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Building a Blood-Pressure-Lowering Environment

David DeRose



1. List five simple ways a person could enhance the blood-pressure-lowering potential of his/her environment. 

2. Enumerate at least three simple strategies to deal with noise pollution. 

3. Describe how social connectedness impacts one's ability to deal with life's stressors. 

4. Summarize salient aspects of the medical literature dealing with the impact of spiritual factors on blood pressure. 


Blood pressure is incredibly responsive to lifestyle and other natural strategies. Although the importance of diet and exercise is often stressed in this context, many clinicians underappreciate the role of the environment factors. In this presentation we will look broadly at environment and blood pressure. We will cover a host of practical factors that encompass not only the physical environment but also look at important issues often omitted from "environmental" discussions including mental, social, and spiritual factors. 


David DeRose

President of CompassHealth Consulting



  • October 26, 2018
    3:00 PM
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So I'm Dr David De Rose I'm a medical doctor I'm a board specialist board certified specialist in internal medicine and preventive medicine if you know much about preventive medicine residency training it includes a master's in public health my M.P.H. emphasized health promotion and health education so I've done a mix of Public Health and Clinical Medicine over the last 30 years or so I've done it in many venues including having the privilege of. Having worked for a short stint as an Adventist pastor the special emphasis and health ministry so we are going to begin with our 2nd segment if you are not with us the past hour Audie over us did record the presentations they're also going to be getting copies of the slides so I guess we'll have a video version of the presentation as well so let's pray together Father in heaven we want to thank you for the privilege you've given us of just being here being able to be with like minded professionals and their support teams are so grateful that. You want to teach us how to be more effective in ministering to our patients to our families to our communities please do that for us today we ask in Jesus' name amen. Well we'll get to the learning objectives for this presentation in a moment because what we've done with the consent of those in the previous hour is since we started bit late in the last hour we actually finished on time but left the topic of choice of beverages and how they impact blood pressure to carry over into this presentation so it's one of the learning objectives from the previous hour so how do beverages impact your blood pressure and what are the best blood pressure lowering beverages Well the 1st message is when it comes to blood pressure you definitely want to avoid alcohol alcohol is not your friend and by the way if you haven't seen the the overwhelming evidence is coming out now in the medical research literature a number of studies now saying that the safest amount of alcohol to consume is erode that there is no amount of alcohol that's safe when you look comprehensively at at health and so there's a number of studies out one this year other study that's been out for about 56 years that's epic the European perspective investigation to cancer nutrition but there's a number of studies showing this but if you look at blood pressure alone. More than 3 drinks at a time raises blood pressure significantly binge drinking can lead to long term blood pressure increases so even if a person is just drinking on the weekends for example their blood pressure can be sustained and elevated as a result of that alone but moderate drinking is also a problem and it's a problem for several reasons 1st of all alcohol can interfere with blood pressure medication effectiveness can increase the side effects of blood pressure medicines but the thing that I'm most worried about when it comes to alcohol is it can undermine weight control efforts actually one of the most calorically dense foods macronutrients is alcohol we usually think of carbohydrates fats and proteins just a quick review how many calories per gram in carbohydrates calories per gram and carbohydrates for that's correct how many calories per gram in protein for how many calories per gram in alcohol 7 and the only thing that's more calorically dense is fat which is 9 calories per gram so the point is alcohol is very calorically dense but even more concern is it works on the frontal lobe and if you look at research on people especially who are what we call restraint eaters they're controlling their appetite they're pushing themselves away from the table if you give them a little bit of alcohol they're much more likely to overeat So alcohol is not our friend when it comes to weight of course weight is one of the things that's driving the diabetes and blood pressure epidemics in the western world so avoiding alcohol is important OK so we cross alcohol off the list we'll go at the soft drinks right that's got to be better than the alcoholic beverages Well they're part of the problem too when it comes to weight gain in fact some of the data would suggest they are the single biggest problem when it comes to weight gain. Actually I was seeing. I told you in the last hour I was at some professional meetings American car a National Congress of American Indians last week or earlier this week sitting in the airport in Phoenix we were changing planes on our way from Denver here to we actually flew into Ontario rented a car sitting next to a guy we got to talking he told me last 18 pounds in the last year what do you think the single lifestyle change he made was it's right that rid of the soft drinks and sugar sweetened beverages just really a huge problem is a great review over a decade ago in American Journal of Clinical Nutrition really looking at a lot of the data and how these sugar sweetened beverages are driving the obesity epidemic and basic bottom line you drink 150 calories in a sugar sweetened beverage and you will not decrease your consumption at that meal by 150 calories or in subsequent meals so you get a lot of calories with relatively little society and we are doing very poorly as Americans you can see the World Health Organization recommends that we consume no more than 10 percent of our calories is added sugar we're about 60 percent more than that and the majority almost the majority of our added sugar in the American diet is coming from sweet and soft drinks it's almost 50 percent so just that one change and I've had patients do it to just stop the soft drinks I'm thinking of a guy right now I lost like 50 or 60 pounds that's all he changed he was a big guy OK but just amazing get these calories out if you look at what's increasing in our die at it is those sweet and soft drinks more than anything else contributing to our sugar intake over the course of one year what would $150.00 calories difference do to your weight. It's a real simple calculation if you look at daily increase in calories just divide it by 10 so if you're to consume $150.00 calories a day more throughout the course of a year and you change nothing else nothing else in your caloric intake or expenditure you would gain 15 pounds over the course of a year really adds up OK that's that diet soft drinks they're the winners when it comes to hypertension Right well actually if you look at the data on diet soft drinks they actually increase the risk of the very things that are associated with high blood pressure this is a study looking at strokes and diet soft drink consumption from Manhattan there in New York City. Multiethnic study about 2500 people and what you see is if you want your lowest risk of vascular events like stroke and heart attack you want to avoid was the diet soft drinks well you knew the answer all along didn't you just stick with water and of course your coffee so you can get going in the morning right how is caffeine when it comes to blood pressure they're actually a very interesting topic. But if you look at what we call acute effects of caffeine they're actually substantial I mean they can raise systolic blood pressure 15 as much as 15 points diastolic blood pressure and similar range but the critics of this kind of data they say well but once you become a habituated coffee drinker your blood pressure really doesn't go up much and yes it's true your blood pressure doesn't go up anywhere near as much as if you're caffeine naive but some years ago Jack James wrote in The Journal Psychosomatic Medicine a a review that I thought had a very telling title critical review of dietary caffeine and blood pressure a relationship that should be taken more seriously so was Dr James telling his fellow professionals. Don't minimize the effect of caffeine on blood pressure that's what he's saying right we need to take it more seriously and perhaps the reason we don't take it more seriously is we have the coffee pots in the doctor's lounges right at the nurses' stations that possible can our own lifestyle affect our choices Here's how James concluded his review extensive evidence that caffeine at dietary doses increases blood pressure it is true that we become less sensitive to caffeine's effects but But even even when a person is using this habitually there still are press or effects that means that caffeine still tends to raise blood pressure and it will raise it in the range of 4 point systolic and 2 points diastolic all come on you say as not playing for points is. Now if you're looking at the construct that we're looking at we're talking about 10 different categories that affect our blood pressure if you look at 10 different categories all of which affect your blood pressure 4 points how much could you affect blood pressure cumulatively if it was additive here Jeff 40 points right but even this small a change population wide if you look at the data that would decrease premature deaths from coronary heart disease by 14 percent in stroke by 20 percent so even just lowering population blood pressure by that range it would make a huge impact you don't understand it. Oh I hear what you're saying so you're saying Don't doctors know that caffeine raises blood pressure because of some you know of doctors that are prescribed caffeine for someone with low blood pressure. You might think that doctors know but this is not something that is typically educations are not typically educated to avoid caffeine in fact the average my experience the average physician would say it's not significant. OK. You know it's interesting the the biggest effects of caffeine the biggest concerns I have with it are moral and behavioral someone else in the last hour was saying Well do you have more on circulation more on inflammation we're just finishing up a book right now called the Methuselah factor it's about hemo Ryall A-G. that's the science of blood fluidity and caffeine has a major impact on this too impairing optimal circulation but I'm actually just quote you something up from the book. I'm just going to read it to you so this is. Perhaps even more amazing example of the connections between caffeine and bad habits we're speaking about the connection between choices and caffeine use caffeine has been called bad habit coup by some neurophysiologists So an even more amazing example of these connections came from a widely touted study published in The New England Journal of Medicine the publicized take on this large study with data initially coming from over 600000 people this is an R.P. study data from a retired persons in America was that coffee drinking help people live longer That's right as one related press release expressed it want to live longer question mark what was the answer drink coffee so this came out in 2012 I saw that the early press releases I've not yet seen the New England Journal report I said I got a look at this study it just came out I hadn't seen it I mean how could this be a caffeine coffee helping people live longer by the way you other studies have come out implying the same thing let's let's look at that this is the 1st one that I know of that actually in a huge dataset that suggested this this is a quote now OK quote from the actual paper. When the raw data was analyzed the researchers observed I'm quoting right from that New England Journal of Medicine paper in age adjusted analyses coffee consumption was associated with increased mortality among both men and women now U.S. health professionals know what that means I try to put in the vernacular because this is in a book for the lay public in other words when comparing 2 people of the same age the one who drinks the most coffee is most likely to die 1st that's what the article said Do you remember what the press release said drink more coffee what happens you live longer I'm looking at the raw data I'm reading this this is I'm reading that the results of the discussion in the paper the more coffee you drink what happened the sooner you died so how can the study come out saying that you live longer by drinking more coffee hang in there you'll get a little epidemiology lesson when they looked at the association between coffee drinking and other bad habits they found something very interesting the more coffee you drank as a rule and this huge population huge retired population in the United States the more likely you were to smoke and small war the more likely you were to drink more than 3 alcoholic beverages daily the more likely you were to eat more red meat the more likely you were to have a lot lower educational attainments neglect figure vigorous physical activity and consume fewer fruits and vegetables now what I'd like to suggest to you what they proved is exactly what we would have postulated based on the concerns that Ellen White raised about caffeinated beverages decades ago she spoke about the mental and moral effects she didn't say don't drink coffee because you'll die sooner. I don't read anything like that maybe there's something there but I don't read that she was concerned about the behavioral in the moral effects and this is what the neurophysiologists are saying if you want to develop a healthy lifestyle habits don't have caffeine because caffeine makes it more likely will stick with your bad habits so you've got this huge data set and when you find all the things that people are being educated not to do like they shouldn't smoke you shouldn't drink so much you should need so much red meat when you're drinking caffeine you're more likely to be doing all those things did you see what I'm saying it's just what you would predict now here's the interesting part of it though because some of you know a bit about statistics in epidemiology what you can do is you can try to control for all the things that something else is associated with to try to just look at the factor in isolation so what they try to do is they try to control for all the bad things that caffeine was associate with coffee specifically was associated with it and they came to the conclusion the coffee actually helped you live longer now you should be very suspect when the raw data shows you one thing and you do a bunch of statistical analyses and you come to a totally opposite conclusion OK but the lay public sees the headlines you know major landmark study drinking coffee helps you live longer and they never read the fine print that the more coffee you drank the sooner you died I mean that and I'm smiling about as tragic isn't it and so I when I'm saying is the message that the God's given us is relevant to what people are hearing today and and what they're being misinformed about. Well you know event of course what should we be drinking there's no surprises you say why do we take all this time we all knew that we should just be drinking water but the more ammunition we have to help our patients I think the better off we are if you haven't seen this study from Loma Linda years ago back in 2002 really excellent data from the had been a self study basically showing doesn't take a lot more water drinking to protect you from a fatal heart attack in the evidence how study the difference was only a few glasses a day we're talking about huge amounts of water just in Fiat 5 more than 5 glasses of water per day compared to less than 2 basically cuts your risk of a fatal heart attack in half it's not true with other beverages you probably gathered that already from most all the other beverage classes we looked at research actually suggests that water drinking can help with weight loss not just by substituting for calories but actually because of metabolic effects and water only fasting has powerful blood pressure lowering effect so powerful in fact that I do not recommend patients who are on medications for blood pressure or diabetes just go on a water only fast without working with a doctor who's adjusting their medications and I won't spend any more time than that but Dr Gold Hammer has published that research so now we're on where we're supposed to be at the beginning of this lecture. With the blood pressure lowering environment so the objectives for the rest of this a presentation are as follows we're going to try to list 5 simple ways a person can enhance the blood pressure lowering potential of his or her environment we're going to enumerate at least 3 simple strategies to deal with noise pollution we'll see why that's important how can so shal connectedness help you in dealing with stress and they will look at the medical literature as it relates to spiritual factors and blood pressure will try to cover all of that in our remaining time together the clock actually ends for us right at $410.00 in my oriented Steve is for town our official ending time OK so that's what we've got ahead of us OK So let's talk about environment and blood pressure so for those of you who are just joining us we're looking at a construct looking at different natural strategies to address high blood pressure we're using what we call the no pressure approach 10 different areas we've talked some about nutrition an optimal choice of beverages we're talking now about environment what in our environment can affect our blood pressure there are a number of things that environment that actually influence blood pressure we're going to talk about 3 at least briefly and that is quiet sunshine and fresh air really interesting data on quiet and how that can affect blood pressure or converse Lee how noise can affect blood pressure the more road traffic noise you're exposed to the higher your blood pressure will tend to be if you live in a more noisy environment your blood pressure will be higher than if you live in a more quiet environment and the research findings if you look at how close you live to a major road that is a direct predictor of what your blood pressure will be now you say Well Dr Drew as I can't change where I live I'm stuck I mean I've got a reverse mortgage what can I do. You can actually move where your bedroom is they've actually shown if you just move your bedroom to the side of the House or the side of the apartment that has less road traffic noise your blood pressure will go down so we're coming up to some practical strategies to deal with noise one is you could move to the country. Second one is you could move your bedroom if you can't move your house and then there is a 3rd strategy by the way this has been studied this strategy has been studied in some of the most noisy environments in the world do you know what some of the most noisy environments in the world are there found were some of you work in intensive care units did you know that they're very noisy places and so they've done research on just giving patients earplugs and blinders dramatically improving not only their sleep but also some of these physiologic parameters and that interesting so noise a lot of us don't think about it but people say well listen I'm eating well I'm exercising what else can I do for my blood pressure control noise in your environment mechanism it's probably activating your sympathetic nervous system and anything that activates those stress hormones will tend to raise blood pressure OK let's talk about some other things in the environment sunshine Well there's a number of lines of evidence to suggest that sunshine lowers blood pressure many people think it's is a result of vitamin D. some debate whether it's a vitamin D. relationship but. Much of the data points us in that direction so we're suggesting that people optimize their vitamin D. status of course there's a multitude of benefits that vitamin D. offers that has immune in Hansing of facts bone health effects anti inflammatory facts it does also seem to have antihypertensive a fax you say well I'll just go out in the sun. Well unfortunately because of the ultraviolet B. rays that we need to make. Vitamin D. in the skin you have to be well you have to be in a place where the sun comes high enough above the horizon that the ultraviolet rays can get through the ozone those U.V.B. rays and you can make vitamin D. This is from a review by Dr Holick Michael Holick is one of the world experts on vitamin D. and it shows you what the data indicates and that is if you live in Boston there's going to be about 4 months of the year where even if you go out and sunbathed on a roof if the weather is conducive and you could do it you know I can make vitamin D. if you come from my wife's father's birthplace Bergen Norway it's 6 months of the year now here's what's really interesting we. Lived and worked in Maine for a while and we'd ask the old Mainers sometimes do they have to do anything during the winter months and they would say many of them would say we had to take cod liver oil they would usually not say it with a smile and you know what cod liver oil happens to be a rich source of vitamin D. So some of these dots were you know just connected by observation maybe it was they noticed their kids had less colds or things because vitamin D. has immunity Hansing effects but very interesting nonetheless So here's what we recommend if you live in a latitude further than 35 degrees north or south of the equator take a vitamin D. supplement during those relevant portions of the year what about FRESH AIR What is the single biggest threat to FRESH AIR As it relates to blood pressure yes tobacco smoke and it's correct. You have any idea how much a single cigarette can raise your blood pressure every cigarette raises blood pressure it's a short effect usually returns back to normal within 30 minutes of the effect seems to be greatest typically with that 1st cigarette and let's actually look at what it is look at this within 4 minutes a 25 point rise in blood pressure Now it's interesting to me as a physician we we often tell patients you know read guidelines you know make sure you haven't had a cigarette in half an hour for going to check your blood pressure if you want to know what it you know what it runs but this person is a habitual smoker What are they doing all day long they're keeping their blood pressure elevated by nicotine so it's interesting well we don't want to measure their pressure but really their ambulatory pressure if you're monitoring it is going to be significantly elevated because they are smoking throughout the day so this is why a lot of the guidelines you know that are starting to emerge are saying we need to look at ambulatory blood pressures What is it really in the free living situation but Cigarette smoking is a significant concern and by the way we don't have time to talk about it here but from a vascular standpoint early data is suggesting that marijuana smoke is worse than tobacco smoke so if you haven't seen some of that data has worse effects on the vasculature than tobacco smoke that's even secondhand marijuana smoke so I know some of you are not interested in that topic at all I'm speaking a bit facetiously I think we should all be interested in it because if you're not already having all kinds of patients coming into your office thinking this is the new wonder drug. It's it's being sadly misrepresented in the literature you say well OK we're not going to small core not going you know but we're going to chew or dip well even the smokeless tobacco those are so seeded with blood pressure elevations. I was speaking with an audience about this once showing them some of this data like why would smokeless tobacco raise blood pressure it's not just the nicotine but the smoke is tobacco often has high sodium content and it often many of them have licorice and licorice is a blood pressure raising effect I was telling an audience distant I heard an automobile gas from the back of the room and it turned out it was a woman of German background who had a special fondness for licorice that she had grown up with I don't know if it's more popular in Europe than it is here and not in the States and she apparently had high blood pressure so this was her moment of illumination that maybe her licorice consumption was contributing to her blood pressure Well here's one of my favorite topics because this we're tied trying to help us see this material not only from the standpoint of clinical medical practice but also our role in our communities and I think every one of us if we're health professionals should be involved in ministry at a church based level at least supporting it in some way you say you know Dr De Rose amp's of spread so thin I can't do one more thing and I respect that but do what you can to encourage healthy evangelism in your local church and one of the things that you can do is just show up and live a healthy lifestyle you realize that your example is powerful and people realize what your example has to do you know that you don't have to advertise that I got involved in health of vandalism without ever wanting to do it I started going to a small church when I was a resident and in that small church after a short while some people came up to me and said we need you to give a nutrition seminar at our church I've never given a nutrition seminar. I said Why do you think I need to give you nutrition summoner they said we've been watching you at potlucks you know you need to tell us how to eat here is a church well it's a long story behind that there are some you know you want to be careful in these kind of circumstances but my point is it's your lifestyle is where things start social support is especially interesting and researchers have looked at social support in relation to blood pressure by the way when we talk about social support do you realize we're talking about why your churches are so important as agencies for lifestyle change in your communities do you realize we're more disconnected than ever before as a society you know we have more ways to connect but we're more disconnected if you thought about that or seen data on that so you know we have all these friends all over the world and you know we you know we have all these Facebook friends and stuff that people there's no one they can turn to. To talk about their deepest problems you know other than someone on line that isn't really there maybe can't support them in any tangible ways so social support is really a needed commodity and it's very important when it comes to blood pressure it's actually a biblical commodity and even Christians some are you know not attending worship maybe even 7th Day Adventists that you know they say well you know there's a better preacher on T.V. than we have here in our home church so we'll just you know turn on the hope channel or turn on 3 A.B.N. Have you heard things like that but we need to come together and this is data. From the end of chronology literature there's a simple case control study that just underscores this point that we're making and that is as you look at different markers of social connectedness or social support the more socially connected people tend to be their bat the better their blood pressure tends to be and again it seems to relate to stress hormone reactivity and they've actually measured some of this and they actually find that it is worse in individuals with low social support Now this is a really fascinating paper you know papers especially fascinating fascinate me are often ones that I can't fully understand this was some very technical what we call spatial analysis they're actually looking at the spread of obesity in America so although I couldn't understand all the specific ways they were these researchers were mapping this it was very very interesting because what they found this is probably the most telling graphic they found that obesity in America over the decades had been spreading like an infectious disease so if you were mapping obese and you look at the spread of obesity you would say this isn't just random you would say there is a disease that started in Greene County Alabama and it just started to spread throughout the southeast and then it has extended to affect most of America you say well what's the significance of that well the significance of it is what these authors were looking at and. Some of their conclusions I think are a little bit. Taken a little bit too far but they're basically saying that social and societal factors may ultimately be greater determinants of obesity than our personal choices. And you know I say well how is that taking it too far because again if you're with us the past hour and we mention this a little bit the social determinants of health what are we doing in this social me you that we live in that can actually change the environment how can we make it easier for people to make healthy decisions and more difficult to make bad decisions and your churches are to be bastions I believe in your communities of healthy living so if you haven't thought of your church that way I'm challenging you think of it that way because it's supported by the research literature here's what they're saying where we live and who we keep company with maybe among the most important factors when it comes to weight optimization what does all this have to do with high blood pressure Well if you're with us the 1st hour or if you just know much about the epidemiology of high blood pressure the more you weigh the more your blood pressure tends to be now it's even more interesting this is from one of the family practice journals they're looking at a problem that we have in America and that is we don't have enough providers to optimally care for the burden of chronic diseases that we have in our country the paper came out about 6 years ago delegating responsibility from clinicians to nonprofessional personnel the example of hypertension control so people they're looking at systems they're saying if we're going to optimally control high blood pressure what do we have to do we have to start involving nonprofessionals how many of you have heard about a movement in America that tries to help nonprofessionals realize that they have a role in the health of their communities and you heard about this movement it's called the 7th they have us Church No really I mean have you did you think about it I mean God God has been giving us this vision that we're to be involved in in health minute is part of our church's. I mean I've said as a pastor in ministerial meetings and everyone's talking about well how can we reach our communities and no one talks about health I've been there you know they're talking about you know having a tiddlywinks club or something that all misunderstand me I don't I'm not saying it's wrong they have a totally Winx Club I'm not saying it's right to have one either they don't but but the point is how can we talk about being relevant to our communities as churches and not talk about having a vibrant health ministry presence and maybe since I'm talking health professionals I'm just speaking of the choir but but you see my point I think we have to be serious about this I know many of you are well in this paper they're saying basically we need to basically have coaches in our communities and really I think our churches are ideal places I know we mar is doing a lot with training their students they have a 6 month program where they train students on being active in their churches and having this role as being coaches how can you work with people as coaches I shared with you in the last hour some of the results from. A program that we have it uses 4 sets of D.V.D.'s and a book. 30 days to natural blood pressure control book and then we have a bridge series called Healing insights from the Gospel of Mark but basically what we're doing is whether people use the D.V.D. based resources or whether they use the free resources that we talked about in the last hour that I'll recap for you who just joined us here we're seeing significant changes now this small series These are 3 community based programs these are all church based administers based programs throughout the country several different places and you can see 25 individuals went through these programs who had high blood pressure using a criteria of a systemic blood pressure greater than or equal to 140 and you can see over the course of a 4 to 8 week program so it's designed as a 30 day program but it can be run over 8 weeks there's 8 modules D.V.D. based modules for the program and you can see an average drop in systolic blood pressure about 17 points diastolic blood pressure about 8 points so you have a comment a question. OK So the question is So this is after a month could a person lower it further at $140.00 and could they lower $78.00 down to $72.00 we could say Well theoretically they could but I mean the data we have is just the data we have so we only have data for the but for the 4 week program or 8 week program depending on what frame they ran it over but the point is this is a mean so obviously there's some people who lowered it below 140 in others who didn't get at that low because that's the you know basically the average of the 25 subjects. OK. OK So the question is OK fair enough fair enough the question is you know what when do you use medications and of course we use medications and anyone who has who has a dangerously high blood pressure and how high is dangerously high I mean of course. You know Nick an acute. Setting 16180 range you're probably going to do something 160 maybe not 180 for sure we're probably going to not have them leave without a medication. You know 100 diastolic probably for sure they're going to leave on a medication even if we educate them on lifestyle and they're going to try to get them off their drug unless we thought there was something unique going on through some you know serious trauma or something but let me just tell you a true story. At this National Congress of American Indians where we were earlier this week the administration which puts on a screening there they've done it every year for a number of years and one of the fellows who was at that screening last year came back to the booth and he told his story he said when he came his blood pressure was in the range of 180 over 130 last year he said the person from the administration had screamed and we have nurses and doctors and others there there doing the screenings said we don't want to let you go and he said you can't keep me here but he said after after that experience he'd not seen a doctor an 18 year is. He went to see his doctor by the way if you're wondering why I have this detailed story I host a weekly radio show called American Indian living and he actually joined me for segment on the show so his name was Jeff and usually we don't tell patients names but he's the whole world's going to hear his name OK so he's fine with it and what So just telling a story and he he goes back to his room he says I got to change my lifestyle he says I'm going to stop drinking and I guess he was drinking quite heavily so he stops drinking he comes back now to screaming so as doctor got on some medication whatever he's off the drugs apparently now. But he's lost 140 pounds he was a bad guy a bad guy big guy he weighed he probably said he was a bad guy too but he weighed over 400 pounds so he's down now to like to 60 he's still got some weight to lose but. Interesting thing you're not going to lose 140 pounds in a month so I share that example with you because some changes do take a long while weight loss is one of them so we'll see benefits from diet quicker then we will see benefits from getting to your optimal way if you've got you know 150 pounds to lose so yes you know we individualize things and I want I want to person I don't I'm not happy with someone's blood pressure running consistently over 140 over 90 so they're going to be on medication if they can't with you know initial lifestyle changes get it below that so they'll be on medication they will try to back them off the medication as they stick with the program if they lose weight as they improve their diet etc etc OK so I told you we had free resources for you last hour some of you were asking me at the break where they are if you go to compass Health dot net that's my website that's the best place you can get Power Point slides you can get scripts of materials you can get free videos there and one of the resources they told you about was this compass Health dot net slash health Sabbath health hyphen Sabbath if you can't get there. Just by navigating on the compass Health website under a free materials just use this address compass Health dot net slash health hyphen Sabbath if you go there it'll take you right to the N A D website and by the way Angie David the NE D. David is the director of the NE D. health department she will be here in this very room giving the next hour presentation but she and her team have a healthy Sabbath every year and in 2018 the health Sabbath was on heart health especially on blood pressure and so my colleague who helped write our book 30 days to natural blood pressure control truly least she's a nurse practitioner she actually adapted our materials put the Power Point slides all together for you gave you scripts if you want scripts so that you can have more than the materials that we touched on in these last 2 hours they are available for you there what we develop more recently is this program if you go to youtube and you type in 30 days to natural diabetes and blood pressure control we have 30 daily 5 to 6 minute videos where I walk people through a lifestyle program and the reason why it's diabetes and high blood pressure is I'm doing a lot of work with diabetes among Native Americans and we're finding that they may think they have a great program at their travel health clinic for diabetes but they're not addressing high blood pressure we start speaking about high blood pressure and diabetes together and they start looking at lifestyle they realize often that there's more material that they need so we prepare these 30 daily 5 minute videos that can be can be watched you can use them in conjunction with things that you're doing at your church in your office I know a diabetes educator and one of the Tribal Health Clinics she's showing some of these to her patients when they come for diabetes education sessions Well we want to conclude by talking about stress management and exercising faith and God. This is actually I think very very interesting and practical material and it does relate to scientific data so we've been walking you through this this construct this in our book 30 days to natural blood pressure control the 14th chapter in this book which is the last major chapter is on spiritual health it's actually called spiritual health neglected dimensions that's the kind of a spin off of the book chapter it's a the D.V.D. that we have that compliments the book for those of you that didn't hear in the last hour Dr stanky who was supposed to present with me is. In the midst of a cross-country transition he had been practicing for a number of years in the northwest and he's relocated to the College Hill Tennessee area so he's staying by the home front keeping his priorities straight while we carry on without him so I told the group the 1st hour but if you have any complaints about what was not covered it's all Dr stanky file to feel we're here we would have had such glaring oversights OK but don't blame him because I gave him permission not to come he wanted to make sure we could still limp along without him but anyway spiritual health neglected dimensions let me tell you what we've tried to do we've tried to actually package many of the truth that God's given us in His word and given to us the 7th Day Adventists in a way that would be that would let's put it this way in a way that would not unnecessarily antagonize people from any spiritual walk so when they're Buddhists New Age atheists agnostics How could you do that how could you present biblical principles and discussions about spiritual health let me just kind of walk you through just an overview of the construct we can't go through it all and then I'll show you some data but. Basically we talk with people in the chapter and in the video that there really is a question that is resonating throughout the world right now and that is is religion good or bad and if you haven't heard this it's really happening all around us when people talk about things happening often religion is brought into the discussion and you may hear people saying oh I wish everyone was you know religious if they were more spiritual if everyone just like Mother Teresa or the Dalai Lama What a wonderful world this would be if you heard things like that the flipside is you know religion causes all the problems in the world there's all kinds of fighting it's because of religion we'd all just be better off if we were you know atheist just intelligent atheists so as if as a physician you know I don't have much credibility in the world to speak on the subject of whether religion is absolutely good or bad but at least have some credibility and you do too as health professionals to speak about whether religion is good or bad for health right we can look at data we can look at connection between spirituality and religion and health there's a lot that's been looked at and so in this chapter 14 and in the video like I said we look at connections between spirituality and health and you'll see there's a number of benefits associated with measures of both spirituality and active practice of religion both went sometimes they call it intrinsic religiosity you know it's like prayer meditation extrinsic religiosity like attending church or worship and benefits and especially when we speak about blood pressure and cardiovascular disease there is data showing that you're more likely to have lower blood pressure less hypertension less cardiovascular disease and a longer life span if you prioritize spirituality and religion Well this is some interesting data. Looking at these 2 different dimensions of spirituality regular church attendance in the literature has been shown in general to be favorable to blood pressure and these benefits are explained by other lifestyle factors like avoiding smoking or socioeconomic status they try to control for these things or something about regular church attendance that's beneficial but. There is evidence that an individual's personal spirituality the personal importance of religion is even more beneficial for lowering blood pressure than church attendance So the bottom line is both are important so when you are attending church in the pastor says you know prioritize your personal devotional life he's not just peaking about spiritual principles you could say speaking about a health principle now there's a number of examples of this I'm not going to spend time on all of them but let's look at this this is very interesting Harold Koh Niggas one of the world leaders in research on Spirituality and Health he's based there Duke University a some of you have seen him he's very friendly toward 7th Day Adventists and Dr Cohen egg and his colleague reviewed some 3200 studies looking at Spirituality and Health they found that 63 of those 3200 papers looked at connections between religion study and blood pressure now 57 percent showed that increased religion and spirituality lowered blood pressure or caused less hypertension was associated with it but a leaven percent showed the opposite more spirituality had higher blood pressure so what would you do with data like that. Well you'd start to ask the question well you know spirituality and religion isn't just homogenous right there's different forms of spirituality different forms of religion so although people often want to talk about how spirituality and religion is good for you even in the literature what we're saying and what I would suggest that you can say to your patients your communities it really depends on what kind of spirituality and religion you have there's actually data to support that Koenecke himself and some other co investigators looked at this and a different context they were looking with people who were dealing with significant illness and they actually found that there was a there are certain types of spirituality that actually hastened their demise they were more likely to die if they had what the authors described as a religious struggle with illness and they actually had several questions several types of lines of thinking that illustrated what they called a religious struggle so the person was wondering whether God had abandoned them. They were questioning God's love for them. They thought that the devil basically was in charge of things that were happening in their life then we would say Well that's true and the devil's doing all kinds of bad things but this is more of that fatalistic outlook that basically your life is just being ruined by by Satan and it really you'd say all of these things undermine God's goodness and God's work in your life so there is a type of spirituality that's detrimental and this is all this is this is medical C.M.E. this is based on the research literature we're just going through what medical research has shown and basically my point is to divorce spirituality from these discussions we speak about chronic disease to divorce religion is actually not doing our patients a service so to me and to some of those who work with me on this spirituality is neglected to mention is to find something across spiritual orientations across the spectrum of spirituality that actually can can talk with people about what kind of principles what kind of principles can you champion as a church that that actually will resonate across your community and what we suggest is that perhaps the very best thing best summary in antiquity of a Evan approach to spirituality that's health and hand saying is the Sermon on the Mount and you say well we know the Sermon on the Mount but I would suggest to you if you look at the principles underlying the Sermon on the mount there are actually principles that every pretty much every. Major religious group would agree with no one says it's bad to be humble No one says bad to try to make peace OK now may you might say Well Dr Drew as I debate that on well in general though and I've had a Muslim patient who looked at the chapter we have and he said you know he resonated with that completely had a new AIDS patient who said you know this just really there are some people that have a problem with anything with the name of God in it but if a person is open minded and they and they look at those principles of the Sermon on the mount what we do and you have resources on their free website we go through medical data that shows that all these things can help you lower your blood pressure if you wondered what that was that was a summary of the Beatitudes OK Those of you were here the few of you that were here the last hour I told you we had submitted a paper recently to a medical journal that looks at these type of topics we entitle that spirituality is a component of complimentary approaches to high blood pressure control does the nature of the spiritual intervention make a difference it was a report from a case series I gave full disclosure to the last group and told them that this particular journal told us that they didn't really want to publish a case series they really wanted us to do a prospective randomized trial which we have not done yet but we thought this was very interesting because what we did is we worked with a small lifestyle center in Europe and we actually did 2 different interventions one of them used. This Beatitudes based approach to give a scientific rationale for why these different principles were health and Hansing and the other we did a different Biblical spiritual approach that was more based on the great controversy. And we found that those who did the approach that was focused on the blessings of the Beatitudes had markedly better blood pressure results in the program than those that had a different spiritual focus Now don't misunderstand me I think the great controversy is an important theme to understand but in the course of one week's time to people that were exposed to this this did not seem to be as health in hand saying as talking with them about blessings if you really think about it this is what we wrote in the paper we submitted the Beatitudes or God's pronouncement of blessing even in situations where a person might be tempted to question their blessedness for example Blessed are those who mourn and blessed are you when men revile you thus the Beatitudes present a God who comes close to his people blessing those who are in adversity these concepts seem calculated to help foster positive religious coping so we're talking about some of the reasons why might an approach based on the Beatitudes especially help blood pressure so my whole point is this what we've been trying to share with you over the course of the last 2 hours especially in this hour is that there's a range of things natural things that we can do they can help control blood pressure and an important part of the equation is the spiritual part of the equation and I would suggest that even though we just have some very preliminary evidence of this there's plenty of literature basis that the elements of the Beatitudes can help people lower their blood pressure but we're also even seeing some in our experience and some data that we've collected that these are especially powerful in helping people with chronic lifestyle diseases in their accepted by people across the spiritual spectrum you can talk about humility and peacemaking and and some of these virtues what I will tell you though especially interesting. Because it comes from the perspective of the Sermon on the Mount in fairness to people I felt we had to share the cultural context of the Sermon on the Mount which means if you read through the 14th chapter in that book 30 days to national blood pressure control you'll read about sin and you'll read about salvation you'll read about the state of the dead in the Sabbath all these things are part of the cultural context in which Jesus spoke so in the course of talking to people across spiritual lines we actually expose them to most all of the major teachings the 7th Day Adventist Church and so and I am what I'm just telling you some people say oh there's a very creative way to bridge people you know to have Vangelis tick series or something where you can use it that way but what I'm telling you is it we're not just talking about bridging people were talking about ministering to people and the things that we sometimes think of his bridging people to to more spiritual events these are actually things that actually help people right where they're at and if you look through that chapter you look through some of our free material on line I think you'll see that come out we have a few minutes if you feel like there's some major loose ends that were not addressed it's Chapter 14 chapter 14. OK The question is about decaffeinated coffee there's there's concerns about decaffeinated coffee as well so the caffeine is not seen to be the only thing that's less desirable for your circulation in coffee there are also a class of compounds called caffeine $1.00 and $1.00 of the things that they seem to raise some of the compounds in coffee even in decaf raise homocysteine which is kind of a rogue amino acid that is felt to be involved in inflammatory processes in the body so I don't think decaffeinated coffee is is necessarily the best option either for people with digestive issues even decaffeinated coffee can have some adverse gastric consequences as well OK Other questions or comments. Oh OK We don't we didn't we do I think well let me just ask a question set of because we do have a few minutes. I sometimes perscribe juices for people who have weight problems and other weight problems in the sense of needing to gain weight OK because of the very reason that we just saw. Liquid calories give you relatively little satiety pre-calc that's true juices as well. So if someone's trying to gain weight we might have them drink some juice a half an hour before a meal so that they're not really eating or drinking between meals so much that kind of but it doesn't seem to be fully compensated during the meal also can be useful in that context but the average person who's overweight if they think juicing is one of the strategies to lose weight in my experience for most patients that is not a good strategy again because you get calories with relatively little satiety OK so if it's helping you and you're active and you're trim is helping you to maintain your weight otherwise you'd waste away than I'm supportive of it well we have one minute so a 32nd question a 32nd answer green tape OK Well green tea of course has caffeine in it so I have concerns about it from that standpoint are there some good things in green tea there are some good things in green tea by the way there's even some good things in tobacco and and other compounds so there's something called E.G. C.G. at the Gallo Catacomb Galle are something has some powerful antioxidant effects but the point is you can get powerful antioxidants from other foods as well so the thing is we don't have to discuss T. totally you know my burden is not to tell people that there's nothing beneficial in it but just that there are better options and in fact that should be one of our our key focal points in health education if you don't remember Ellen White said are if you want to use the modern term entree should be what something better something better Ok I met no we need to close let's close with a word of prayer together. Father in heaven we thank you so much that you haven't left us just at the whims of the scientific winds that sometimes seem to blow and even sometimes seem to blow with data supporting them but you've actually given us insights that are holding holding up under the most rigorous scientific scrutiny help us to realize that we actually have been entrusted with a message that the world is literally longing for and literally dying for we pray that you'd help us each know better how we can be involved in medical evangelism in our practices in our churches in our homes in our communities Please help us to that is we ask in Jesus name in this media was brought to you by audio verse a website dedicated to spreading God's word through free sermon audio and much more if you would like to know more about audio verse or if you would like to listen to more sermons lead to visit W W W audio verse or.


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