Thursday, January 22, 2015

Why You Shoul Know Your Numbers!

This is not math – this is your key to long-term survival.  The important numbers for most people are:  blood pressure, blood sugar, cholesterol levels, and weight. For some of these numbers you will need a collaborative relationship with your doctor, nurse practitioner, or physician’s assistant.  We are so lucky to have great clinics and health systems here in West Marin.  With a few appointments you can find your numbers and work on getting them in a healthy range.   Young people tend to feel invincible, middle aged people are too busy, and many (not all) men bypass health checkups for a wide variety of reasons.  I won’t speculate on what they are, but I have been told  (by several guys) that it’s a guy thing!  In addition, even with better health insurance coverage, a clinic visit and lab teats can be expensive.  However, once you understand your initial numbers, you can do a great deal of self-monitoring. By bringing your numbers into the normal range, you may be saving your future.  That’s a big deal. 

Blood Pressure:  High blood pressure is often a symptomless disease, that can lead to heart attack, congestive heart failure, stroke, kidney damage and many other problems.  You should know your blood pressure numbers, and discuss them with your clinician if they are abnormal..  You should have a reliable home blood pressure kit that you use regularly, and take medication  if advised to do so.  You can reduce high blood pressure with a regular walking program, the DASH diet, gradual weight loss, and self-calming practices such as meditation.  Books on the DASH diet are available at the library.  DASH stands for Dietary Approach to Stop Hypertension.  You will not go hungry on the diet, and you will start to feel better.

Blood Sugar: -High blood sugar, better known as blood glucose, can be a sign of impending diabetes or full-blown diabetes.  Normally your blood glucose levels increase after you eat, causing the pancreas to release insulin, and enabling your cells to absorb glucose for energy production.  You can find out your blood glucose level by having a blood test at the clinic after an overnight fast, 
or by having a slightly different blood test that will show your glucose levels in the past month.  Recent studies show that 27% of adults over age 65 have diabetes, and 35% of all adults have pre-diabetes.  The rise in this illness is related to the overweight and obesity crisis in the US to day.  Once you know your blood glucose level, if it is high you can self-monitor with a home blood glucose meter.  You can bring your glucose levels down with regular exercise (walking is fine) and an eating plan that emphasizes vegetables and protein and avoids foods with sugar and refined flour.  The Mayo Clinic Diabetes Diet is a good place to start.  Get the book out of the library, or from your book store.

Cholesterol Levels:  Cholesterol is a substance made in the liver and found in animal foods that we eat.  While the body makes, and needs, some cholesterol, too much can increase the risk of heart disease.  You probably know that sub-fractions of cholesterol have different effects on us  - HDL cholesterol is the “good cholesterol” that can help prevent heart disease, while the LDL type is “bad” and can promote blockage in the arteries.  Family history, age and gender all play important roles in the cholesterol story.  Your clinician will do a blood test to determine the levels of all your blood fats, including triglycerides, and advise you on a plan to achieve or maintain normal levels.  If your levels are elevated, you may need to take medication, or you may be able to use diet, exercise and weight loss to bring your levels down.  It is a good idea to have a blood test for blood fats (also called lipid levels) in your twenties, and follow up as needed.  Know your levels, and proceed accordingly, in collaboration with your clinician. 

Weight:  As a country, we have gained a lot of weight.  The causes, as you know, are inactivity and unhealthy food.  Get a bathroom scale, and start weighing yourself regularly.  Many people weigh themselves daily to maintain a normal weight.  You can find your ideal weight at the clinic, or on the web – weight.  This link will also give you your BMI, or Body Mass Index.  Keeping a healthy weight is not just a question of how you look, but is directly associated with heart disease, diabetes, many cancers, and other problems.  The New York Times Magazine on 1/18/15 has an article about mice who were allowed to eat regular kibble, high fat food, or food with fats and sugars.  Those who could eat only in a 9 or 12 hour window remained sleek and healthy, in all groups. The researchers think that this ‘time restricted eating’ influences the body’s internal metabolic clock, and will probably help humans as well as mice.  “The clock starts with that first cup of coffee with cream and sugar.”  If you have had trouble with other weight loss plans, you could try this one.  However, every body needs healthy food – especially vegetables, protein, fruits and unrefined  grains.  Don’t eat junk food or mouse kibble for 12 hours instead of 24!

Know Your Numbers.  Don’t smoke. Avoid a beer belly.  That’s my final word for today.

Sadja Greenwood, MD, MPH

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