Preventive medicine for men

 The #1 reason why men don't get healthy


- they don't go to the doctor

Preventive Vs Diagnostic services

- preventive - preventing before something happens
- diagnostic - after something happens

Today is mainly about preventive :
Annual physical - 100% covered
Diagnostic - copay and deductibles

Why is prevention important?
- 70% of diseases are prevntible4
- most chronic disease do not have symptoms
- early detection associated with higher cure rates
- better health and quality of life
- increases productivity
- reduces health care cost
- saves lives

Prevention is not perfect - benefits vs harms

Screening test - false positives, false negatives, unnecessary biopsies, over-diagnosis
USPSTF recommended tests = A and B grades

Leading causes of death in the US
- heart disease
- cancer
- unintentional injuries
- chronic respiratory disease
- stroke
- alzheimers
- diabetes
- pneumonia and influenza
- kidney disease

This is in contradiction with what people think and read in the news.

1 out of 100 meet AHA guidelines for ideal heart health. that means 99 people don't

What increases risk of heart disease
- high blood pressure (at home when you are calm) - A
- diabetes - B
- high cholesterol - B

ASCVD risk estimator plus

how to reduce the risk of heart attack:
- exercise
- plant based diet
- the above 2 can reduce risk by 50%

- meds

South Asians - coronary heart disease 10 years earlier than general population
25% of south asian heart attacks are under 40. 50% are under 50%
in California, South Asians get admitted for heart disease 4 times more than other ethnicities
once a South Asian gets a heart attack - there mortality increases by 40% as compared to the average population

Why South Asians?
- salt poor environments moving to salt rich env - increases hypertension
- South Asians - insulin higher when they eat food,
- China - Diabetes
- Moving places
- both women and men

Cancer:
Colon cancer - men and women, 1 in 20 people, 90% in 50 or older , Grade A after 50.
Choosing the right test:
Colonoscopy - camera looking for polyps
polyps before cancer - every 10 years
blood in the stool - FIT test every year for 10 years - equivalent to colonoscopy - missing a year then colonoscopy s better

Prostate cancer - 1 in 7 men, grade C - not a fantastic test
out of 1000 men, 120 false positives
urologist - will do biopsy which can cause infection , pain and bleeding and still be a FP
out of which 50 will have treatment- 5 will die, 0 to 1 person can be saved

clinicians inform about harms and benefits PSA test - decision up to patient

Android app ePSS to check grade for test

Lung Cancer

Broad health
Premature death - genetics(30%), exercise n diet (40%), environmental  (20%), insurance (10%),

Blue Zones - Longevity hotspots - people who live 100 years or more - Loma Linda, Sardinia, Nicoya, Icaria, Okinava

move naturally
purpose
down shift
80% full
plant
wine @ 5
belong
loved ones first
right tribe - spiritual belief

an epidemic on aging middle men - for men suicide is 7 and for women it's 14.

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