The power of choices

Around five years ago, a family member gave Dr. Monty Leavitt a book that changed his life. It was The Paleo Solution by Robb Wolf, the former Chicoan who pioneered the diet that avoids sugar as well as processed carbohydrates and oils.

As an emergency medicine physician at Enloe Medical Center, Leavitt was active. He’d gone to college in Canada, at the University of Alberta, on a basketball scholarship and continued playing into middle age; but by that point, in his mid-50s, he had quit the sport due to aches and injuries.

He’s found that switching foods has had a transformative effect. Leavitt said he notices a difference when he eats a more healthful diet: He feels “dramatically better.” Now 58, he’s back on the basketball court and “can compete with 25-year-olds.”

Leavitt is a walking—and playing—testimonial to the power of lifestyle choices in maintaining or improving health. He imparts information on diet and exercise to patients in the emergency room, while he completes advanced training in functional medicine. He hopes to move into a specialized internal medicine practice focused on teaching wellness rather than just treating illness.

Through this lens, Leavitt has a distinct view on a year-capping medical announcement: The National Center for Health Statistics recently released updated data on life expectancy, death rates and leading causes of death in the United States.

Capturing national headlines, the NCHS revealed that the overall death rate has risen for the first time in a decade and life expectancy (i.e., the age to which a newborn can expect to live) has dropped for the first time since 1993.

Secondary in media coverage but not in significance, numbers increased in nine of the top 10 causes of death—eight to a degree considered statistically significant. The leading causes remained the same (see infobox), with heart disease still first; the No. 2 cause, cancer, had decreased numbers but still outpaced unintentional injuries (including accidents and overdoses) and chronic lower respiratory diseases.

In all instances, the shifts were slight. Life expectancy dropped about six weeks, from 78.9 years to 78.8 years, and the biggest jump in any leading cause of death was four more deaths per 100,000, due to Alzheimer’s disease.

Plus, as pointed out by Dr. Andy Miller, Butte County’s public health officer, the infant mortality rate remained unchanged—as did life expectancy for seniors over 65. “So, it’s hard to draw a whole bunch of conclusions,” he said. “It’s more [a situation of] slipping on a lot of fronts than one particular problem.”

Leavitt does see a common denominator, life choices—even for causes of death as diverse as Alzheimer’s disease and drug overdoses, not just for lifestyle-attributed cancers, cardiovascular diseases, breathing impairments and diabetes.

“We as Americans have not been doing well on our diet, so we’re becoming chronically ill, and with that the consequences are we’re probably going to have a shorter lifespan,” he said. “Alzheimer’s, Parkinson’s, MS, a lot of neurodegenerative diseases, they’re actually all categorized as inflammatory diseases; a lot of the inflammatory things we suffer from are actually diet-induced…. It’s all part and parcel of the same thing.”

The rise in accidental drug overdoses coincides with an increase in narcotic prescriptions, Leavitt continued, starting in the 1980s when health care providers began to measure “pain as a fifth vital sign” using a 1-to-10 scale.

“I think we can modify these things by having people adopt better lifestyle choices, and then they won’t need all these pain medications all the time,” Leavitt said. “I’ve seen many people, once they adopt a better choice of food and drink and lifestyle, they don’t need the pain medicine anymore.”

According to the NCHS, part of the U.S. Centers for Disease Control and Prevention, about 2.7 million American residents died last year, and 74.2 percent died from one of the 10 leading causes. Miller said comparable statistics for Butte County are not yet available.

Of the national numbers, Miller said: “It will be interesting to see if it’s a trend that goes beyond one year’s data.” While cautioning against making too much from “one data point,” Miller added that “it would be irresponsible not to take it seriously because it has been many years since life expectancy decreased—[back] during the HIV/AIDS epidemic…. It shows that we have lots of work yet to do. If we thought we were winning the war, we were mistaken. It was a minor setback, but it was a setback.”

What should the public take away from this report?

“I think they should take what we take away—that it’s not a given that our health care and technology will improve our life expectancy,” Miller said. “It takes constant effort and vigilance by individuals, health systems and public health departments. It takes attention.”

Leavitt emphasizes individual action. He recommended a diet free of sugar, processed carbohydrates and “industrialized oils” (such as canola, corn, safflower and peanut).

“I think most people—if you talk to them and say, ‘Do you want to take pills to mask your symptoms or live and be well?’—they’d tell you they want to live and be well,” he said. “Whether they can stick with it or not is another story, but I think most of them would rather do it naturally if they had the choice.”