Tuesday, September 24, 2013

Don't be a statistic

If you haven't heard of Coursera yet, let me introduce you to it as my mom did for me. It is a website that offers free courses from colleges and universities all over the world. With video lectures, assigned readings and quizzes and assignments, it is similar to college without the loud unwashed roommate. It also has the advantage of allowing you to take classes on almost any topic taught from a variety of perspectives. I've already taken several classes through it and am currently taking a public health class from the University of Copenhagen. When I was a finalist for the Fulbright, my proposal was to work with the University of Copenhagen's public health program as it was one of the best in the world and I wanted to go to Denmark. While I wasn't able to do that, I now find myself getting lectures from some of the professors with whom I would have been working. One topic that continues to be reiterated through the course is the idea of disability and loss of quality of health. 

Daly is no longer just the bed fellow of dilly. In public health terms, DALY stands fo disability adjusted life years. A DALY is equal to one year lost of an otherwise healthy life. This can be due to premature death as well as periods of disease that impacts your quality of health. I like this measurement(as opposed to just life expectancy) because what's the point of living a long life, if half of it is spent unable to do the things you love. According to my Coursera course professors, prior to the industrial revolution, the majority of DALYs in the US were from infectious diseases. After the industrial revolution, as the population aged(due to less maternal and infant deaths and longer life expectancy), food became more readily available, jobs became more sedentary and infectious diseases becoming less prevelant due to germ theory and microbiology, there was a shift to a larger contribution from non-communicable diseases or NCDs. NCDs are degenerative diseases or chronic diseases that are now causing many of the DALY's in the US population.

If you look at the top 25 leading risk factors for development of DALYs, numbers 1(high blood pressure), 2(smoking), 4(diet low in fruit), 5(alcohol use), 6(high body-mass index), 7(high fasting plasma glucose level-to some degree), 10(physical inactivity), 11(diet high in sodium), 12(diet low in nuts and seeds), 13(iron deficiency), 15(high total cholestrol level), 16(diet low in whole grains), 17(diet low in vegetables), 18(diet low in seafood n-3 fatty acids), 19(drug use), 22(diet high in processed meat), and 24(diet low in fiber) are all things that most(but not all) of us have control over.

That's a whole lot of risk factors over which we have control. There certainly are other factors that play a role in these risk factors that may be more out of control than originally appears. For example, undernourished mothers give birth to children who have higher insulin resistance and slower metabolisms which has been thought to lead to diabetes and metabolic syndrome. Likewise, living in urban areas has been shown to reduce one's ability to exercise freely(safety concerns, air quality, access), and get inexpensive healthy food options. Education itself has a huge role in health with a direct correlation between maternal education and that child's longevity. BUT there are still things we can all do to live healthier lives with less years lost to disability and death.  For the most of us, healthier eating is something we can control to some degree. Even if you cannot afford to shop at Whole Foods, you can opt to buy more fruits and vegetables and avoid trans fats and foods with excessive sugar and salt as well as not eat so much. Hand in hand with that is we can exercise more. Now those of you that are ultra-athletes thinking that this is a free-pass for you to continue to beat your bodies into the ground, here's the caveat: while some exercise is good, more isn't always better. As I have mentioned before you can overdo it. Don't. Your body will tell you if you're overdoing it. Listen to it. Now for the majority of the population out there, that's underdoing it: get out and exercise. Even if you eat well, if you're not exercising, you're not doing all you can to live a healthy life.

"Health is more than just the absence of disease"

Don't wait until you're sick to start eating well and exercising. A HUGE risk factor for development of chronic low back pain is aerobic exercise participation(as well as psychological elements-also shown to be improved by exercise). Don't wait to have the pain to start exercising. Find something you love to do and get out there and do it:) Let living healthy be the new epidemic that helps improve your days of quality life.

Maybe like bike riding up Mt Kearsarge this Saturday with Amber?

No comments:

Post a Comment