The news is rife with articles about younger people getting cancer, heart attacks, high blood pressure, atrial fibrillation, and arthritis. We used to think of these as diseases of aging, but now we are finding high blood pressure and atherosclerosis in people as young as 20. The guidelines for colon cancer screening have been lowered to age 45 for people at normal risk. Experts can’t explain why this is happening. We can point to many factors like environmental toxins, lack of exercise, modern-day stress, lack of nutritious food, fast food, increased sugar and salt intake, microbiome changes, and viral infections. I suspect it is a combination of all of these, and more will be uncovered over time. But until that happens, I’ve noticed another trend that is more disturbing. Here’s a common example:
Roger is a 56-year-old father who thought he was in good health. He works hard as a fireman, hikes, and bike rides on the weekend. He loves meat and BBQ and is overweight (dad bod) with a BMI of 34. He looks like all of his friends. He has hypertension and is happy to take his blood pressure pill. He is on a statin for high cholesterol and triglyceride levels. He doesn’t have diabetes, but his tests show some insulin resistance in his cells. These are all metabolic changes that are huge warning signs for bad health and future problems.
He becomes short of breath and is diagnosed with atrial fibrillation in the ED.
Atrial fibrillation is a common heart arrhythmia that can be caused by a heart attack and damaged heart muscle. Other causes are alcohol intake, sleep apnea, type 2 diabetes, obesity, atherosclerosis, and extreme exercise. Atrial fibrillation can be persistent or intermittent. Medications can control the heart rate, and cardiac ablation is a procedure that works for some to restore the normal rhythm of the heart.
My patient underwent a successful cardiac ablation and is still on all of his original meds, with a few new ones added. Yay, modern medicine!
But here’s the rub. Nothing has changed with his health status. His bag of medicines has increased, but he’s still at risk for heart attack, stroke, cancer, full-blown diabetes, erectile dysfunction, and heart failure.
Like so many others who have a wake-up health event, Roger thinks he’s been “cured” by the ablation. He’s really just bought a little time, and without major lifestyle changes, the future is pretty predictable. We all want to be healthy and vital as we age. Roger needs to recognize that medications are just putting band-aids on the problems. The cure is weight loss, nutrition changes, and exercise, coupled with proper rest, meaningful relationships, and laughter. Big results require big changes.
The evidence is clear that obesity is the mother of all diseases. If Roger doesn’t make some major changes in his life, we will be dealing with another health event in the future. This is what preventive and integrative medicine is all about.
Toni Brayer is an internal medicine physician.
