September Blog 2011


By Clive Lindley-Jones | September 2, 2011 10:52 am

An epidemic of chronic disease

An epidemic of chronic disease threatens to compromise the health of our population and the effectiveness and economics of our healthcare system. Alarming projections suggest that future generations may have shorter, less healthy lives if current trends continue unchecked.1Because of its focus on acute care, the current medical model fails to confront both the causes of and solutions for the chronic disease epidemic, and must be replaced with a model of comprehensive care and prevention that is systems-based, integrative, patient-centered, and much more effective. 

1 Olshansky SJ, Passaro DJ, Hershow RC, Layden J, et al. A potential decline in life expectancy in the United States in the 21st century. NEJM. 2005;352(11):1138-45

This piece from the prestigious  New England Journal of Medicine highlights some sobering facts about our prospects in the future, should we not be able to change the new, gloomier trends of life expectancy that are in sharp contrast to the rosier picture of ever expanding life expectancy that we have grown to expect over the twentieth century.

Next month I will be off to London for a tough, but fascinating  week to take the Institute of Functional Medicine’s The Institute for Functional Medicine much praised week-long course in Applying Functional Medicine in Clinical Practice. As part of our philosophy at Helix House of constant and never ending improvement, this will further expand my skills in this direction, enhancing and complementing the osteopathic philosophy of whole person medicine that has guided our approach for more than three decades. Functional Medicine  is all about addressing  complex chronic disease. More on the learnings from this, later in the year.

Life expectancy : Never mind the length feel the quality!

Are we in danger of allowing  numerous factors in our present situation from economic regulations , life style choices, health care systems, food industry imperatives and no doubt many other factors, in halting and potentially reversing the long running trends of expanded life expectancy? According to the Office of National Statistics Between 1981 and 2007, estimates of life expectancy (LE) and disability-free life expectancy (DFLE) at birth in Great Britain increased for both males and females; healthy life expectancy (HLE) at birth in the period 1981–2006 also increased for each sex. National Statistics Online – Healthy Life Expectancy.

The difference between estimates of LE and HLE/DFLE can be regarded as the number of years a person can expect to live in poor general health or with a limiting persistent illness or disability. The increase in LE over these periods largely exceeded increases in both DFLE and HLE, leading to a rise in the years of life spent with a limiting persistent illness or disability and the years spent in poor general health.

In 1981 males at birth could expect to spend 12.8 years of their life with a limiting persistent illness or disability, compared with 13.7 years in 2007. For females these figures were 16.0 and 17.1 years respectively. Similarly, years of life spent in poor general health between 1981 and 2006 rose from 6.4 to 8.7 years for males and from 10.1 to 11.0 years for females.

So although our overall life expectancy is still increasing at present, unlike that forecast  for  todays children,  the chance of spending longer with a disability that effects the quality of our life is increasing. None of us looks forward to one or two decades of poor health and/or disability. During the winter I will be writing on how to increase the chances of extending your life and reducing that gap between life (LE)  expectancy and Healthy life expectancy (HLE).

This should be something we should all be concerned about. Even if one forgets for a moment that we are all really one, and the illusion of separation is just that, a trick of the light,  we are sleepwalking into an epidemic of increasing and largely, preventable, disability.

Along with the pensions crisis, tobacco and alcohol abuse and the epidemic of type 2 diabetes, which alone is expected to soon gobble up 10% of the NHS’s funds,  we may well reach a time soon when our ability to pay for all this increased dysfunction in society, will just run out. Helping people, in large enough numbers, to make the life style changes required to reverse this, is heavily dependent on changing significant, growing and persistent aspects of or culture, inequality being  just one aspect,  but there are a few simple things we can do for ourselves.

Every so often I come up with the subject of the health benefits of physical movement, see; March | 2010 | Health & Wellness from Helix HouseApril | 2010 | Health & Wellness from Helix House.  But for some the whole issue can be confusing.

Running Confused.

If you have got better things to do than follow these stories, you might well sometimes feel a little confused at the seemingly conflicting news items on exercise. The topic is a fairly steady journalistic favourite. You know the headline:”Boffins show 4 minutes of exercise per month, adds years to your life”Actually a new study published last month in the Lancet,Minimum amount of physical activity for reduced mortality and extended life expectancy: a prospective cohort study showed that it looked as if even a small amount of exercise is better than nothing, although this should not be taken to mean that this is all you need to take. While this Taiwanese study suggests that even with as little as fifteen minutes a day, we might significantly add some years to our life, elsewhere, the news is that the public have been misled as to how much exercise is really needed to make significant health benefits.  BBC NEWS | Health | Public ‘misled’ on exercise needs

But the truth is probably that, despite all these general suggestions, whether it be 15 minutes or 60 minutes a day, science really cannot say, with any great accuracy, if there is such a number.  There are really too many difficult to control variables to know. However, each researcher has a lab to support and so is obliged to get maximum publicity for their research,  journalists need to fill spaces and this kind of pronouncement is an easy hit with most editors and readers.

Perhaps all we can say is that the more our advanced technological society engineers out the need to move for us to carry on eating and living, the more we need to factor it  back in, to allow us to stay on living longer in that magic (DFLE) zone; that all important disability-free life expectancy.

At least this is something we can have some influence on our health and future. Sadly, most of us have conditioned our bodies into believing the lie, we like to tell ourselves, that we get enough exercise walking to the shops and doing the garden.

Enough for what? Would you like to live three more  healthy years or ten? It probably feels all a bit hypothetical if you are under 50, but that kind of thing has a habit of growing in interest as one gets older! So if in doubt get that body moving every day, enough to rediscover the joy your body and mind always used to find in movement when you were a child, before you were made to put on ugly gym kit or play hockey in the cold.

Exercise is, happily, on area we can choose to influence positively, unlike one  we cannot, retrospectively, effect. That is  the growing scientific realisation that our risk of chronic illnesses may have been profoundly effected before we were born, by our nutritional status in the womb and our subsequent  birth weight.

Something to think about!