„lebensstil“ im wandel der zeiten...survival probabilities for current smokers and for those who...

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„Lebensstil“ im Wandel der Zeiten „Lebensstil“ im Wandel der Zeiten „Lebensstil“ im Wandel der Zeiten „Lebensstil“ im Wandel der Zeiten Dr. med. Viktor Jörgens, Mainz, 8.2.2014 Dr. med. Viktor Jörgens, Mainz, 8.2.2014 Dr. med. Viktor Jörgens, Mainz, 8.2.2014 Dr. med. Viktor Jörgens, Mainz, 8.2.2014

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Page 1: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

„Lebensstil“ im Wandel der Zeiten„Lebensstil“ im Wandel der Zeiten„Lebensstil“ im Wandel der Zeiten„Lebensstil“ im Wandel der Zeiten

Dr. med. Viktor Jörgens, Mainz, 8.2.2014Dr. med. Viktor Jörgens, Mainz, 8.2.2014Dr. med. Viktor Jörgens, Mainz, 8.2.2014Dr. med. Viktor Jörgens, Mainz, 8.2.2014

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Dr. Christian Wilhelm Hufeland

* 1762 Langensalza Ɨ 1836 Berlin

1783 Dr. med. in Göttingen

1791 Hofmedikus in Weimar

Behandelte Herzog Karl August, Goethe, Schiller, Herder und Wieland

1793-1801 Professor in Jena

1801 Ruf nach Berlin

Page 3: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

Dr. Christian Wilhelm Hufeland

* 1762 Langensalza Ɨ 1836 Berlin

1783 Dr. med. in Göttingen

1791 Hofmedikus in Weimar

Behandelte Herzog Karl August, Goethe, Schiller, Herder und Wieland

1793-1801 Professor in Jena

1801 Ruf nach Berlin

Page 4: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

1801 Berufung nach BerlinLeitung der Charité

Hofarzt der Königlichen Familie, begleitete sie nach Tilsit.

Pro Tag bis zu 30 Hausbesuche –für Mittellose gratis

Hufeland führte die Pockenschutzimpfung ein.

„Früh verbraucht starben fast zu allen Zeiten immer nur die unbekannten Armen, denen es trotz größter Leistungen für die herrschenden Klassen sogar am täglichen Brot fehlte.“

Dr. Christian Wilhelm Hufeland

Page 5: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

Dr. Christian Wilhelm Hufeland

Page 6: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 Years of Age.

Jha P et al. N Engl J Med 2013;368:341-350.

Überlebenswahrscheinlichkeit von Rauchern und Nichtrauchern. Adjustiert für Alter, Alkoholkonsum, Sozialstatus und BMI.

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Risks of Death for Participants Who Continued to Smoke and for Those Who Quit Smoking According to Age at the Time of Cessation.

Jha P et al. N Engl J Med 2013;368:341-350.

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Bewegung ist gesund

„Wer stark gesund und jung bleiben will,

sei mäßig, übe den Körper, atme reine Luft“

„Gehen ist des Menschen beste Medizin.“

Hippokrates von Kos (460 ?-377 ?)

Page 9: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

„Wer stark gesund und jung bleiben will,

sei mäßig, übe den Körper, atme reine Luft“

„Gehen ist des Menschen beste Medizin.“

Hippokrates von Kos (460 ?-377 ?)

Bewegung ist gesund

Page 10: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

„The most important element of all in the

treatment of myocardial disease is

graduated exercise, not on the level, but

on hills of various grades.

The distance walked each day is marked

off and is gradually lengthened. In this

way the heart is systematically exercised

and strengthened.“

Sir William Osler

The principles and practise of medicine

7th Edition 1911

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Auch gar nichts zu verschreiben, ist zuweilen eine vortreffliche Medizin

Hippokrates von Kos (460 ?-377 ?) vor Christus

Behandlung ohne Medikamente

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Cumulative Incidence of Diabetes According to Study Group.

Diabetes Prevention Program Research Group. N Engl J Med 2002;346:393-403.

DPP: Ohne Medikament mit „Lifestyle-Therapie“ besse res Ergebnis

Page 13: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

The Look AHEAD Research Group. N Engl J Med 2013;369:145-154.

Massive Intervention bringt nicht mehr als konventi onelle

Page 14: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

Schulungsprogramme

Page 15: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

Hazard Ratios for All-Cause Mortality among Participants with Incident Type 2 Diabetes, According to Body-Mass Index (BMI) Shortly before Diagnosis of Type 2 Diabetes.

Tobias DK et al. N Engl J Med 2014;370:233-244.

Hazard Ratios for All-Cause Mortality among Particip ants with Incident Type 2 Diabetes, According to Body-Mass Index (BMI) Shortly before Diagnosis of Type 2 Diabetes.

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Geboren 20.8.1786

Erstbeschreiber und Namensgeber

des Cholesterins,

starb im Alter von 103 Jahren 1889

Cholesterin: Michel Eugène Chevreul

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1974 –

Olivenöl verboten

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2003 – Kongress über das Thema, wie gesund u. a. Olivenöl ist

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Bernard ShawThe Doctors

Dilemma

No doctor seems able to advise what to eat any better than his grandmother or the nearest quack.

Deutscher Titel: Arzt am ScheidewegErste Aufführungen 1906 London, 1908 Berlin, Druck 1911

Page 20: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

Risk ratio und 95% CISTATIN PLACEBO(10269) (10267) STATIN besser STATIN schlechter

LDL (mmol/l)

< 3.0 (116 mg/dl) 602 761

> 3.0 < 3.5 483 655

> 3.5 (135 mg/dl) 957 1190

Gesamt-Cholesterin (mmol/l)

<5.0 (193 mg/dl) 361 476

> 5.0 < 6.0 746 965

> 6.0 (232 mg/dl) 935 1165

ALLE PATIENTEN 2042 2606(19.9%) (25.4%)

24%SE 2.6Reduktion(2P<0.00001)

0.4 0.6 0.8 1.0 1.2 1.4

SimvastinVaskuläres Ereignis gegen frühere Lipidwerte

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Keaney JF Jr et al. N Engl J Med 2014;370:275-278.

2014 wieder mal eine Cholesterindebatte:USA Therapie nach Risiko - ESC Therapie mit Zielwert

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Um die Gesundheit zu erhalten: nicht bis zur Sättigung essen

Hippokrates von Kos (460 ?-377 ?) vor Christus

Nicht zu viel essen

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The survival time of chocolates on hospital wards: covert observational study

Die Überlebenszeit von Schokolade in Krankenhausabteilungen

27 December 2013

8 Packungen Schokolade (mit 258 Stück Schokolade) wurden in 4 Krankenhausabteilungen ausgelegt.

Im Mittel wurden die Schachteln nach 12 Minuten geöffnet.

Die mittlere Überlebenszeit der Schokolade betrug 51 Minuten.

Robert S. Levine, Orthopaedic Surgeon

Wayne State University Bioengineering Center, Trailwood Court, Bingham

Farms, MI USA 48025

© 2014 BMJ Publishing Group Ltd BMJ

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Gajendragadkar P R et al. BMJ 2013;347:bmj.f7198

©2013 by British Medical Journal Publishing Group

Can roses really grow on you?

Page 25: „Lebensstil“ im Wandel der Zeiten...Survival Probabilities for Current Smokers and for Those Who Never Smoked among Men and Women 25 to 80 ... The survival time of chocolates on

©2013 by British Medical Journal Publishing Group

Or are these more up your street?

Gajendragadkar P R et al. BMJ 2013;347:bmj.f7198

Survived longer

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Fig 1 Kaplan-Meier survival curves for Quality Stre et and Roses chocolates across all wards.

Gajendragadkar P R et al. BMJ 2013;347:bmj.f7198

©2013 by British Medical Journal Publishing Group

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Fig 2 Bar chart showing number and type of chocolat e consumed by role of staff.

Gajendragadkar P R et al. BMJ 2013;347:bmj.f7198

©2013 by British Medical Journal Publishing Group

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Um die Gesundheit zu erhalten: nicht bis zur Sättigung essen und sich vor Anstrengungen nicht scheuen.

Hippokrates von Kos (460 ?-377 ?) vor Christus

Nicht zu viel essen

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Ein jeder, dem Dauer und Blüte seines Lebens am Herzen liegt, vermeide den außerehelichen Umgang mit dem anderen Geschlecht und verspare diesen Genuß bis zur Ehe. Dr. C. W. Hufeland

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Dr. Christian Wilhelm Hufeland

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Figure 2

Source: The Lancet (DOI:10.1016/S0140-6736(13)62247-3)

Terms and Conditions

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Figure 3

Source: The Lancet (DOI:10.1016/S0140-6736(13)62247-3)

Terms and Conditions

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Seelenruhe, Heiterkeit und Zufriedenheit

sind die Grundlagen allen Glücks, aller

Gesundheit und des langen Lebens.

Dr. Christian Wilhelm Hufeland

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