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Caitlin Whyte (Host): Hello and welcome to the American College of Osteopathic Internists' podcast Docs Off the Clock. Juggling the business of medicine and caring for patients means doctors always seem to be on the clock. Docs Off the Clock features some of today's best voices in healthcare with tips on how to live a better, balanced life.

Thanks for stopping by today. February is American Heart Month, and there is no better time than right now to explore your heart health and wellbeing as a medical student or physician. Joining us for this important conversation is Dr. Laura Rosch, the Joplin Campus Dean at Kansas City University, who will give us some steps that can be taken to help promote one's own heart health.

Now, Doctor, we're talking about heart health today, and I'd like to start with focusing on doctors and medical students. How are their hearts and lifestyles different than the general public. Are they really any healthier?

Laura Rosch, DO, CS, MPH, FACOI (Guest): Well, this is an interesting thing. Some studies that have looked at the difference in lifestyle factors and risk factors for heart disease in physicians and in medical students, when compared to the general public have found that doctors actually have less risk-taking behavior. So things like they are less likely to smoke, less likely to drink, you know, ride motorcycles without their helmet on that sort of thing. Physicians in general are much less likely to do that. And they've also looked at other factors that are really interesting, such as the prevalence of obesity. And doctors, male doctors are in general, significantly less likely to be obese than the general public. We have about over 33% of Americans have a body mass index in the obese range, or even greater. And among male physicians, for example, the obesity rate is only 11%. So that's pretty impressive.

Host: That is so interesting. It does make sense though, I guess, but I'd also love to focus on another subset. Let's talk about women. What are some concerns that are unique to women and their heart health?

Dr. Rosch: Well, we do know that for years and years and years, and since the 1980s, women's health, especially women's heart health, didn't really account for a lot of the research. And it wasn't until later when the National Institutes of Health began to investigate more the incidence of heart disease. You know, heart disease among women is the number one cause of death for women in the United States, it still remains significant. And when we, when they looked back at some of the studies and some of the prevalence of heart disease in women, it was found that one of the leading causes of missed detection and diagnosis of heart disease in women was that the symptoms of heart disease in women can present atypically. For example, a woman might present with shortness of breath with some nausea and dizziness. I have a really good friend who was putting her laundry away one day. And this is just so typical women, right, in the house, cleaning, cooking, putting everything away, running around, like I'll get to it, I'll get to it.

And she said to her husband, oh, you know, I'm feeling a little bit nauseated, but I gotta finish folding the towels and put them in a closet. And he came around the hall and he looked there and he goes, yeah, you know, you don't look so good. Maybe we should go to the hospital and turns out yes, she had the big one. She was experiencing angina and she had heart disease and her symptoms were, you know, a little bit nausea, a little bit of regurge, headaches and fatigue. And the other interesting thing I think is that you can have symptoms of, for example, sudden and random sweating, kind of like menopause type symptoms, right.

And women might think, oh, this is just a hot flash or this, you know, the sort of just go away. But when in reality, if you have some of the underlying risk factors for heart disease, it can actually be a manifestation of the symptoms of a heart attack. Yeah. So get your, get your heart checked.

Host: Well, that leads me into my next question. You know, there's different subsets, we're talking about, doctors, we're talking about women, but everyone has a heart. What can we do to help improve our overall heart health for really anyone?

Dr. Rosch: For everyone. Well, you know, five really, really simple things that are going to make a big impact that you can do just almost right away. The first is a healthy diet. So, we do know that healthy foods like fruits, vegetables, nuts, whole grains, healthy fats, omega-3 fatty acids are really, really helpful for the promotion and prevention of heart disease. Unhealthy foods like hi fat red meats, sugar-sweetened beverages, things with trans fat, and then a lot of sodium, not good for the heart.

So your healthy diet is key. The other thing is having some healthy physical activity. Now starting anywhere helps. Anywhere is helpful. So even 30 minutes a day of a moderate to vigorous daily activity is just key. It's important for so many things, but, but in particular for your heart. So you could even break it up 10 minutes here, 10 minutes here, 10 minutes there doesn't have to be all at one straight shot, but 30 minutes a day of moderate to vigorous activity is healthy for you. Also to maintain a healthy body weight, meaning a body mass index that's between 18 and 24. That, that's kind of the sweet spot where you want to be. And the fourth thing that you can do, which is really important. And can't overemphasize this is to, if you smoke to quit smoking, there's no healthy amount of smoking at all, anywhere everywhere, so to quit smoking. And then, you know, we don't think of this, but it's really important. And I have a lot of friends, you know, we, we get together and we'll have a glass of wine to really have moderate alcohol intake. That would be the fifth thing. Cause alcohol, when you really think of it as broken down, it's, it's, it's a carcinogen and really we're not designed to, I know that they have a variety of recommendations. They say red wine is a good thing for you. You can have a glass here, here, or there, but really, really to limit the alcohol intake as much as you can, because we do know that any amount of alcohol intake is associated with higher risk. And it's something that you can do almost immediately and just, you know, keep it out of your diet.

Host: You know, I do have one more question as we wrap up here. I'm 31 years old. And I think about heart health as something I won't have to worry about for a couple more years. Right? 10, 20 years if I'm lucky.

Dr. Rosch: What? No, no, no. Stop that. You need to think about it right now today. Know those five things I just told you to do. Please do them if you can, because you're worth it. Right. I think like doctors don't realize how valuable they are and how long it takes to train them and how smart they are. And we have a lot of sometimes unhealthy coping mechanisms. We don't sleep very well. Sometimes we just eat junk food in the doctor's lounge. We don't watch our weight or might smoke to even cope with the stressors, you know, what we have to deal with every day. And that, that extends, you know, that can extend all the way down, starting at the age of 20, you can be diagnosed with heart disease, right?

So any of those other kinds of risk factors that you might have, if you smoke, if you're overweight, if you don't have healthy physical activity, you are at higher risk. And I think it really starts with your mindset, that you are a valuable person, that you have much to contribute, in terms of practicing medicine and taking care of your patients, to take care of yourself with these types of behaviors.

Because we do know that physicians health practices strongly influence their patient health practices, right? Obese doctors are more likely to not address issues of obesity with their patients. Isn't that interesting. Or if physicians smoke, they're not going to talk to their patients about smoking because this is what they do. So promoting your own healthy lifestyle really leads to significant influence on your patient's health habits. And talking about prevention and health promoting behaviors is really key to substantially reducing any kind of cardiovascular risk when taking care of patients.

Host: Well, just for the record, I am going to my primary for the first time in a long time next week, next week. So I'm getting back into it.

Dr. Rosch: We've done five things. Do you do those five things? You, you eat a lot of fruits and vegetables and

Host: I try, Ido, I do a lot of yoga. I'm getting better at being plant based. So I feel good about it, but I know I need to do a little more.

Dr. Rosch: Yay. Well, on a physiologic level, it makes a big, and it helps your brain. And, and, and I think probably one thing that isn't always emphasized, but I, I find, I think about more now that I'm getting older is the importance of sleep, right? It's very restorative and I don't want to develop any dementia. So, we do know that sleeping, getting a good sleep between six and eight hours a night is really important.

I know a lot of doctors, it's a challenge to get that kind of sleep because they're very busy, but to try to maybe focus on restructuring your schedule or your day, particularly as you age, to get more sleep, to help your prevent, not only heart health, but you know, your emotional health and your physical health and wellbeing.

Host: Well, Doctor, I appreciate the reminders. We appreciate your time here today. You know, February is American Heart Month. Is there anything else that we need to know? We touched on a lot, but did we miss anything?

Dr. Rosch: Well, I know I was going to mention briefly about the medical students. You know, what's really interesting. They, there hasn't been a lot of, a whole heck of a lot of studies that looked at medical students and their health. But when they've compared the association between medical students' lifestyles and their attitudes towards prevention and counseling; it's very similar to the physicians. The medical students who take care of themselves, eat better diets, have more healthy lifestyles and behaviors are more likely to help their patients with those types of behaviors as well. They're more likely to counsel them on their weight, their smoking, their health habits, because they know that it's important and they live that lifestyle. So, yeah, isn't that interesting?

Host: It's crazy how it all stems back, you know, it's a cycle, right? Yeah.

Dr. Rosch: Right. Get yourself a skinny doctor, right? That's what Zig Ziegler used to say, I want them to be, I remember he always said you want to lose weight, get yourself a skinny doctor. You know, they're doing something.

Host: Well, Doctor, thank you so much for your time today. We appreciate it so much. We know everyone's busy, but it really helps us out.

Dr. Rosch: Yeah, it was my pleasure. Thank you. Take care. Have a great day.

Host: Well, this has been Docs Off the Clock. We look forward to future podcasts, where we will continue to explore issues of importance to you. For additional information, please contact the ACOI directly at 1-800-327-5183. That's 1-800-327-5183.

Or visit our website at acoi.org. Be sure to follow us on Facebook, LinkedIn and Twitter. And you can also email us at This email address is being protected from spambots. You need JavaScript enabled to view it.. Until next time, be well.