I must say at the outset that the book is somewhat of a
disappointment. It’s virtually impossible for a book to live up to such an
audacious title and I hope it was the publishers who titled it rather
than the author. In reality, the book offers little hope for an end to illness.
Rather, it mainly offers a peek into a future in which, through genetic and
protein testing, a patient can be well informed about his/her predisposition to
various diseases and responsiveness to drug therapies. But the value of such
knowledge seems to be overstated. Agus postulates that, knowing one’s tendency
towards obesity will motivate someone to eat better and exercise more. However,
all of us should be trying to do so. It is best to do all we can to maintain
and improve our health, rather than merely targeting our greatest weaknesses.
Also, many people know what their vulnerabilities are, from overeating to
smoking to inactivity to drug abuse, but such knowledge most often fails to
correct such adverse behavior. Thus, the book’s praise of what the author’s companies
do comes across as both self-aggrandizement and advertising of services or
investment opportunities.
Despite the weaknesses in the book, it offers some good
basic health advice, most of which has been widely reported in other books and
articles on health. Some of the book’s major points {with the book's recommendations in bold and my comments in brackets}:
We may never understand illnesses such as cancer. In fact,
we may never cure cancer, which is why prevention is key. {This obvious point contradicts
the book title’s hype. While preventive measures can reduce the risk of cancer,
and possibly delay its onset to more advanced ages, there is no indication of
anything on the horizon that can prevent cancer. In fact, as we continue to
improve treatment of heart disease and infectious disease, a greater percentage
of people are likely to live long enough to die of cancer.}
Everyone should ask for the following tests at their
checkup. {The first three are typically done. The C-reactive protein is usually
done for those with risk factors for heart disease. The PSA test is often done
but is controversial because of its poor ability to determine who really needs
further, more invasive, procedures. The test for thyroid stimulating hormone is
not typically done except if there are symptoms suggesting a need for it. The
hemoglobin A1C is not typically done but is a better test of long-term blood sugar than the standard
blood glucose test as an indicator of diabetes risk.}:
·
Fasting lipid profile· Comprehensive metabolic panel – status of kidneys, liver, electrolyte and acid/base balance, blood sugar, blood proteins
· Complete blood cell count - red, white, platelets
· High-sensitivity C-reactive protein
· PSA for men
· Thyroid stimulating hormone
· Hemoglobin A1C – Measures long-term blood sugar
Daily aspirin reduces the risk of cancers of the
gastrointestinal tract, prostate, lung, colon/rectum, esophagus {Anyone contemplating
taking a daily aspirin should first check with his/her doctor as the drug
increases the likelihood of potentially serious or even fatal internal bleeding}.
Genetic tests can show risk of cancer (breast, colon, lung,
prostate, stomach, melanoma), autoimmune disease, vascular problems (aneurism,
deep-vein thrombosis), macular degeneration, glaucoma, Alzheimer’s, multiple
sclerosis, restless leg syndrome, atrial fibrillation, heart attack, Crohn’s
disease, celiac disease, type II diabetes, obesity, osteoarthritis, and
dose-response to drugs. {Of course, Agus’s company would be the obvious
candidate to do such testing}.
Even though Vitamin D has looked good in some observational
studies, it was associated with a rise in falls and fractures in older women. High
blood levels of Vitamin D may also be associated with an increased risk of more
aggressive forms of prostate cancer. {While it still appears that Vitamin D
supplementation is advisable, particularly in less sunny parts of the world, large
daily dosages (in excess of 1,000 IU) should likely be avoided}.
Antioxidants can worsen cancer because the body uses free
radicals to fight bacteria and cancer. Free radical oxidation is a normal part
of energy production, immune reactions, and cell signaling. {This is one of the
most important points in the book. Most books and articles today suggest that
the more anti-oxidants the better. However, supportive evidence applies mainly to
eating foods high in antioxidants rather than taking antioxidant supplements. Also,
Agus points out that Vitamin C can be health-promoting if you don’t have cancer,
but it can actually enhance the growth of cancerous tumors once they invade
your body.}
In a large trial, beta carotene increased the risk of
mortality, and showed an increased risk of lung cancer in a Finnish study,
while vitamin E increased the risk of hemorrhagic stroke but decreased the risk
of ischemic stroke. Heavy vitamin use was associated with an increase in the
more deadly form of prostate cancer. {Agus is generally against vitamin
supplementation, especially in megadoses, and he makes a fairly strong case.}
Keep a
strict, predictable schedule of eating, sleeping, and exercise, even on weekends.
{I think this is one of the weakest parts of the book. Agus is adamant about
the importance of keeping on a regular schedule, but he presents the barest of
evidence to support his case. Humans are by nature flexible and adaptable. I don’t see any harm at exercising at different
times of day if that is what you can fit into your schedule. It’s certainly
better than skipping exercise sessions.}
Reduce inflammation by wearing comfortable shoes daily,
getting an annual flu vaccine, and asking your doctor about taking a statin and
daily baby aspirin. {Caution: A recent study showed that statins increase the likelihood
of memory problems and diabetes. Aspirin can increase the risk of bleeding. So either
of these drugs should only be used when needed and for people who can well
tolerate them. A more natural way to prevent inflammation is to eat a diet high in vegetables and fruit and low in saturated fats and cholesterol.}
Because the causes of death among men are ranked as follows,
exercise is extremely important for health (the numbers in parenthesis represent
percent contribution to death risk). {It may seem surprising that obesity is low
on the list, but that is likely because it represents the risk of obesity
independent of all the other risk factors. But we know that obesity actually increases
the likelihood of all the other risk factors except smoking. So it is still important to avoid obesity.
- Low cardio-respiratory fitness (15)
- Hypertension (14)
- Smoking (8)
- High cholesterol ( 4)
- Diabetes (4)
- Obesity (2)
Share your
medical information whenever possible. {I feel that, in his enthusiasm about
potentially having an enormous database with which to analyze disease risk,
Agus totally fails to recognize the privacy concerns of patients. How can one
be sure that one’s personal medical information will not be used to deny
medical or life insurance coverage, inflate rates, or discriminate in hiring
based on perceived disease risk?}
Don’t
disturb the body’s homeostasis via excess drugs, supplements, inconsistent
schedules, sleep deprivation, or excessive eating, drinking, or exercising. {Yes, it is possible to exercise too much. The main threat of too much exercise is overtraining syndrome, characterized by fatigue, irritability, sleep disturbance, and a decline in physical performance. It can take weeks or months to recover from severe overtraining syndrome, so it is best to be sensitive to symptoms.}
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