Preventive Care: A new monthly health and wellness series with Dr. Troy Jackson

It seems that the more access to health information we have, the harder it has become to understand what is good or bad for one’s health.

• Am I supposed to eat carbs or not?
• Should I be worried about microplastics?
• Why are people putting butter in their coffee again?

My name is Troy Jackson. I am a husband, father to two young kids, an amateur bread baker and a local family physician who loves learning about the human body, how to prevent disease and how to extend health span. Born and raised in Mississippi, I came to Asheville to complete family medicine residency training at MAHEC and have been in private practice since 2019.

I also enjoy writing, so I am thankful that Xpress has agreed to provide a regular column that allows me to extend my voice beyond the walls of my medical practice. My desire is to share health-focused ideas that may help you in your wellness journey as well as cut through the confusing noise of health advice to bring you something empowering rather than paralyzing.  

First topic: Heart health 

Since February is American Heart Month, there is no better place to start a wellness column than on heart disease prevention. Heart disease and strokes comprise the No. 1 and No. 5 reasons for death in the United States, respectively, and have reigned as two of the most deadly diseases since the 1920s. For 40%-45% of Americans who have a heart attack in a given year, their first symptom will be sudden cardiac death. And for the other 60%, their life is forever altered.

But delaying or even preventing heart disease is an attainable goal for most of you reading this. In fact, studies on the American Heart Association’s list of “Life’s Essential 8” show that those who can manage their risk factors for heart disease can dramatically reduce their risk of future heart attack and stroke, sometimes more so than commonly prescribed cholesterol medications.

Life’s Essential 8 (LE8) is a scoring system developed by the American Heart Association composed of eight domains: 

• Healthy behaviors: nutrition, physical activity, sleep, not smoking.
• Healthy factors: weight, cholesterol, blood sugar, blood pressure.

The score can range from 0-100. In most studies, the average is around 65. You can find the calculator online at avl.mx/ejv.

Several studies show that having a moderate LE8 score between 50-79 reduces your risk of cardiovascular death by 32%-39% compared with those who had a score less than 50. Having a score of more than 80 reduces your risk by 81% compared with those with a score of less than 50. Most studies followed patients for 10-14 years.

These are incredible results and highlight three things I want to share with you:

1. You don’t have to be perfect to have better heart health. Although scoring a 100 gave participants the best risk reduction, you ​can achieve impressive benefits by just being better than the average (65). So maybe you are doing a lot of great things for your heart and your blood work is optimal, but you just cannot get to a “normal” BMI. If you can get your score greater than 65 in other ways, you will see reduced risk and, hopefully, reduced worry. 
2. We all have room to improve. I’ve seen a lot of patients in my job as a family physician and have yet to meet someone who’s got it all figured out all of the time. I want to encourage you to reflect on your current state of health and identify one area that you can change for the better. It could be dedicating one day per week to a 30-minute strength training routine or avoiding that fast food chain on the way home from a busy workday. Any healthy choice, no matter how small, is impactful when done consistently. Going back to these LE8 studies, any 10-point improvement you can make gives you an additional 15% risk reduction. Therefore, the data is clear that any change is worth it.
3. Let time be on your side. The younger you are when you pay closer attention to your heart health, the greater the benefit you will receive. And the longer you maintain good health, the lower your risk. Health is akin to compounding interest: Invest early for greater rewards later. Start with getting blood work. Check your LE8 score and identify an area to improve. Start now, so you can experience better health later.

Final thoughts 

We (medical professionals) often put too much emphasis on prescriptions and procedures. It’s how we are trained, for better or for worse. I vividly remember in medical school seeing textbooks that dedicated multiple pages to medications and their side effects but only gave a flippant, one-sentence comment about lifestyle factors. Don’t get me wrong, medications can be extremely helpful if you find yourself already at high risk. But medications should rarely be prescribed without first evaluating a patient’s lifestyle and taking an opportunity to seek out improvements. 

It is clear with these LE8 studies that having optimal cholesterol numbers, blood sugar and blood pressure will not get you into the high-score range by themselves. Most of us will need a combination of both good lab work and good adherence to lifestyle factors to truly keep our hearts healthy for the long run. More importantly, these health behaviors are also key strategies in reducing your risk for other conditions like diabetes, dementia and multiple types of cancer.

I look forward to this opportunity to share my thoughts about health and wellness with you in this new column. I’ll try to write on relevant or interesting topics but am also open to your questions and suggestions. If you have a specific medical topic you’d like for me to explore or a question about health you’ve always wondered about, please write to me directly at troyjackson@authentichealth.com with the subject line “MountainX Health Question.”