Health for a Lifetime

Heart Health

Three Angels Broadcasting Network

Program transcript

Participants: Allan Handysides, Don Mackintosh

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Series Code: HFAL

Program Code: HFAL000101


00:46 Hello and welcome to "Health for a Lifetime"
00:48 We're glad that you're with us and Dr. Allan Handysides,
00:51 we're glad that you're with us as well today.
00:54 Thank you very much.
00:55 Now your role is with the
00:56 "General Conference of Seventh-day Adventists"
00:58 You are a physician that works for them,
01:01 and it's no longer Health and Temperance,
01:03 it's "Health Ministries Department" - That's correct
01:06 And you have kind of a global perspective,
01:09 and you look at the major killers around the globe,
01:12 not just maybe in one country, but you're kind of in charge
01:15 of different departments that
01:17 look around the world. That's right
01:19 Now here in America, it's my understanding that one of the
01:23 major killers is heart disease. You're right, it's serious
01:26 But what about in terms of a global health issue,
01:29 is it an important issue globally?
01:32 It's probably not as much of
01:35 a global issue in some of the developing countries,
01:38 but you must remember countries like those in Europe,
01:42 and certain parts of the Far East are becoming
01:45 very sophisticated societies,
01:47 and heart disease is becoming an
01:49 increasing problem in those societies... Like Singapore
01:54 Like Singapore and Korea, for instance is becoming
01:58 much more sophisticated.
02:00 Big cities in China?
02:02 I don't think the Chinese are probably quite into the
02:07 high-fat intake that we are as yet,
02:09 but they are moving in that direction.
02:11 So why is heart health such an important issue?
02:14 When you look at the whole body you've got...
02:16 your liver, you've got your knees, you've got your nose,
02:18 you've got your heart... why is the heart so important?
02:20 I mean, that may be begging the question, but why...
02:23 Because you're leading me on!
02:25 Why is that so important to you?
02:27 If we cut off your nose, you wouldn't look so good,
02:29 but you'd still carry on. That's right
02:31 If we cut out your heart, you'd stop dead. Right
02:34 Now the thing is that there are
02:36 half a million deaths a year in the United States
02:41 secondary to heart disease.
02:45 It's estimated that there will be about 70% of the
02:48 male population will have heart disease.
02:51 ...70%, that will be one of the causes that
02:54 leads to their demise. That's right
02:57 And women - it's a little less, maybe down to 50-55%
03:00 women will have heart disease.
03:02 That doesn't mean that they don't have heart disease,
03:07 but they don't have symptoms of heart disease,
03:10 and they don't show that they have heart disease.
03:12 Now, when you talk about heart disease,
03:13 when you're talking about heart disease,
03:15 I think about different things...
03:16 I think about, you know, an enlarged heart,
03:19 or as some people call that, congestive heart failure.
03:22 I think about a heart attack.
03:24 I think about a problem with one of the valves.
03:27 What do you mean when you say that?
03:28 Well when I say that, I'm really talking about
03:31 arteriosclerotic heart disease.
03:33 So we're talking a vascular problem feeding the heart.
03:38 Now this separates it from the children
03:41 born with congenital heart disease.
03:43 It separates off those with a quiet heart disease
03:47 such as rheumatic fever.
03:49 And I'm not really talking about people who have
03:51 an infected heart problem like some of the myocardiopathies,
03:58 nor things like subacute bacterial endocarditis
04:01 which proportionate to the rest of heart disease,
04:05 are a very small proportion.
04:06 So, infections in the heart, that kind of stuff.
04:08 Yes they occur, but they are somewhat exotic.
04:12 Now your training is with women's health issues,
04:16 and also with pediatrics, but speaking of pediatrics
04:19 or children, is it a big problem with children - heart disease?
04:22 Well, heart disease, the congenital
04:25 heart disease, is a big problem.
04:27 I remember when I worked at "The Hospital for Sick Children,"
04:31 any one day, we could count maybe 65 children
04:34 in the hospital with a congenital abnormality.
04:38 And they would do, perhaps every day,
04:40 25-30 cardiac catheterizations to diagnose what the problem was
04:45 ...but very seldom, did we see arteriosclerotic heart disease.
04:50 Although our pathologist told us that when they did autopsies
04:54 on children, they could see in the children arteriosclerotic
04:58 changes in children as young as a year of age -
05:01 already beginning to see change there.
05:05 And what was that coming from - did they think?
05:07 What did they find in there?
05:09 We felt that that was probably related to the fat content,
05:13 the high-fat content in even infant formulas -
05:17 the diets that children were
05:19 receiving that weren't being breastfed.
05:21 Well let's talk about that fat intake... what's that?
05:25 What's the relationship between fat and heart disease?
05:28 Can I beg to just go back a little bit
05:33 and to talk about heart disease... Sure
05:35 Perhaps the underlying lesion in heart disease
05:40 is what we call "plaque"
05:42 Underneath the intima or the lining of the blood vessel,
05:46 ...here's the blood vessel, underneath the lining -
05:49 the little tiny one cell skin of the lining,
05:54 there is an accumulation of material.
05:57 Now we've tended to think that's just fat...
05:59 Well that's just erroneous, it's not just fat.
06:02 Probably there's a damage, first of all, an intimal damage
06:05 takes place - damage to that lining.
06:07 That may be because of oxidized low density lipoproteins,
06:14 a form of cholesterol.
06:15 It may be because of bacteria.
06:17 There's even an association between dental health,
06:20 and heart disease.
06:22 So it may be bacteria similar to those that are
06:25 around our teeth and gums in gingivitis.
06:28 So whatever the trigger is,
06:30 it sets up an inflammatory process...
06:34 and that inflammatory process
06:35 calls in tissue- white blood cells;
06:39 macrophages, platelets, clot onto this damaged area,
06:44 fibrin- which is a proteinaceous material, is released in there,
06:48 and so we get a buildup of these various substances -
06:52 it's not just pure fat sitting on the blood vessels.
06:55 So damage to that inner layer and whatever that damage
06:59 comes from, could be different factors, you're saying,
07:01 it causes these other blood clot type things to come to the area.
07:06 Well, what it does is it gradually expands,
07:08 and closes down the space within the vessel.
07:13 Now, if you take 1/2 inch pipe, in plumbing,
07:18 and you compare it to a 1 inch pipe in plumbing,
07:21 you'd say, "Well, I'm getting half the flow
07:23 through the 1/2 inch pipe than I'd get through the 1 inch. "
07:27 That's not correct!
07:28 The flow is not just hard when you go from 1 inch to 1/2 inch,
07:33 it's to a factor of about 16
07:35 for same pressure and things like that.
07:37 So in other words, this narrowing of the blood vessels
07:39 particularly in our heart vessels,
07:41 is very, very significant and very important.
07:44 Sort of like a garden hose when you squeeze it...
07:47 REALLY has a lot of change on those vessels.
07:52 Well what about the fat thing, let's come back to that.
07:55 How does fat relate to heart disease then?
07:57 Well the fats that are carried around in our body,
08:01 fats are very important to them and we can't live without fats..
08:04 More important to some people than others... Definitely!
08:08 But the balance of the fats have a very important role to play
08:13 in heart health.
08:14 Remember I said that one of the triggers is the
08:17 oxidized low density lipoproteins - the LDL
08:21 Now, if you have an elevated level of LDL,
08:25 then you're going to find that there is more chance of it
08:27 than being oxidized and, of course, that is where
08:30 antioxidants come in and protect against that,
08:32 and they will then be deposited part of that motley crew of
08:36 substances in that plaque.
08:37 And that's the thing that messes up the intima,
08:41 the little, inner layer... That is what will mess up the intima.
08:43 High density lipoproteins, on the other hand,
08:46 they are important for removing oxidized low density
08:51 lipoproteins from the clot.
08:52 So if we have higher levels of high density lipoprotein,
08:55 we get a better balance...
08:56 And of course, the total cholesterol has a bearing
08:59 on all of these factors.
09:01 Now where do these come from?
09:03 They come from the fats that we eat.
09:06 So if we, as the average American,
09:09 is eating 40% of our calories from fat,
09:12 we're taking far too much for our body's needs;
09:15 far too much for our body to be able to cope with,
09:17 and so we throw these fats in our blood -
09:20 we throw them into imbalance.
09:23 Now the saturated fats, which come from animal sources,
09:29 are by far and away, the most dangerous of the fats.
09:33 And we would like to see saturated fats reduced,
09:36 reduced, reduced, reduced, reduced, brought right down low.
09:39 There are some other fats that are good for us,
09:42 although nothing is absolutely black and white in this area,
09:48 but they are better for us, so we should have
09:50 proportionately more and those are the unsaturated fats,
09:54 and particularly the monounsaturated fatty acids
09:58 which we call "MUFAs"
09:59 So what would be some examples of the MUFAs?
10:02 Well, the MUFAs - if you read in the common literature,
10:07 they'll talk about fish oils.
10:09 They'll be talking about fish oils as being a "good source"
10:12 of MUFAs... Flaxseed though
10:13 Ah ha, but you see, when you take something
10:16 that may be polluted... look at the mercury levels
10:20 in the sea or in the dioxins and so forth,
10:23 then you're running into problems
10:25 of these other contaminants.
10:27 Whereas if you take the MUFAs, say - in flaxseed,
10:31 then you're going to be able to take a higher level
10:35 of monounsaturated fatty acids WITHOUT the collateral problems
10:39 that come along with some of those other contaminants.
10:41 But if you just say "no fat," you may cut out
10:43 the omega-3s and that could be damaged to what?
10:45 That's right... nobody, today, is saying "no fat"
10:49 You know, I don't think anybody who is current is saying- no fat
10:53 We all know - we don't want the cholesterols to go to nothing
10:58 because cholesterols are important for brain function,
11:01 neuro function and so forth.
11:03 In fact, there have been some studies that were done on
11:06 excessively low cholesterol levels being associated with
11:09 depression, psychiatric disorders,
11:12 even increased suicide rates have been correlated
11:15 with very low cholesterol levels.
11:18 So what we try to aim for is the healthiest levels,
11:22 and they've just revised the cholesterol levels.
11:25 What are they now... what should they be?
11:28 Okay, they've left the total cholesterol level 200 mg/100 ml
11:37 that stayed the same; although there has been some
11:39 thought that maybe they should lower that,
11:40 but they've left that the same.
11:42 But they have raised the level of high density lipoproteins;
11:47 they now say - instead of 35 being the low,
11:49 they'd like to see... in other words, you should be
11:51 above 40 with your high density lipoproteins.
11:53 And then for your low density lipoproteins,
11:57 they would like those a little lower...
11:59 And so, they now look at a level,
12:01 once you start getting above 65,
12:04 they say that's not a good level.
12:06 They are adjusting now, these levels at a national level
12:10 or international level and they are saying...
12:13 They are saying, "Let's be more
12:14 stringent on our cholesterol control.
12:17 When should we start checking our cholesterol, and how often?
12:20 I mean, you are a pediatrician,
12:22 should children have cholesterol checks?
12:23 I think we should start at maybe about age 20.
12:26 The reason I would recommend that is that it's a
12:29 national recommendation, but also because
12:33 you will pickup those people who have familial
12:36 inherited problems with fat regulation,
12:40 and those people need to be very, very careful about
12:44 their diet and their lifestyle,
12:47 and they may even need to go on
12:49 cholesterol-lowering medications because they have an
12:52 abnormal high enzyme problem.
12:56 Even if it is familial, in other words...
12:58 let's say you had someone that is not eating high fat foods,
13:01 not eating high cholesterol foods,
13:03 but they still have a high cholesterol.
13:05 They are in real danger.
13:07 Yes, so they have a metabolic disorder.
13:12 If you were to compare them to the diabetics,
13:14 we'd say they are like the type 1 diabetics.
13:16 They are genetically in trouble.
13:18 Then there is the vast majority of us who run into
13:21 cholesterol troubles because we are like the
13:24 type 2 diabetics - we're out of whack with our lifestyle...
13:27 But that group, they will be benefiting by having their
13:30 cholesterols measured when they are early,
13:32 and then maybe every 5 years
13:34 thereafter we should have this profile to keep an idea
13:37 as to where we are going with our cholesterols and fats.
13:40 So we need to know our numbers...
13:41 We need to know our numbers, arithmetic - basic stuff.
13:43 Know where they are.
13:45 Okay, other important aspects of heart health...
13:48 We talked about cholesterol;
13:49 we've talked about the vascular narrowing...
13:53 We can't leave it without talking about smoking.
13:55 Smoking! Okay...
13:56 No way that we can leave without talking about smoking.
13:58 Smoking is one of those factors that damages the intima.
14:02 So it is an initiating factor in setting up the process.
14:08 So how does that work? You smoke, it goes into your...
14:11 The nicotine goes in the neck, causes vasoconstriction,
14:13 maybe hypoxic damage - we don't know,
14:15 maybe direct chemical damage
14:17 from some of the contents of the smoking...
14:19 And here you've got the beginning... the seed is sewn
14:23 for arteriosclerotic heart disease.
14:26 Someone told me once that in that layer -
14:28 and I'm just checking with you to see if that's true,
14:29 there is a substance that is released right in that layer,
14:33 inner layer, that sort of like nitroglycerin.
14:35 It's sort of like that and it can help it relax,
14:38 but when you smoke, that disrupts that.
14:41 Am I correct on that? That's right
14:43 It interferes with the vasoactive components
14:46 in the vessel and it causes spasm,
14:49 and in and of itself, narrows the vessel.
14:54 I had a colleague - he was a physician,
14:56 should have known far better.
14:57 He got chest pain; he sat down and he said,
15:00 "I think I'll have a cigarette, I don't feel good"
15:03 Took the cigarette and he was found dead in the office.
15:05 Is that right? The cigarette probably
15:08 was the straw that broke the camel's back
15:11 in his particular situation.
15:12 What would be the most dangerous?
15:14 And I hate to put you on record of saying what this is
15:16 and maybe you don't want to be on record...
15:17 But let's say you had to choose between that very
15:20 high fat diet and cigarette smoking,
15:22 which is the most dangerous of those two?
15:24 Oh, that's like saying... Which would you rather be
15:27 run over by a Mack truck or be run over by...
15:30 you know - a train or something.
15:31 They are both bad - they are very, very bad.
15:34 Now one thing - another factor is exercise.
15:39 And in our lifestyle, we love to talk about foods,
15:43 but exercise - we talk about it a little bit,
15:46 we don't like to do it.
15:48 You know to get that sweat there and to work it up,
15:51 and 20 minutes a day of, you know, come out in a light sweat,
15:55 and you sort of feel hot for the next hour...
15:57 We don't like that kind of feeling.
16:00 We don't want to be uncomfortable.
16:01 And yet, statics show that a fit smoker,
16:08 as far as health risk is concerned,
16:10 is no worse off than an unfit nonsmoker.
16:15 A fit smoker is no worse off than an unfit nonsmoker.
16:22 You've heard it right here.
16:23 That's kind of bad news maybe for some of us.
16:25 We're talking to Dr. Allan Handysides
16:27 Join us when we come back to talk about heart health.
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17:39 Welcome back, we've been talking about your heart
17:40 and health, and we've been talking about the fact
17:43 that there are a lot of things we can do to avoid heart disease
17:45 ...one of America's #1 killers and a global concern as well.
17:49 When we left, we were talking about exercise,
17:52 and you were telling me that a smoker who is fit
17:54 is no better off really, than the person that's
18:00 NOT fit who doesn't smoke.
18:02 They are about the same and you were telling me
18:04 it's a one-pack-a-day type smoker.
18:05 That's on a one-pack-a-day, yes.
18:08 A person who smokes one-pack-a-day,
18:10 but is an athlete and is fit is no worse off than the
18:14 nonsmoker who is a couch potato.
18:16 So we do need to be exercising, that's what you're telling us
18:18 that for - to underline that. Yes, that's what we're saying.
18:21 And when we say "exercise," does this have to be
18:23 aerobic exercise... or does anything help?
18:27 Well, I suppose anything is better than nothing,
18:32 but there are some things that are better than others.
18:35 Walking for most people is probably the easiest
18:40 and simplest way of achieving heart health.
18:45 Now you need to walk probably briskly for about 20 minutes,
18:49 but people must not go out - anybody listening to this
18:51 program must not go out and walk briskly for 20 minutes.
18:54 They need to know where they are at before they try that.
18:59 But they need to be able to, in graduated exercise,
19:03 get to the point that they can walk 20 minutes briskly,
19:07 and breaking a light sweat and that would give definite
19:14 and proven benefits.
19:16 Now if you're out there walking briskly or whatever,
19:19 and you've been cleared by your doctor or lightly
19:21 and what are the symptoms of heart disease,
19:25 maybe not just for walking but other symptoms as well?
19:27 What are warning signals that you better go in and get
19:29 checked out by your physician?
19:30 Interestingly, they are different between
19:32 males and females.
19:33 We've traditionally taught, both physicians and the public
19:39 that the crushing pain in the chest - you know the elephant
19:42 foot just on there - that tightness that comes on
19:46 with exercise or with exertion, anger or stress -
19:52 that could be a sign of cardiac disease...
19:55 And in the male, he may develop angina,
19:59 and angina is symptoms of the pain that may be
20:06 is associated with a heart attack,
20:07 but it disappears when the activity is stopped,
20:11 and it repeats - the pattern repeats itself - that's angina.
20:17 Angina doesn't last for just a couple of seconds.
20:21 Angina isn't something that you can induce by
20:24 pressing on your chest.
20:25 A lot of people have tenderness on the chest...
20:27 They think that that's heart pain.
20:29 That's not heart pain - that's connective tissue,
20:32 muscle, joint - something like that.
20:35 The difference with women is that women will often
20:39 have associated nausea, or fatigue and the pain
20:46 often goes up into the neck and into the jaw.
20:49 So they may be getting a jaw pain or a neck pain,
20:53 referred pain and not recognize it...
20:55 And for many years, doctors misdiagnosed women
20:59 because they were looking for
21:01 something other than heart disease.
21:03 We also thought that women were protected
21:05 against heart disease, but now we know
21:07 within 7 years of the menopause, women are just as likely
21:11 as men to have cardiovascular problems.
21:14 So we have to keep aware of the symptoms are
21:17 different for men and women.
21:18 What is the youngest person you've seen
21:20 that has had a heart attack?
21:21 I saw a 14-year-old boy die of a classical myocardial infarction
21:26 at "The Hospital for Sick Children"
21:27 Now, he was a diabetic which brings us to another factor,
21:32 but he was a diabetic and he died.
21:34 And at autopsy, his vessels
21:36 looked like those of a 75-year-old man.
21:38 The diabetes maybe just accelerated
21:41 the problems with his vessels.
21:43 Well, the diabetes definitely accelerates the problem.
21:46 The diabetes causes atherosclerosis;
21:49 it causes small vessel disease,
21:52 and it interferes with fat metabolism,
21:55 and, of course, insulin resistance is very present
21:59 in a lot of diabetics.
22:00 So, the youngest I ever saw when I was working
22:03 in the emergency department, we'd see a lot of people
22:05 come in and we'd have 5 or 6 heart attacks
22:07 at a time in the morning, in the hospital there,
22:10 was a 17-year-old that had none of this;
22:14 not a diabetic or anything.
22:15 So I don't know - the reason I asked
22:17 the question was to see if I was right which
22:19 I was going to say - "Look this is something we need to
22:21 think about a lot younger. "
22:22 But those are the exceptions, but we do need to think of it.
22:26 In fact, what we need to do is, we need as a people
22:29 here in North America to think about our lifestyle.
22:32 We need to say - When are we going to
22:36 take care of ourselves.
22:37 Stop being couch potatoes, reduce that fat content.
22:40 Watch out for the smoking.
22:42 When are we going to sort of protect our young people
22:46 against these evils that are health hazards.
22:51 So those are really things that you're
22:52 clicking out there that we can
22:53 do to PREVENT heart disease. That's right!
22:55 Get them out there working, not being couch potatoes.
22:58 I know there is an exercise program,
23:00 have them eating the right kind of food so they don't
23:03 like that fat taste and just subsist on that,
23:05 and what else to prevent...
23:07 Well the other thing, of course, is the positive benefits
23:09 that come from all these antioxidants.
23:11 If you're going to talk about foods that are protective
23:14 antioxidant foods, you have to think about the rainbow.
23:17 We just had a thunderstorm going on outside
23:20 which I hope that they haven't heard on the program here...
23:25 But the colors of the rainbow,
23:28 if you look for the colors of the rainbow in your diet,
23:30 you KNOW you're getting the right foods...
23:32 those beautiful REDS, and those lovely GREENS and...
23:37 This isn't red Jell-O, green Jell-O...
23:38 No, this isn't artificial flavoring,
23:40 this is the red tomato, this is the red berries,
23:43 the deep plums - the fruits
23:46 and the vegetables that are rich like that...
23:48 And when we take these multiple colors in our diet,
23:53 and that's an easy way -
23:54 Anybody, you don't have to be a
23:55 dietitian to put color in your diet.
23:58 You know, those nice sweet potatoes with the orange hues.
24:02 All those things are really healthy for your heart.
24:04 Very healthy - good antioxidants
24:06 Remember I said - "the oxidized low density lipoprotein"
24:10 Okay, antioxidants are going to protect better.
24:12 It's a WONDERFUL net - this health business makes me just
24:17 over and over again - say, "what a wonderful Creator
24:22 when He created us"
24:24 He gave us the right kind of food to protect us.
24:26 He gave us the right kind of food;
24:27 He gave us the right system!
24:29 You know, He created the metabolism in such a way
24:32 that He could truly say when He created Adam and Eve,
24:35 they are not only good... VERY GOOD! Yeah!
24:39 Now, what if you've had a heart attack...
24:40 I mean, we're talking about preventing, avoiding...
24:43 If you've had a heart attack, is there any hope that
24:44 you could give someone that has had a heart attack?
24:46 Of course! People live for YEARS after
24:49 a heart attack.
24:51 Of course - that's if they take heed of the warning!
24:54 They say - "My goodness, I've had this heart attack,
24:56 I'd better mend my ways. "
24:57 And they go through the same things that we've talked about.
25:00 Although they now need to do it under medical supervision.
25:04 The exercise needs to be very graduated.
25:06 But in this area, a very interesting study...
25:09 showed that men who had had heart attacks
25:12 who did not have social support,
25:14 they didn't have a wife and a family.
25:16 They were lonely people.
25:19 Those people died at 40-50% higher rates
25:25 than the people who had the social support.
25:27 Now there is something that we
25:28 can do to help people who have had a heart attack.
25:31 We can go and visit them.
25:32 We can show them that we do care.
25:35 And by the spirit of community, the spirit of social support,
25:39 we can impact on the people's lives.
25:42 So there's a role for a church group;
25:44 there's a role for a civic group;
25:47 there's a role for getting people involved,
25:50 and this can really save their life.
25:51 This save their life... just the fact that they belong,
25:55 the effect of connectedness is very important.
25:59 Any other advantage you'd like
26:02 to share in the last 2 minutes we have?
26:04 Okay, well you know, people are very interested in advances.
26:08 Nowadays, they are talking about threading tiny little probes
26:13 into the cardiac vessels and maybe put a stent in there,
26:18 or they blow up a balloon and they crush the plaque down,
26:21 or they are even talking about lasers to vaporize the plaque.
26:25 And, what do they call these, you know, microwaves -
26:28 they are experimenting with all these kind of things.
26:31 And it sounds very wonderful and I think it's VERY exciting
26:35 as long as it's your heart that is being catheterized not mine!
26:38 And, I mean, I feel great if I'm an interventional radiologist,
26:42 but really, the thing is - Wouldn't it be better
26:46 NEVER to need all these wonderful advances?
26:49 So the greatest advance would be to
26:52 not have to have the greatest advance.
26:53 THAT'S THE GREATEST ADVANCE! YES
26:55 And I think we could do that!
26:56 With this program that you have here,
26:58 I congratulate you on this program...
27:00 of constantly repeating and educating the public
27:03 as to ways and means that they can impact their own lives
27:07 to the glory of God and to the enjoyment of life.
27:10 So it's true or false - it can be reversed.
27:13 You can have a plaque that then diminishes over time...
27:16 Yes, you can reverse it - not in everybody, not everyone.
27:22 I would think that probably
27:23 you can also dilate the blood vessels.
27:25 You can restore some of the elasticity to the vessels.
27:28 But overall, you can definitely improve the situation.
27:31 And in some cases, the plaque
27:33 has been demonstrated to be removed.
27:36 That's good news! Real good news!
27:39 We've been talking with Dr. Allan Handysides
27:42 He has given us not only a picture of heart disease
27:45 in America but globally and he has shared some good news.
27:48 There are some things that we can do to prevent,
27:51 reverse or better yet, AVOID heart disease.
27:53 We can exercise and we can eat right.
27:55 We can trust in God and have a social support system.
27:58 We hope this has been helpful.


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Revised 2014-12-17