health for guys be the best you can be being a well man in the 21 st century presented by dr. peter...
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Health for GuysBe the Best You Can Be
Being a well man in the 21st CenturyPresented by Dr. Peter Vasquez
Regional Medical Director, Take Care Health Systems
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Presenter
Peter Vasquez, MD Regional Medical Director,
Take Care Health Systems
30 years in practice, Family Medicine
Certified in Family Practice and Public Health
Many years of consulting in Population Health
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Health issues
Conditions – Heart Disease/stroke (CVD)– Back Pain– Diabetes (DM)– Behavioral Health
Anxiety Depression Substance abuse (SA)
Cancer
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Who’s got it?
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It’ll Kill ya…
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CONDITION MEN WOMEN
Heart disease 322,000 330,000
Cancer 287,000 267,000
Stroke 59,000 91,000
Accidental Death 72,000 40,000
Diabetes 35,000 38,000
Why Women Live Longer
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Health Issues
Risks Hypertension – HTN (Risk for CVD)
DM (Risk for CVD)
Obesity (risk for CVD, DM, HTN, ? Cancer)
Physical inactivity (Risk for HTN, obesity, CVD, DM, Depression, Anxiety, Accidental Injury/Death, ? Cancer)
Behavioral Health (Risk for CVD, Obesity, Accidental Death)
– Chronic Stress (Risk for HTN, Obesity, Depression, Anxiety)
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Behavioral Health
Chronic Stress
Depression
Anxiety
Post Traumatic Stress Disorder (PTSD)
Substance abuse
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Stress
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Any force serving to change the state of balance (homeostasis)
Life events, whether welcome or unwelcome
Additional work and home responsibilities
Caring for children and aging parents
Abuse
Finances
Stress and Health
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Perceived life and work stress related to
Serum cortisol – increases blood pressure and blood sugar
Abdominal Body Fat – increases blood pressure and blood sugar
Sleep patterns
Second heart attacks
Depression
Stress and Cardiovascular Disease
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Chronic Stress and Heart Disease
• Do not underestimate the potential effects of stress. In a study by Schnall and Cornell, stress had a relative risk = to cholesterol, cigs, etc.
• In their work, stress, age and BMI were the only reliable predictors of hypertension
– The average effect of stress seems to be 7mm Hg, may be as high as 12mm Hg
So What?
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Obesity leads to HTN, DM, Heart disease and possibly cancer
Behavioral Health Issues lead to each other, in a vicious cycle– Substance abuse
– Depression
– Suicide
Behavioral Health Issues both impair and respond to Lifestyle change
It’s what everyone says
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Eat right
Exercise
Stop smoking
Screen for risk factors preventable conditions, and early treatable conditions
EAT RIGHT
The Mediterranean diet.
Minimally processed foods Majority of food intake:
– Fruits and vegetables– Breads and cereals– Beans, nuts and seeds– olive oil as main source of dietary lipids
limited intake of:– dairy products– Eggs– red meat.
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EAT RIGHT
The Mediterranean diet.
Good quality scientific studies demonstrate specific measurable potential benefits of the Mediterranean diet.
– lower mortality
– lower rates of heart attack and stroke in people with known heart disease.
– weight loss
– decreased risk of cancer.
– There is also some evidence that such dietary habits decrease the risk of likelihood of developing neurological conditions such as Parkinson’s disease and Alzheimer’s
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EAT RIGHT
The DASH diet. Good quality scientific studies demonstrate
significant decreases in hypertension among individuals participating in the DASH diet
– high intake of fruits, vegetables, nuts and legumes, low-fat dairy products, and whole grains
– low intake of sodium, sweetened beverages,
and red and processed meats. DASH diet + 3.5 hours physical activity + BMI
< 25 = prevented 57% of new cases of high blood pressure!
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PHYSICAL ACTIVITY
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Current Medical Evidence suggests:– 2.5 to 5 hours of moderate level (heart rate
120 as above) physical activity weekly, slows the progression of arterial atherosclerosis.
– 5-7 hours stops the progression.
– More than 7 hours reverses the disease.
Heart rate 120 or more. – At this rate you will be able to answer
questions with a 4-5 word sentence, but not be able to chat.
– You should feel yourself breathing, but not be panting.
– You should be perspiring lightly.
Screen for Risk Factors, Preventable and Treatable Conditions
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Based on decades of quality medical evidence
Recommendations by the US Preventive Services Task Force, updated whenever significant additions to the medical data
Age and gender specific recommendations
May be done during:– Wellness Programs
– Annual Preventive Exams with Primary Care Provider
– Ongoing continuity care of chronic conditions
Preventive Screenings
Screening exams Frequency/Comments
Skin Cancer screening Every 1-3 years
Testicular exam Annually
Dental Exam Every 2 years
Vision/eye exam Every 2 years until age 60, then annually
Screening for depression Annually
Screening for substance abuse
Annually
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Preventive Screenings
Screening Tests Frequency/Comments
EKG Based on risks
Cholesterol/lipids Every 1-3 years if > 35; annually if > 20 and at risk for cardiovascular disease
Diabetes < 45 y.o.: Annually if at risk (BMI > 25 & 1 of the following: physical inactivity, 1st degree relative with diabetes, high risk ethnic population)45 or older: Every 3 years if negative
HIV testing At least once, more frequently, based on at-risk behaviors
Vitamin D testing Dependent on geography, sun exposure, and ethnic background
Colorectal Cancer Screening Colonoscopy every 10 years; flexible sigmoid every 5 years; CT colonography every 5 years (if available)
Rectal Exam for Prostate Cancer Screening
Combined with PSA blood test; Informed discussion of risks and benefits begin at 50 for average risk
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Prostate Cancer Screening
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The PSA is a blood test used to screen for prostate cancer. This is highly controversial.
The AUA recommends that routine PSA screen be offered to men 40 years of age and older.
The AAFP and the USPSTF find that the benefits of screening may not outweigh the risks of further testing and treatment..
– Most prostate cancers diagnosed by screening do not result in death or disability.
– Studies have not consistently shown a reduction in mortality from prostate cancer by screening with the PSA.
– A falsely positive test may lead to costly evaluation and emotional stress that may result from a positive result.
– Even if prostate cancer is truly diagnosed, treatments may have long-term consequences including erectile dysfunction and incontinence while not necessarily prolonging life.
Otherwise, think, and act wisely
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Prevention of accidents, seat belt use, safe driving behaviors (alcohol, fatigue), bicycle helmets, safe storage of firearms
Prevention of injuries (stretching, appropriate lifting, gradual increases in physical activity)
Tobacco cessation
Safe sexual practices
Sun exposure protection
Recognition of life stresses (job change, child bearing/rearing, marriage, divorce)
Questions???
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Additional Health Resources for Cisco Employees & Families
LifeConnections Health Center
www.ciscolifeconnections.com– Onsite medical facility for Cisco employees and
their families
Alere Healthcarewww.alerehealthconnections.com
– Online health information, condition management and health coaching services
HealthConnectionswwwin.cisco.com/go/health
– Cisco’s employee health-enhancement program, with information and resources to take charge of your health in the areas of nutrition, fitness, sleep, life balance, preventive care, and condition management
Additional Health Resources for Cisco Employees & Families
OptumHealth Behavioral Solutionswww.liveandworkwell.com
– Confidential Employee Assistance Program (EAP) services for Cisco employees and their families
LifeConnections Fitness Center powered by Plus One
http://wwwin.cisco.com/wpr/empserv/fitness/us/ca_sanjose/
– Onsite fitness center located in SJC-Q. Offers multiple specialty areas for exercise, group fitness, stress management, one-on-one personalized instruction, teambuilding, and social networking.