Why America was overdue for a health epidemic

 

Called the “invisible enemy” [1], COVID-19 has seemed to take many Americans by surprise.  The flu death rate hovers around 0.1%, and the COVID-19 death rate sits higher at 1-3.4% [2].  While this can appear both shocking and scary, one can not help but wonder why the media and government are not all up in arms over cardiovascular disease and cancer.  The Center for Disease Control (CDC) makes no attempt to hide the fact that 1 in 4 Americans die every year from heart disease--that’s a 25% death rate [3].  A close second behind heart disease is cancer, whose death rate the CDC places at ~18% [4].

So, statistically speaking, if COVID-19 is not America’s biggest killer, why is society turning upside down with stay-at-home orders, forced business shutdown, and social distancing?  The answer is that, while heart disease and cancer kill way more people, those deaths are spread out such that the health care system can handle them; they are not infectious disease that spread at exponential rates.  “The faster the [COVID-19] infection curve rises, the quicker the local health care system gets overloaded beyond its capacity to treat people...more and more new patients may be forced to go without beds, and more and more hospitals may run out of the basic supplies they need to respond to the outbreak” [5].  Translation: COVID-19 is putting too much stress on our health care system.  

Heart disease and cancer can be curtailed with healthy lifestyle choices as simple as diet, exercise, and not smoking [6].  But what about COVID-19?  Can that be avoided with good lifestyle decisions, or is everybody at the mercy of this beast?  According to the CDC, besides the elderly, those with heart disease, lung disease, and diabetes are at the highest risk of severity, hospitalization, and death from COVID-19 [7].  It should also come as no surprise that those who are obese are at higher risk for COVID-19 [8].  In fact, before the unique COVID-19 strain of corona virus really broke out, a paper was written linking weight to other corona virus deaths [9].  Being overweight is why obese-laden states like Louisiana are being hit harder with COVID-19 deaths when compared to other states [10].

Personal trainer Paul Robinson said it best: “Hand sanitizer, toilet paper and masks are not the answer. To protect yourself against this global killer, take the following steps: avoid smoking, manage your weight (avoid obesity), be more active, emphasize plants and whole grains in your diet, reduce meat.  The number one cause of death in America is the American diet. Instead of clearing store shelves of masks, we should be filling our carts with fruits and vegetables. Lifestyle-related deaths will far surpass anything the Coronavirus can dish out (half the population is obese), yet all we talk about is hand sanitizer and toilet paper” [11].

As a nation, we must take responsibility for our own actions.  This includes diet, exercise, and lifestyle choices.  To give an analogy, picture a married couple who hasn’t been on a date in years, constantly argues, doesn’t go to counseling.  When one spouse finally has an affair, it is so easy to blame “the other woman” or “the other man”.  However, had the marriage been strengthened over the years, this tragedy may have been avoided.  It’s the same with our nation’s health.  Had we been making healthy lifestyle choices for years, this COVID-19 wouldn’t have had the disastrous effect on society that it does now.  And for all the people who believe their health only effects them, take a look at the economic tragedy, massive job loss, and quarantine-induced depression.  How much of that could have been avoided if we were all healthier?  Just some food for thought.   

The CDC estimates that ~70% of Americans are overweight and ~40% are obese [12].  To determine if you are at a healthy weight, the CDC has a free Body Mass Index calculator www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html

References:

1. Kurtz, Howard.  “Trump ramps up after dire report, media also getting low marks”.  Fox News.  18 March 2020.  www.foxnews.com/media/trump-ramps-up-after-dire-report-media-also-getting-low-marks

2. Swenson, Dan.  “Coronavirus vs. the flu: A look at key statistics and why that comparison is a no-contest”.  Nola News.  29 March 2020. www.nola.com/news/coronavirus/article_e33c0cf0-7090-11ea-b3da-53f5ab31dd4b.html

3. “Heart Disease Facts”.  CDC.  5 April 2020.  www.cdc.gov/heartdisease/facts.htm

4. “Cancer”.  CDC.  5 April 2020.  www.cdc.gov/nchs/fastats/cancer.htm

5. Specktor, Brandon. “Coronavirus: What is 'flattening the curve,' and will it work?”.  Live Science.  16 March 2020.  www.livescience.com/coronavirus-flatten-the-curve.html

6. Willett, Walter C et al.  “Prevention of Chronic Disease by Means of Diet and Lifestyle Changes”.  NCBI. 1 Jan 2006.  www.ncbi.nlm.nih.gov/books/NBK11795/

7. “Situation Summary”.  CDC.  26 March 2020.  www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html

8. Morrison, Oliver.  “Coronavirus and obesity”.  Food Navigator.  24 March 2020.  www.foodnavigator.com/Article/2020/03/24/Coronavirus-and-obesity-industry-urged-to-act-post-crisis

9. Moser, Joe-Ann S et al. “Underweight, overweight, and obesity as independent risk factors for hospitalization in adults and children from influenza and other respiratory viruses”.  NCBI. 4 Dec 2018.  www.ncbi.nlm.nih.gov/pmc/articles/PMC6304312/

10. Brooks, Brad.  “Why is New Orleans' coronavirus death rate twice New York's? Obesity is a factor”. Reuters.  2 April 2020.  www.reuters.com/article/us-health-coronavirus-new-orleans/why-is-new-orleans-coronavirus-death-rate-seven-times-new-yorks-obesity-is-a-factor-idUSKBN21K1B0

11. Robinson, Paul.  “Fitness column: Unhealthy diet and lifestyle far surpass Coronavirus risk”. Edmonton Journal.  12 March 2020.  https://edmontonjournal.com/health/diet-fitness/fitness-column-unhealthy-diet-and-lifestyle-far-surpass-coronavirus-risk/

12. “Obesity and overweight”.  CDC.  1 Jan 2018.  www.cdc.gov/nchs/fastats/obesity-overweight.htm

Do you really need cancer screenings at the doctor?

Below are the results of my research.  I am not a medical professional and make no claims to be.  Here are the recommended cancer screenings for women:

• Breast Cancer Screening - annually for women 40-55, every two years for women over 55 [1]
• Cervical Cancer Screening - every three years for women in their 20s, every five years for women 30-65 years of age, at their discretion for women over 65 years of age [1]

If someone is at risk for cancer, then I certainly think they should get screened.  However, for those not at risk, I do not see the reason for screenings.  Just as a non-smoker would not get a cancer screening for lung cancer, I ask myself why those not at risk for other cancers are being encouraged to get screened.  Why undergo a painful screening that could do immense harm in the event of a false positive?  False positives are when the doctors think you have cancer when you really don't.  This leads to biopsies, surgeries, body parts being removed, and a lot more poking-and-prodding that can have permanent consequences.

Breast Cancer False Positives
"The more mammograms a woman has, the more likely it is she will have a false positive result that requires follow-up tests. The chance of having a false positive result after 1 mammogram ranges from 7%-12%, depending on your age (younger women are more likely to have a false positive results). After 10 yearly mammograms, the chance of having a false positive is about 50%-60%.  The chance of a false positive result is higher among younger women and women with dense breasts. (Most women younger than 50 have dense breasts, so there's overlap among these groups."

Cervical Cancer False Positives
"We need to remember that informed consent is a legal and ethical requirement for all cancer screening, some women will choose not to have pap tests and mammograms. So often women are ordered, pressured and even coerced into testing with no real information on the actual benefits and risks with screening.  I’ve watched other countries and believe the Finns and Dutch are the ones to watch when it comes to cervical screening, they’ve followed the evidence and put women first, all women, the small number who might benefit from cervical screening and the vast majority who can never benefit but can be harmed by false positives, excess biopsies, and over-treatment."[3]

Breast Cancer Risk Factors
"All women are at risk for breast cancer. Increased risk factors include a family history of cancer, atypical hyperplasia, delaying pregnancy until after age 30, no children or no breast-feeding, early menstruation (before age 12) late menopause (after age 55), current use (in the last 10 years) of oral contraceptives, more than 4 years of hormone replacement use, postmenopausal obesity, alcohol consumption, exposure to second-hand cigarette smoke, low physical activity and exposure to radiation." [4]

Cervical Cancer Risk Factors
"Human papillomavirus (HPV) is found in about 99% of cervical cancers....HPV is estimated to be the most common sexually transmitted infection in the United States."[5]
While rare, those not at risk for sexually transmitted disease could still get cervical cancer - "When a nun has symptoms suggestive of cervical cancer, that diagnosis should be considered as seriously as for any other woman. Irregular vaginal bleeding, inter-menstrual bleeding or recurrent vaginal discharge, should lead to a full pelvic examination under anesthesia."  [6]

Money, Power, and Greed
"The United States performs screening, particularly for cancer, more commonly than other advanced countries. We spend tens of billions annually on cancer screening, including $8 billion for breast cancer, over $6 billion for cervical cancer, and $3 billion for prostate cancer.  Why do we encourage large numbers of healthy people to undergo testing that may reveal some future problem, without informing them of the efficacy of these tests and their possible harms, while insisting that people who actually need medical intervention give informed consent? The reasons are more political than scientific. Patient-advocacy groups attract donations, gain prestige, and accumulate power by pushing screening for particular diseases. Physician-specialty groups promote screening in their areas of expertise. Most important, politicians of both parties garner support by funding screening programs for important constituent groups. Yet the effectiveness of screening is overrated: many screening programs mislead the public, waste scarce medical resources, and harm the people they are supposed to help." [7]

References
1.  "American Cancer Society Guidelines for the Early Detection of Cancer."  American Cancer Society, 30 May 2018.
2.  "Accuracy of Mammograms." The Susan G Komen Breast Cancer Foundation, 26 Jun 2019.
3.  "There's a better way to screen for cervical cancer." Healthy Debate Opinions, 13 Apr 2016.
4.  "Facts and Info."  Breast Cancer Research and Assistance Fund, 1 Jan 2015.
5.  "Cervical Cancer Overview." National Cervical Cancer Coalition, 1 Jan 2019.
6.  "Nuns, virgins, and spinsters. Rioni-Stern and cervical cancer revisited."  Gynecological Oncology, 23 Sep 2011.
7.  "Stop Overscrening for Cancer."  City Journal, 4 Apr 2016.

Wellness Tips

Healthy Eating

• Eat lots of good food
• Fruits, vegetables, and whole grains are excellent for you. The more you eat, the better you will be. Also, opt for organic and non-GMO whenever possible.
• Limit the not so good food
• Have meat, dairy, sweets, and processed grains sparingly. While they can be enjoyed in moderation, they will make you unhealthy if overindulged.

Healthy Nutrition

• Know what your body needs and check your diet if you are feeling bad.
• Research credible medical resources to know what you need / how much for yourself. Many health problems can be traced to not getting certain foods / nutrients.
• Avoid drugs, alcohol, and smoking
• What some may consider popular will just age you in the long run.

Healthy Moving

• Do not sit all day
• Too much sitting is not good for the body. Get up and stretch, move around, and walk.
• Make exercise fun
• Join a sport club, ride a longboard, take a hike, fly a kite, etc. Exercise should be fun, not a chore.

Healthy Sleep

• Get your beauty rest
• Aim for 9 hours of sleep. Keep a bedtime routine and enjoy your rest.
• Avoid caffeine
• If your body is telling you to rest, listen. Too much reliance on caffeine leads to masking tiredness, which often leads to under-eye bags and wrinkles.

Healthy Beauty

• Pay attention to labels and beware of false claims
• This goes for food and beauty products. Stay as natural as possible and avoid harsh chemicals that can steal your beauty over time. Be patient with natural remedies.
• Protect your skin
• Moisturize day and night. In the summer, wear sunscreen. Also cover yourself to avoid sun exposure (i.e.- hats, visors, etc). If burned, use aloe or apple cider vinegar.

Healthy Knowledge

• Stay current on health and wellness
• Read scientific articles on health. Blogs or websites may not be accurate.
• Take note of how your body changes
• Record your biological patterns, foods that upset you, products that work for you, etc. As time goes on, it helps to keep a log of patterns for what works and doesn’t work.