“SUSTAINABLE HEALTH IN AN AGEING POPULATION” | 老龄化人口的可持续健康

Contributions by: Prof Ian Brighthope

What if I told you, that science had discovered a pill that could halve your risk of dying of cancer, and slash your chances of contracting cancer at all? That when this substance was tested, in a randomized, controlled trial, the trial had to be stopped because of, I quote “the apparent reductions in total cancer mortality and total cancer incidence” in the experimental group. The researchers could no longer ethically justify not giving this substance to the placebo group.

What if I told you that if everyone diagnosed with heart disease took a particular pill, their chances of dying of this disease would be enormously reduced. That when researchers in the United States looked at this as a possible disease treatment, they projected they would save 310,000 lives over a ten-year period in the US alone?

Well, this is all true. These substances have been discovered, tested and have stood the test of time. The substance that will prevent your cancer is a mineral called selenium, and the paper I have quoted is from the Journal of the American Medical Association, a very prestigious journal, published in 1996. The substances that will enormously reduce your chances of dying from heart disease are called Folic Acid and Vitamin B12. This was also published in the Journal of the American Medical Association in 2001. All of these substances are cheap and extremely safe.

I could tell you similar stories about vitamin C, Zinc, Saw Palmetto and Coenzyme Q10. I could tell you similar stories about dozens of other substances that we categorize as natural or complementary health products. I have been a nutritional doctor for 25 years, and I have treated thousands of patients, frequently very sick people, with all manner of illnesses, including cancers and psychiatric diseases. But I write only a few scripts per year. Most people don’t know about the power of these substances, and so today I want to talk to you about the future of health in this country, and how I believe we can improve it.

Over the past two decades, Australians have enthusiastically embraced natural healthcare products and philosophies. They frequently position natural products as their first choice in health care. This phenomenon is not peculiar to Australia, as there is a worldwide trend to safer natural healthcare.

As a consequence of this escalating consumer demand for products, knowledge and services, we have witnessed a rapid growth of industry activity and health professional training programs but unfortunately to a lesser extent, little increase in research into Natural Health. However there has been a virtual explosion in the quantity of literature on nutrition and nutrients.

Australians have used natural health products, or NH for longer than today’s mainstream medicine has been in existence. When your mother gave you a spoonful of cod liver oil, she was practicing NH. Over 60% of the Australian population use some form of NH, and the public spending on NH far exceeds the patient contributions for all pharmaceutical medications.

Figures......

Dollar value figures are hard to find here, but in the US, the NH industry is estimated to be worth about US$21 billion. In Australia, it may be about $1.5 billion. Despite the obvious fact that the public is voting with their feet, there is still an astonishing amount of opposition to NH in this country. Mostly due to ignorance, vested interests and intellectual rigidity, this resistance discourages health professionals from choosing the best care for their patients, by ignoring a great many valid and helpful treatments.

The basis behind much of this resistance, especially in the medical, political and research professions, is what I call the “drug and disease” paradigm – a paradigm of power and money.

Health is not the absence of disease. Health does not follow from the appropriate medical care of a patient with a disease. This concept is not simply a question of syntax, but shapes our entire health system.

In fact, our Health Department should call itself “The Disease Department”. Our entire system of health care is devoted to the idea that: you wait until you get a disease, then you choose a drug to fix it.

Causes of disease are deeply rooted in social mores and behaviours, and many factors contribute to the attitudinal origins of disease-care.

Doctors are trained to think and act in terms of disease. Prevention is a secondary consideration in most medical schools and practices, and true health optimisation is almost non-existent.

Let’s look at a few genuine health promotion activities. These are very safe, proven and effective ways to actually pro-actively care for our health.

Firstly, consider heart disease, our number 1 killer. Many Australians take statin drugs, the recognised mainstream way to reduce high cholesterol. A common scenario goes like this – middle aged Australian male is prescribed statins for high cholesterol. The statins, in blocking the metabolic pathways that make cholesterol, also block the production of an important energy regulator called Coenzyme Q10. Low Coenzyme Q10 levels cause an increase in blood pressure, and a weakening of heart muscle. The long-term prognosis for our patient is not so good.

Instead, if men at risk of heart disease used the NH treatments of an exercise regime, fish oils, plant sterols and dietary changes, high cholesterol could be brought down, gradually and safely, without the side effects of drug therapy. The strategies our doctors use to look after their hearts is also important. For example, why do 44% of American cardiologists take vitamins C and E themselves, but only 15% of Australian cardiologists take these vitamins? And how many prescribe for their patients?

Another example relating to heart disease is to compare the costs of a Coronary Artery Bypass Graft with the Ornish program. The Ornish program is a viable and cheap series of intensive lifestyle changes that has been proven to lead to regression of coronary atherosclerosis after one year.

Bypass surgery must be the ultimate example of disease care – the human equivalent of changing a punctured tyre and not picking up the nails on the road. Increasing the amount of omega 3 fatty acids, from fish, in the diet will not only prevent coronary artery disease, but also reduce cancer rates, stroke, heart attacks, give improved diabetic control, and be effective in depression. How often is this recommended to people at risk of heart disease? A recent study has shown that folic acid, vitamin B12 and vitamin B6 can prevent blocking of arteries after angioplasty.

Depression is another example of a condition that causes untold heartache, receives enormous amounts of government and research funding, and is only seen in the context of drug and behavioural therapy.

Depression is a biochemical illness, and the self-evident idea that depression is not a prozac- deficiency is completely ignored. We know prescription antidepressants don’t work. This was recently shown conclusively by Kirsch and Moore in the journal, Prevention and Treatment.

Electric shock therapy does work, but my experience is that patients simply become too lethargic to harm themselves after shock treatment. The evidence supports St. John’s Wort for anxiety, a natural chemical called SAMe (s-adenosyl methionine) for depression – there are excellent studies on SAMe in mild and severe depression, and C and B group vitamins. I have had fantastic clinical experience treating depression by removing foods to which the patient had a previously undiagnosed sensitivity or allergy. Hippocrates taught me this. But the cheapest therapy with fantastic data support is exercise. In our next month’s issue of e-news, we will look at some scripts written for that. To be continued in our next issue.

如果我告诉你，科学家已经发现了一种药物，它可以让癌症的死亡风险减半，并完全降低癌症患病率，你会怎么想？在测试这种物质的时，在随机对照实验中，实验不得不停止，因为，我引用研究人员的说法：在实验组中“癌症总死亡率和总发病率明显降低"。研究人员再也无法从伦理上证明不给安慰剂组服用这种物质是合理的。

如果我告诉你，如果每个被诊断患有心脏病的人都服用一种特定的药物，他们死于这种疾病的几率将会大大降低。当美国的研究人员把它作为一种可能的疾病治疗方法时，他们预计在10年内仅在美国就能挽救31万人的生命？

这些都是真的。这些物质已经被发现，经过测试，经受住了时间的考验。能够预防癌症的物质是一种叫做硒的矿物质，我引用的论文来自于1996年出版的美国医学协会杂志，这是一本很有声望的杂志。能够大大降低你死于心脏病几率的物质叫做叶酸和维生素B12。发表在2001年的《美国医学协会杂志》上。所有这些物质价格都不高，而且非常安全。

我可以告诉你关于维生素C、锌、锯棕榈和辅酶Q10的类似故事。我可以告诉你关于其他几十种物质类似的故事。这些物质都归类为天然的或补充类健康产品。我做了25年的营养医生，我治疗过成千上万的病人，经常是病情非常严重的人，患各种各样的疾病，包括癌症和精神疾病。但我每年只开为数不多的几种处方。大多数人不知道这些物质的力量，所以今天我想和你们谈谈这个国家健康的未来，以及我们可以如何改善它。

在过去的20年里，澳大利亚人热情地接受了天然保健产品和哲学。他们将天然产品作为首选的保健产品。这种现象并不是澳大利亚特有的，因为世界各地都出现了一种更安全的天然保健的趋势。

由于消费者对产品、知识和服务的需求不断增长，我们见证了行业活动和健康专业培训计划的快速增长。但很遗憾，对自然健康的研究却很少增加。然而，关于营养和营养物的文献数量却呈爆炸式增长。

澳大利亚人使用天然保健品的时间比如今主流医学存在的时间还要长。当妈妈给孩子吃鱼肝油时，她就是在使用天然保健疗法。超过60%的澳大利亚人口服用某种形式的天然保健品，在天然保健品上的公共支出远远超过了病人对所有药物的消费。

数据

很难找到澳币价值数据，但是美国的天然保健产业估值约210亿美元。在澳大利亚，这个数字可能在15亿澳币左右。在澳洲，反对天然保健的人数还是惊人的多。主要由于无知、既得利益和智力僵化。这种抵制阻碍了卫生专业人员为他们的病人选择最好的护理，忽视了许多有效和有益的治疗方法。

这种抵制的基础，特别是在医学、政治和研究领域，是我所称的“毒品和疾病”范式——基于权力和金钱的范式。

健康并不是指没有疾病。健康并不是由病人得到适当的医疗护理而来的。这个概念塑造了我们整个医疗系统。

事实上，我们的卫生部门应该自称为“疾病部门”。我们整个医疗体系都致力于这样一个理念：等到得了病后，再选择一种药物来治疗它。

疾病的根源深深植根于社会习俗和行为中，许多因素促成了疾病护理的态度根源。

医生被训练得从疾病的角度思考和行动。在大多数医学院和实践中，预防是次要考虑因素，真正的健康优化几乎不存在。

那些真正的健康促进的活动。都是非常安全的、经过验证的、有效的方法，能够真正主动地促进我们的健康。

首先来看，我们的头号杀手——心脏病。许多澳大利亚人服用他汀类药物，这是公认的降低高胆固醇的主流方法。举例来说，澳大利亚中年男性服用他汀类药物治疗高胆固醇。他汀类药物在阻断生成胆固醇的代谢途径的同时，也阻断了一种重要的能量调节因子——辅酶Q10的产生。低辅酶Q10会导致血压升高和心肌衰弱。所以病人的长期预后并不是很好。

相反，如果有心脏病风险的男性采用锻炼、鱼油、植物固醇和饮食改变等天然保健疗法，高胆固醇就可以逐步安全地降低，而不会产生药物治疗的副作用。医生用于心脏保健的策略也很重要。例如，为什么44%的美国心脏病专家自己服用维生素C和维生素E，而只有15%的澳大利亚心脏病专家服用这些维生素？有多少医生给病人开这些保健品呢？

另一个与心脏病相关的例子是比较冠状动脉搭桥术和欧尼斯方法的费用。欧尼斯方法是一种可行且廉价的一系列强化生活方式的改变，已被证明一年后会使得冠状动脉粥样硬化消退。

搭桥手术必须是疾病护理的最终方法。在饮食中增加鱼类omega - 3脂肪酸的含量，不仅可以预防冠状动脉疾病，还可以降低癌症发病率、中风、心脏病发作，改善糖尿病的控制，对抑郁症也有效。有心脏病风险的人的服用建议是什么呢？最近的一项研究表明，叶酸、维生素B12和维生素B6可以防止血管成形术后的动脉阻塞。

抑郁症是另一种非常困难的疾病，获得了政府和研究的巨额资金，而且只在药物和行为疗法的背景下出现。

抑郁症是一种生化疾病，抑郁症不是百忧解缺乏症这一不言而喻的观点完全被忽视了。我们知道抗抑郁药不起作用。最近，Kirsch和Moore在《预防与治疗》杂志上的文章结论性地证明了这一点。

电击疗法确实有效，但我的经验是，患者在电击疗法后会变得昏昏欲睡，从而不会伤害自己。有证据支持贯叶连翘治疗焦虑的作用，它含有一种天然的化学物质叫做s-腺苷蛋氨酸可治疗抑郁。有出色的研究表明它可以治疗轻微和严重抑郁症，还有维生素C和B族的作用。我在治疗抑郁症方面有非常棒的临床经验，通过去除病人先前未诊断出的过敏或过敏食物来治疗抑郁症。这是希波克拉底教我的。但最便宜又有惊人数据支持的疗法是运动。下期的电子快报，让我们看看针对这方面的处方。后续内容下期更新。