The way to a healthier tomorrow 2008

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  • Lab values out of control…..Glucose in the 400-500’s, ….After determining why she was here I stopped and asked if she knew what caused her diabetes….and how her dit was…
  • The faucet of preventable disease is overflowing on the floor and as we respond with an acute care, emergent response very few people are reaching for the faucet.
  • Modifiable behavioral risk factors are leading causes of mortality in the United States. (JAMA, 2000 Mokdad et al. CDC)
  • Modifiable behavioral risk factors are leading causes of mortality in the United States. (JAMA, 2000 Mokdad et al. CDC)
  • --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/obesity.pdf --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/obesity.htm
  • --http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/pdf/obesity.pdf
  • http://www.cdc.gov/diabetes/statistics/incidence/fig1.htm
  • --http://www.ncbi.nlm.nih.gov/pubmed/12679416-- --http://www.chrp.org/pdf/HSR10_08_04.pdf --http://www.nchc.org/facts/cost.shtml --Catlin, A, C. Cowan, S. Heffler, et al, "National Health Spending in 2005." Health Affairs 26:1 (2006): 142-153. --Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006. -- http://www.mathematica-mpr.com/health/ --http://aspe.hhs.gov/health/NDAP/NDAP04.pdf
  • All prices from pharmacychecker.com Generics selected for pricing purposes All values based on recc. Therapeutic use
  • -- 6/22/02 radio address :Americans who are obese spend approximately 36 percent more on health care services than the general population. They spend 77 percent more on medications. --Catlin, A, C. Cowan, S. Heffler, et al, "National Health Spending in 2005." Health Affairs 26:1 (2006): 142-153.2.Borger, C., et al., "Health Spending Projections Through 2015: Changes on the Horizon," Health Affairs Web Exclusive W61: 22 February 2006. -- http://www.mathematica-mpr.com/health/ --http://www.nchc.org/facts/cost.shtml
  • http://www.who.int/research/en/
  • --http://findarticles.com/p/articles/mi_m0795/is_n4_v15/ai_15868836/pg_2 -- our of the six countries have 2.2-3.1 physicians per capita, and the other two (Japan, United Kingdom) have roughly 1.5 physicians per capita. This compares with 2.3 per capita in the United States. However, the specialty distribution of physicians is strikingly different between the United States and the other countries. In the United States, only about 33 percent of all physicians declare themselves to be primary care physicians (Politzer et al., 1991). This contrasts with the other countries, which have predominantly primary care physicians (53-63 percent) (Chaulk and Bialek, 1993; Rodwin et al., 1990; Fielding and Pierre-Jean, 1993; McAuley, 1992).
  • --http://www.who.int/whr/en/ -- (behind such notables as Oman, Saudia Arabia, Portugal etc.)
  • --http://www.healthierus.gov/STEPS/summit/prevportfolio/power/index.html#we --1in 4 health care dollars spent to treat HTN, Obesity, High lipids and diabetes
  • We are all painfully aware of the ongoing challenges in our economy; the subprime mortgage market, job losses, questionable solvency of the SSA, and even fortune 500 companies suffering from excess costs and reduced margins. In fact according to Business week, the only new job market has been the industrial medical complex.
  • --How did folks like JW get into such straits?
  • -- President’s Address on 6/22/02 :Americans who are obese spend approximately 36 percent more on health care services than the general population. They spend 77 percent more on medications.
  • -- http://www.ers.usda.gov/briefing/consumption/Effects.htm
  • --IOM rec on Na: AI 1.5g/d UL 2.3g/d --http://www.cspinet.org/ --http://www.ama-assn.org/ama/pub/category/16461.html -- http://www.iom.edu/?id=18495&redirect=0 -- Dr. Heikki Karppanen of the University of Helsinki and Dr. Eero Mervaala of the University of Kuopio report that an average 30-35 % reduction in salt intake during 30 years in Finland was associated with a dramatic 75 % to 80 % decrease in both stroke and coronary heart disease mortality in the population under 65 years. During the same period the life expectancy of both male and female Finns increased by 6 to 7 years.The most powerful explaining factor for the favorable changes was the more than 10 mmHg ("point") decrease in the average blood pressure of the population. A marked decrease in the average cholesterol levels of the population also remarkably contributed to the decrease of heart diseases. The extensive use of drugs contributed less than 10 % of the observed decreases in blood pressure, cholesterol, and cardiovascular diseases. -- http://www.iom.edu/Object.File/Master/20/004/0.pdf http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5140
  • --http://www.ers.usda.gov/publications/foodreview/jan1996/frjan96a.pdf
  • --Or as Dr. Goldhamer likes to say…that is a lot of Cow Puss Folks
  • ---- http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/obesity.htm -- http://www.ers.usda.gov/briefing/consumption/Effects.htm -- http://www.agmrc.org/agmrc/markets/Food/foodconsumptiontrends.htm
  • -- http://www.cdc.gov/nccdphp/dnpa/physical/index.htm -- http://www.cnn.com/2003/HEALTH/diet.fitness/08/15/cdc.exercise.ap/
  • Remember that an av. Inc. in caloric intake of 500KCal/day results in an av. weight gain of 1lb per week
  • 6/22/02 radio address :Americans who are obese spend approximately 36 percent more on health care services than the general population. They spend 77 percent more on medications.
  • -- http://www.cdc.gov/nccdphp/publications/factsheets/Prevention/obesity.htm --http://www.nhlbi.nih.gov/health/prof/heart/hbp/salt_upd.pdf --http://www.nhlbi.nih.gov/health/prof/heart/hbp/salt_upd.pdf --http://www.usatoday.com/news/health/2008-02-10-salt-dangers_N.htm -- Intersalt Cooperative Research Group (1988). Intersalt: an international study of electrolyte excretion and blood pressure. Results for 24 hour urinary sodium and potassium excretion. BMJ . 297 : 319–328. --The contradictory nature of these findings accords with the unreliability of the methods used in NHANES III and IV (ie, 24-h dietary recall). Twenty-four-hour urinary sodium from complete urine samples is the only accurate way to estimate dietary salt intake, and this was not measured in NHANES III and IV. The large international study—INTERSALT, 2 which had 24-h urinary sodium and BP measured, showed that salt intake is directly associated with BP and the increase in BP with age in more than 10,000 individuals including both hypertensives and normotensives. -- -- http://www.nhlbi.nih.gov/new/press/nov30a99.htm -- Healthy adults living in a temperate climate can maintain a normal sodium balance with as little as 115 mg of dietary sodium per day. In consideration of the wide variation in Americans’ physical activity and climatic exposure, a safe minimum of 500 mg of sodium per day has been recommended. -- Dr. Heikki Karppanen of the University of Helsinki and Dr. Eero Mervaala of the University of Kuopio report that an average 30-35 % reduction in salt intake during 30 years in Finland was associated with a dramatic 75 % to 80 % decrease in both stroke and coronary heart disease mortality in the population under 65 years. During the same period the life expectancy of both male and female Finns increased by 6 to 7 years.The most powerful explaining factor for the favorable changes was the more than 10 mmHg ("point") decrease in the average blood pressure of the population. A marked decrease in the average cholesterol levels of the population also remarkably contributed to the decrease of heart diseases. The extensive use of drugs contributed less than 10 % of the observed decreases in blood pressure, cholesterol, and cardiovascular diseases. -- http://www.iom.edu/Object.File/Master/20/004/0.pdf http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=3&tax_subject=256&topic_id=1342&level3_id=5140
  • ---http://win.niddk.nih.gov/publications/energize.htm --http://www.ama-assn.org/ama/pub/category/17091.html --http://www.cdc.gov/nccdphp/dnpa/physical/index.htm --http://www.americanheart.org/presenter.jhtml?identifier=1200009 --http://www.fns.usda.gov/eatsmartplayhardhealthylifestyle/ --http://www.fda.gov/hearthealth/lifestyles/lifestyles.html --http://www.who.int/topics/obesity/en/
  • -- Bull World Health Organ. 2002;80(12):952-8. Epub 2003 Jan 23. Chopra M et al
  • --There is unanimous agreement that meaningful lifestyle change must be at the heart of re-0birth for our nation.
  • The famed German Fr. Sebastian Kneipp who was purported to have cured himself of tuberculosis through daily water treatments
  • --Dean Ornnish MD PRI --Neal Barnard MD PCRM
  • The Tipping Point Malcolm Gladwell
  • John Knowlwes, Science as quoted in K Pelletiet.

Transcript

  • 1. A Presentation at NationalHealth Association Annual Conference 2008 Stephan Esser MD www.esserhealth.com
  • 2. Natural Hygiene 2008 Leading the way to a healthier America! Stephan Esser M.D 07.20.08
  • 3. Goals• Take you to the past• Explore the present• So we can shape the future
  • 4. Or……….• Present a Problem• Discuss the Solution• Offer you a Challenge
  • 5. Key Concepts• How is healthcare in America?• How did we get here?• What does the future hold?• How can we make a difference?
  • 6. Julia Watkins34 y/o Obese AAF• DM2, Hyperlipidemia, HTN, Claudication, Peripheral Neuropathies, Lower Back Pain, Depression• Medx: HCTZ, Lisinopril, ASA, Insulin L/Novo, Glipizide, Lipitor, Plavix Cilostazol, Gabapentin,Tylenol prn, Prozac, Prilosec,
  • 7. US Healthcare Today!
  • 8. In America Today • We spend too much • We apply too little to prevention • We die by our knives and forks
  • 9. Leading Causes of Death in US
  • 10. Actual Causes of Death in US
  • 11. Associated Pathology JW • CVD: • Obtstetrics: – Hypertension – Gestational DM – Congestive Heart Failure – Macrosomia – PVD – Inc. C Section rate – Impotence – Inc. Perinatal Morbidity • DIABETES – Claudication Endocrine: – Diabetes • – Inc. Pre/Eclampsia Cancer: – Prostate – PCOS – Colon – Hypothyroidism – Breast – Infertility – Endometrial • Orthopedics: – Renal Cell – Osteoarthritis – Gallbladder – AVN – Esophageal Adeno. • Hepatic: • Other: – #1 cause of liver dz in US • Hyperuricemia, Pancreatitis, Gallstones, Sleep Apnea, Alzheimer’s, Dyslipidemia, Metabolic Syndrome
  • 12. Overweight ↑ risk of DM2 by 3 foldObesity ↑ risk by 9 fold
  • 13. Diabetes is the #1 cause of…. – Kidney Failure – Amputation – Blindness
  • 14. Cost to the Nation• Over 20.8 million Americans have diabetes (CDC 2005).• Healthcare is 2-3 times that of those without DM(WHO)• Projected $156 billion by 2010 and $192 billion in 2020• Perspective• Cost of DM2 care in 2005 > budget of the D. of Ed.• Diabetes care is 12 percent of the total federal health care spending nationwide—roughly one of every eight dollars.
  • 15. JW’s Monthly Drug costs• Hctz $19 QD• Lisinopril $26.14 QD• Januvia $75 QD• Glipizide $13.80 BID • Cost: $394.04• Asa $7.96 QD• Lipitor $19.80 QD Cilostazol $50 BID Plavix $33.3 QD • # Pills/day: >15• Gabapentin $66.95 TID• Tylenol $1.00 prn• Prozac $44.49 QD • Annual Cost:• Prilosec $45.90 QD >$4800
  • 16. Total Healthcare Spending • $2.3 TRILLION in 2007, or $7,600 per person • 16% of the gross domestic product (GDP) • Projected to exceed $4 TRILLION by 2015
  • 17. Chart of Spending-2 times as much as Canada -3 times as much as Britain - > 60% privately funded
  • 18. • Spend more per capita than any other country on earth• U.S. is 37th in the global health rankings
  • 19. Financial Expenditures• Chronic Dz ≈ 75% of health care costs – Acc. to Dept of HHS: • CVD and CVA $351.8 billion (2003) • Cancer $171.6 billion (2002) • Diabetes $132 billion (2002) • Obesity $117 billion (2000) • Arthritis $82 billion (1995) • Smoking DMC $75 billion LP $80 billion • Physical Inactivity $76 billion (2000) • Poor Nutrition DMC $33 billion LP $9 billion
  • 20. Economic Woes
  • 21. We spend more yetwe are one of the sickest most obese over-medicatedsocieties on Earth!
  • 22. How did this happen?
  • 23. Genetic Shift or LifestyleChoices?
  • 24. ↑39%Av. of 52 tsp added sugar/person/day in 2000
  • 25. •IOM: (UL) for salt is 5.8 g/day > 95 percent US Males 31 - 50 > 75 percent of US females 31- 50 regularly in excess of the UL.
  • 26. ↑66%
  • 27. ↑57 lb/capita
  • 28. ↑400%
  • 29. 60% ↓ insweetenersVegetables 10%↑ in4×’s↑dark green/yellowveggies 3 ×’s ↑dry beans, peas and lentils ↑ 114-150% in fruit 36% ↓ in total fat
  • 30. What about Exercise?
  • 31. US Gov. Reccomendations 30 minutes/day 30 minutes per day for 4-5 days a week 4-6 days/week
  • 32. Perspective • We eat more – Sugar, Salt, Meat, Dairy, Fat – 1970-2000: • ↑ 24.5 % C/day ≈ 530K/day • We get far less then ideal – Exercise
  • 33. Wehave a problem of epidemic proportions!
  • 34. What is the answer?
  • 35. What if……….. …….we ate MORE fruits,vegetables,whole grains and legumes…. ………we ate l e s s meat, fish, dairy, eggs, oil, sugar and salt & increased our exercise habits!
  • 36. Some Say……. – If 10% of adults began a regular walking program, $5.6 billion in heart disease costs could be saved. – If Americans↓ Na intake by 2300mg/day = 3-6 mm Hg ↓ in SBP • 11 % ↓ strokes • 7 % ↓ coronary events • 5 % ↓ total mortality
  • 37. “A global response to aglobal problem: the epidemic of overnutrition.” WHO 2002 It is estimated that by 2020 2/3 rds of the global burden of disease will be attributable to chronic noncommunicablediseases, most of them strongly associated with diet. The nutrition transition towards refined foods, foods of animal origin, and increased fats plays a major role in the current global epidemics of obesity, diabetes and cardiovascular diseases, among other noncommunicable conditions. Sedentary lifestyles and the use of tobacco are also significant risk factors. …….. A concertedmulti-sectoral approach, involving the use of policy, educationand trade mechanisms, is necessary to address these matters.
  • 38. All Major Health Institutions• Encourage: – Inc. Consumption of Fruit and Vegetables – Inc. Fiber Intake – Inc. Exercise – Weight Loss – Reduce Salt intake – Reduce Fat Intake – Reduce Cholesterol Intake – Effective Stress Management
  • 39. Who does that sound like?
  • 40. Natural Hygiene
  • 41. Basic Tenets• Plant Based Diet• Exercise• Sleep• Emotional Poise• Sunlight• Clean Water and Air
  • 42. Heritage
  • 43. Our Message
  • 44. “Let food be thy medicine” -Hippocrates-
  • 45. Fr. Sebastian Kneipp 1821-1897“The Waßer Cure”
  • 46. Dr William Andrus Alcott 1798 - 1859•Co-founder of AmericanPhysiological Society•Major force behind AmericanVegetarian Society
  • 47. Dr Isaac Jennings MD 1788-1874 • Father of “Orthopathy” • Father of Natural Hygiene?
  • 48. Dr. Russell Thacker Trall MD 1812 - 1877• American Vegetarian Society• The True Healing Art or Hygienic vs. Drug Medicine Smithsonian Address 1862
  • 49. Dr Henry Lindlahr 1862-1924• Nature Cure• “No Surgery, No Drugs, No Serums.”• Vegetarian diet, sunbaths, airbaths, exercise, hydrotherapy, and manipulation.
  • 50. Bernarr McFadden 1868-1955 • The Father of “Physical Culture”
  • 51. John H Tilden 1851 - 1940
  • 52. Jack TroppWilliam Esser ND DC Carlos Arguello Sr
  • 53. Dr David Katz MD Dr & Mrs McDougall MD Dr Neal Barnard MD Dr Walter Willett MDDr Hans Diehl DHsc MPH Dr Dean Ornish MD
  • 54. Lifestyle Medicine
  • 55. Policy-Making/P.H. Promotion
  • 56. Community Based
  • 57. Natural Hygiene• Has a rich and colorful heritage• “Trend-setters” before trend setting was popular – Before phytochemicals, Noni Juice and ORAC• ALL Hygienists!!!
  • 58. Our Mission• Educate• Empower• Motivate
  • 59. “It is time we descended from Olympus and began to address the people…. to educate them about the realities of health and disease, to teach them what they can do to helpthemselves and what we cannot do. They must be taught about the marvelous capabilities and the serious limitations of medicine.” Moser, R.H “Knowledge is not Enough.” NEJM 1977
  • 60. 2008• Need• Answer• Evidence• Obligation• Support
  • 61. Why Me?Knowledge is Power is Responsibility!
  • 62. Your Mission• Educate Change for Good• Empower• Motivate
  • 63. Who shall set a limit to the influence of a human being Ralph Waldo Emerson
  • 64. Tipping Point• Create an epidemic of good health• Identify personal “Circle of Influence”• Positive, contagious behavior• Small changes have big effects• Change happens rapidly
  • 65. Lifestyle Survey!
  • 66. Let’s change the world….one life at a time! andLet’s start with ourselves today!
  • 67. You must be the change you wish to see in the world. Gandhi
  • 68. I want you to be concerned about your next door neighbor. Do you know your next door neighbor? Mother Theresa
  • 69. If you judge people, youhave no time to love them. Mother Theresa
  • 70. In this life we cannot do great things. We can only do small things with great love. Mother Theresa
  • 71. Happiness is when what you think,what you say, and what you do are in harmony. Gandhi
  • 72. A small body of determined spirits fired by an unquenchable faith intheir mission can alter the course of history. Gandhi
  • 73. Thank You !
  • 74. Natural Hygiene is for people who are looking for the good life, and not just a pretty good life, a very good life. It offers you the opportunity to live the healthiest, happiest life possible. Health Science
  • 75. “I believe the idea of a “right” to health should be replaced by that of a moral obligation to preserve one’s own health. The individual has the “right” to expecthelp with information, accessible services of good quality, and minimal financial barriers. Meanwhile the people have been led to believe that national healthinsurance, more doctors and greater use of high-cost, hospital based technologies will improve health.” John Knowles Science
  • 76. “The art of medicine consists of amusing the patient while nature cures the disease.” -- Voltaire 1694-1778 --
  • 77. Enjoy more powerpoints and educational resources at www.esserhealth.com