DISEASE - Johns Hopkins Medical Institutions

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COVER STORY STAYING ONE STEP AHEAD OF DISEASE Even with weight loss programs like the Paleo Diet and the South Beach Diet bolstering a billion-dollar diet industry, chronic disease remains the leading cause of death and disability across the United States. Indeed, 75 percent of the money spent on health care goes to the treatment of chronic diseases like Type 2 diabetes and congestive heart failure. And yet these illnesses are also highly preventable. Of course, diet and exercise alone can go far in avoiding a lifetime of poor health. But if you want to stay a step ahead of disease, your doctor should be a primary partner, and preventive screenings and care should be considered mandatory steps in your pursuit of good health. “If you don’t go to the doctor, there may be no one telling you to change the bad habits,” says Alice Lee, M.D., an internal medicine specialist with Johns Hopkins Community Physicians at White Marsh. “It’s a lot easier to be unhealthy if you don’t go to the doctor, because you’re basically putting your head in the sand.” Perhaps the simplest step toward disease prevention is a regularly scheduled physical exam. Considered a staple of preventive medicine, a physical generally consists of a doctor taking your medical history, checking your blood pressure, weight, and other vital signs, examining your body (head, neck, skin, extremities, etc.) and possibly conducting a battery of lab tests. While much of the exam focuses on assessing your current health, your physician should also screen for disease risk. 4 • PatriotLife • SUMMER 2013 www.hopkinsmedicine.org/usfhp
“If someone comes in for a physical, we always talk about their history and what kinds of risks they might have and advise them accordingly,” Lee says. “If they have a family history of heart disease, we’re going to be even more likely to recommend a healthier diet and regular exercise and to encourage them to monitor their cholesterol and WHEN IT COMES TO AGE, there’s your chronological age and there’s your biological, or health age—and the two don’t always line up. Determined by issues like weight, disease history, diet and exercise habits, health age measures the degree of aging your body has experienced versus how old you actually are. A healthy-eating 45-year-old aerobics instructor with no history of chronic illness might have a health age of 37. Conversely, a 45-year-old smoker who is overweight might have a biological age of 62. In this age of obesity and chronic disease, “we see a lot of people who are older than their actual ages,” says Wendy Bowen, a health coach with USFHP. “We deal with a lot of chronic diseases and obesity, and those patients will be older because of their conditions.” Smoking, a high-fat diet and a sedentary lifestyle all increase your disease risk, and likewise, your health age. The good news? While chronological age moves relentlessly onward, your health age is less constant. If you give up your regular trips to McDonald’s or kick the smoking habit, time can be turned back. “IF YOU DON’T GO TO THE DOCTOR, THERE MAY BE NO ONE TELLING YOU TO CHANGE THE BAD HABITS.” —ALICE LEE blood pressure.” Of course, while some preventive measures are applicable to everyone, gender and age can also play a role. At age 50, for instance, both men and women should begin to get screened for colon cancer. Women ages 18 to 65 should have a pap smear every three years (after three consecutive normal tests), while mammograms are advised annually for women starting at age 39 (and earlier for those at high risk). Prostate cancer screening for men is more controversial and should be discussed with the primary care physician. Men between 65 and 75 who smoke should have an ultrasound to screen for abdominal aortic aneurysm. “The kinds of screenings we recommend are highly dependent on the age and gender of the person,” Lee explains. “There’s a big difference in what I’d recommend to someone who is 22 years old, versus 73 years old.” She notes that it’s crucial to utilize screening tests well before symptoms occur. “Once you have symptoms, that’s not a screening anymore,” she says. “The idea is to get tested for something before symptoms appear so that you can be treated and remain healthier.” Further, she says, no test or screening can substitute for a healthy, active lifestyle of nutritious eating and regular exercise. “Diet and exercise are, of course, good preventive measures, and they’re also the treatment measures we use to reverse chronic illnesses,” she says. “We often have patients who say, ‘My father died at age 57. I want to be there for my children and grandchildren. What can I do to live longer?” To find out screening recommendations, visit the links under Adult Health at: www.hopkinsmedicine. org/usfhp/members_visitors/health_education/library. html. * How Old Are You, Really? “People can change their lives so that they’re eating healthier and exercising regularly,” says Bowen. “We’ve seen diabetics lower their blood glucose levels and people with high blood pressure decrease their need for medication—all by making changes and developing a healthy lifestyle.” You can start making small changes so that, eventually, you are the health age you’re supposed to be, or even younger. To find out more about USFHP’s health education programs, or connect for free with a health coach, visit: www. hopkinsmedicine.org/ usfhp/members_visitors/health_education/ www.hopkinsmedicine.org/usfhp PatriotLife • SUMMER 2013 • 5
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DISEASE - Johns Hopkins Medical Institutions

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