Do I Really Need All These Pills?

Lifestyle Changes Like Diet and Exercise May Be Equally Effective

Two years ago, Ron Gerhart, in his late 50s and newly retired from the world of advertising, was taking prescription pills for both high blood pressure and high cholesterol. His doctor had recently doubled his daily dosage of Lipitor from 40 to 80mg.

Lots of medications, but little to cheer about. The extra Lipitor made his muscles ache. He was overweight.

And he just felt crummy. He wasn’t sleeping well. He was becoming less and less active, and asking himself: “Is this the way life’s going to be? Do I want to live my retirement years not feeling well?”

Baby Boomer Health

Plenty of others in Ron’s generation, the 78 million baby boomers born between 1946 and 1964, have been asking themselves the very same questions as they enter their 50s and 60s paunchier, more fatigued, and more medication-strapped than they’d ever thought they’d be.

But this generation, who acquired more education than any previous generation, who grew up questioning the status quo and searching out alternatives, is once again spurring societal change. Many are asking: Are medications my only option? Is there a better, cleaner way to fend off chronic disease? Stay vibrant and healthy? Or can I at least reduce the dosages I’m on?

All good questions, especially considering recent bad news about prescription meds like Avandia, the diabetes drug, and Zetia (also found in Vytorin), the cholesterol reducer.

Side Effects

And the fact is: All drugs carry both risks and benefits. Beta blockers, for example, may make blood sugar and triglycerides more difficult to control, and may cause fatigue, weight gain, Type 2 diabetes, loss of motivation to exercise, depression, and impotence.

Statins’ potential side effects include liver problems and muscle pain which, in its most severe manifestation – albeit rare – can lead to severe muscle breakdown and release of a muscle protein (myoglobin) that can cause kidney failure.

Some diabetes medications may cause excessively low blood sugar, liver damage, and heart failure.

That’s why for many nationwide lifestyle alternatives are looking better and better. Exercise, diet, and other lifestyle changes, several studies have affirmed, are potent weapons in the war against this nation’s epidemic diseases, including the #1 killer heart disease.

Consult With Your Physician

Of course, it’s always vital to consult with your physician at home or at the Pritikin Longevity Center before making any changes in pills. “When it comes to medications, individualization is essential,” cautions Dr. Ron Scheib, Medical Director at Pritikin.

“Each patient must work closely with his or her doctor. Yes, in our current health care system toxicity is a major problem, as is overuse of drugs, but the worst case scenario would be discontinuation of a drug followed by a significant event like a heart attack or stroke.”

“And sometimes drugs may have benefits we’re only starting to learn about,” continues Dr. Scheib. “Statins, for example, may, in addition to improving cholesterol levels, help limit plaque growth. And some drugs, like hypertension-controlling ACE inhibitors, may be used for other benefits, such as renal protection for diabetics.”

But embracing a healthier lifestyle like the Pritikin Program is certainly worth the effort because the benefits are fast, profound, and side-effect-free, counsels Dr. Robert Vogel of the University of Maryland and one of America’s leading cardiologists.

Dr. Vogel is also author of the new book, The Pritikin Edge: 10 Essential Ingredients for a Long and Delicious Life, published by Simon & Schuster and scheduled to be released at booksellers worldwide September 2008.

Better Quality of Life

“I readily use medications in my practice to lower cholesterol in patients who cannot or will not change their lifestyle,” writes Dr. Vogel in The Pritikin Edge. “On the other hand, my patients who lower their cholesterol through diet and exercise look better, are more physically fit, and enjoy a better quality of life than those just taking medications.”

A much better quality of life, asserts Ron Gerhart, our advertising executive. After coming to the Pritikin Longevity Center last year, he dropped 40 pounds and cut his LDL cholesterol and triglycerides levels in half, as we described last year in this newsletter.

Today, Ron is completely off blood pressure pills, and his Lipitor dosage is so low that “my doctor is talking about eliminating it completely.” His total cholesterol is now 105. His LDL cholesterol is 43, and his triglycerides are 69.

Best of all, he feels fantastic. Last summer, he and spouse Cheryl took off for heli-hiking in the Canadian Rockies. They celebrated his 60th birthday running a 5K. They are now training for an upcoming trip to Peru to hike the Inca trail to Machu Picchu.

Adventure Weeks

And last month Ron returned to Pritikin for “Adventure Weeks.” He and fellow Pritikin adventurers took off for kayaking, golfing, horseback riding, mountain biking, and hurling themselves over the ocean’s waves on jet skis.

“We had a blast!” Ron laughs. “This is living. This is fun.”

This is age 60, done well.

Ron’s “partner in crime” during Pritikin’s Adventure Weeks, 53-year Mike Galdi, owner of a real estate office in Philadelphia, had so much fun “that I came home and bought my own jet ski.”

When Mike first came to Pritikin three years ago, he was diabetic, struggling with high cholesterol, and so overweight “that my feet hurt. I could barely move.”

Today, he’s flying over the surf and “keeping up with the younger guys” at golf and other sports. “I’ve got my life back – the life I want. I wish I had found Pritikin when I was in my 40s, but what the heck. I’m doing well now. And I love watching my doctor’s jaw drop when he sees my blood work after I get back from two weeks at Pritikin.”

Below is a brief review of three leading health problems in the U.S. and scientifically-validated strategies for preventing/managing them without medications.

CHOLESTEROL

Dietary changes have been proven to lower both total and LDL cholesterol by about 20% to 30%. That’s about the same effect that moderate dosages of statins have.

University of Toronto researchers put men and women with high LDL cholesterol on a vegetarian diet rich in foods full of soluble fiber, such as oatmeal, bean soups, barley, vegetables, berries and other fruit, as well as some soy products, nuts, and margarine enriched with plant sterols. In just one month, LDL levels fell an average 28%.

The Pritikin Program, which involves regular exercise and an eating plan full of fruits, vegetables, whole grains, beans, and moderate amounts of nonfat dairy foods and lean meat, has also documented dramatic cholesterol-dropping results. Research on 4,587 men and women attending the Pritikin Longevity Center showed, in just three weeks, an average 23% drop in total cholesterol and 23% drop in LDL cholesterol.

The Pritikin Program has also been found to enhance the effectiveness of statin therapy. Scientists at UCLA tracked the progress of 93 men and women who had reduced their total and LDL cholesterol levels about 20% using statins. In just two weeks at the Pritikin Longevity Center, their cholesterol levels plummeted on average another 19%.

Key Lifestyle Actions To Lower Total and LDL Cholesterol Are:

• Eat far fewer saturated fats (such as butter, palm oil, coconut oil, meat fats, and milk fats); trans fats (such as margarine, vegetable shortening, and partially hydrogenated oils); and dietary cholesterol.
• Eat far more fiber-rich foods (especially soluble fiber from beans, yams, oats, barley, and berries, or BYOBB).
• Eat fewer refined sugars (especially fructose) and refined grains (such as white flour).
• Increase physical activity, working out at your Training Heart Rate, as you learned at Pritikin.

DIABETES

Many studies have found that people whose blood sugar levels have started to rise, but haven’t yet reached diabetic levels, are able to prevent the onset of full-fledged Type 2 diabetes by diet and exercise alone. No pills are needed.

In fact, in one of the largest of these studies, exercise and diet did a much better job than pills at fending off diabetes. Scientists at George Washington University randomly assigned 3,234 pre-diabetic, middle-aged men and women to take metformin (Glucophage) or make lifestyle changes that involved losing weight, adopting a low-fat, low-calorie diet rich in fruits and vegetables, and exercising about 30 minutes every day.

Within three years, nearly twice as many people in the Glucophage group ended up with diabetes compared to the diet-and-exercise group. For preventing diabetes, “lifestyle intervention was significantly more effective than metformin,” stated lead author William C. Knowler, MD.

Similarly, Dr. James Barnard at UCLA found that 243 people in the early stages of Type 2 diabetes (they were not yet on medications) did very well within weeks of adopting the Pritikin Program. A full 76% were able to lower their blood sugar to levels where they no longer met the clinical definition of having diabetes.

What about people who already have Type 2 diabetes and are on medications? Can they get their blood sugar under better control and reduce or eliminate their dependency on drugs? Very likely, but research indicates that some lifestyle changes work much better than others.

One study, for example, randomly assigned 99 people with Type 2 diabetes to follow either the American Diabetes Association (ADA) diet or a vegetarian diet low in fat and very high in fruits, vegetables, whole grains, beans, and other unrefined, unprocessed carbohydrates.

After 22 weeks, blood glucose levels fell two and three times as much among those on the vegetarian diet compared to those on the ADA diet. What’s more, the vegetarian group lost twice as much weight – 14 pounds versus 7 pounds.

Pritikin is another lifestyle-change approach proven to work exceptionally well at getting blood glucose under control and reducing dependency on drugs. A meta-analysis by scientists at UCLA of nearly 300 Type 2 diabetics on oral drugs found that 74% were able to lower their blood glucose to normal levels and discontinue their diabetic medications after just three weeks at the Pritikin Longevity Center.

In the same study, 44% of Type 2 diabetics on insulin left the Pritikin Longevity Center insulin-free, their blood glucose in normal ranges.

Key Lifestyle Actions To Improve Blood Sugar Levels Are:

• Lose weight.
• Eat plenty of unrefined, low-calorie-dense carbohydrates like fresh vegetables, fresh fruit, beans (pinto, black bean, etc), starchy vegetables like potatoes (with the skin) and yams, and whole grains, preferably varieties that are cooked and water-rich, such as hot cereals, brown rice, and whole-wheat pasta.
• Emphasize foods rich in soluble fiber, especially low-calorie-dense varieties like beans, fresh vegetables, fresh fruits like berries and apples, and cooked oatmeal. When eating fruit as a snack, combine it another high-fiber food, especially raw or cooked vegetables.
• Avoid refined carbohydrates, including fruit juices as well as refined sugars and grains.
• Avoid foods with significant amounts of saturated and trans fats.
• Minimize “dry carbs” such as dry cereals, crackers, pita chips, and breads.
• Eat smaller but more frequent meals (grazing).
• Exercise daily, optimally 60 to 90 minutes of brisk walking, or its equivalent. It’s fine to divide up your workout, for example, an hour of exercise in the morning and a 30-minute walk in the late afternoon or evening.
• Limit calorie-rich drinks, including alcohol. For men, no more than 7 drinks weekly (no more than 1 to 2 drinks per day). For women, no more than 4 drinks weekly (no more than 1/2 to 1 drink per day).

HIGH BLOOD PRESSURE

“If there’s one condition that you can change without a pill, it’s high blood pressure,” recently stated the editors of the Harvard Health Letter, a monthly newsletter by Harvard Medical School.

In several landmark studies, the Dietary Approaches to Stop Hypertension (DASH) diet achieved decreases in blood pressure that were as good as anti-hypertension medications, particularly when sodium intake was reduced to 1,500mg a day.

So compelling is the data on the blood-pressure-controlling benefits of a low-sodium diet that the 2005 U.S. Dietary Guidelines stated that “individuals with hypertension, blacks, and middle-aged and older adults should aim to consume no more than 1,500 mg of sodium per day.”

The DASH diet recommends a lot of fruits and vegetables (optimally 9 or more servings daily), whole grains, and legumes (beans); moderate amounts of seafood, lean poultry, nuts, and low-fat or nonfat dairy foods; minimal amounts of fat (especially saturated-fat-rich foods like red meat) and calorie-dense foods like sweets.

The Pritikin Program, similar to DASH, has also been found to reduce blood pressure quickly and substantially, so much so that many people have been able to lower their dosages of anti-hypertensive drugs or eliminate them altogether.

In a 2005 meta-analysis of 1,117 hypertensives who attended the Pritikin Longevity Center, systolic blood pressure fell on average 9%. Diastolic pressure fell 9%. Of those people on hypertension drugs, 55% returned home free of all these drugs. Most of the others were able to eliminate some of their drugs and/or reduce dosages.

The biological reasons why diet, exercise, and stress management are effective at normalizing blood pressure are becoming more and more evident. One key player is turning out to be nitric oxide (Though laughter can certainly be stress-reducing, nitric oxide is not to be confused with laughing gas, which is nitrous oxide.)

Nitric oxide relaxes the arteries, which is a very good thing. When your arteries relax, your blood pressure decreases, and your blood flows more freely throughout your body. Drugs such as Viagra and Levitra increase your body’s production of nitric oxide.

So does a healthy lifestyle. In just three weeks, the Pritikin Program showed significant increases in nitric oxide production in men with hypertension. And their blood pressure plummeted to normal or near-normal levels.

Key Lifestyle Actions To Lower Blood Pressure Are:

• Lose weight
• Limit sodium intake to less than 1,500 mg daily. Even lower intake is better if you’re older than 50.
• Eat plentiful amounts of fruits and vegetables daily – at least 4 servings of vegetables and 3 servings of fruit. Fruits and vegetables are great not only for losing weight (they’re low in calorie density) but also because they’re good sources of nutrients, like potassium, magnesium and calcium, that help blunt some of the toxic effects of sodium.
• Don’t drink alcohol excessively. (In excess of 3 drinks daily can increase blood pressure.)
• Exercise daily, optimally 60 to 90 minutes.
• Enjoy stress-relieving activities such as yoga and meditation.