What I've learned in 3 years of practicing integrative medicine | #21
Plus: health risks of smartphones, too much 'good cholesterol,' and the neuro-plasticity of coffee drinkers.
Greetings and happy holiday season everyone!
This month I published a blog on Dignity Integrative about what I’ve learned after three years of practicing integrative medicine. As I’ve thought about where I started after leaving emergency medicine, to where I am now, a few things stuck out:
There is a dire need for a different approach in healthcare. Most of my patients are coming to me after years of failed traditional approaches, and often within months, using an integrative and functional medicine approach, we can make a substantive improvement to their health and wellness.
Nutrition continues to be the most important pillar of the 4 pillars. This continues to be more and more clear, and it’s a big part of why I’ve brought on Amanda Applebaum as our new nutritional health coach.
A defined set of baseline lab testing is enlightening, but that can often be supplemented by functional genetic testing. This year, I’ve also started working with 3X4 Genetics, which helps me to create a personalized genetic roadmap that helps personalize care plans.
If you’re curious about more of my learnings, and how Dignity Integrative has changed this year, I encourage you to read the whole post here.
Now, on to this month’s recommendations:
#1: New study of 50,000 kids shows health risks associated with smartphone use
As a father to a 13-year-old, I am fighting this battle daily myself—and it is clear that high cell phone use is detrimental to teens (and likely to all of us).
In this study of more than 50,000 Korean adolescents, those who used a smartphone for more than 4 hours per day had higher rates of adverse mental health and substance use. They also had higher rates of stress, thoughts of suicide, and substance use than those with usage below 4 hours per day.
Interestingly, adolescents who used a smartphone 1-2 hours per day encountered fewer problems than adolescents who did not use a smartphone at all. My advice is to use the lockout timers/ downtime schedule on your phone especially for early and late in the day. At the very least it provides a reminder to think twice before continuing to be attached to your phone.
#2: Innovative nutritional study uses twin research to show better cardiovascular health with a plant-based diet
There are many criticisms of nutritional studies, not least among them are the unique genetic differences between individuals.
But this innovative study of 22 sets of twins removes the genetic factor. It showed that moving to a plant-based/vegan diet showed significant reductions in biomarkers such as LDL cholesterol, insulin levels, and weight in as little as eight weeks.
While most people will not become vegan, it emphasizes the importance of moving to overall less animal protein and showed that eating a more plant-based diet is possible for many people to improve their overall health.
#3: Rethinking “Good” Cholesterol
Too high levels of so-called ‘good cholesterol’ may not be so good.
This study looked at data from 19,000 patients from the ASPREE (Aspirin in Reducing Events in the Elderly). It looked at those with very high HDL cholesterol levels and showed that levels above 80 mg/dl incur a 27% higher risk of dementia, especially for those over 75 years old.
HDL is commonly, and somewhat incorrectly, referred to as ‘good cholesterol’ since in theory part of its role is moving cholesterol back to the liver to be converted into energy. Ideal levels of HDL are over 45 but there appears to be too much of a good thing once you get over 80 mg/dl.
#4: Not so good news for coffee drinkers
While I enjoy my morning cup of Joe there was a study recently published that calls chronic caffeine use into question.
One of the key components of mental resiliency is maintaining neuroplasticity, or the ability to develop new neural connections, as we age. This study of only 20 subjects sought to understand how caffeine functions as a competitive, non-selective adenosine receptor antagonist. These receptors are deeply involved in the modulation of long-term potentiation (LTP), which is fundamental to learning and memory formation.
While this is a small study and more research is certainly needed it may call into question our daily cup of coffee specifically in regards to how our brains learn and adapt over time.
#5: Men are dying even sooner than women—and life expectancy overall is still falling
U.S. men and women now have the largest life expectancy gap in nearly 30 years, 5.8 years. Meanwhile, overall life expectancy continues to decline in the U.S.—76.1 years in 2021. This is down from 77 years in 2020, and 78.8 years in 2019, pre-COVID.
This gap between men and women has been known for 100 years (and has been largely attributed to men’s smoking habits) but has been increasing over the last 25 years. COVID continued that trend.
The overall lowering of life expectancy in the U.S., before COVID, is attributed to contributors such as unintentional injuries, diabetes, suicide, homicide, and heart disease. While these post-COVID dips in life expectancy have recovered in many countries, in the U.S. it has persisted and worsened.