Narrator: Coming up on Mayo Clinic Q&A,
Dr. Stephen Kopecky: We cannot prevent aging. We can slow
aging. But we can prevent disease, it's certainly possible
to do. And if you do a certain lifestyle, you can affect that.
Narrator: Most of us want to live a long, healthy life. But
how do we do that? Well today on Mayo Clinic Q&A, we'll take a
look at an evidence-based approach to preventing common
diseases and maybe find some answers for living that longer,
healthier life.
Dr. Stephen Kopecky: But the real answer is there is no just
one thing. Because if you are exercising, eating great, but
you're sleep deprived and super stressed, you just can't sustain
the rest of your healthy habits. So, you really need to take care
of everything.
Dr. Halena Gazelka: Welcome, everyone to Mayo Clinic Q&A. I'm
your host, Dr. Halena Gazelka. Well, we all know that our
health affects our longevity and our quality of life. It's often
very difficult to convince ourselves to do the little
things that could help keep us healthy. There is a new book
that might help us it's called Live Younger Longer: 6 Steps to
Prevent Heart Disease, Cancer, Alzheimer's, Diabetes and More.
Here to discuss is Mayo Clinic preventative cardiologist and
the book's author, Dr. Stephen Kopecky. Welcome back to the
program, Steve. Thanks for being here, and congratulations on
your new book.
Dr. Stephen Kopecky: Thank you very much. It's a lot of fun.
Dr. Halena Gazelka: Wonderful to have you here. And what a
wonderful time of year for a book about our health. Because
oftentimes, even though we know it should be a year-long effort,
we start thinking about this again, and we start thinking
about a new year and how we're going to face a new year. So,
perfect timing.
Dr. Stephen Kopecky: Right, we point out in the book that
January 17, you know, of course, what that date is. It's the
date the average American breaks their New Year's resolution.
Dr. Halena Gazelka: Oh, my goodness,
Dr. Stephen Kopecky: Because we try to change so much. We try to
do so much at once and say I'm gonna change my diet completely,
I'm gonna change my exercise routine completely, and we last
a little less than three weeks.
Dr. Halena Gazelka: Okay, well, you'll have to tell us some
techniques. Now, I understand that you had self interest in
mind when you wrote this book that you're a cancer survivor,
Steve.
Dr. Stephen Kopecky: Right. I had a cancer in medical school,
it was just kind of a bump in the road to me. But then 14
years later, I had a wife, three children, the youngest which was
two-years-old, and premature death was not an option at that
point. I wasn't even 40 yet. And so, I figured I had to do
something to change my chances of getting cancer because my
sister had just died of breast cancer.
Dr. Halena Gazelka: Oh.
Dr. Stephen Kopecky: And so, I really looked into it. And I was
a treating cardiologist at the time, not a preventive
cardiologist. So, this was all new to me. But I looked into it,
and found that even though I had two cancers, the odds are I was
going to die of heart disease, because that's the number one
killer for men, certainly. And then I realized that anything I
would do to prevent heart disease would also prevent
cancer. So, it kind of went together very, very well. And I
tried all sorts of things, you know, big changes, it never
lasted. So, then I started looking into the science of
changing. It has to be tiny, little habits. You know, there's
a great quote from Dr. Charles Mayo it says, It is unfortunate
that people do not understand what small things diseases come.
So, it's tiny little things that get us. It's death by 1000
cuts. And you can overcome that with just small steps over a
lifetime.
Dr. Halena Gazelka: That's amazing. That's wonderful. Thank
you for sharing, candidly, your own story with us. And now, in
the book you mentioned that, Steve that there are things that
we cannot change. We can't change our genetics, we can't
change our age, we can't change our sex. What can we change?
Dr. Stephen Kopecky: Yeah. Well, that's a very good question. You
know, we cannot prevent aging. We can slow aging, but we can
prevent disease. I mean, that's certainly possible to do. And if
you do a certain lifestyle, you can affect that. Now, you
mentioned genes, and you know, if we have, say, a bad
lifestyle, or bad genes, if you have bad genes for heart
problems, your risk goes up about 40%. If you have a bad
lifestyle for heart problems, meaning you may not exercise,
you may eat the wrong foods, you're not very active
physically, you smoke or have diabetes, your risk goes up 400%
Dr. Halena Gazelka: Oh, my goodness.
Dr. Stephen Kopecky: So, the epigenetics is that the way we
conduct our lifestyle affects how our genes manifest. And you
can actually do that by doing things every day to prevent that
from happening.
Dr. Halena Gazelka: Wow, that's amazing. I didn't know. You
know, we always seem to think that genetics predetermine us to
have something, but not necessarily, I guess.
Dr. Stephen Kopecky: Yes, no that's very true. And even
breast cancer from which my sister died is, you know, a very
small percentage of that is genetic, but mainly its
lifestyle. And that's what many of the cancers and most of the
heart disease, Alzheimer's, all these things come from.
Certainly, diabetes comes from a lifestyle. So, the things we do,
and what we write about in the book is basically a compass. If
you think of a north, south, east, and west, so North is
nutrition, which is now the number one risk factor for early
death and disease in this country and this world. East is
exercise. South is things like smoking and spirits or alcohol,
but also the two forgotten risk factors, I call them stress and
sleep. And then West is weight, the weight isn't quite as
important as people think. If you get into really good
physical shape, your weight really doesn't matter that much.
Because when you get into good physical shape with activity and
exercise, then you lose your abdominal fat or visceral fat,
which is very pro-inflammatory and causes a lot of these
diseases that we don't want like cancer, heart disease,
Alzheimer's.
Dr. Halena Gazelka: So, is that compass the habits that we
should develop in life?
Dr. Stephen Kopecky: Right, the compass or the habits, the steps
that we should develop in life. And you know, so many people
come to me as a preventive cardiologist and say, Doctor,
what, I'm taking this supplement. I understand this
supplement will really protect me. Or Doctor, I'm eating this
superfood, you know, this single food is going to protect me,
right? Or I have this exercise machine or this exercise
workout, that's going to protect me from everything. I say, it's
not just one thing, it's a multitude of things that all fit
together. So, for instance, we give examples in the book, like
if you are sleep deprived, and/or stressed, and who isn't
stressed these days. But if you get a vaccine, you know, if we
had a vaccine that we said was 20% more effective, we would say
I want that vaccine. But if you're sleep deprived, or very
stressed, your benefit from the vaccine is reduced 20% because
your immune response just can't pick it up and do the things it
needs to do. So, we really have to take care of ourselves. And
the issue with our country, with our health care system, it
really is designed to wait until we get disease, and then treat
the disease. So, the prevention unfortunately is all on us. We
need to prevent and take care of ourselves.
Dr. Halena Gazelka: Steve, I think one of the hardest things
about making lasting change is making it last. You mentioned
January 17, that people often break their resolutions. What
is the answer to incorporating long lasting positive change in
life?
Dr. Stephen Kopecky: Yeah, that's a great question. And,
you know, if you look at diets, you know, the average American
goes on a couple of diets a year, and they last, you know,
two to three months, whatever. Our weight in our lifetime goes
like this, you know, we lose, we gain we lose, we gain. So, the
answer, I think, is to make small sustainable steps that you
can live with. And when I say small steps, like for diet, I
tell patients one bite, one bite of something healthy, I mean,
take off some processed meat off your plate, or processed foods
and put on something like a legume or a bean or black bean
or something. After a couple of years, that one bite difference
will lower your risk of having a heart attack. So, it's really
small things that you can live with. And that's very important.
Now, you know, these holiday times are really tough, because
we all want to go back to Grandma's or Mother's or
whatever and eat some of her great food. I tell people have
that great food, just don't eat that great, maybe unhealthy food
every day. Have a little bit of it, or have some while you're
there, put some other things on your plate that are healthy. So,
enjoy it certainly. Don't deprive yourself, but just not
every day. Have some smaller amounts. And when you can
control what you eat, try to make things a little better. You
know, the fruits, the vegetables, the legumes, the
fish, white meat poultry, have your main source of fat, the
olive oil, extra virgin olive oil, and a few nuts. These are
things that you can eat and really enjoy them. But you got
to work to find the things that you really like best and
everybody's a little different.
Dr. Halena Gazelka: Steve, what does literature or data tell us
about how long it takes someone to actually form a positive new
habit. I'm thinking of myself, I get up at 4 a.m. every morning
to exercise, but I can tell you that several years ago that
wasn't a very welcome task to me, and it took me some time to
make that such a part of my routine that now I wouldn't even
consider skipping it.
Dr. Stephen Kopecky: Yeah, that's a great point. Great
question. The, you know, kind of the common thinking is it takes
about three or four weeks.
Dr. Halena Gazelka: Okay.
Dr. Stephen Kopecky: That's really based on a plastic
surgery study decades ago. That's how long it took people
to get used to the changes from their plastic surgery. So,
really the habit, you know, the term break a bad habit is not a
correct term. Nothing could be more untrue. You never actually
break a habit, you just replace it with another habit that you
enjoy just as much, if not more, and is healthy. So, for
instance, you didn't, when you started exercising in the
morning, you didn't just one day, say I'm going to do this.
It was like a process. First you started getting up at that
time of the morning. And then you started putting on your
tennis shoes that time of the morning. And then you started to
actually maybe sit on the bike or the treadmill, and not just
do anything, you just stand there. Then it's a process.
It's little steps one at a time that you can live with and
sustain. And the secret is when you do it, get some dopamine in
your brain going, because that's what lays down the habit for
memory. And the way you do that is to reward yourself, you know.
So, I get up every morning also, and if I'm in the kitchen at 5
a.m., I'm making coffee. And sometimes, you know, it's a
habit, and a habit by definition is something you do while your
brain can do something else. The brain loves habits because
it doesn't have to spend energy on them. So, I'll make the
coffee, I'll drink it and I look around I think who made this
coffee? Is Linda my wife here? Nobody is in the kitchen but me,
and I made the coffee obviously. So, you know the habit is
something that you just get into the process of doing. If you
can make it a healthy habit, that's the best part. And that's
exactly what you've done, Halena.
Dr. Halena Gazelka: That's wonderful. I love hearing about
incremental change. Because I do think it's true that people just
take too much on it once. And so, this is good news for us.
Dr. Stephen Kopecky: Yeah, you know, if I wrote a book that
said here's how to make a million dollars in a month, or
here's how to raise a perfect child in a month. You'd say
this guy doesn't know what he's talking about. You can't do that
in a month. You know, you have to save a little bit of money
every week with your paycheck so you can retire. You need to
always be there for your kids as they're growing up so, you know,
they can learn from you. And the same thing with our habits. We
need to in our healthy habits, we need to just incrementally
slowly change them.
Dr. Halena Gazelka: Steve, where can we find the book?
Dr. Stephen Kopecky: Well, of course Mayo. It's a Mayo Clinic
Press book, and Mayo has it. You can find it on just about every,
you know, online, Amazon, Barnes & Noble, Target. I was talking
to one of my friends the other day in Seattle, he said it's in
four bookstores in Seattle. So, really it's all over, but
everything is bought online these days. So, I encourage, you
know, BAM, or one of those, Books A Million, all those have
them.
Dr. Halena Gazelka: We will make certain that we have a link to
it on our Mayo Clinic News Network site as well.
Dr. Stephen Kopecky: Yes. I appreciate that very much. It
really is very readable. I tell people, it's a very scientific
book, scientifically based, but it's easy to read. It's a
classic Mayo Clinic, you know, built for a patient to read and
understand and get a take home message from it.
Dr. Halena Gazelka: Do you have any last words of wisdom for us
today, Steve?
Dr. Stephen Kopecky: Well, yeah, sure. I usually get asked,
What's the one thing? What's the one thing that we need to do?
And the answer is, you know, it's a two-part answer. First
is, if there's one thing that you're doing that's really way
off the charts, like not good, like smoking, or say you're
very, very sedentary. Or say you're eating lots of
ultra-processed foods every day which is 57% of the calories we
eat in this country, then change that. Try to change that a
little bit at a time. But the real answer is there is no just
one thing. Because if you are exercising, eating great, but
you're sleep deprived and super stressed, you just can't sustain
the rest of your healthy habits. So, you really need to take care
of everything. And sleep, for instance is one of those things
that if we miss some sleep, we've missed it the rest of our
life. Unlike calories, we can always make up the calories we
miss for eating, but we can't get back the sleep. And the
stress is something that we all have to deal with. We cannot,
you know, you can't say okay, stress is going to go away. It
never will if you have a job or a family or anything else. But
you can kind of mitigate it or make it so it's not quite so
bad, and it's not quite so harmful to you.
Dr. Halena Gazelka: Wonderful. Thank you for being here today,
Steve.
Dr. Stephen Kopecky: Halena, thanks for having me. I
appreciate it.
Dr. Halena Gazelka: And we thank each of you for joining us today
to hear about Dr. Stephen Kopecky's new book, Live
Younger Longer: 6 Steps to Prevent Heart Disease, Cancer,
Alzheimer's, Diabetes and More. I know I'm gonna go pick up a
copy because I learned something new today. I hope that you did
too. And we wish each of you a wonderful day.
Narrator: Mayo Clinic Q&A is a production of the Mayo Clinic
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