Greenimalist

Even in the era of Lipitor, lifestyle matters more than we realize.

Sean Lo furrows his brow as he tries to make sense of the cocktail of medication he is about to take. On his table lie oblong pills of pink and white, round tablets of gray, and little discs colored like olives. Inside each hermetically-sealed capsule lies a precisely measured, bioactive ingredient: 4mg of doxazosin, for his high blood pressure; 90mg of Cardizem, to treat angina; and 20mg of sennosides, used as a powerful laxative. These drugs are every bit as potent as they are difficult to pronounce, and knowing which ones are safe to take can be more of a black art than a medical science. In the last year, Lo has had his drug regimen changed three times by three separate physicians, each time without explanation. The only medication he could recognize today was a pouch of pills containing nitroglycerin. This was a precursor for making dynamite, that much he knew. What he couldn’t figure out was how an explosive could help his heart problems.

These drugs—over ten of them lie scattered on Lo’s desk—represent the triumphs of modern medicine. They have kept Lo alive for over three decades, the time since he first suffered from a cardiac arrest. Now at the age of 83, he has far-outlived his ancestors, who could not grasp the concept of a heart attack, much less treat one. Yet Lo has been far from well: apart from keeping him alive, the pills have done little to improve his overall health. In addition to hypertension, Lo has been troubled by new conditions like constipation, fatigue, and insomnia. His physicians responded by doubling his medication and prescribing a new set of muscle relaxants designed to relieve his general malaise. They calmly reassured him that the new formulation was safe to take—only, it wasn’t. For the next three days, Lo—my grandfather—stumbled around the house in an exhausted stupor, spending half the week collapsed in bed.

Side effects may come and go, but trust, once broken, is hard to rebuild. For patients like my grandfather, disillusionment may eventually set in. This can become dangerous if a desperate patient turns to quackery when he instead needs real medical treatment. Snake oil salesmen, however, will continue to flourish until modern medicine fixes its deficiencies. One such shortcoming is the tendency for doctors and patients alike to solve serious ailments through quick fixes in the form of a pill. All too often, a patient’s first reflex to suffering is to reach for more drugs. Patients with high cholesterol often take one of dozens of statin drugs such as Lipitor, Crestor, and Zocor. Out of instinct, they reach for histamine antagonists like Zantac or proton-pump inhibitors like Prilosec whenever he suffers from heartburn. Sleeping meds like Ambien may lead to addiction, but doctors prescribe them to insomniacs anyway because fixing poor sleeping habits is too much work. Building lasting health and wellness is simply not worth the trouble when high-tech treatments are available.

This reliance on chemical expedients is one reason Americans are not living to their full potential. This year, the pharmaceutical industry is expected to generate almost $900 billion dollars in revenue worldwide, almost half of which will come from the United States alone (1). It is not uncommon in the US for a patient to spend over $1500 per year on prescription drugs alone. Our life expectancy, however, has only improved marginally considering how much we spend. Globally, the USA ranks at #50 (78.37 years), only slightly ahead of Cuba (#57 with 77.70 years), and even behind a few impoverished nations like Bosnia and Jordan (#45 with 78.81 years, and #29 with 80.05 years, respectively. 2). Some officials are even worried that life expectancy will slide backwards in the coming decades, from around 78 years today to less than 75 (3). Today’s newborn infants might die younger than their parents.

The fault lies with the drugs themselves. Rather than curing the disease, most drugs merely treat symptoms. A pill can provide immediate relief and remove imminent danger, but it must be taken daily remain effective. By itself, it cannot remove the underlying cause of illness. Eventually, large doses of medicine can cause irreversible damage to vital organs. I witnessed this first-hand with my grandmother, who as a diabetic had to take a multitude of drugs. Eventually, this poisoned her liver; she died, in part, due to hepatitis complications.

A more permanent solution requires a hard look at lifestyle rather than drugs. For my family, the health culprits are painfully obvious. Most of my extended family members live unhealthy, Westernized lifestyles, from my father-in-law who returned from heart surgery this year, to my mother who is fighting high-cholesterol, to my father who was recently diagnosed with hypertension. The recurring patterns are unmistakable: junk-food diets, couch-potato habits, high-stress jobs, and not enough rest. When I paid a visit to my grandfather, I saw the same tell-tale signs. His meals often consisted of candies, processed meat, and greasy take-out; fresh fruits and vegetables are virtually ignored. I once left him a bag of brown rice, hoping the extra dietary fiber would help with his constipation. When I returned two months later, I found the bag untouched. “It’s too rough,” he told me, before helping himself to a second portion of dessert. After dinner, he spent the next four hours watching TV.

Should we measure a person's health in push-ups and mile runs?

Not everything stems from lifestyle. Old age, genetics, and pathogens can bring illnesses that even fruits, veggies, and exercise cannot cure. For many common illnesses, however, lifestyle can make a tremendous difference. Heart disease, diabetes, breast cancer, colon cancer, prostate cancer, and Alzheimer’s disease are just a few of the dozens of illnesses linked to a high-stress, consumer lifestyle. Even patients who do not directly suffering from Western illnesses could certainly benefit from a healthier way of living. My grandfather, certainly, would have aged better with less sugary desserts.

Most of us would benefit tremendously from simple lifestyle changes. A more wholesome, simpler life—one without fast food, traffic jams, and television shows—is the proverbial ounce of prevention, worth pounds in high-tech cures. It is far better to prevent a disease early than to react to one after it becomes expensive and life-threatening. A decades-long habit of eating a whole-foods, plant-based diet could prevent the agony and expense of chemotherapy. Perhaps an hour-long, daily bicycle commute could prevent the onset of colon cancer, and perhaps a good night’s sleep could stave off the flu (while saving electricity, too).

Most of all, what is needed is a more holistic approach towards health. Quality of health—feeling good as opposed to feeling sick—matters just as much as a long lifespan. Until a person can wake up each morning without feeling tired, he is not healthy. Until he can climb up a flight of stairs unassisted, do a hundred jumping jacks, and jog for a mile each morning, he is not healthy. Crossing the street should not cause shortness of breath. Day-to-day tasks should not require constant medical intervention, whether that’s in the form of drugs, hospital visits, or surgery. And so the elusive quest for true health often ends up, not in a scientist’s lab of modern elixirs, but with a brisk morning walk and the spinach served on a dinner plate.

1. Activery forecasts global revenue to be $897 billion for 2011; Wikipedia reports that 2006 revenue was $643 billion.
2. The USA ranks #50 according to the CIA World Factbook’s data on life expectancies.
3. Obesity is lowering our life expectancy according to epidemiology professor S. Jay Olansky.
4. Photo credits: Greg I. Hamilton, Official U.S. Navy Imagery, CC BY.