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Chronic Disease Management - Non-Pharma Approach for Better Outcomes Print E-mail
Written by Jeffrey Herschler   
Tuesday, 25 April 2017 12:10

It’s no secret that cardiovascular disease, hypertension and metabolic disorder are among the top chronic conditions in the U.S. today ( The Western diet of carbohydrate rich, processed foods combined with sedentary lifestyles are major drivers of these diseases. Cigarette smoking, excessive alcohol consumption and obesity are also significant risk factors (  Health spending in the U.S. is currently approaching 20% of GDP and growing (The Fiscal Times). Thus, properly preventing, delaying and/or managing chronic conditions is critical for the long term health and wealth of our nation.

Despite lip service to diet, exercise and  life style modifications to address chronic disease, many practitioners are quick to reach for the prescription pad ( And why not? It's tough to persuade patients to eat right, workout, quit smoking and reign in alcohol consumption. Furthermore, a lot of the medications used to treat chronic conditions are inexpensive, effective  and widely considered safe.

However, these various drugs are not a panacea. First, although generally considered safe, many of these drugs are associated with significant Adverse Affects (AEs) ( and Second, meeting lipid profile guidelines and controlling blood pressure and blood sugar naturally (i.e. via diet and exercise) intuitively seems more healthful than artificially (i.e. via prescription meds). Western medicine appears to be in agreement with that intuitive conclusion. For example, the almost universally embraced Framingham Risk tool examines various data points to assess ten year risk of a cardiac event. In order to earn a low risk rating, a patient needs to have a systolic BP of less than 130 mm Hg. If the patient's BP is being treated with medicines, the risk increases even if the below 130 mm Hg benchmark is achieved. Finally, a patient who relies on prescription medications might be more likely to avoid important lifestyle changes. E.G. If my blood cholesterol is fine on the statin, why lose weight? If my blood pressure is under control with the lisinopril, why quit smoking?

Chronic inflammation and poor gut health are both implicated as major contributors to chronic disease ( and JAMA). Meanwhile an anti-inflammatory diet ( combined with a sensible exercise program can simultaneously address chronic conditions synergistically and deliver a host of additional health benefits with no AEs. A diet of healthy fats, lean protein and lots of fruit and vegetables united with exercise (30 minutes a day, five days a week, balanced between aerobic and anaerobic activity) will naturally reduce systemic inflammation and restore gut health ( and and WebMD). Anti-inflammatory supplements and probiotics can complement the diet/exercise treatment plan. Benefits include improved cardiovascular health (better lipid profile and reduced blood pressure), improved gastrointestinal function, reduced cancer risk as well as improved metabolic and sexual function. Such a treatment plan promotes healthy weight, reduces tobacco and alcohol cravings, lessens joint pain and supports restful sleep and general well-being.

Not every patient has the determination necessary to adopt a disciplined diet and exercise program. And not all patients will be able to completely restore their health without prescription medications. But a huge segment of our population could transform their health without drugs. Most of the remainder could benefit by relying on lower dosages of fewer medicines. Both healthcare practitioners and patients can prosper by adopting diet and exercise as a first line of defense against chronic disease.
Last Updated on Tuesday, 25 April 2017 12:36
23andMe Receives FDA Nod Print E-mail
Written by FHI's Week in Review   
Monday, 10 April 2017 16:49

According to an news release dated 4.6.17:
The U.S. Food and Drug Administration (FDA) today allowed marketing of 23andMe Personal Genome Service Genetic Health Risk (GHR) tests for 10 diseases or conditions. These are the first direct-to-consumer (DTC) tests authorized by the FDA that provide information on an individual's genetic predisposition to certain medical diseases or conditions, which may help to make decisions about lifestyle choices or to inform discussions with a health care professional.

Read more in the current issue of Week in Review>>

Last Updated on Monday, 01 May 2017 18:12
NY Attorney General Sanctions Highlight Need for Higher Standards for mHealth Research and Development Print E-mail
Written by Jennifer S. Geetter, Chelsea M. Rutherford |   
Thursday, 06 April 2017 00:00

On March 23, 2017, the New York Attorney General's office announced that it has settled with the developers of three mobile health (mHealth) applications (apps) for, among other things, alleged misleading commercial claims. As part of the settlement, each developer must revise its advertising, consumer warnings and privacy practices, and must pay a monetary penalty to the Office of Attorney General. This settlement underscores for all mHealth developers the importance of having sufficient scientific evidence to support their commercial claims.

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Last Updated on Friday, 07 April 2017 17:31
Engaging Patients to Optimize Medication Adherence Print E-mail
Written by FHI's Week in Review   
Monday, 03 April 2017 00:00

An NEJM Catalyst post dated March 29, 2017 examines the problem of medication non-adherence:

...for many Americans, taking their medications according to their health care provider's instructions is a challenge. About half of patients with chronic diseases don't take their medication as prescribed.

Medication non-adherence has important health consequences, ranging from decreased quality of life and poorly managed symptoms to death. But the implications of medication non-adherence extend beyond the individual; non-adherence is also associated with significant societal costs.
Read more in the current issue of Week in Review>>

Last Updated on Monday, 24 April 2017 17:15
Mortality and morbidity in the 21st century Print E-mail
Written by Anne Case and Sir Angus Deaton |   
Saturday, 25 March 2017 08:35

In "Mortality and morbidity in the 21st Century," Princeton Professors Anne Case and Angus Deaton follow up on their groundbreaking 2015 paper that revealed a shocking increase in midlife mortality among white non-Hispanic Americans, exploring patterns and contributing factors to the troubling trend.

Case and Deaton find that while midlife mortality rates continue to fall among all education classes in most of the rich world, middle-aged non-Hispanic whites in the U.S. with a high school diploma or less have experienced increasing midlife mortality since the late 1990s. This is due to both rises in the number of "deaths of despair"-death by drugs, alcohol and suicide-and to a slowdown in progress against mortality from heart disease and cancer, the two largest killers in middle age.

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Last Updated on Tuesday, 18 April 2017 17:10
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