10 lessons for chronic disease prevention and rehabilitation

Some populations are healthier compared to others. Japan and Okinawa come to mind.

So what can Canadians learn from these communities’ basic health behaviours relating to diet, alcohol, smoking and physical activity?

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Four unhealthy behaviours account for 80% of the chronic disease burden and mortality, but Canadians living with a range of chronic diseases can learn to improve their health with the following 10 steps.

1. Healthy weight
Thing about the process versus outcome when thinking of weight, said Dr. Paul Oh, medical director and scientist, cardiovascular prevention and rehabilitation program, with Toronto Rehabilitation Institute, speaking at Benefits Canada’s Health Outcomes Conference on Wednesday. “If losing weight is based on the scale, sometimes you feel like a failure.” You have to really focus on the process and what it means to be healthy, he continued. “Fit trumps unfit no matter what your body weight,” he said.

2. Cholesterol and the heart
Drugs can be used to reduce the production of cholesterol out of the bloodstream (which forms as plaque) and back to the liver, says Dr. Oh. Lowering cholesterol can be down through a combination of lifestyle and medication.

3. Eat your fruit and veg daily
Eat healthy with the DASH diet, (Dietary Approaches to Stop Hypertension), which focuses on fish and fibre, nuts and seeds, and fruits and vegetables. Studies show that blood pressure can decrease 11/6.

“Diet is not about taking things away,” he said. “The Greek word diaita means a way of living, a way of life.”

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4. Glucose control and cardiovascular events
“If you have diabetes or not, normal glucose is the goal,” said Dr. Oh. “That is the single goal for everybody.”

5. Blood pressure
Having an arbitrary threshold for blood pressure (140/90) is helpful, but it could be doing us a disservice, he said. Some patients with high blood pressure may be able to avoid taking medications and simply make changes to their blood pressure with diet. A simple recommendation such as the DASH diet might be all they need, he said.

6. Alcohol
Limiting alcohol is also a route to healthy living. “If you drink, don’t start,” he said, “and if you drink a lot, drink less.” A healthy amount of alcohol is one drink per day for women and two drinks for men.

7. Smoking
Don’t stop the campaigns to quit smoking, said Dr. Oh, adding that if a person quits, their risk of cardiovascular disease decreases. Employers must continue to offer smoking cessation programs.

And while some people may find they’re too old to give up their cancer sticks, Dr. Oh said it’s never too late to quit.

8. Stress versus strain
There is a difference between stress and strain, said Dr. Oh. If we take a stressor and repeat it and make it real in our head, that is strain.

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“We all need stress,” he said. “Strain we don’t need.” Learn to develop ways of managing stress, he said, such as learning a strategy of breathing for 30 seconds.

9. Sleep
Sleep is a needed part of a healthy life. But if you have sleep apnea, seek out help, because it can produce elevated blood pressure and increase your risk of stroke, he said.

10. Physical activity
Physical activity is one of the secrets to longevity, said Dr. Oh. “The fitter you are, the lower the risk of dying or developing heart disease.”

In conclusion, Dr. Oh said that about 1% of the population in the world behaves in a healthy way. “Every day, health is a choice, and we can choose. Be part of that 1%.”

Look for more coverage of the Healthy Outcomes Conference in our September issue of Benefits Canada.