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.