Nothing is more fatal to health, than an over care of it. -- Benjamin Franklin
The idea of health makes its presence felt everywhere. Health foods, health clubs, health care, health sites, blogs and columns have become unremarkable parts of our landscape. More than half of all Americans take a supplement to promote their health. The U.S. government spends more on health care (27 percent of federal budget) than education (four percent) or defense (22 percent).
Sounds good.
And yet, there is something fundamentally unhealthy about all this. We are more conscious and less confident about our health than ever before. While the idea of health surrounds us, the thing itself has become an endangered natural resource.
What is health?
It has become an end in itself rather than a means to doing what is important and meaningful. We do not seem to be seeking more vitality in living as much as staving off disease and death.
Why?
We have outsourced a personal sense of health (vitality, capacity, potency, wellbeing) to a variety of experts who know little about us or health.
A constant flood of "health news" (accurate and inaccurate) bombards us in two forms. One warns about the multitude of things that will make us sick. The other informs us that we are already sick. Both messages conclude with a prescription; a food to stop eating, a food to start eating, a supplement, a medication, a surgical procedure.
These disempowering messages push us toward patient-hood. It is not health news. It is sick news. We do not have a health care system. We have a sick care system. Disease is the doctor's domain, not health, if health is more than the absence of disease.
Contemporary medicine has inadvertently contributed to our malaise. Millions of people are taking drugs, having operations and getting tests that will not make them better. An Institute of Medicine report estimated that one third of health care expenditures ($750 billion) do nothing to improve health.
Medical testing is at the center of this problem.
Advances in imaging technology and screening practices have given rise to an epidemic of unnecessary testing. These tests do not contribute to a person's care or outcome. There are three hundred million people in the U.S. In 2006, Americans underwent 18 million nuclear medicine scans and roughly a hundred million CT and MRI scans in 2011. In fact testing is the single highest volume medical activity with 4-5 billion lab tests performed annually.
Unlike colon cancer, screening and treatment for prostate and thyroid cancers, has not significantly decreased the death toll from these diseases. It has created hundreds of thousands of anxious patients.
So what tests do make sense for those who want a simple but telling indicator of where they stand with health, not disease?
How do we retrieve a yard stick to measure health but not get tangled in unnecessary testing and needless worry?
Here are my Select Six. They provide a baseline assessment to monitor the building blocks of a meaningful healthy state. With these tests you can see how you're gaining ground (or loosing it) over time. (They are not a replacement for testing that your physician recommends when you are not well.)
What is my C-Reactive Protein (CRP)?
This blood test provides a biomarker for inflammation, the body's first response to most problems. The most common causes of inflammation are western diet, inactivity, stress and excess fat tissue. CRP can predict cardiovascular disease, stroke, metabolic syndrome, high blood pressure and cancers. It is a stronger predictor of cardiovascular events than LDL-cholesterol.
What is my Waist Circumference?
This low-tech test packs prognostic power. Independent of BMI or weight in confers additional health risk for diabetes, hypertension and dyslipidemia. It provides a rough measure of visceral fat (the kind associated with health problems) Men: >102cm (40"), Women >88 cm (36.5")
What is my Body Composition (BC)?
This indicates how much fat and muscle you have. Most people focus on the fat. BC is included in the Select Six list for the muscle data. Medicine has neglected muscle mass as an essential part of health throughout the life cycle. Insulin sensitivity, glucose control, metabolic rate, skeletal integrity, inflammation fighter and of course strength/power all depend on adequate muscle.
What is my Resting Heart Rate?
People with slower heart rates outlive their contemporaries whose hearts beat faster. In fact the predictive power of heart rate for mortality is higher than that of cholesterol or blood pressure. Studies have documented a continuous increase in risk with heart rates above 60 beats/min. This suggests that a substantial lowering of the upper limit of the normal range of resting heart rate (60-100) would be desirable.
What is my Sitting Time?
Sedentary behavior doubles the risk of cardiovascular disease and is equivalent to the risk of smoking, HTN or obesity. Inactivity also increases the risk for depression, dementia, colon, prostate, and breast cancers. Unfortunately the damage done by extended periods of sitting is not undone by even daily workouts. You need to move. And just in case you think your not inactive, a recent study assessed self-reported vs. objectively measured activity using accelerometer data. 62% reported meeting the recommended amount of physical activity while in fact only 9.6% had done so. Small things like standing up at your desk for a few minutes every half hour can make a difference.
What is my Helping Time?
Volunteering service has been shown to improve both physical and mental health. There is no better medicine than taking the focus off yourself and making someone else's life better. Those who volunteer are less likely to develop hypertension than nonvolunteers. They also experience greater increases in psychological well-being, social connectedness and physical activity levels than nonvolunteers. Interestingly, in the same way that less than 10,000 steps per day is considered insufficient activity, there may be a cutoff for volunteering. One study suggests that the benefits of volunteering require an investment of 200 hours per year.