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Better than a good doctor is a good lifestyle
www. mmtimes. com the pulse 47
Living well in Myanmar
Better than a good doctor is a good lifestyle
CHRISTOPH GELSDORF MD
livingwellmyanmar @ gmail. com
Sufferers of Parkinson’ s disease are being encouraged to combat the disease through movement, including dance. Photo: Bloomberg
‘ Movement is medicine’: Dance for Parkinson’ s disease
THE first thing to notice at Lucy Bowen McCauley’ s dance class for people with Parkinson’ s disease is the range of symptoms among the 15 people seated in a wide circle around the room. There is a guy with the severe hand tremors that I associate with the degenerative neurological disorder. But there’ s also a woman who moves with a stiff, awkward gait, a woman confined to a wheelchair and another man who shuffles and suffers from a pronounced, repetitive twitch of his mouth.
A few people appear to have nothing wrong at all. Most of them are friends and relatives there to support Parkinson’ s sufferers, I would find out later, but one is a fellow who has calmed his symptoms with a deep-brain stimulator implanted in his head.
That is Parkinson’ s-- a range of terrible, idiosyncratic, life-altering symptoms caused by the loss of various neurotransmitting chemicals in critical parts of the brain.
The music starts, and it is clear these people are united by more than just the bad break they share. Their brains- all our brains, actually- love music, rhythm and dance in some primal way that creates joy and nourishes the body. Especially a body wracked by tremors or slowed by herky-jerky arms and legs.
“ We just trump the disease while we’ re here,” McCauley says after the class at Maryland Youth Ballet in Silver Spring.“ It’ s the perfect antidote.”
Movement is medicine, powerful preventive stuff that keeps your arteries clear and your muscles strong. Here, exercise is therapy, perhaps no match for Parkinson’ s disease over the two decades that it generally inflicts misery on its 1 million victims, but certainly a dose of nonprescription relief in the short term.
In a 2009 review of the relatively scant medical literature on dance as therapy for Parkinson’ s, researchers found it as effective as other forms of exercise and noted additional advantages: Music may serve as an
‘ Exercise literally produces chemical changes in your brain that are beneficial.’
Joyce Oberdorf National Parkinson Foundation external cue that facilitates movement; dance involves stopping and restarting movement, something that is difficult for some people with Parkinson’ s; dance requires multitasking; and dance is social-- an activity that fosters relationships and keeps people with Parkinson’ s from withdrawing from communities.
“ It’ s like Miracle-Gro for your brain,” says Joyce Oberdorf, president and chief executive of the National Parkinson Foundation.“ Exercise literally produces chemical changes in your brain that are beneficial, especially when you’ re a quart low on dopamine, as people with Parkinson’ s are.”
Music and rhythm also appear to benefit people with dementia in some similar ways.
Calling for more study, the Parkinson’ s researchers nevertheless concluded that“ the benefits of dance for those with PD appear to be of large enough magnitude to be clinically meaningful.”
Parkinson’ s sufferers and their advocates long ago decided that is true. The movement started in Brooklyn in 2001, when the organiser of a Parkinson’ s support group persuaded the Mark Morris Dance Group, an internationally known professional troupe, to offer dance instruction to people with the disease.
Since then, it has spread to more than 100 communities in the United States and eight other countries, according to the Dance for PD Web site. The Parkinson Foundation also offers dance classes at its 23 chapters across the country, and other groups offer them as well.
After a series of warm-ups and stretches, McCauley and another teacher, Alvaro Palau, take their students through dance steps while they hold onto barres and, finally, through some moves around the floor. The music,“ Mack the Knife,”“ Memories” and the like, is decidedly from the past, but even that has a purpose. According to Oberdorf, it cues up a time when these people moved more freely, helping them visualise a body that once was able to do more.
To end the class, they hold hands in a circle and, one by one, each bows theatrically to the person next to him or her. It is a wordless gesture of thanks, of empathy, of support that is impossible to miss. Then they all bow once more, together, toward the center of the circle, and head outside into the rain. – Bloomberg
REGARDLESS of whether I am treating patients at my clinics in Yangon or Northern California, I can’ t suggest a medical intervention with more potential benefit than improving a patient’ s lifestyle. In the last 150 years, however, Western medicine has become the globally dominant curative modality precisely because it offers a series of specific responses to diseases of specific organs. The appeal of“ fixing a problem” using pills or surgery is the basis for most of our national healthcare systems and has created the global biomedical complex.
From a purely statistical point of view, however, we don’ t have any magical tablets that are better at keeping you well than leading a healthy lifestyle. Is there a way in which you can reduce your chances of having a heart attack, getting cancer, suffering from joint pain, struggling with dementia or becoming incapacitated from a stroke? Yes, it’ s called optimising your lifestyle.
Maintaining a healthy lifestyle can help reduce:
- the chance of having a heart attack by 83 percent
- the chance of having a stroke by 79pc
- the chance of all cancers by between 36 to 64pc
- the chance of developing type 2 diabetes by 93pc
- the chance of high blood pressure by 78pc- the chance of heart failure by 47pc- your overall chance of dying by up to 65pc
So what does a leading a healthy lifestyle mean? There are five basic choices: Eat vegetables, beans, nuts, fish and olive oil; don’ t smoke; exercise 90 minutes each week; don’ t become overweight; and drink a glass of alcohol( but not more) every day.
A good doctor should hassle you about these choices at every visit. A great doctor will help you take the steps to achieve these goals. Of course, you don’ t need a doctor for any of it – you just need to decide that lifestyle maximisation is right for you and your family.
I’ ll address aspects of lifestyle in more detail in future issues of this column. However, a suggested initial approach is to think about which of these five choices sound most attractive and address those first. It’ s less important to fix everything right away than it is to take it slow and increase the likelihood of doing most things right for many years. By doing this, the statistics will start to be on your side.
Oily fish helps fight breast cancer
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EATING a portion of tuna, salmon, sardines or other oily fish once or twice a week reduces the risk of breast cancer, according to a review published by the British Medical Journal( BMJ).
Researchers based in China looked at 26 previously published studies covering more than 800,000 volunteers in the United States, Europe and Asia whose health was monitored and
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who gave details about their eating habits.
Oily fish is rich in so-called n-3 polyunsaturated fatty acids, or n-3 PUFAs, which are involved in the immune system, blood-vessel activity and chemical messaging in the brain.
The group of n-3 PUFAs has four members, known by their initials. EPA, DPA and DHA are mainly found in oily fish and ALA is chiefly found
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in nuts, seeds and leafy vegetables.
The analysis showed that women with a high intake of n-3 PUFAs had a 14 percent reduction in risk of breast cancer compared with those who had a low intake.
But the protective effect came only for fatty acids that come chiefly from fish, and not for ALA acids. Those who showed the most benefit were women in Asia, whose diet was richer
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in fish than in Europe and America.
In statistical terms, every 0.1-gram increase in fish fatty acids a day was linked to a 5pc reduction in breast cancer risk.
As a guide for daily living, this means one or two portions of oily fish a person a week.
Breast cancer has been dubbed a“ silent killer” of women because it is often diagnosed too late.
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The disease accounted for 23pc of total cancer cases among women and 14pc of cancer deaths in 2008, according to figures in the study.
Genetic heritage also plays a role in breast cancer, most notoriously in variants in the BRCA1 and BRCA2 genes, although how this interacts or not with food, lifestyle and environmental factors is unclear.
– The Washington Post
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