person for their actual patient. The time crunch also prevents them from being fully informed on each and every drug they prescribe. Instead, they rely on the information provided to them by the drug companies, who also provide the information for the Physician’s Desk Reference (PDR).
The goal of the drug companies is to maximize profits while they hold a patent on a new drug. In order to do this, they market their drugs as one-size-fits-all and recommend the largest, effective dose. However, as any caring physician knows, individual response to drug dosage is highly variable. Therefore, it is best to start with a low dosage and gradually build the dosage if required. This methodology avoids the high rates of side effects, some of which are quite severe, even deadly, that are generated by blindly following drug company guidelines. But drug companies make this more appropriate policy extremely difficult when they manufacture their medication in only one dosage and/or in a formulation that is not readily divisible.
Cohen discusses a wide range of drugs, their side effects at standard dosages, and their effectiveness for many, or even most, individuals at significantly lower dosages. Each chapter ends with charts that provide the information in an easily-grasped format. If you are a senior, or a woman, or of small body build, or someone who has shown sensitivity or side-effect reactions to drugs, or someone who is concerned about the issue of drug side effects, then I strongly urge you to read OVERDOSE: The Case Against the Drug Companies.
AnthroHealth Tip of the Month: In line with this month’s opening comment on history and wisdom, the Tip for this month is to go to the online Archive and re-read last year’s issues of AnthroHealth News. The information presented in those issues continues to be valid and important. Re-reading it will help reinforce any behavioral changes you made in the past year and will encourage you to make renewed efforts to live the AnthroHealth way.
© 2001-2009 Kathleen E. Fuller, PhD. All rights reserved.