Achieve Vibrant  Health & Well-Being With T herapeutic (Wellness) L ifestyle  C hanges ©2008 by Christopher Katke
Paris   In  the   The Spring
The Burden of Common  Preventable  Chronic Diseases   <ul><li>70% to 90% of deaths from chronic illnesses in the U.S. are ...
From: “ A Potential Decline in Life Expectancy in the United States in the 21st Century” NEJM 2005; 352: 11 What does this...
 
 
From: “ Disease Management and the Organization of  Physician Practice” JAMA 2005;293:485-488 “ There is a large gap betwe...
From:  Chronic Diseases 1 “ Preventing chronic diseases - how many lives can  we save?” Lancet 2005; 366: 1578 “ A 2% impr...
From:   ACS / ADA / AHA Scientific Statement Preventing Cancer, Cardiovascular Disease, and Diabetes A common Agenda for t...
Health care costs main cause of personal bankruptcy, study finds Feb. 4, 2005 –  A study published Wednesday in the policy...
From:   ACS / ADA / AHA Scientific Statement Preventing Cancer, Cardiovascular Disease, and Diabetes A common Agenda for t...
From: “ Effectiveness of Therapeutic Lifestyle Changes  in Patients With Hypertension, Hyperlipidemia,  and/or Hyperglycem...
 
Purpose of this lecture: TO AWAKEN YOU TO THE POSSIBILITY OF A WELLNESS LIFESTYLE. To inspire to you actually make the nec...
National Cholesterol Education Program Recommends 12 weeks of “Therapeutic (Wellness) Lifestyle Changes” (TLC) as “first l...
National High Blood Pressure Education Program “ Use (Wellness) lifestyle interventions first, then drug therapy for highe...
National Health Organizations recommended  Therapeutic (Wellness) Lifestyle Changes  (TLC)  as a “first line” treatment <u...
From: “ Effectiveness of Therapeutic (Wellness) Lifestyle Changes in Patients With Hypertension, Hyperlipidemia, and/or Hy...
From: “ Effectiveness of Therapeutic Lifestyle Changes  in Patients With Hypertension, Hyperlipidemia,  and/or Hyperglycem...
From:   ACS / ADA / AHA Scientific Statement   Preventing Cancer, Cardiovascular Disease, and Diabetes A common Agenda for...
Presentation Objective Introduce the system we use to provide  Therapeutic Lifestyle Changes (TLC’s)   Our system is: <ul>...
From:    AHA / NHLBI Scientific Statement “ Diagnosis and Management of the Metabolic Syndrome”  An American Heart Associa...
From:    AHA / NHLBI Scientific Statement “ Diagnosis and Management of the Metabolic Syndrome”  An American Heart Associa...
From: “ Prevalence of the Metabolic Syndrome Defined by the International Diabetes Federation Among Adults in the U.S.” Di...
From: “ Metabolic Syndrome: Time for Action” Am Fam Physician 2004;69:2875-82, 2887-8  “ Soon metabolic syndrome will over...
From: “ Metabolic Syndrome: Time for Action” Am Fam Physician 2004;69:2875-82, 2887-8  “ All patients diagnosed with metab...
From: “ Metabolic Syndrome in Normal-Weight Americans New definition of the metabolically obese, normal weight individual ...
 
 
 
 
 
 
 
 
From: “ Effect of a low glycemic index diet with soy protein  and phytosterols on CVD risk factors in post-  menopausal wo...
  Comparing Arms  From: “ Effect of a low glycemic index diet with soy protein  and phytosterols on CVD risk factors in po...
  Triglyceride / HDL Ratio  From: “ Effect of a low glycemic index diet with soy protein  and phytosterols on CVD risk fac...
From: “ Effect of a low glycemic index diet with soy protein  and phytosterols on CVD risk factors in post-  menopausal wo...
From a clinical trial comparing: Healthy Diet or Healthy Diet with a Medical Food Research conducted at the Functional Med...
 
Ann Fam Med 2005;Vol. 3, Supp 2: p.S4-S11 Healthy behavior produces  productive, happy, healthy people!
Benefits of a System for TLC’s <ul><li>Meets patient demand, is cost effective </li></ul><ul><ul><li>Many of our patients ...
Upcoming SlideShare
Loading in...5
×

FirstLine Therapy. Prevent chronic Disease

1,195

Published on

0 Comments
2 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
1,195
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
2
Embeds 0
No embeds

No notes for slide

Transcript of "FirstLine Therapy. Prevent chronic Disease"

  1. 1. Achieve Vibrant Health & Well-Being With T herapeutic (Wellness) L ifestyle C hanges ©2008 by Christopher Katke
  2. 2. Paris In the The Spring
  3. 3. The Burden of Common Preventable Chronic Diseases <ul><li>70% to 90% of deaths from chronic illnesses in the U.S. are believed to be caused by poor nutrition, sedentary living, and tobacco use. </li></ul><ul><li>65% of U.S. adults—or about 129.6 million people—are either overweight or obese . Obesity and overweight cost the U.S. an estimated $117 billion in direct medical costs and indirect costs such as lost wages due to illness. </li></ul><ul><li>In addition to hypertension, manifestations of the lifestyle syndrome include the metabolic syndrome , obesity, dyslipidemia, CVD, cancer, osteoarthritis, depression, sexual dysfunction, and type 2 diabetes mellitus. 6 </li></ul><ul><li>  </li></ul>
  4. 4. From: “ A Potential Decline in Life Expectancy in the United States in the 21st Century” NEJM 2005; 352: 11 What does this say about our present state of health? Why are we witnessing the forecast of a decline in life expectancy in the next generation in the face of being the most medicated society the world has ever seen? - comment by Jeffrey Bland, PhD
  5. 7. From: “ Disease Management and the Organization of Physician Practice” JAMA 2005;293:485-488 “ There is a large gap between what physicians do for patients with chronic diseases and what should be done.” What is the potential benefit of eliminating that gap?
  6. 8. From: Chronic Diseases 1 “ Preventing chronic diseases - how many lives can we save?” Lancet 2005; 366: 1578 “ A 2% improvement in the prevention of chronic disease would avert 36 million needless deaths by 2015 with a gain of about 500 million years of life”. What if we just focused on cancer, cardiovascular disease and diabetes?
  7. 9. From: ACS / ADA / AHA Scientific Statement Preventing Cancer, Cardiovascular Disease, and Diabetes A common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association Circulation 2004;109:3244-3255 <ul><li>Cardiovascular disease, cancer, and diabetes account for nearly 2 of every 3 deaths in the US </li></ul><ul><li>At a cost of $700 billion </li></ul><ul><li>“ While healthcare costs skyrocket, the national investment in prevention was estimated at less than 3% of the total annual healthcare expenditures.” </li></ul>
  8. 10. Health care costs main cause of personal bankruptcy, study finds Feb. 4, 2005 – A study published Wednesday in the policy journal Health Affairs found that approximately half of people in the US who file for bankruptcy cite medical costs as a significant reason for their financial troubles. Based on a survey of 1,771 personal bankruptcy filers, the researchers extrapolated that between 1.9 and 2.2 million people were driven into bankruptcy because of health care costs in 2001 Chronic, mostly preventable disease is the principal cause of death and disability, and consumes 78% of health expenditures… 70% to 90% of deaths from chronic illnesses in the U.S. are believed to be caused by poor nutrition, sedentary living, and tobacco use.
  9. 11. From: ACS / ADA / AHA Scientific Statement Preventing Cancer, Cardiovascular Disease, and Diabetes A common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association” Circulation 2004;109:3244-3255 “ In spite of hundreds of medical studies, media reports and advice from health officials, Americans still have not got the message that they can prevent most cases of chronic disease.” – John Seffrin, American Cancer Society CEO
  10. 12. From: “ Effectiveness of Therapeutic Lifestyle Changes in Patients With Hypertension, Hyperlipidemia, and/or Hyperglycemia” American Journal of Cardiology 2004;94:1558-1561 “ National clinical guidelines have promulgated therapeutic lifestyle changes as a standard of care in the management of conventional risk factors (for coronary heart disease).”
  11. 14. Purpose of this lecture: TO AWAKEN YOU TO THE POSSIBILITY OF A WELLNESS LIFESTYLE. To inspire to you actually make the necessary lifestyle changes for a healthy life. To give hope where hope is lost. To have the opportunity to share this massage of hope and healing to others <ul><li>Just some of the benefits (Hope): </li></ul><ul><li>Dramatically reduce the risk the cardiovascular disease and cancer </li></ul><ul><li>Increase insulin sensitivity… The secret to easy to weight loss </li></ul><ul><li>Virtually eliminate the risk of Type 2 diabetes </li></ul><ul><li>Slow down age related degenerative diseases </li></ul><ul><li>Improve cognitive function while removing the risk factors for Alzheimer's </li></ul><ul><li>Improve lean muscle mass, the #1 biomarker for premature aging </li></ul><ul><li>Reduce the financial burden caused from the Rx of chronic illness </li></ul>
  12. 15. National Cholesterol Education Program Recommends 12 weeks of “Therapeutic (Wellness) Lifestyle Changes” (TLC) as “first line” treatment for high cholesterol For most patients drugs should be used only if 12 weeks of TLC failed
  13. 16. National High Blood Pressure Education Program “ Use (Wellness) lifestyle interventions first, then drug therapy for higher levels of BP or if insufficient response to lifestyle modifications.”
  14. 17. National Health Organizations recommended Therapeutic (Wellness) Lifestyle Changes (TLC) as a “first line” treatment <ul><li>National Health Orgs. </li></ul><ul><li>National Institutes of Health </li></ul><ul><li>Am. Heart, Blood & Lung Institute </li></ul><ul><li>Am. Diabetes Association </li></ul><ul><li>Am. Heart Association </li></ul><ul><li>Am. Association Clinical Endocrinologists </li></ul><ul><li>Arthritis Foundation </li></ul><ul><li>North American Menopause Society </li></ul><ul><li>Many others </li></ul><ul><li>Conditions </li></ul><ul><li>High Cholesterol </li></ul><ul><li>High Blood Pressure </li></ul><ul><li>High Blood Sugar and/or Diabetes </li></ul><ul><li>Heart Disease </li></ul><ul><li>Osteoarthritis </li></ul><ul><li>Osteoporosis </li></ul><ul><li>Metabolic Syndrome </li></ul><ul><li>Menopausal symptoms </li></ul><ul><li>Many others </li></ul>
  15. 18. From: “ Effectiveness of Therapeutic (Wellness) Lifestyle Changes in Patients With Hypertension, Hyperlipidemia, and/or Hyperglycemia” American Journal of Cardiology 2004;94:1558-1561 “… the findings clearly show that many patients who have conventional risk factors for coronary heart disease can achieve goal levels without medications within 12 weeks of initiating therapeutic lifestyle changes…”
  16. 19. From: “ Effectiveness of Therapeutic Lifestyle Changes in Patients With Hypertension, Hyperlipidemia, and/or Hyperglycemia” American Journal of Cardiology 2004;94:1558-1561 “ Moreover, therapeutic lifestyle changes can generally be implemented less expensively than most medications and, unlike single drug therapy, favorably impacts multiple cardiovascular disease risk factors.”
  17. 20. From: ACS / ADA / AHA Scientific Statement Preventing Cancer, Cardiovascular Disease, and Diabetes A common Agenda for the American Cancer Society, the American Diabetes Association, and the American Heart Association Circulation 2004;109:3244-3255 “ At present, preventive health receives only sporadic attention, in the context of office visits for acute and chronic medical problems. Health care providers and medical organizations must transform this model into systems that provide preventive care and early detection as an integral part of standard medical practice .”
  18. 21. Presentation Objective Introduce the system we use to provide Therapeutic Lifestyle Changes (TLC’s) Our system is: <ul><li>Supported by research </li></ul><ul><li>Realistic and manageable </li></ul><ul><li>Clinically effective </li></ul><ul><li>Fulfilling for us & our patients </li></ul>
  19. 22. From: AHA / NHLBI Scientific Statement “ Diagnosis and Management of the Metabolic Syndrome” An American Heart Association / National Heart, Lung, Blood Institute Scientific Statement Metabolic Syndrome confers: <ul><li>A 2-fold increase in relative risk for ASCVD events. </li></ul><ul><li>A 5-fold increase in risk for developing DM-II in individuals without established diabetes. </li></ul>“ This finding implies that the metabolic syndrome imparts a relatively high long-term risk for both ASCVD and diabetes.” Circulation 2005;112:000-000 @www.circulationaha.org
  20. 23. From: AHA / NHLBI Scientific Statement “ Diagnosis and Management of the Metabolic Syndrome” An American Heart Association / National Heart, Lung, Blood Institute Scientific Statement Circulation 2005;112:000-000 @www.circulationaha.org <ul><li>The NCEP ( National Cholesterol Education Program) ATP (Adult Rx Panel) III proposed a simple set of diagnostic criteria: </li></ul><ul><ul><ul><li>Waist circumference </li></ul></ul></ul><ul><ul><ul><li>Triglycerides </li></ul></ul></ul><ul><ul><ul><li>HDL-Cholesterol </li></ul></ul></ul><ul><ul><ul><li>Blood pressure </li></ul></ul></ul><ul><ul><ul><li>Fasting glucose level </li></ul></ul></ul><ul><li>Abnormalities in any 3 of these 5 measures constitutes a diagnosis of metabolic syndrome. </li></ul>
  21. 24. From: “ Prevalence of the Metabolic Syndrome Defined by the International Diabetes Federation Among Adults in the U.S.” Diabetes Care 2005;28:2745-2749 “… almost 40% of U.S. adults were classified as having the metabolic syndrome”
  22. 25. From: “ Metabolic Syndrome: Time for Action” Am Fam Physician 2004;69:2875-82, 2887-8 “ Soon metabolic syndrome will overtake cigarette smoking as the number one risk factor for heart disease among the U.S. population. The NCEP ATPIII has identified metabolic syndrome as an indication for vigorous lifestyle intervention .”
  23. 26. From: “ Metabolic Syndrome: Time for Action” Am Fam Physician 2004;69:2875-82, 2887-8 “ All patients diagnosed with metabolic syndrome should be encouraged to change their diet and exercise habits as primary therapy.”
  24. 27. From: “ Metabolic Syndrome in Normal-Weight Americans New definition of the metabolically obese, normal weight individual Diabetes Care 2004;27:2222-2228 “ Individuals in the upper normal-weight and slightly overweight BMI range have a relatively high prevalence and are at increased risk of having the metabolic syndrome. Therefore, screening in individuals with normal or slightly elevated BMI is important in the prevention of diabetes and cardiovascular disease.”
  25. 36. From: “ Effect of a low glycemic index diet with soy protein and phytosterols on CVD risk factors in post- menopausal women ” Nutrition, Feb 2006;22:104-113 This study compared a low glycemic index diet combined with a medical food to the AHA Step I diet in obese, postmenopausal women.
  26. 37. Comparing Arms From: “ Effect of a low glycemic index diet with soy protein and phytosterols on CVD risk factors in post- menopausal women ” Nutrition, Feb 2006;22:104-113 -7.8 lbs -14.8 lbs Weight -.5mg/dL +2.8 mg/dL HDL-C +3.2 mg/dL -28 mg/dL LDL-C -2.6 mg/dL -43 mg/dL T-Chol -49 mg/dL -95 mg/dL Triglycerides AHA Step 1 Diet LGI diet with medical food
  27. 38. Triglyceride / HDL Ratio From: “ Effect of a low glycemic index diet with soy protein and phytosterols on CVD risk factors in post- menopausal women ” Nutrition, Feb 2006;22:104-113 <ul><ul><li>High triglycerides and low HDL are features of Metabolic Syndrome </li></ul></ul><ul><ul><li>TG/HDL ratio of 3 or higher suggests individual has Metabolic Syndrome </li></ul></ul>% Change Change After Before -48% -2.2 2.4 4.6
  28. 39. From: “ Effect of a low glycemic index diet with soy protein and phytosterols on CVD risk factors in post- menopausal women ” Nutrition, Feb 2006;22:104-113 +3% +2.1% 63.2% 61.1% % lean body mass -8% 15 lbs 171 lbs 186 lbs Weight -5%/-8% -6/-7 mmHG 124/77 mmHG 130/84 mmHG Blood Pressure -25% 2.1 mcIU/ml 6.2 mcIU/ml 8.3 mcIU/ml Fasting insulin -34 % -1.7 mg/dl 3.3 mg/dl 5.0 mg/dl hs-CRP -48% 2.2 2.4 4.6 TG/HDL-C -21% 1.2 4.6 5.8 tChol/HDL-C +6% +3 mg/dl 51 mg/dl 48 mg/dl HDL-C -15% -27 mg/dl 158 mg/dl 185 mg/dl LDL-C -16% -43 mg/dl 231 mg/dl 274 mg/dl Total Cholesterol -45% -95 mg/dl 117 mg/dl 212 mg/dl Triglycerides % Change Change After Before
  29. 40. From a clinical trial comparing: Healthy Diet or Healthy Diet with a Medical Food Research conducted at the Functional Medicine Research Center Gig Harbor, Washington Medical food with SKRMs: -12.9 lbs, Med Diet: -12.5 lbs, Rimonabant: -11.6 lbs
  30. 42. Ann Fam Med 2005;Vol. 3, Supp 2: p.S4-S11 Healthy behavior produces productive, happy, healthy people!
  31. 43. Benefits of a System for TLC’s <ul><li>Meets patient demand, is cost effective </li></ul><ul><ul><li>Many of our patients don’t want to take meds </li></ul></ul><ul><li>Applies national guidelines </li></ul><ul><ul><li>Allows us to do what we already know we should be doing </li></ul></ul><ul><li>Produces superior clinical outcomes </li></ul><ul><ul><li>Addresses underlying cause of problem </li></ul></ul><ul><ul><li>Addresses broad range of health problems unlike single drugs </li></ul></ul><ul><li>Provides patients with the necessary support </li></ul><ul><ul><li>Patients receive the guidance and assistance necessary to achieve vibrant health and physiologic function </li></ul></ul>

×