#ACC 16: Take the Stairs!

#ACC 16: Take the Stairs!

I stepped on the scale at my fitness center to reveal that I had gained 5 pounds. It wasn’t a surprise to me. Earlier in the morning, the mirror had given me the same feedback as I stared at myself after having a shower. While attending a Harvard writer’s conference, I had gone on hiatus from my regular exercise program (and perhaps had too many sweets). I had also recently developed an upper respiratory infection and just wasn’t feeling inspired to work out.

Based on recent reports, it appears that by the year 2025, one out of five people will be considered obese. It’s not surprising…there have been reports for many years that we are suffering from an obesity epidemic. A recent report suggests that only 2.7% of people are able to maintain the appropriate combination of lifestyle habits. The real issue has to do with what we as a society can (and will do) to combat chronic illness.

I was very interested to follow reports coming out of the American College of Cardiology 2016 conference which was held in Chicago this past week. Based on the media reports and late-breaking clinical trials, you would surmise that modification of lifestyle factors such as diet and exercise have very little to do with the future of health in our country.  In the media, there were reports about using statins to decrease cardiovascular events in patients with intermediate risk (ie HOPE3 trial). Statin therapy corresponded with a reduction in events in about one out of 100 patients. There was also data about the new PCSK9 inhibitors (GAUSS trial) which proved effective in reducing cholesterol levels in patients who are intolerant to the statin medications. With all the excitement and buzz, there was very little regarding lifestyle modification which made it into the popular media.

Perhaps the most telling commentary from ACC came from the social media surrounding the conference which could be tracked on Twitter with the hashtag, #ACC16. There was a tweet and accompanying photo that seemed to poke fun at cardiologists who appeared to favor the escalator over taking the adjacent stairs. #Takethestairs, one tweet advised.

Years ago while visiting with a patient who had just suffered from a heart attack, I tried to explain the principles of diet and exercise. “Sir it’s recommended that you exercise at least 30 minutes per day for most days of the week.” His first question for me was , “So is that what you do?” I remember staring at my medical student… stupefied that I had even been asked about my own behaviors. Truth of the matter …it was a fair question.

In my clinical practice, I see patients who are dying from inactivity, dying from poor nutrition, dying from tobacco use, dying from alcohol abuse. As the scale advised me this morning, I myself am at risk if I slide too far off the path. I am grateful for all the pharmacologic advances we have had, but to see the health of our nation improve it will be important for clinicians to play a larger role in changing lifestyle behaviors.  For me the biggest message from the ACC, was the reminder that we as clinicians have an opportunity to lead by example. More of us (myself included) need to #takethestairs.