Health Promotion and Disease Prevention: 21st Century Medicine

In this Director's Forum, the "father of aerobics", Dr. Kenneth Cooper focused his remarks on the four components of 21st century medicine: proper weight, proper nutrition, proper exercise, and proper supplementation.

Cooper's philosophy is simple---it is easier to maintain good health through proper exercise, diet, and emotional balance than to regain it once it is lost.

"From 1968-1990, the U.S. led the world in reduction of deaths from heart attacks—a 48 percent decrease in that period of time. Two-thirds of the reason was due to lifestyle change, one-third of the reason was due to improvements in medical technology," Cooper said. During that time, Americans were quitting smoking in great numbers. Also, baby boomers started getting their blood pressure checked and started paying attention to their nutrition, thus their cholesterol dropped.

According to Cooper, "It is not stress that kills, it is how you handle it that kills." The best way to control stress is aerobic exercise. Aerobic exercise is also the best way to increase the protective type of cholesterol, the HDL cholesterol. In addition to aerobic exercise, vitamins such as folic acid, B6, and B12 have been shown to lower the risk factors for coronary heart disease.

While life expectancy increased 6 years from 1970-1990, it began to flatten thereafter. The reason, according to Cooper, is an increase in obesity. It has become a major problem worldwide. "It is globesity. We now have 300 million people around the world who are overweight, and100 million are obese (above 30 lbs overweight)." With obesity comes an increase in heart attacks and an increase in sleep apnea. Even more alarming though to Cooper is the increasing rate of diabetes. Twenty-one million Americans suffer from diabetes—90 percent of those are adult-onset diabetics.

Obesity is also now affecting children. At least 30 percent of American children are overweight. "What is really tragic is finding kids 9, 10, 11 with adult onset diabetes. Because of this epidemic of obesity and diabetes we are seeing in our children, projections show that by 2050, the life expectancy will not be 77-80 years, it will be 72 years." The reasons for obesity in children according to Cooper are these: 1. Lack of physical education programs in our school systems 2. Kids don't walk to school or ride their bicycles like they used to. 3. Kids are spending anywhere from 25-40 hours a week watching television, playing video games or sitting at their computers. 4. The fast food generation—there are close to 50 million Americans sitting at fast food restaurants every day.

With regard to food and nutrition, despite conventional wisdom, saturated fats are not the enemy. "You need some saturated fat to manufacture HDL cholesterol." The problem again is obesity. Obesity raises overall cholesterol and decreases the good cholesterol, while aerobic exercise decreases the total cholesterol and increases the good cholesterol. In terms of fats in our food, transfats are the real enemy. "Every time you hydrogenate an oil to increase the shelf life, it decreases your life," Cooper said. The foods to avoid--margarines, pastries, donuts, French fries--are all loaded with transfats. Cooper was proud to announce that "As of Jan. 2006, because of our work, it is now required that all nutritional labeling contain the amount of trans fats."

Employers are paying the penalty for obesity with missed work and medical expenditures of employees. As time goes on, Cooper believes that employers will be concerned about hiring someone who is overweight. As it stands now, worksite wellness programs are on the increase. Employers are figuring out that wellness increases productivity. "People who are physically fit are less depressed, have an improved self image, and a better attitude toward life," said Dr. Cooper.

In conclusion, Cooper emphasized the fact that it is never too late to improve one's health habits. He gave many examples of people in their 60s, 70s, even 80s that turned around their health. If you want to slow down the aging process, you must eliminate 4 things: 1. cigarette smoking 2. inactivity 3. obesity 4. stress.

"People can grow healthier as they grow older,"said Cooper.