Men’s Health - Chronic Disease, Metabolic Health & Cardiovascular Health

Chronic Disease, Metabolic Health & Cardiovascular Health

Many of us would struggle to define some of these terms! What exactly is Chronic disease? What exactly is Metabolic Health? And how are they related?

Chronic Disease:

Chronic Disease is an umbrella term for those (often) reversible health conditions that we associate with a sedentary lifestyle, a diet high in processed foods, little or no exercise, stressful work and personal lives, and poor sleep hygiene. In short, it refers to the presence of the below conditions that are responsible for 80% of all deaths over the age of 50!

• Vascular Disease. This includes Cardiovascular (Heart Attacks), Cerebrovascular (Strokes), and High Blood Pressure
• Dementia (such as Alzheimer’s Disease)
• Cancer
• Metabolic Conditions. This refers to a spectrum of conditions ranging from Insulin resistance to obesity, to non-alcoholic fatty liver disease, to Pre-Diabetes, to Type 2 Diabetes. This is the foundation layer of chronic disease, the other conditions above often emerge from these metabolic conditions.

As good as our modern healthcare system is at dealing with issues once they present such as acute trauma, infectious illnesses, obstetric and orthopaedic medicine, etc, the healthcare system when it comes to chronic disease is a treatment-centric model. We need a combined prevention and treatment model to deal with these major health burdens.

Prevention and Treatment:

The first steps in Chronic Disease prevention and treatment are understanding our individual risk factors, and either removing or optimising these. What is very important to understand is that many of these risk factors are underpinned by some of the same fundamental mechanisms. Some of the factors that we need to remove, measure, track, and improve include:

• Smoking: - Many pharmacies can provide support around smoking cessation and Nicorette replacement therapies.
• Lipid and Cholesterol measuring and optimisation: - Think of cholesterol and lipids as part of a transport and energy system with both good and bad components. Ask your GP about the important ratios such as Total Cholesterol: HDL Cholesterol, and novel metrics such as ApoB (number of LDL particles), and Lp(a). There are a number of therapies available to address any issues identified.
• Insulin Resistance: - Our bodies can become more resistant to the effects of insulin (released by our pancreas in response to carbohydrates) that can become sustained from ultra-processed-food diets and poor-quality carbs, driving Obesity and Type 2 Diabetes. Lowering insulin through ‘Healthy Real Food’ diets and exercise is the most important way to avoid this phenomenon. There is also medication that helps regulate insulin and glucose levels such as Metformin. This has also been shown to reduce weight and improve longevity.
• High Blood Pressure (BP): - Measure your BP regularly. Your blood pressure status is often lifestyle-related, so improving diet and exercise practices, as well as optimising Insulin/Glucose control and looking at markers such as Uric Acid, are important considerations. Your GP or Pharmacist may recommend a 24-hour monitor to determine whether your BP is high. Treatment can often involve many safe and effective therapies recommended by your Pharmacist or prescribed by your Doctor. Sustained high blood pressure over long periods can lead to organ damage and increase the possibility of events such as strokes and heart attacks.
• Body Composition Optimisation: - Obesity is now the second biggest risk factor for cancer after smoking. Obesity is predominantly driven by poor diet (processed foods) leading to sustained Insulin levels. Improve your body composition through Nutritional strategies and Appropriate exercise (combination of strength, cardiovascular, stability, and flexibility). There are several novel therapies now available to aid in weight loss such as GLP-1 analogues that have been covered widely in the media in recent months. Have a discussion with your GP or Pharmacist about whether they may be suitable for you.
• Liver Function: - Non-Alcoholic fatty liver disease (NAFLD) is a major phenomenon in both developed and developing societies driven by bad diet, especially poor-quality carbohydrates, and sugar. Once identified it is easy to address through lifestyle intervention. It is closely related to all other metabolic dysfunction.

The solutions to Chronic disease prevention and treatment use a combination of the following strategies:

• Nutritional Intervention: - Almost all strategies or diets are ultimately pulling on one or a combination of 3 levers: What we eat, When we eat, and How much we eat. Eat a nutrient-dense real-food diet that combines some elements of Time Restricted Eating (TRE). It is also important to remember that some diets can give rise to nutritional deficiencies so it may be important to supplement your diet if it is missing any macro or micronutrients. E.g. Vitamin B12 supplementation.
• Exercise: - Optimal exercise regimens should incorporate the following: Strength/Resistance work, Cardio (Zone 2 and VO2 Max training), Stability and Flexibility. Using some of our wearable devices can help us monitor and improve our exercise through the tracking of metrics such as steps, resting heart rate (RHR), and heart rate variability (HRV). The fitter we become the lower our RHR and the higher our HRV. Our VO2 Max is one of the best predictors of longevity and the good news is that it can be trained, even if starting at a very low level.
• Sleep: - Sleep optimisation has become one of the key frontiers in chronic disease management and can be enhanced through lifestyle management. Sleep tracking is very popular through wearable technology and the data they show can provide valuable insights into why our sleep may be disrupted. E.g. alcohol use, timing, sleep apnoea, urological symptoms, etc.

Stress Reduction and Mental health optimisation

• Improved Hormonal Health: Speak to your Health Care provider about the benefits of Hormone Replacement Therapy, for both Women and Men.
• Supplementation: There are a variety of important supplements that can be used to support Metabolic health (including heart), Immune function, Bone strength and Recovery, etc. Many of these supplements have synergistic effects and are best taken in combination. Vitamin D has important metabolic, hormonal, and immune function properties, and higher doses are required in those living at latitudes that get little sunlight for large parts of the year e.g. Ireland. Magnesium is important for cardiac and muscle health and for regulating circadian rhythm thus improving sleep. Vitamin K2 supports cardiac and metabolic health in combination with Vitamin D. Omega 3 fatty acids (EPA and DHA) are important for both brain and cardiac health.
• Medication: We discussed some of the prescribed medication earlier. Speak to your Doctor or Pharmacist if you require advice about medications that may improve and treat chronic disease and poor metabolic health.