Jews Praying In The Synagogue on the Day of Atonement by Maurycy Gottlieb (Tel Aviv Museum of Art)
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Saturday, July 9, 2016
A Short Guide to a Long Life by David B Agus MD , Simon & Schuster
Israelis who want to be healthy but don’t know how to or are confused by conflicting reports are advised to read the Hebrew translation of a bestseller by a leading US doctor and researcher.
Mixed summer salad. Realizing that a healthy lifestyle can significantly extend life, most Israelis now seem to want a part of it. When the World Health Organization declared that processed meats can cause cancer, supermarket shelves heaped with salami, hot dogs and pastrami suddenly were skipped over by customers. Salad greens and whole wheat bread have become wildly popular, soft drink sales are down and people boast about how much they exercise. But while this is a welcome trend, many Israelis are confused by shifting advice from “experts” who dream up the latest “recipes” for changing lifestyles. Should one drink a glass of red wine or take “baby aspirin” daily? Are multivitamins not prescribed by doctors a good thing? Are high-heeled shoes harmful? Should one get a flu shot every year? Are security scanners at airports risky? Are “detoxification” treatments beneficial? David Agus can fit the bill for Israelis who want clear and rational advice. Even the Health Ministry in Jerusalem recently admitted that it erred foring almost completely on treating disease, on hospitals and health fund clinics rather than encouraging the population to prevent disease by promoting and conserving good health. Medicine is undergoing a revolution around the world. Instead of your doctors telling you what to do and treating you based on inflexible, one-size-fits-all rules, empowering patients to take a major part in decision- making and personalized medicine are taking over. Dr David Agus, an oncologist, researcher and engineering lecturer at the University of Southern California who helped found two companies for personalized medicine, expands on his bestselling 2012 book The End of Illness, in which he shared the knowledge about keeping healthy that he had accumulated over two decades. After readers of the first book asked for an easier way to digest this information, the author condensed it into 65 short, simple “rules” based on medical evidence that are designed to help readers share responsibility for their physical and mental health. “It boggles my mind to think the conversation remains stuck on figuring out how to pay for health care rather than diminishing our need for it,” wrote Agus, a professor of medicine at the Keck School, professor of engineering at the USC Viterbi School of Engineering and director of the USC Norris Westside Cancer Center and USC Center for Applied Molecular Medicine. “Each one of us can make a difference if we each are part of reducing the overall demand for healthcare... When we start living strong, robust lives, we’ll lessen our need for health care, causing the demand to decrease and costs to go down,” he noted. “I’m excited and proud [of the book],” Agus said. “It’s a step forward in my evolution as a physician and scientist.” The volume, which is accompanied by simple black-on-white line drawings, is divided into three sections: What to Do, What to Avoid and Doctor’s Orders. He clearly wants his readers to change their daily habits and think before they do things that can harm their health. “At least twice a week,” writes the California oncologist, “I tell a patient that I have nothing left in my arsenal to combat his or her cancer. It’s over, and in most cases the end is near. That we are no better at treating cancer today, with a few notable exceptions, than we were 50 years ago is maddening. More infuriating still is that many of my patients could have prevented their cancer or other life-altering disease had they just adopted a few healthy habits early on and avoided the ones that lead to illness. The best way to fight not just cancer but all the other ailments that typically develop over time is to prevent them.” But, writes Agus, “prevention is a hard sell. Think about yourself for a moment: can you see yourself 20, 30, or 40 years from now? We all want to live however we choose today and pay our dues later. In our age of information, where health tips are dispensed like sweets by the media, the work of being healthy has become complicated. It’s common practice to rely on experts to tell us how to live – news stories covering the latest scientific findings, bestselling books that tout one theory or another, government recommendations, claims on labels, and doctors like me. But this advice is so terribly common that it commonly conflicts. What is a person to do with a hot media account of a new study that finds multivitamins effective in preventing cancer – only to read another media account the next day that says multivitamins can increase your risk of cancer and do nothing for heart health? “My goal is to allow you to take the confusion out of how to live to be healthy. It’s as pure and direct as it gets – less about theory, research, history and science and more about the basic practices to follow in your daily life. Nothing is meant to be a rigid directive.” Each of Agus’s rules fills a small chapter of two or three pages. (An index and a bibliography are, unfortunately, not included.) The rules are not meant to be universal recommendations, especially when it comes to prescription medications. The point, he notes, is to raise the issues with your personal physician and your family and think about new direction you want your life to take as you age. “You are in charge of you. My aim is to help you know when to be introspective and when to question things,” he notes. “If I suggest something that offends you, or that you flatly reject, just move on. At the heart of my message is knowing how to raise awareness about the things you do today that affect your tomorrows.” HIS FIRST rule is to get to know your body, what your blood pressure and pulse are, how they are affected by what you do, how tense you are, how much you weigh, whether you’re happy, how well you sleep and if you want to change your life. The second rule is to use a few of the 7,000-and-counting smartphone applications to monitor your health (but don’t overdue this, as it could make you more tense). Another one is eating and sleeping at set times to “regularize” your life (creating homeostatis) and taking prescribed medications for chronic illnesses at set times. If your body is used to having a meal at noon, keep to schedule, as “starving it” for a few hours can cause a rise in the stress hormone cortisol and makes it difficult to keep a healthy, stable weight. Keep your health records on your smartphone (secured by a password) and give access in emergencies to a close relative or friend. Never smoke! Even one cigarette can trigger debilitating and fatal diseases. Stay away from smokers, as passive smoking is no less dangerous than puffing on nicotine delivery systems by yourself. As much as possible, eat real, not processed, food, advises Agus. “This means – with the exception of flash-frozen fruits and vegetables that keep their nutrients – anything that doesn’t come with an officially approved nutrition and facts label is likely to be real, as ironic as that sounds.” Although vegetables and fruits are beneficial, if they aren’t frozen they quickly lose their nutrients, especially if they have to be transported across long distances to reach your table. Get to know and befriend the employees of your supermarket/grocery so you can get clear answers on whether produce was picked when ripe (good) rather than when unripe, and on whether or not it’s fresh. Try growing fresh herbs, vegetables and other beneficial things in a pot, planter or garden and integrate them in your meals. Have a glass of wine with dinner (women should drink a maximum of one, and men no more than two glasses in the evening. “Now we know that moderate alcohol intake, especially from red wine, can reduce one’s risk of heart disease,” Agus writes. But “this benefit does have a caveat, however: drinking can potentially increase one’s risk for breast cancer, and drinking too much is far worse for your heart than being a teetotaler.” Caffeine from tea and coffee is no longer regarded as harmful as long as it is consumed in moderation and the beverages are not too hot (they should be below 65º C). “Caffeine, especially from traditional sources and not modern, factory-made concoctions that sell as energy drinks, may actually have protective anti-cancer properties. But, again, moderation is key.” Eat at least three servings of cold-water fish – salmon, sardines, tuna, trout, anchovies, herring, halibut, cod, black cod, or mackerel – a week, as they are excellent sources of high-quality protein, healthy fats and naturally occurring vitamins and minerals. He also advises taking a low-dose aspirin daily, but only after first consulting with your doctor, as it could cause bleeding and other side effects to some patients. In general, “aspirin has far-reaching effects on the body as a whole that go beyond easing our headaches and sore backs. Many high-quality research studies have confirmed that the use of aspirin not only substantially reduces the risk of cardiovascular disease, but it can even ward off a medley of ailments through its anti-inflammatory powers.” Take care of your teeth and your feet, which if allowed to deteriorate will cause misery. Take note of weird-looking or painful growths or discolorations that emerge on your feet and get them examined and treated. Women should avoid high heels that cause potentially harmful inflammation and instead buy good and comfortable shoes. Wash your hands regularly, especially after visiting the bathroom, diapering infants or handling raw chicken, meat and fish. Never skip breakfast, Agus advises, as after fasting all night long your body needs a metabolic jumpstart to begin the day. Hunger in the morning can cause people to become overweight and lack energy. Skipping those morning calories to lose weight is one of the worst habits a person can develop. Avoid (as much as possible) trans fats, high-fructose corn syrup, preservatives, food colorings, artificial flavorings, sweeteners and additives, hydrolyzed protein and fruit juices (concentrate or juiced). As for commercial places that promise to “detox” your body, forget it, says Agus. Your body is expertly designed to detox naturally thanks to your kidneys, liver, sweat glands, lungs and digestive system. There’s no such thing as an “immune-boosting” anything, he adds. The best way to enhance your immune system is to eat well and stay active. Walk as much as you can to help lose weight and keep it off, as well as challenge your heart and lungs. As married (or at least cohabiting) couples are known to live longer for a variety of reasons (women especially tend to worry about their male partners’ health and ensure that they get the necessary medical care), living alone is not advisable, Agus notes, adding that having children – despite the stresses – is also recommended for good health. Regularly stand naked in front of a mirror to look for any changes in your body – front and back – and go to the doctor if there are any. Strengthen your core and maintain good posture. “You can tell a lot about someone just by looking at the way he carries himself. With the right posture, anyone can appear younger, thinner and more confident. But these effects aren’t just for vanity’s sake. Maintaining correct posture may be one of the best-kept secrets for achieving a longer, healthier and more enjoyable life.” The third and final part of the book sets down specialists to visit and basic tests to undergo during the decades of one’s life from age 20 and onward – and if your doctor doesn’t refer you, find another physician.