To my Patients,
Here are the latest health news highlights…enjoy!
Keep those caps on
Good news: we actually can impact how we age! Telomeres—the important protective caps of genetic material found at the ends of chromosomes—tend to become shorter as our cells repeatedly divide over the course of our lives. Telomere length has been considered to be a biological marker of age; shortening is correlated with a decreased life span and with the development of many chronic conditions such as cardiovascular disease, cancer, and dementia.
According to research, we can maximize the lengths of our telomeres (and potentially our lives) by:
- reducing chronic stress
- following a healthy anti-inflammatory nutrition pattern which includes an array of fruits, vegetables, legumes, and whole grains and which minimizes the intake of sugary or processed foods
- engaging in regular exercise
- optimizing optimism by incorporating gratitude into our daily lives
- minimizing alcohol intake
- quitting smoking
I encourage you to take a few minutes to watch this brief presentation by Dr. Elizabeth Blackburn, a former President of the Salk Institute for Biological Studies who earned the Nobel Prize in Medicine 2009 for her groundbreaking work in this area, in which she discusses the impact of chronic stress on the lengths of our telomeres.
On a related note, a new set of guidelines just published by the World Health Organization WHO confirms that the same lifestyle factors can reduce the risk for cognitive decline in older adults. The authors indicate that “what is good for our heart, is also good for our brain.” Are telomeres involved? Seems likely.
According to a study of over 19,000 patients recently published in JAMA Network Open, patients who visited their primary care doctors in the afternoons versus in the mornings were less likely to be counseled adequately with respect to colon and breast cancer screening. The authors speculate that “as each shift progresses, clinicians may fall behind schedule. The tendency may lead to shorter interactions with the patient at the end of the morning and afternoon shifts. In these situations, cancer screening may not be discussed or may be deferred to the future.” So for those patients who see their physicians for annual physicals in the afternoon, be sure inquire about all the appropriate screening modalities so that nothing important gets overlooked.
Obstructive Sleep Apnea (OSA)—a potentially serious sleep disorder in which breathing is repeatedly interrupted—is a well known but frequently overlooked condition that, if left untreated, can contribute to significant health problems, including daytime fatigue (which can lead to motor vehicle accidents, mood disturbances and reduced quality of life), headaches, diabetes, weight gain and cardiovascular disease. A study just published in the Journal of the American Medical Association (JAMA) found that, among patients undergoing major non-cardiac surgery, those with severe untreated OSA had an almost 50% greater risk for cardiac death, stroke heart attack or heart failure, pulmonary embolism and heart rhythm disturbances in the first 30 postoperative days. The study suggests that all physicians should do a better job of screening for OSA and counseling patients with respect to the diagnosis and management of the condition.
Factors that increase the risk of OSA include:
- Loud snoring
- Excess weight—fat tissue around the upper airway can obstruct breathing.
- Neck circumference—thicker necks are associated with narrower airways.
- A narrowed airway — this can be inherited, or enlarged tonsils or adenoids can narrow the airway, especially in children.
- Male gender—men are significantly more likely to have OSA. However, women are at increased risk if they are overweight, and their risk also appears to rise after menopause.
- Being older — sleep apnea is more common in older adults.
- Family history—having family members with OSA might increase your risk.
- Use of alcohol, sedatives or tranquilizers—these substances relax the muscles in your throat, which can worsen OSA.
- Smoking—smokers are three times more likely to have OSA.
- Chronic nasal congestion
An interesting (and encouraging) study just published in the Journal of the American Medical Association (JAMA) revealed that a 2017 tax on sugar-sweetened and artificially-sweetened beverages in Philadelphia resulted in a significant reduction in the volume of those beverages sold. Previous studies have also shown that these so-called sin taxes are effective in improving health-related behaviors, such as reduced smoking, particularly in young adults. As far as I’m concerned, we should welcome this form of taxation nationwide.
A number of recent surveys have revealed some discouraging findings with respect to interference with patient care on the part of the health insurance industry. According to a recent large survey conducted by the American Society for Radiation Oncology (ASTRO), insurance red tape results in significant delays in radiation treatment for cancer patients. Specifically, the study uncovered the following upsetting findings:
- One-third of radiation oncologist had been forced to use a less-preferred form therapy for over 10% of their patients because of prior authorization delays
- 85% of radiation oncologist indicated that benefit management companies require the generation of multiple treatment plans, time-consuming process that can take hours to complete
- One-third of community-based radiation oncologist reported average treatment delays of over a week
- 44% stated that prior authorization reviews were not conducted by licensed radiation oncologists, and in many cases, these reviewers could not even correctly pronounce medical terms associated with the particular cases and question.
These delays can add significantly to patients’ fear and anxiety, and can negatively impact outcomes. And often, cancer treatments end up being denied. A recent lawsuit involving UnitedHealthcare shines a spotlight on this frustrating problem. My cynical take based on these findings (and on my experience as a practitioner): health insurance companies are often more focused on the bottom line than on the health and well-being of their customers. Sadly, I don’t see this problem going away any time soon.
On a more positive note, spring seems to have finally arrived… so let’s all start our engines and get outside
That’s all for now…see you soon. Relax, de-stress and enjoy the sunny days ahead!
Larry Leibowitz, MD