Dr. John Abramson

 Dr. John Abramson

"In 2002 the medical journal of the American Heart Association, Circulation, published an article that reviewed the important studies on coronary heart disease prevention through diet and lifestyle interventions. The article concluded that by following the recommendations that emerge from the scientific evidence, 'coronary heart disease can be eliminated to a large extent' among people less than 70 years of age."- Overdo$ed America page 237-238

Dr. John Abramson described in his book in 2005, Overdo$ed America, about the manner that big pharma had affected the medical industry since the 1970s and has led to significant difficulties. We learn that Dr. Abramson left clinical practice because of the irregularities and discrepancies that existed between trying to treat patients with the best medical care in primary care and the interests that existed for pharmaceutical companies. We learn that Dr. Abramson describes in his book the manner that lifestyle changes including exercising every day, eating nutritious and healthy food, and smoking cessation can lead to better health.

Dr. Abramson describes the manner that the medical industry has changed from previous decades due to the interests that big pharma has on medicine. Dr. Abramson describes how even medical journals are not immune to influence from pharmaceutical companies that have the intention to lead to greater amounts of newer medications (new meds that have not been proved to be better than older and generic medication) being prescribed instead of discussing the importance of disease prevention, lifestyle changes, and nutrition and dietary counseling. 

"With slight modifications and the inclusion of safety recommendations, here is the list: 

1. Avoid tobacco.

2. Exercise moderately for at least 30 minutes or more on most days, engaging in activities such as brisk walking, biking, or gardening. 

3. Consume alcohol in moderation, if at all.

4. Eat a healthy diet:

-Cut down on red meat in favor of chicken and fish (including fatty fish at least once a week), and vegetable proteins

-Eat at least a pound of vegetables and fruits every day

-Limit salt to less than a teaspoon a day

-Cut down on sugar (the recommendations in the book of Dr. Abramson suggest no more than 10 teaspoons per day.)

-For cooking, use vegetable oils such as canola and olive oil

-Minimize intake of saturated fats and cholesterol

-Consume less than 2 percent of calories in trans fat ("the partially hydrogenated oil" found in many margarines and many baked goods, cookies, crackers, candy bars, and breakfast cereals; check ingredient labels). The optimal daily intake of trans fat: none.

-Keep your body mass index (BMI) from going over 25 (meaning, do not be overweight for your height). The good news is that if you do the other things on this list, your weight will be much easier to keep in check.

5. Use seat belts and bike helmets. Most important, do not drink and drive.

6. Do not engage in unsafe sex" - Overdo$ed America Page 238

Dr. Abramson describes in his book how credible studies have shown that exercising minimum two hours every week can help decrease the probability of cardiovascular disease, obesity, strokes, diabetes, hypertension, and high cholesterol and also improve health. There is also the importance of nutrition counseling and learning how to prepare nutritious food describing eating protein that has less fat describing chicken and fish (tuna fish has been shown to have mercury), vegetables and fruits with high fiber and nutrition, and avoiding junk food that can have a number of high calories without any nutrition.

This describes the importance of being able to persevere taking care of ourselves by making sure that we exercise almost every day and eat food that has nutrition while avoiding a sedentary lifestyle high in calories and no nutrition. Dr. Abramson describes that pharmaceutical companies have attempted to cause individuals to think that the solution to their health problems is newer medication, aggressive treatment, and interventions when a lifestyle change towards exercise, moderation, and avoiding unhealthy food can help tremendously.  

Newer Prescribed Medications That Did Not Offer Health Benefits Compared to Healthy Lifestyle Changes Describing Exercising and Adequate Diet

"The Pravachol article seemed likely to have the effect of exploiting the deeply ingrained trust. Had the purpose of the study truly been to assist doctors in reducing their patient's risk of stroke, it certainly would have mentioned other proven approaches to achieve that goal. Even taken at face value the article's claimed 19 percent reduction in the risk of stroke- just to make this point- other more effective ways to decrease the risk of stroke has been well documented at the time the article was published. For example, simply eating fish once a week reduces the risk of stroke by 22 percent. Controlling high blood pressure reduces the risk of stroke by 35 to 45 percent. And even moderate exercise for less than two hours a week reduces the risk of stroke in an elderly population by about 60 percent."- Overdo$ed America (page 17)

Dr. Abramson described in his book the manner that there were specific newer medications that were not offering health improvements compared to older, generic medication and lifestyle changes describing exercising minimum two hours per week and eating a healthy nutritious diet. We learn that Pravachol was a newer statin drug that offered to help with lowering hypertension while decreasing the likelihood of strokes. We learn that Dr. Abramson was able to describe how true medical studies had demonstrated that Pravachol did not offer better treatment than older generic statins and caused side effects including an increased risk of stroke. We learn that there were also medical journal articles that supported the use of Pravachol. Dr. Abramson describes the manner that there are questions concerning how Pravachol could be prescribed when there were better alternatives for treatment. We learn that the study that favored Pravachol treatment described the sample population averaging 62 years of age while the general population that has strokes is over the age of 70. Half of the men who have strokes are over the age of 71 and half of the women are over 79. 

"This is important because the patients in the study age 70 and older who had been treated with Pravachol actually had 21 percent more strokes than the patients given a placebo."- Overdo$ed America (page 16)

"Eighty three percent of the people included in the study were men, but three out of five stroke victims in the general population are women. The fact that fewer than one out of eight people in the Pravachol study were women turns out to be important because the women in the study who were given Pravachol experienced 26 percent more strokes than the women who were given a placebo."- Overdo$ed America (page 16)

Dr. Abramson also describes about other medications similar to Pravachol that were not an improvement nor prevented side effects from developing. We learn that Celebrex and Vioxx attempted to "help" with rheumatoid arthritis and were two other medications that were described being newer and better meds according to some medical journal articles while actually leading to side effects. Vioxx was a newer medication that may have caused side effects including heart attacks, strokes, and cardiovascular deaths. We learn that compared to Naproxen, Vioxx had greater side effects. Dr. Abramson describes the manner that while the study showed statistical significance meaning Vioxx caused more side effects including heart attacks than naproxen, the language of the article attempted to dismiss the finding by saying that it may have been due to chance. When there is statistical significance in a study, the study is able to prove that the results are not due to chance if p-value is less than .05.

"According to a medical journal article, people who took Vioxx had twice as many heart atacks, strokes, and cardiovascular deaths and four times as many heart attacks as the people who took naproxen (p<.05 and p<.01, respectively.) But then, rather than addressing these serious complications, the authors dismissed them with a most unusual statement: "The difference in major cardiovascular events in the VIGOR trial [of Vioxx] may reflect the play of chance because "the number of cardiovascular events was small (less than 70)." The comment that a statistically significant finding "may reflect a play of chance" struck me as very odd. Surely the experts who wrote the review article knew that the whole purpose of doing statistics is to determine the degree of probability and the role of chance."- Overdo$ed America (page 26) 

Concerning Celebrex, the newer medication was said to "help" with rheumatoid arthritis and osteoarthritis while decreasing ulcer complications compared to NSAID's. When Dr. Abramson researched the study findings, he found out that the researchers only published the first half of the study in the Journal of the American Medical Association known as JAMA. They did not report the second half of the study where six of the seven serious gastrointestinal complications were seen. We learn that the first six months of the study were documented showing a reduction of the risk of ulcer complications, yet the data from the last six months were left unreported that described individuals that developed gastrointestinal complications.

"Phase 4 study that included over 8000 people with rheumatoid and osteoarthritis, compared the risk of gastrointestinal problems in people taking Celebrex with the risk in those taking ibuprofen (Motrin, Advil) and diclofenac (Voltaren). The article in JAMA concluded that Celebrex, "when used 6 months... is associated with a lower incidence of clinical upper GI events than comparator NSAID's (ibuprofen and diclofenac)." The accompanying editorial supported this conclusion "The results of this important study... provide promising data to suggest that [Celebrex is] ... effective in reducing, but not eliminating, the risk of symptomatic [minor] ulcers and [major] ulcer complications in the enormous number of individuals who might benefit from these drugs..." "There was, however, one very large problem. The manufacturer's original research plan, as submitted to the FDA had defined the duration of the Phase 4 study that compared Celebrex with ibuprofen as 12 months, and that of the study comparing Celebrex with diclofenac as 16 months. And, indeed, the combined study had run for a full 12 months. The authors, however, submitted only the first 6 months for the article in JAMA. Left unreported (and unmentioned) in the JAMA article were the data from the second 6 months of the study, during which time, as shown in the data of the FDA's website, six of the seven serious gastrointestinal complications that occurred where in patients taking Celebrex."- Overdo$ed America (page 29-30)

We learn that naproxen was a better alternative to Vioxx. We learn that NSAID's were a better alternative to Celebrex. We learn that in the case of fighting high blood pressure and strokes, there was a 60 percent reduction in the risk of stroke when individuals decided to exercise for a minimum of two hours per week compared to the "supposed" 19 percent reduction from Pravachol.

Dr. Abramson described the manner that patients were requesting and demanding that they be prescribed newer medication (Celebrex, Vioxx, Pravachol) when there were better treatment options. Celebrex and Vioxx were included in the leading medical journals of medicine in the U.S., the Journal of the American Medical Association and New England Journal of Medicine describing positive results initially. We learn that Dr. Abramson was able to describe that the data set and results from the FDA actually described that there were side effects to the medication and that there was better treatment. For Vioxx, the researcher from the medical journal stated that the probability that Vioxx caused heart attacks was due to chance while there was statistical significance, and for Celebrex, there were serious gastrointestinal complications when taking Celebrex that were not reported in the medical journal concerning the second half of the study. Dr. Abramson describes that the leading journal articles in the past were authoritative and allowed for the development of treatment plans based on science, sound clinical judgment, and the scientific method. We learn that financial ties between researchers and medical companies were not allowed in the past, yet there were financial ties between the medical researchers in the Vioxx and Celebrex studies and pharmaceutical companies. Dr. Abramson described the manner that medical journals had changed from publishing truth and having integrity to obvious lack of transparency, ethics, and giving preferance to the pharmaceutical companies agenda. Vioxx and Celebrex were among the most prescribed medications in 2001.

"57 percent of all the money spent on prescription arthritis medication in the United States was spent on Celebrex and Vioxx." Overdo$ed America (Page 38)

Additional Treatments That Were Unsafe and Were Prescribed

Hormone Replacement Therapy in Post-Menopausal Women in the 1960s

"The truth about HRT came out very slowly and was difficult for most doctors to accept. Even after the article appeared in JAMA in 2000 showing the 8 percent per year increase in the risk of breast cancer in women taking combined hormone therapy, most experts continued to recommend, and most doctors continued to prescribe, routine hormone replacement for postmenopausal women."- Overdo$ed America (page 68)

Hormone replacement therapy for women was touted as a method to help women in the 1960s with menopause. Dr. Abramson describes the manner that medical journal articles and health studies have shown that HRT actually causes disease instead of helping. We learn that there is a probability of 8 percent increase of breast cancer each year that hormone replacement therapy is used in women taking combined hormone therapy. 

The 2003 Women's Health Initiative study described how 16,000 women in the study had been "randomly assigned to take either combined (estrogen and progestin) HRT or a placebo. The study had been scheduled to run through 2005, but the women received letters instructing them to stop taking the study medication because the risk (increase in breast cancer, heart attack, stroke, and blood clots) associated with combined HRT had been found to be significantly greater than the benefit. The study found a statistically significant increase (15 percent) in the overall frequency of adverse events in the women taking HRT compared to the women who took a placebo. (page 69)" 

"In May 2003 more results from the Women's Health Initiative were published showing that combined HRT not only did not prevent Alzheimer's disease, but actually doubled the risk of developing dementia (primarily Alzheimer's disease) in women aged 65 and older, causing about 1 additional case of dementia for every 100 women treated with HRT for five years."- Overdo$ed America (page 69)

Women were more likely to develop adverse side effects from HRT than benefits. We learn that HRT also can cause Alzheimer's Disease aside from increasing the risk of cardiovascular disease. There were claims that HRT helped fight against Alzheimer's disease when studies showed that the use of HRT increased the risk of developing dementia. Instead of helping with Alzheimer's disease, the use of HRT doubled the risk of getting dementia.

Scientific Studies in 2002 Described How Hormone Replacement Therapy Caused Cancer and Heart Attacks in Women

Dr. John Abramson described in his book, Overdo$ed America, that hormone replacement therapy for women was prescribed since the 1960s without knowing the side effects and health complications that it could cause. It was not until 2002 that the side effects and health complications were studied thoroughly. There were scientific studies that described that hormone replacement therapy for women actually caused cancer and heart attacks. There are studies that show that hormone replacement therapy caused health issues and also that the benefits did not outweigh the risks. The Adult Development and Aging Textbook by Susan Krauss Whitbourne also denotes how there were scientific studies in 2002 and 2003 that described how hormone replacement therapy may not be beneficial and may cause health complications. 

“Estrogen-replacement therapy (ERT) was introduced in the 1940s to counteract the negative effects of estrogen loss on postmenopausal women. Later, estrogen was combined with the hormone, progesterone, to reduce cancer risk. Administration of both hormones is referred to as hormone replacement therapy (HRT).” Adult Development and Aging (page 91)

We learn that estrogen replacement therapy was started since the 1940s and not fully researched until 2002. We learn that while there were several health benefits advertised for estrogen and hormone replacement therapy, in 2002 it was noted that hormone replacement therapy may have caused health complications instead. Instead of helping postmenopausal women, hormone replacement therapy caused cancer and heart disease. In a second study by Hays in 2003, it was noted that women did not receive the supposed health benefits of hormone replacement therapy. The study showed that there were “no significant effects of hormone replacement therapy on general health, vitality, mental health…” This is surprising being that the effects of estrogen replacement and hormone replacement therapy were not studied entirely until 2002. The treatment of estrogen replacement therapy and hormone replacement therapy were prescribed for many decades without being aware of the side effects and health complications of estrogen and hormone replacement therapy.

"Initial studies on HRT's effects on the body provided enthusiastic support, citing positive effects on skin tone and appearance, bone mineral density, immune functioning, thickness of the hair, sleep, accidental falls, memory, and mood. Through the summer of mid-2002, health professionals working with menopausal women felt confident that they were making the right decision by prescribing HRT. Then, in the summer of 2002, everything changed with the publication of a major international study on the relative risks and benefits of HRT. This study, the Women's Health Initiative (WHI) funded by the U.S. National Institutes of Health and an Italian medical foundation, involved 161,809 postmenopausal women ranging from 50 to 79 years. After five years, researchers discontinued the study when they observed an increase in the number of invasive breast cancer cases and heart attacks in women taking HRT. In addition there was a higher risk of heart attacks among women taking HRT. The study's author suggested that rather than prescribing HRT, physicians should provide postmenopausal women with medications designed to target specific conditions associated with estrogen loss such as bone loss and sleep problems (Rossouw et al., 2002).”- (page 91)

“The second major finding to call into question the benefits of HRT was in the area of well-being. A randomized clinical trial on over 16,000 women in the United States, 10% of whom were studies over a three year period, showed that there were no significant effects of HRT on general health, vitality, mental health, depressive symptoms… Although small improvements were observed after one year in some quality of life symptoms, these were not clinically meaningful nor did they persist in the group studied in the entire three years of the study (Hays et al., 2003)”- (page 91)

Aggresive Chemotherapy and Bone Marrow Transplant in 1990s

There were questions concerning if aggressive chemotherapy and bone marrow transplant was better than less aggressive chemotherapy. Initially, treatments favored aggressive therapy with bone marrow transplant. Four randomized controlled trials described that bone marrow transplantation was of no benefit. Only a small trial that had fake data was published that supported bone marrow transplantation. The American Society of Clinical Oncology had a meeting and American researchers visited the South African researcher's laboratory that showed that the data was fraudulent (page 52). The researcher's article was retracted by the Journal of Clinical Oncology, and the researcher was dismissed from his university position.

"Finally, in 2000, this unfortunate chapter in medical history was brought to an end when the results of a study published in the New England Journal of Medicine failed to show any benefit from high-dose chemotherapy followed by bone marrow transplantation." 

This describes the importance of researching medical studies to know if there are actual benefits from treatment. We learn that Dr. Abramson described that bone marrow transplantation was an accepted therapy when there was not enough data to know if there was actual improvement by bone marrow transplant or not. Similar to the HRT treatment in post-menopausal women, there was not enough evidence initially to know if the treatment actually helped with Alzheimer's disease, osteoporosis, and hot flashes. Instead, 34 years later after treating post-menopausal women with HRT it was acknowledged that treatment with combined hormone therapy treatment caused side effects and actually led to an increased risk of Alzheimer's disease.

Anti-Arrhythmic Drugs Prescribed in 1980s That Were Not Completely Researched

"These so-called class I antiarrhythmic drugs were routinely prescribed into the 1990s. It turned out that eventhough these drugs do effectively decrease the frequency of extra heartbeats, they increase the risk of death. One study documenting a higher death rate in people treated with these drugs was completed in 1980. The results, however, weren't published until 1993. According to a 2003 article in JAMA, had doctors been aware of these findings earlier, their use may have been stopped sooner. The JAMA article then presents a frightening calculation: 'There are estimates that 20,000 to 75,000 lives were lost each year in the 1980s in the United States alone from inappropriate administration of class I antiarrhythmic drugs.'"- Overdo$ed America (page 114)

Dr. Abramson described that there were specific anti-arrhythmic drugs prescribed in the 1980s that were "supposed" to help the heart prevent additional beats and arrhythmias while they actually caused side effects. We learn that there was a study conducted in 1980 that showed that the medications were dangerous, yet the study was not published until 1993. This describes that medications that caused adverse side effects were prescribed for 13 years without knowing how the medication worked. The study in the 1980s described that the anti-arrhythmic medications (Quinaglute, Norpace, and Pronestyl) caused increased risk of death. This is similar to the other medications that were not fully researched. There is the need to know if the newer drugs cause increased risk of side effects including death. 

This allows us to know that we can not trust in medications that have not been fully researched or that have obtained a rapid review and approval similar to Rezulin. While it appeared that the anti-arrhythmic medication helped initially with arrythmias, there was no information published concerning side effects or adverse symptoms from anti-arrhythmic drug use. We are able to see that some of the studies that showed that some newer pharmaceutical drugs were not helpful were removed or not published. The "positive" reviews of the newer pharmaceutical drugs were published. The same was seen in anti-depressant medication.

The Swedish Drug Authority Reviewed Five Newer Antidepressent Drugs and Found Out That Negative Articles Were Not Being Published 

"In Sweden, drug applications must include all known studies-published or not- relevant to the new drug. When researchers from the Swedish Drug Authority went through the new drug applications for the five new anti-depressants, they found that a total of 42 studies had been completed. It turned out that exactly half of these showed that the new antidepressants are more effective than the placebos and half found that they are not. The 22 positive articles that had been published represented 19 of the positive studies (3 were published twice). In contrast, only 6 of the 21 studies with negative or inconclusive findings had been published. Even the most conscientious doctor could know only the results of the studies that had been published and would resonably conclude that the weight of the evidence about the new antidepressants was overwhelmingly positive."- Overdo$ed America (page 115)

The Swedish Drug Authority was in the process of reviewing five newer anti-depressant medications for approval. They found out that there were 28 different clinical trial that were published in medical journals that showed that twenty two of the articles were positive although three articles were published twice. In Sweden, the review process includes all the articles of the new medication regardless if they were published or not. The Swedish Drug Authority found out that there were actually 42 completed studies. Only six studies were published that described negative findings when there were twenty one total studies that were not published that had negative findings or inconclusive findings. This describes that there were actually nine-teen favorable studies compared to twenty one unfavorable or negative reviews of the new anti-depressant drugs. This allows us to know that forty percent of studies were not published describing that there could be bias and that the benefits of the medication needed to be questioned.

The FDA Reviewed Newer Anti-Depressant Medication and Found Out That They Were No Better Than Older Medication

"In another study, researchers in the United States obtained data under the Freedom of Information Act from all of the studies (both published and unpublished) that the FDA had reviewed in the process of approving seven new anti-depressants (Prozac, Zoloft, Paxil, Effexor, Serzone, Remeron, and Wellbutrin SR) between 1987 and 1997- a total of 5200 pages of documents. The results of all the 'pivotal' studies (those deemed to be of high enough quality to be used in the FDA's determinations) for these seven antidepressants were then put together to assess the overall effect of the new drugs. By looking at all the studies, the researchers avoided the distortion of 'publication bias' and were able to determine whether or not the scientific evidence really showed that the new antidepressants are more effective and safer than the older ones. When all the evidence is considered, it turns out that the new antidepressant drugs are no more effective than the older tricyclic anti-depressants (the classic being amitriptyline, brand name Elavil). More important, the new antidepressants were found to be not even 10 percent more effective than the placebos: Symptoms of depression improved by 30.9 percent in the people who took the placebos; by 40.7 percent in the people who took the newer antidepressants; and by 41.7 percent in the people who took the older antidepressants.'"- Overdo$ed America (page 115-116)

Dr. Abramson described the manner that a healthy lifestyle and exercise can help. We learn that there were other studies published that describe that exercising thirty minutes each day can fight off symptoms of depression. We learn that the newer medication was no better than the older medication. We learn that in the controlled randomized trials comparing the antidepressant medications with older medication and the placebo, the placebo caused a 30.9% improvement of symptoms. We learn that instead we are able to see that exercising can not only improve health so that there is no diabetes, hypertension, and high cholesterol, but that exercising also helps against depression.

Possible Risk of Cancer With Prolonged Use of Statins

"The 2001 cholesterol guidelines were reassuring about statins' not causing cancer: 'There is no evidence that currently used cholesterol-lowering drugs promote development of cancer...' However, a paper titled "Carcinogenicity of Lipid-Lowering Drugs," published in JAMA in 1996, was apparently overlooked. This paper pointed out that statins caused cancer in laboratory animals at blood levels only three or four times those typically achieved in cholesterol-lowering therapy for people. The authors raised the possibility that increases in the risk of cancer caused by statins could take many years to be detected, and therefore would not be evident in the large studies that have been done to date. (The average duration of the studies is about five years, and the average age of patients is less than 60.) We can not know whether statins will turn out to increase the risk of cancer when used long term, nor can we know from one study whether older people might be particularly susceptible. The one thing we can know is that the denials of the evidence of such a relationship in the 2001 cholesterol guidelines and by the authors of the PROSPER article (sponsored by Bristol-Myers Squibb) suggest that the principle 'First do no harm,' which should be fresh in our minds from the increased rate of breast cancer caused by HRT, seems, once again, to have been forgotten.'"- Overdo$ed America (page 145-146)

Dr. Abramson described that there was a study in JAMA from 1996 that described that long term use of statins to reduce cholesterol levels could potentially cause cancer. During 2001, there were new cholesterol guidelines that stated that statins did not cause cancer and that statin use could help against heart disease. The 2001 cholesterol guidelines described that lowering cholesterol with statin use was to be prioritized to prevent heart disease. We learn that the guidelines did not describe the importance of exercise and diet counseling in reducing high cholesterol. Instead statin use was prioritized, and possible side effects of statin use were not mentioned or were not given importance. 

Dr. Abramson describes how the studies concerning HRT for women describe the importance of studying possible side effects of newer medication. We learn that statin use treatment for high cholesterol began in 1987 with Mevacor that is now a generic medication called lovastatin. Since then there are newer statin drugs that are promoted to help against heart disease and lowering cholesterol levels. We learn that the 2001 cholesterol guidelines attempted to describe the need for more individuals to take statins based on cholesterol levels. This guideline would have increased the number of people who needed to take statins. 

The High Cost of Medicine and Lower Quality of Healthcare Since the 1990s

"Yearly increases in health care insurance premiums once again started to balloon out of control, rising steadily from a low 2 percent annual increase in 1996 to 13.9 percent in 2003. The cost containment potential of HMOs and managed care was, initially, a serious threat to drug companies and medical device manufacturers. But the broader coverage offered by the new plans turned out to have the most profound unintended consequences: Instead of containing healthcare costs, HMOs and managed care plans facilitated the almost unrestrained increases in healthcare spending that followed." Overdo$ed America (page 82)

Dr. Abramson describes the manner that healthcare costs in the United States have been increasing since the 1970s while there has not been a significant improvement in quality of care. We learn that while healthcare costs have increased over the decades, the quality of healthcare has actually decreased. Dr. Abramson describes that since the 1980s there were attempts at trying to decrease costs with HMOs and insurance plans that allowed for cheaper co-pays and reduced medication plans. While the healthcare plans were working and helping communities, we learn that there was negative media coverage about the insurance plans since they were actually reducing costs and improving health of communities where individuals had decreased sicknesses, decreased emergency room visits, and decreased number of hospitalizations. This was due to health care providers (primary care and family practice) and health care HMOS and insurance companies working together to decrease costs and improve the quality of care given. 

"Even the public anger at the witholding of care by overly aggressive or greedy "gatekeepers" turned out to be largely a myth: a study conducted by a nationwide managed company, United Healthcare, showed that fewer than 1 in 100 requests for referals were being denied, leading the insurer to drop its requirement for primary care approval of referrals. Still, as an American researcher in a Canadian medical journal, "Regardless of the evidence, there is a strong sentiment among both physicians and patients that managed care is harming quality of care." So what was the real problem? Initial cost savings had come fairly easy. Doctors, hospitals, and other healthcare providers had little choice but to accept discounted fees in order to be included in the newly formed networks of healthcare providers; otherwise they risked losing access to their patients. These so called volume discounts controlled prices during the transition to managed care, but the apparent solution was short-lived. Once the discounts had been factored in, this apparently exquisite solution to controlling costs- local health care budgets set by the market place instead of the government- became the problem. When there were no more cost savings to be squeezed out of the fees paid to healthcare providers, HMOs and managed care companies had only one avenue open: they had to start to really "manage" care, that is, control costs by eliminating unnecessary or wasteful care. Almost overnight, the hyperbolic hopes for managed care and appreciation of the greater coverage quickly turned into hyperbolic villification. In one survey, 59 percent of the people expressed negative feeling about HMOs and managed care in general, but 69 percent of the same people were satisfied by the actual care they were receiving from their own HMO or managed care plan."- Overdo$ed America (page 81-82)

We learn that Dr. Abramson states that it is possible that the pharmaceutical companies, medical equipment industries, hospital services, and specialty care physicians may have caused there to be a negative perception on news media about insurance plans that were actually created to instruct preventative care and provide optimal healthcare. We learn that negative news coverage of healthcare plans was negative compared to positive after the integration of HMOS and health insurances that decreased costs of healthcare and improved quality of care. We learn that the negative coverage by the news media caused there to be a false perception that people were disliking their medical care with fake stories about patients being rushed from doctor visits when medical journal articles in the 1990s described that doctors were spending additional minutes with patients instead of decreasing their patient visit times. Physicians were still seeing their patients with the same frequency. These fake stories caused people to think that the HMO and health coverage was sub-standard when people were enjoying their healthcare. After the 1990s, the costs of healthcare increased significantly leading to healthcare plans increasing in costs along with prescription medications and treatments. By 2003, the health premiums had increased annually to 13.9 percent from a low 2 percent in 1996. The high cost of medical care in the U.S. can be explained partially by rising premium costs, decreased number of primary care providers compared to specialty physicians, and increased risk of litigation leading to more labs and studies ordered based on litigation prevention than health concerns. These are some of the reasons that the cost of health care has increased over the years while not necessary improving the quality of care received. There is also big pharma's influence on leading medical journals leading to physicians prescribing more expensive and newer drugs already described in the Vioxx and Celebrex examples. The pharmaceutical companies have gained influence over the years even leading to regulators being influenced by financial ties with big pharma.

"The most dangerous consequence of these changes was that the number of drugs approved by the FDA but later withdrawn from the market for safety reasons increased by 1.6 percent of drugs approved between 1993 and 1996 to 5.3 percent between 1997 and 2000."- Overdo$ed America (page 86)

Regulators including FDA and NIH Did Not Prevent Rezulin From Being Approved When There Were Results of Liver Toxicity and Truthful Facts

"The blood sugar-lowering diabetes drug Rezulin is one of the drugs that were approved in haste by the FDA- and later withdrawn, but much too late for many americans. The details of the story were first presented by David Willman of the Los Angeles Times. Also in 1996 Warner-Lambert submitted Rezulin to the FDA for approval, and it became the first diabetes drug to be given an accelerated review. The medical officer evaluating the new drug application, Dr. John L. Gueriguian, was a 19-year veteran of the FDA. His review recommended that Rezulin not be approved: the drug appeared to offer no significant advantage over other diabetes drugs already on the market, and it had a worrisome tendency to cause inflammation of the liver. Warner-Lambert executives 'complained about Gueriguian to the higher-ups at the FDA." Dr. Gueriguian was then removed from the approval process for this drug. When the Advisory Committee met to decide on the approval of Rezulin, they were not informed of Dr. Gueriguian's concerns about liver toxicity. The FDA approved Rezulin in February 1997, and brisk sales soon earned it 'blockbuster' status. Despite the mounting reports of liver problems in the United States, Rezulin was not withdrawn from the U.S. market until March 2000. By that time, $1.8 billion worth of the drug had been sold. The Los Angeles Times reported that, all told, Rezulin was suspected in 391 deaths and linked to 400 cases of liver failure."- Overdo$ed America (page 86-87)

Rezulin was a diabetes drug that was "supposed to help" with blood sugar levels. We learn that it was given preferance to be in a clinical study where the difference between medication treatment or lifestyle interventions would be seen by the NIH. The FDA reviewed the application of the drug and the reviewer in charge of the application found out that the drug, Rezulin, was not better than previous diabetes medication and actually caused liver disease. When Dr. Gueriguian offered a real and truthful review about the drug, the executives of the drug company complained to the FDA and he was removed from the reviewer position having 19 years experience. We learn that when the FDA made the decision to approve the drug, the FDA was not informed about Dr. Gueriguian's review of Rezulin causing liver disease. We learn that even regulators were affected by the financial ties with pharmaceutical companies.

This describes the importance of integrity and ethics even amidst the supposed hope of new drug medications. Rezulin lasted four years on the market before being removed after individuals were harmed by the diabetes drug. This helps us know that we can not trust new medications that are approved in haste not knowing the side effects of newer medication. The drug application process took almost a decade to know the effects of drug therapy and if the drug therapy is beneficial. Dr. Abramson helps us understand the importance of lifestyle changes describing exercising and diet counseling to improve health and the need to be cautious about newer drug medication that has not been approved within the normal timeline of testing 8-10 years minimum. 

Health Recommendations Concerning Sex

In the health recommendations, we also read about the need to not practice unsafe sex. The guidelines were from 2002, and there are news from previous years that speak about the increase of antibiotic resistant sexually transmitted diseases. From a Christian perspective, safe sex means sex in a marriage consisting of a man and a woman. We learn that because of the practice of polyamorism and adultery, the antibiotics that were created less than a hundred years ago are not helping against antibiotic resistant STD's describing Gonorrhea, Chlamydia, and Syphilys. This describes new variants of antibiotic resistance. 

There is the need to protect oneself from fornication and adultery knowing that there are new strains of STD's that do not have treatment. We learn that antibiotics do not help if individuals get such STD's. We learn from Scripture that sex is only allowed in a marriage. If individuals are single, there is the need to avoid lust, fornication, adultery, and homosexuality that attempt to lead to difficulties and diseases. We can make sure to know the difference being able to know that we can use our time and resources for the worship of GOD Almighty and not believe the temporary lies of evil that want to lead to the practice of vices.

Updates Concerning covid "vaccines"

We are able to see from the previous years about the manner that covid news attempted to say that the immune system could not fight against covid being that the immune system is able to combat viruses, parasites, bacteria, and fungus. We learn that the news media stated on repeat that the only manner to fight against covid was to get the covid "vaccine". We learn from biology that the immune system is able to combat viruses and can even develop immunity from infections. The news media described the need to "vaccinate" in order to fight covid and prevent covid infection when exercise and nutrition can help our immune system fight viruses. The news media did not mention the importance of exercise and diet on helping the immune system nor on being able to trust the immune system.

We learn that we can not believe everything that the news media says because of how they tried to make it seem that the immune system could not fight covid and the only manner to fight covid was with the covid "vaccine". We are able to know that we can instead trust in our immune system that GOD Almighty has created in amazing wonder and have healthy skepticism about the covid "vaccines" since there is no information concerning the source, no decade long studies on how the covid "vaccine" functions or if it provides health benefits, and we still do not know the source of the covid variants. All of this causes questions regarding on the need to "vaccinate" against covid and instead allows us to trust in our immune system.

Clinical Phases of New Drugs and Vaccines

When there was the creation of a new drug or vaccine in the past, we learn that the process took anywhere from 8–10 years to approve the new medication or vaccine. This was with the intention to study the effects of the new medication or vaccine. There were four different clinical phases to know if the new medication or vaccine was helpful in treating diseases or preventing viral disease in the case of new vaccines. The four clinical phases took years between each phase to research if the new medication or new vaccine was causing adverse side effects or could lead to health complications. During the four clinical phases, the participants had to be informed of the potental risks of the new medication or new vaccine along with the study design. Once the participant was informed, they were required to sign an informed consent form to describe that they understood the risks of participating in a new medication or new vaccine study. This describes the ethics and morality that existed in the clinical research phases prior to approving a new medication or vaccine. If at any time there were adverse health effects such as side effects or health complications, the participant was removed from the study and the medication or vaccine was not approved.

We learn that science is a tool that can be used to prevent disease and help society, but must be used with responsibility and ethics. We learn that with the polyomyelitis vaccine, measles, mumps, and rubeolla (MMR) vaccine, and the initial flu vaccine (not 1976 flu), there were different phases of clinical research that were needed to be approved before the vaccine was successfully approved for use. Side effects and adverse health complications were researched in case allergic reactions, respiratory symptoms, or even neurological symptoms developed. If there were side effects and adverse health complications, the newer medications and new vaccines were not approved. For this reason, we must be cautious against the covid “vaccine” and “boosters” that took 9 months to develop and “approve” for “emergency use” when clinical studies take 8–10 years to successfully research and comprehend their usefulness and efficiency. 

Persevering Learning About Health and Science While Keeping Integrity and Ethics

Science is a tool that can be used to help us understand how to optimize and improve ourselves through obtaining nutrition in our diet and also by prioritizing exercise. There are several books on Health and Science that describe the health benefits of exercising minimum thirty minutes every day and also of eating nutritious food. This is to persevere with energy and motivation and help our immune system. We have learned through different doctors and scientists that the immune system is a fantastic and intricate system that is able to improve with age. We have learned with the experimental “vaccines” of covid that it is better to exercise and eat a good nutritious diet than to get vaccinated with the covid “vaccines”.

There are other health options that we can also take to help our immune system and our health. There are scientific studies that have described the benefits of antioxidants in the diet. There is the free radical theory (Sohal, 2002) that states that there are free radical particles that cause damage to the cells. One manner to prevent free radical damage is to consume antioxidants that are found in several different vitamins including vitamin C and vitamin E. Citrus fruits including lemons, limes, oranges, mango, cranberries, and pineapples are known to contain vitamin C. Tea and coffee is also noted to contain antioxidants. It is also noted that high vitamin C intake through juices or teas can help combat colds.

The Importance of Exercising and Keeping Healthy Weight

“Total body weight increases from the 20s until the mid-50s, but declines after that.”

Exercising almost every day except for Shabbath for thirty minutes each day can help keep the immune system healthy and also decrease body fat. Exercise can help the immune system remain healthy by providing oxygen to the brain and body and also by strengthening the immune system. By exercising almost every day, the immune system is strengthened and its cells are able to protect against viruses, parasites, bacteria, and microorganisms. The immune system's cells, B cells and T cells, are able to protect against foreign cells describing bacterial infections, parasite infections, viral infections, and micro-organisms that can cause sickness (page 93). It is noted that exercise and proper dieting can prevent immune senescence or the decline of the immune system functioning.

“Active leisure time activities that can range from 15 to 90 minutes a day, can reduce age-related accumulation of body fat (Raguso et al, 2006).” (page 77)

By exercising almost everyday for thirty minutes each day, our immune systen is strengthened and body weight remains stable. There are studies that describe that with aging from the 20s to the mid-50s, body weight increases. It is noted that most of the weight gain that occurs through the years of middle adulthood is due to an increase in Body Mass Index (Ding et al, 2007). This is usually due to a lack of proper diet regulation and sedentary lifestyle. Exercising regularly with aerobic exercise (cardio) can help “maintain muscle tone and reduce the fat deposits of middle-aged spread” (page 77). Healthy sport activities that can range from fifteen minutes to ninety minutes a day can also help reduce body fat. By exercising close to every day, we are able to strengthen our immune system and decrease unneeded body fat. This allows us to keep our body weight stable and healthy and also help the immune system. 

Calorie Restriction Diet Studies

"Caloric restriction is also being investigated as a possible mechanism to slow down sarcopenia. (Dirks and Leeuwenburgh, 2006)"- (page 79)

There is also the theory of the calorie restriction diet (Walford, et. al, 2002). There are other studies (Hyun et. al, 2006) describing the benefits of calorie restriction diets. There are scientists that have created studies concerning how fasting also known as calorie restriction diet can help prolong life. There are several studies done in the past including in India and the United States that describe how intermediate fasting can help individuals remove dangerous cancerous cells from developing and help the immune system work better. Other studies describe that the calorie restriction diet can help prevent sarcopenia, or muscle loss. There are multiple studies that have shown that even fasting once a month can have positive health outcomes. There have been studies that have attempted to prove that fasting can prolong life and prevent disease such as cancer.

Calorie restriction diets work because they help reduce free radical formation. There are different mechanisms of action that are described yet the important point is that fasting can help prevent free radicals. If there is no formation of free radicals, then there is no oxidative stress. This is interesting because fasting is spoken in Scripture, and there are actual health benefits that exist from fasting. We learn that fasting can actually help when done for the worship of GOD Almighty. Scientifically it has been shown that intermediate fasting can have health benefits including improving the immune system, remove or prevent cancer cells from forming, and help prevent free radical formation that can have negative effects on cells. 

Keeping the Immune System Healthy

There is also gratitude knowing that I am not vaccinated not even once with the covid “vaccine”. There are published studies in books about Health and Science that describe how the immune system can keep strong even with age. This describes that there is no need of an experimental vaccine that “supposedly” helps the immune system. The study published by (Chandra, 2004) describes how the mineral zinc and vitamin E can help the immune system function optimally. Moderate exercise also helps the immune system described by (Stasser et. al, 2006). We can exercise every day for thirty minutes every day and eat a well balanced diet that prevents the immune system from atrophying and diminishing. We do not need experimental covid “vaccines” that who knows how they function.

There are significant studies that have demonstrated that the immune system can keep functioning regardless of age. Yet there is the need to eat a well balanced diet with less fat, complex carbs, and include protein. There are studies that state that age does not affect the immune system as much as a sedentary lifestyle and lack of adequate diet with antioxidants, complex carbs, and proteins. This describes that exercising almost everyday and including the essential amino acids found in protein help individuals persevere with a healthy immune system. Potatoes, grains, and pastas contain complex carbs and 7 grams of proteins per serving. Beans and lentils contain protein (beans are noted to contain 8 of the 10 essential amino acids that are only obtained in the diet). Animal protein such as fish, chicken, and beef are known to have protein. General rule: The less legs on the animal, the more protein it has. This is helpful because we learn about diet and exercising that allows us to persevere with a healthy immune system.

Helping the Immune System With Soups

There are certain measures that we can take to help our immune system function properly. We learn that the immune system can improve with age being able to help fight infections and disease. With a proper diet and exercising each day, we can help the immune system. There is the advice that chicken soup can help combat against colds and help the immune system. While I have not read of studies describing the benefits of chicken soup, yet it is a well known fact that there are benefits of eating chicken soup when there are colds. Grandparents taught the importance of eating chicken soup and soups to help obtain needed nutrients and fight off colds. Chicken soups can successfully combat colds seen in the manner that chicken soup has protein, minerals, and nutrients that can help the immune system. There is evidence that suggests that soups provide greater nutrition than baked and fried cooked foods.

This is because the nutrients found in chicken soup are better absorbed in the form of soup or broth compared to food served in a fried or baked manner. There is the understanding that chicken soup bone broth can help the immune system because of the nutrients found in chicken bone describing marrow and calcium, fats from chicken skin, and protein. A diet with substantial protein can help the immune system function optimally understanding that the immune system uses proteins to function adequatelly. There are studies that prove that a diet with a lack of protein when aging can lead to decreased immune system function. Soups are usually helpful in including protein, carbs, and fats while including vegetables that have minerals and vitamins.

Stress and Negative Emotions Can Negatively Affect the Immune System

“Stress and negative emotions are thought to have deleterious effects on immune functioning which, in turn, can result in tissue damage and vulnerability to disease.”- (page 93)

There are scientific studies that prove that stress and negative emotions can affect the immune system. This is interesting because the Scriptures speak about how there is a need to avoid negative emotions in both the Old Testament and New Testament. There are scientific studies that describe that anger and negative emotions can lead to a decreased functioning of the immune system. It is also noted by scientific studies that positive emotions help individuals have a better functioning immune system. The Scriptures describe that, “Gladness of heart is good medicine, but envy makes the bones rot.” We learn to have dominion over negative emotions and remove negative emotions. Instead we can persevere with happiness and gratitude knowing that the worship of GOD Almighty helps us persist with health.

“One study of a small sample of healthy volunteers found no age differences in a variety of immune system measures (Carson et. al, 2000).”- (page 94)

There are also longitudinal studies that describe that individuals that live to longer life tend to be grateful and have a cheerful attitude. Positivity has been linked to increased well being, better health, longer life, and resiliency. Scientific studies have shown that being positive has a strong correlation to better health and longer life. There are longitudinal studies that span over decades that have shown that individuals that have lived to a hundred years of age tend to be positive, grateful, and industrious. There are studies that show that age does not affect the immune system as much as inactivity and lack of proper diet and nutrition. 

Exercising Almost Everyday Helps Prevent Obesity and Sarcopenia

“Strength training is the number one preventative measure that can counteract the process of sarcopenia in adulthood (Hunter et. al, 2004). Although older adults do not achieve as high a degree of improvement as do younger adults, only 16 weeks of resistance training can improve fast-twitch muscle fiber numbers to the size of those found in the young (Kosek et. al, 2006).”- (page 79) 

The immune system is able to function optimally when individuals exercise close to every day for a minimum of thirty minutes each day. There are many health benefits to exercising almost everyday including helping strengthen the immune system, fighting against weight changes and obesity, helping the cardiovascular system function optimally, and help fight against sarcopenia described being muscle loss. There are health studies that speak about how exercising can help prevent muscle loss and instead maintain muscle mass even into old age (even helping individuals that are in their 100th year of age). Scientists have described how exercising for a minimum of thirty minutes almost each day can help prevent sarcopenia and osteopenia or bone loss in old age. If we are younger, we can understand the importance of keeping an exercise routine almost every day except Shabbath so that we can keep healthy weight and strengthen the immune system. If individuals have not established an exercise routine, the earlier the age the better. This is important because I have seen in the past how the post-modern system does not want individuals to learn (be self-didactic) after 20 years of age nor exercise after 30 years of age. This is because learning helps us improve ourselves and gain understanding of different topics including nutrition and diet, and exercising helps us keep young. 

"Perhaps reflecting their greater mobility, people living in rural areas have higher bone density than people living in urban environments. (Pongchaiyakul et. al, 2005)"- (page 80)

I am grateful that grandparents have taught the importance of exercising because exercising helps keep individuals young and prevents health complications seen in a sedentary lifestyle. I am surprised with how grandparents exercised almost every day going on long walks and persevered without health issues. There are different types of exercise that can help maintain healthy weight and keep muscle mass. For the younger ages, going on long walks, jogging, or using the treadmill can help keep healthy weight. Practicing moderate exercising, by utilizing cardio by doing push-ups, sit-ups, and jumping in place (or utilizing the jump-rope) can also help by increasing the intensity of exercise. For the older ages, leisurely long walks, tai-chi, or strength training can help keep muscle mass and avoid sarcopenia and osteopenia.

"People as old as a 100 years of age can benefit from this form of exercise [weight-training]. Effective training typically involves eight to twelve weeks, three to four days per week, at 70–90% of the one-repetition maximum.”- (page 79) 

I am able to say that exercise is something that we need to practice almost each day. Grandparents were able to go on long walks and never developed diabetes, high cholesterol, and hypertension. Grandparents that exercised almost every day also had good muscle movement and motivation. It is noted that sarcopenia tends to affect older people in their 50s who do not exercise causing muscle cells to decrease and be substituted by connective tissue and ultimately fat. Sarcopenia can lead to increased fat in the body. Sarcopenia can also aggravate osteopenia, or bone loss, that can lead to decreased bone strength and lead to falls in older age. With proper exercise almost each day, there are studies that prove that sarcopenia and osteopenia can be decreased so that they do not lead to health difficulties. Even individuals that are in their centenarian age have proved that exercise can help keep individuals healthy and young (There are stories of individuals that maintained exercise routines well into their older age. I remember a video of a 90 year old who kept exercising and practicing weight-lifting and was healthy and gave presentations on the importance of exercising. There was another individual who started running in his 80th year and kept being able to exercise and run well into his 100th birthday.) We are able to learn from our grandparents about the importance of exercising almost each day. We can learn to value exercise and also having a proper diet so that we can persevere without covid “vaccines” and trusting in the immune system that GOD Almighty created in amazing manner. We can also avoid smoking, heavy alcohol use (better to abstain from alcohol at all because of the times that we live in), and keep a healthy diet (calcium, magnesium, and vitamin D have been noted to help prevent osteopenia).

"Smoking (Baheiraei et. al, 2005) , heavy alcohol use (Samelson et. al, 2006), and poor diet (Chen et. al, 2006) can exacerbate the process [osteopenia]."- (page 80) 

Avoiding Smoking Cigarettes, Illicit Substances, and Heavy Alcohol Use

There are studies that have shown that smoking and excessive alcohol use can lead to osteopenia. There is the understanding that smoking can also lead to adverse health effects including cardiovascular disease, lung disease, and health complications. We can avoid smoking cigarettes knowing that it has been known since the 1990s (there were commercials in the 1990s that described that some commercial cigarettes contained added chemicals that are toxic to human beings) that some commercial cigarettes have a large amount of additives that are not tobacco. Smoking cigarettes has been noted to cause health difficulties. There is no need to smoke illicit substances because they can lead to the diminishment of chemical brain receptors (for example, dopamine). It is noted scientifically that when individuals use illicit substances for the first time, there is a sense of a supposed “euphoria” that can not be reproduced by the use of illicit substances on multiple occasions or increased use of illicit substances. This is because the brain receptors begin to decrease with illicit substance use. This is why there is the risk of overdose with illicit substances because the number of chemical receptors in the brain decreases with increased illicit drug use. We learn that if the dopamine receptors of the brain decrease with illicit substance use then there is no point in using illict drugs that can also lead to severe addiction (for example meth and crack), health complications (H.I.V. with heroine use), and even madness (cannabis with pcp, hallucinogenic acid, and lsd). Instead exercise can help us develop discipline, motivation, keep healthy, and avoid addictions.  We can avoid smoking cigarettes and avoid illicit substances that also cause health issues including addiction and risk of overdose.

“Conversely, smoking has deleterious effects on cholesterol, leading to decreased HDLs and increased LDLs, as well as the accumulation of other harmful forms of fat in the blood (Kuzuya et. al, 2006).”- (page 83)

Heavy alcohol use has also been noted to cause osteopenia. We learn that due to the times that we are living in, it is better to not drink alcohol and persevere sober-minded. It is noted through documentaries that heavy alcohol use can lead to liver disease, esophagitis, esophageal cancer, and alcoholism. I remember a documentary that described a physician (prior to the times of covid) that described that one of the biggest causes of problems, disease, and difficulties in society was alcoholism. Alcoholism and excessive alcohol use can cause disease and even malnutrition (Wernicke's syndrome and Korsakoff) in some cases. In these times, it is better to avoid alcohol at all knowing that it is better to persevere in the worship of GOD Almighty and exercising. 

Exercising Takes Care of the Cardiovascular System

“Our cardiovascular efficiency is indexed by aerobic capacity, the maximum amount of oxygen that can be delivered through the blood, and cardiac output, the amount of blood that the heart pumps per minute. Both indices decline consistently at a rate of about 10% per decade from age 25 and up so that the average 65-year-old has 40% lower cardiovascular efficiency than the young adult (Maron et. al, 2001).”- (page 82)

There are scientific studies that prove that exercising a minimum of thirty minutes a day almost every day allows the cardiovascular system to also function optimally. There are studies that state that even leisurely exercise can help the cardiovascular system. Moderate and intense exercise have also been shown to help keep the heart and arteries healthy. Exercise helps the high density lipoproteins transport lipids to be converted to bile acids or excreted, and also decreases the cholesterol that exists in the blood. Exercise also helps metabolize cholesterol. For males, cholesterol is converted to testosterone and for females to estrogen. This describes that exercise not only decreases the risk of heart disease due to high cholesterol and hypertension, but also helps convert cholesterol to testosterone for men and estrogen for women. This process prevents atherosclerosis that is plaque build up in the arteries that can lead to heart attacks and strokes. Smoking has been shown to lead to atherosclerosis build up in the arteries and heart. By quitting the smoking of cigarettes and exercising, studies have shown that individuals can improve cardiac health.

“Declines in aerobic capacity occur even in highly trained athletes, but those who continue to exercise at a high level of intensity maintain their aerobic capacity longer than non-athletes (Tanaka and Seals, 2003).”- (page 82)

There are also studies of individuals that were able to exercise well into their older age. While it is noted that with age the aerobic capacity and maximum cardiac output decreases, we learn that older individuals that keep on exercising have better aerobic capacity and maximum cardiac output than sedentary older individuals. It has been demonstrated that there have been older individuals that were able to keep exercising well into middle and older age. (We learned about Dobri Dobrev who walked kilometers every day and was able to be 100 years of age. There is the 90 year old who still practiced weight training, and the 100 year old who began running in his 80s that demonstrate that exercise can help keep individuals young despite the age.) Individuals are noted to be healthier into older age when they decide to exercise close to every day. Studies have proven that exercising 3–4 days a week allows individuals to live healthier lives, fight obesity, and live longer lives. There are studies that show that exercising at 60-75% of the max capacity must be practiced three to four times per day to achieve positive results. Exercise is proven scientifically to help individuals live longer and stay healthier. Even minimum exercise can help individuals compared to a sedentary lifestyle. The important part is to pick an exercise routine and stick with it being that there are different sports and aerobic activities that help including walking, dancing, bicycling, jumping rope, swimming, roller skating, playing racquetball, or even wall ball.

“Continued involvement in exercise throughout adulthood therefore does not appear to result in stopping the biological clock. However, exercise can help slow down that clock by benefiting functional capacity, lifestyle, and control over body mass. Add to this the benefits of avoiding cigarette smoking, and the impact on cardiovascular functioning and hence the quality of daily life of these positive health habits can be significant (Christensen et. al, 2006).”- (page 82-83)

Taking Care of the Cardiovascular System Prevents Heart Disease

The Adult Development and Aging Textbook by Psychologist Susan Krauss Whitbourne describes multiple scientific studies about how lifestyle changes can help against heart disease. We learn that there are four areas that can affect an individuals probability of reducing heart disease. The first is eliminating a sedentary lifestyle. This describes how exercise helps keep us healthy and prevents cardiac disease. Eliminating smoking cigarettes can help prevent heart disease that happens when individuals smoke cigarettes. There are studies that prove that smoking cigarettes causes damage to the arteries and makes them susceptible to atherosclerosis or plaque build up that can lead to myocardial infarctions (heart attacks) or strokes. It is estimated that one fifth of the adult population smoked cigarettes in the 2000s.

“The relationship between leisure activity and heart disease is well established, with estimates ranging from a 24% reduction of the risk of myocardial infarction among nonstrenous exercises to a 47% reduced risk among individuals engaging in a regular pattern of strenous exercise (Lovasi et al., 2007).”- (page 113)

The maintance of exercising can help prevent obesity and help individuals keep healthy weight. There is strong correlation stating that obesity can lead to heart disease and heart attacks. We can fight against obesity maintaining a healthy diet and exercising close to every day except Shabbath. We learn that keeping the sugar intake to less than ten teaspoons per day can significantly prevent additional pounds from being added to the weight. This means drinking water throughout the day and decreasing or eliminating sugary drinks that can contain more than 39 grams of sugar per serving. Some sodas can have up to 290 calories per serving. Another manner to eliminate heart disease is preventing heavy alcohol use. It is noted that drinking more than two beers or glasses of wine can lead to an increased risk of strokes. These health precautions can help prevent metabolic syndrome where there is high levels of abdominal obesity, abnormal levels of blood cholesterol, hypertension, insulin resistance, high blood fats, high levels of C-reactive protein in the blood (an indication of inflammation), and the presence of coronary plaques (page 114).

“Heavy alcohol intake (more than 60 grams of alcohol or 2 beers or 2 glasses of wine a day) may be associated with increased stroke risk (Reynolds et. al, 2003).

Exercise and Diet Can Help Prevent Heart Disease in Adulthood if Individuals Are Overweight in Childhood or Early Adulthood

“Although a high BMI is associated with increased risk of heart disease in middle and later adulthood, people with high BMIs in childhood and young adulthood are not necessarily at higher risk of developing cardiovascular disease. A study of nearly 15,000 young people in Great Britain revealed no association between early BMI and later development of either cardiovascular disease or stroke (Lawlor et. al, 2006)”- (page 114)

We learn from scientific studies in the 2000s that although high BMI can lead to a higher risk of heart disease in middle and later adulthood, children with high BMIs can fight against getting cardiovascular disease in adulthood by exercising and eating healthy diets. I remember that in early adolescence I was overweight. I remember that at that time, we were eating out (from fast food restaurants) three days of the week, particularly, the weekend, and drinking soda throughout the day (there was minimal drinking of water and mostly soda for every meal except breakfast which included orange juice). I was able to improve by choosing to exercise and drink less sugary drinks throughout the day describing sodas. Over the time span of a year of decreasing the drinking of sodas and eating more home cooked meals in the weekends, I was able to lose weight and be healthier.

I can say that exercise and eating a healthy diet based on home cooked meals is of great importance to prevent being overweight and fight obesity. This helps us understand that we can instruct the importance of decreasing or avoiding sugary drinks that can add substantial calories that are not needed. Preparing home cooked meals also helps keep healthy weight because it has been noted that home cooked meals have less calories than meals from fast food restaurants. We have seen in the documentary Supersize Me about how fast food restaurants have substantial calories. This does not mean that we can not eat at fast food restaurants (...well prior to covid) but that there is the need to practice moderation. It is noted that fast food restaurants began to display the calories of their menu after the documentary was released. There are also suggestions that eating a Mediteranean diet can help prevent cardiovascular disease. The Mediterranean diet consists of eating minimally processed fruits and vegetables, seeds, grains, olive oil, low amount of red meat and dairy foods (Serra-Majem et. al, 2006). The Mediterranean diet has been shown to help decrease the risk of heart disease.

Decreasing Sugar Intake Can Help Prevent Adult Onset Diabetes

“The main risk factors for diabetes are obesity and a sedentary lifestyle. Epidemiologists attribute the rise of diabetes to an increase in BMI, noted earlier as a risk factor for heart disease (Centers for Disease Control and Prevention, 2003). Researchers in this area warn that older adults are becoming increasingly likely to experience metabolic syndrome, noted earlier in the chapter as a dangerous combination of obesity, insulin resistance, high lipid levels, and hypertension, leading to greater risk of cardiovascular and kidney disease (Bechtold et. al., 2006).”- (page 126)

Exercising and having a healthy diet can prevent cardiovascular disease and also prevent type 2 diabetes. We learn that the adult onset of diabetes can occur due to an increased amount of sugar intake. We learn that the guidelines given by the American Heart Association in 2002 describe the need to eat healthy food including protein, complex carbs, minimal fats, a pound of vegetables per day, and decrease sugar intake. We learn that Dr. Abramson described that the number of teaspoons of sugar per day should not exceed 10 teaspoons. This is because sugars can become fats in the body when there is too much sugar consumed. Sugary drinks such as soda can contain close to 39 grams of sugar per serving. We learn that in two servings that is 78 grams of sugar per day not including candies, deserts, and additional calories of breakfast, lunch, and dinner. This is not meant to lead to obsessive calorie counting and instead allows individuals to know the approximate amount of calories that specific food and drinks can have.

“Given the clear relationship between obesity and diabetes, the most important means of preventing Type 2 diabetes are control of glucose intake, control of blood pressure, and control of blood lipids.”- (page 126)

We learn that drinking water instead of sugary drinks can help with keeping a healthy weight. We learn that the body needs water instead of sugary drinks. This does not mean that we can not have a drink with sugar in it at times but that we need to practice moderation. This helps prevent excess sugar from being converted to fats in the body. We learn that adding more than 10 teaspoons per day (32 teaspoons in two servings of soda, for example) to the diet can lead to 1 pound of weight added per month. In five years, that can be 60 pounds of additional weight. We learn that drinking water can help prevent adding additional unneeded weight and keep healthy weight. This can help fight obesity and prevent type 2 diabetes from leading to metabolic syndrome.

“By 2000 this had increased to 32 teaspoons of sweeteners per day, providing an additional 135 calories. (Just one 20-ounce bottle of soda, for example, contains about 16 teaspoons of sugar.) Without any other changes in diet and exercise, a person taking in an extra 135 calories per day gains more than 1 pound each month (3500 calories lead to 1 pound of weight gain.) The result is perfectly predictable: the percentage of obese adults doubled between the early 1970s and 2000, and during the same period, the percentage of obese children and adolescents increased by a factor of almost four.”- (page 237)

The Benefits of Exercising and Learning Keeps the Brain Young

“Early research on nervous system functioning in adulthood was based on the hypothesis that, because neurons do not reproduce, there is a progressive loss of brain tissue across the adult years that is noticeable by the age of thirty. The model of aging based on this hypothesis was called the neuronal fallout model. However, in years intervening since that early research, it has become clear that, in the absence of disease, the aging brain maintains much of its structure and function. The first evidence in this direction was provided in the late 1970s by an innovative team of neuroanatomists who found that mental stimulation can compensate for loss of neurons.”- (page 94)

Based on scientific studies, there is proof that exercising not only helps the immune system function well, fights obesity and high cholesterol, helps the cardiovascular system stay strong, and improve muscle endurance and bone strength, but also helps keep the brain young. There are studies that describe that the brain also improves with exercise and helps individuals obtain greater amount of oxygenation during moderate exercise. There were theories as to how the brain ages, and one of the theories stated that after the age of thirty, the neurons do not reproduce and the brain can go through loss of brain tissue. The theory was proved incorrect because there are studies that show that the brain and the neurons can go through plasticity that allows individuals to keep the brain young and healthy. Mental stimulation can compensate for loss of neurons.

“According to the plasticity model, although some neurons die, the remaining ones continue to develop, and, in fact, some areas of the brain involved in complex language and word processing skills do not completely mature until middle age (Bartzokis et al., 2001). Research continues to accumulate supporting the notion of plasticity (Burke and Barnes, 2006), including studies on the value of diet and physicial exercise as a manner to maintain brain function (Pinilla, 2006), and consequently, cognitive functioning (Dishman et. al, 2006). Aerobic exercise in particular appears to be most beneficial in preserving and maximizing brain functioning (Colcombe et. al, 2006).

There are studies that prove that learning each day helps the brain stay young. Just like exercising almost everyday helps keep us young, learning everyday helps the brain stay active, functional, and healthy. This is interesting since post-modern society has attempted to make it seem that if someone is over twenty there is no need to keep learning. We learn that learning helps the mind by creating connections between neurons. These neural connections allow for the brain to improve in function. Activities such as reading a new book, learning a new language, and writing have been proven to help the brain keep young. It is also surprising that specific neuronal functions involved in complex language and the processing of words does not completely mature until middle age. This means that individuals are able to keep improving with age and exercise instead of seeing age as a burden. 

Studies on antioxidant benefits and calorie restriction diet from Adult Development and Aging: Biopsychosocial Perspectives by Susan Krauss Whitbourne

(I recently began to read the book from Dr. Abramson since I had bought the book several years back yet did not read it thinking that it was about the opioid epidemic. Upon reading the book in the past few days, I am able to understand why individuals are skeptical of pharmaceutical companies and why healthy lifestyle changes describing exercise and dietary changes are of great importance.)