Você já percebeu que a expectativa de vida aumenta a cada ano? De acordo com o último censo do IBGE, em 2020 a estimativa era de 76 anos, o que equivale a quase 22 anos a mais do que poderia viver uma pessoa nascida na década de 1960. Porém, isso não quer dizer necessariamente que as pessoas estão vivendo melhor e com mais saúde.
É nessa linha que falaremos neste post sobre alguns conceitos trazidos pelo médico neurologista Dr. Pedro Schestatsky (@drpedroneuro) no livro “Medicina do amanhã: Como a genética, o estilo de vida e a tecnologia juntos podem auxiliar na sua qualidade de vida”, conceitos estes que se aplicam diretamente à nossa qualidade de vida e nossa relação com a saúde.

Crédito imagem: Metrópoles
Uma explicação para o aumento da expectativa de vida se dá por vários fatores que foram progredindo ao longo do tempo e que contribuíram para que pudéssemos viver mais: descoberta de vacinas, novos equipamentos e tecnologias, melhoria das condições sanitárias, criação de UTIs, descoberta do DNA, etc.
Porém, o livro traz um estudo sugerindo que pela primeira vez na história da humanidade, talvez os filhos viverão menos do que seus pais.
Segundo a análise, o aumento da esperança de vida nos Estados Unidos dos últimos dois séculos pode chegar ao fim em breve. Pelos elevados índices de obesidade e suas complicações, como o diabetes, essa estimativa pode se nivelar ou mesmo cair ainda antes de 2050.
No Brasil ainda não há pesquisas semelhantes, mas a obesidade também é crescente por aqui: em dez anos, o aumento foi de 60%. Hoje, segundo o Ministério da Saúde, um em cada cinco brasileiros está acima do peso.
Além do peso em excesso, outros aspectos caracterizam o estilo de vida dos grandes centros urbanos, como o sedentarismo e o estresse.
Para ilustrar: Atualmente, os portugueses vivem em média 81 anos e os investimentos anuais em saúde, por pessoa, giram em torno de 2300 dólares. Já os norte-americanos vivem menos, em média 78 anos e gastam quase quatro vezes mais com saúde a cada ano (aproximadamente 8700 dólares). No mínimo curioso, não?
Diante de dados tão alarmantes, como podemos resolver? O Dr. Pedro defende que a saúde do futuro começa mudando hábitos HOJE, e explica de forma prática como podemos reverter esse cenário.
E ele começa encarando a forma como enxergamos a medicina. O juramento de Hipócrates (aquele feito nas formaturas dos cursos de medicina) e o paternalismo médico transferem a responsabilidade sobre a saúde para o médico, detentor do conhecimento e da saúde. O problema é que esse paternalismo cria uma relação cômoda para ambas as partes. De um lado, o médico não tem suas regras questionadas. Do outro, o paciente não precisa se responsabilizar pelos resultados.
Ele mesmo relata já ter descoberto que era um daqueles pacientes assintomáticos, como é o caso do “magro de ruim”. Com menos de 40 anos, uma bomba-relógio prestes a explodir. Sendo médico e com um senso crítico aguçado, o Dr. Pedro não se conformou ao ouvir em suas consultas o que para ele são sentenças como “vá para casa, você está bem.” que podem ser entendidas como “fique doente e depois volte aqui”. Diante disso, suas buscas por respostas o levaram à Medicina Funcional, às Práticas Meditativas e às Tecnologias que devolvem ao paciente as rédeas da sua própria saúde.
Ressalta que a definição de saúde da OMS (Organização Mundial da Saúde) criada em 1940 “um estado de completo bem-estar físico, mental e social e não somente ausência de afecções e enfermidades” merece uma atualização, pois não leva em conta algumas mudanças que surgiram nas últimas décadas. Alguns sinais podem indicar desde cedo um possível problema, mesmo que o paciente não apresente nenhum sintoma agora. Hipertensão, diabetes e câncer são algumas das doenças “silenciosas” que podem levar anos para nos incomodar. Portanto, ter saúde é diferente de “não ter doenças”.
A boa notícia é que com o passar dos anos temos cada vez mais avanços e tecnologias para tornar mudanças positivas possíveis. O homem em sua inteligência cria tecnologias fantásticas, mas o desenvolvimento de hábitos e o cuidado com a saúde de cada um ainda precisa de atenção e mudanças. A fonte desses problemas está na forma de pensar saúde.
Dessa forma, o Dr. Pedro propõe que além de “ter”, precisamos “criar” saúde. Porque “a saúde não está nos consultórios, nem nos remédios ou cirurgias. Encontra-se em sua casa – especialmente na cozinha -, em suas atitudes e decisões.” É sua responsabilidade, de forma que o médico se torna um facilitador e parceiro nos cuidados com a sua saúde. Se você já dependeu de convênios médicos, do sistema público de saúde ou de pílulas mágicas que te “curam” por uns dias, mas depois tudo volta a ficar como antes, também deve estar cansado deste modelo não sustentável. Há uma falsa ilusão de que tomando um remédio você já fez a sua parte, e a partir daí é só esperar a cura.
Você pode dizer “mas eu já tentei uma nova dieta, um novo hábito e não consigo”. Oras, acredito que se um ser humano é capaz de realizar algo, então os outros da mesma espécie podem fazer igual, ou melhor! Além disso, temos muita facilidade de informação nos dias atuais, de forma que o que precisamos é de fontes confiáveis, com ações que se adequem à nossa rotina. Aqui queremos te mostrar que é possível melhorar 🙂
A informática facilitou a busca por dados, e se informar sobre doenças e causas nos dá, como nunca, a oportunidade de debater com o profissional de saúde de uma forma positiva. Além disso, os smartphones estão presentes cada vez mais na vida das pessoas e permitem controlar, por exemplo, a quantidade de passos e calorias gastas no dia. Indo além, hoje já é possível através de conexões bluetooth monitorar, através de biossensores, a glicose, frequência cardíaca, sono, entre outros parâmetros. E de forma ainda mais aprofundada, o mapeamento do genoma e do microbioma humano podem trazer dados riquíssimos para serem interpretados pelo médico, o que pode te auxiliar de uma forma parceira e mais precisa a se livrar de uma série de burocracias para focar no mais importante: você, sua saúde, sua felicidade!
É por isso que o livro traz a visão da chamada Medicina de Precisão, que propõe medidas terapêuticas mais individualizadas e por consequência, efetivas.
De forma didática, é colocada como a Medicina dos 5 P’s, 5 etapas que definem como deve ser a Medicina do Amanhã:
1. Preditiva: por meio de uma revisão de dados clínicos e laboratoriais, identifica (ou seja, prediz) males em potencial e, assim, engaja o paciente em atitudes preventivas.
2. Preventiva: concentra-se na prevenção de doenças crônicas, como diabetes, hipertensão e doenças autoimunes, que são a maior causa de morte – representam 63% delas – e perda de qualidade de vida na atualidade.
3. Proativa: em vez de esperar o paciente ficar doente para “atuar”, busca tendências e fatores de risco sutis de cada indivíduo com o intuito de prevenir doenças, agindo, e não somente reagindo.
4. Personalizada: considera as particularidades de cada indivíduo; por isso, cada pessoa deve ter dieta, exercícios e exames periódicos específicos, de acordo com informações pessoais.
5. Parceira: o médico não é mais a única autoridade, até porque essa posição muitas vezes inibe o paciente de falar de seus problemas. Os dados gerados por ele, com o apoio da tecnologia, vão fazer com que ambos aprendam e caminhem juntos rumo à criação da saúde.
Falaremos mais detalhadamente sobre os “P’s” nos próximos posts, prometo!
O que fica em questão de forma alarmante é que a maioria das dez doenças que mais matam no mundo podem ser prevenidas (ou pelo menos adiadas) sem remédios, “apenas” com mudanças no estilo de vida. Por exemplo, no topo da lista estão as doenças cardiovasculares representando 31% de todos os óbitos em nível global, e lideram o ranking há pelo menos quinze anos. Uma alternativa elencada pelo Dr. Pedro é trabalhar desde cedo e com mais ênfase os fatores comportamentais de risco: tabagismo, alimentação não balanceada, falta de atividade física, uso nocivo de bebidas alcoólicas, etc.
“Tomar remédios apenas para aliviar sintomas, sem mexer na raiz do problema, é o mesmo que usar uma toalha debaixo de um chuveiro ligado: você se seca e se molha em seguida.”
A tecnologia de testes de sequenciamento genético também é algo em ascensão e é possível saber se você possui mutação em algum gene que pode te levar a desenvolver alguma doença. É possível ainda saber como estão os telômeros (extremidades dos cromossomos, estruturas que carregam nossa informação genética). Eles têm a função de proteger o material genético e estão diretamente ligados ao envelhecimento. Se os telômeros estão curtos, pode ser um sinal de envelhecimento acelerado e morte precoce. Resultado esse encontrado no mapeamento do Dr. Pedro, que culminou na mudança proposta em seu livro.
Falando de mudanças de hábitos, e para auxiliar nisso, o Dr. Pedro propõe um método que engloba os pilares essenciais da saúde humana: Movimento, Alimento e Pensamento, ou MAP (não coincidentemente, significa mapa em inglês).
Em um cenário onde o paciente se torna protagonista ou “agente”, ele nos norteia sobre alterações necessárias em nossos hábitos: na maneira de comer, de movimentar o corpo, e de encarar a vida.
Explicitando cada uma dessas frentes, temos dicas valiosas para começar hoje mesmo a mudar a nossa relação com a saúde.
Movimento: o sedentarismo pode levar ao surgimento de diversas doenças. Uma pesquisa feita na China com 417 mil pessoas mostrou que o grau de atividade física é inversamente proporcional ao risco de morte. Ou seja, quanto mais exercícios físicos você faz, menos chance tem de morrer. A dica aqui é praticar a “desconveniência”: por que não estacionar o carro alguns metros mais longe do seu destino e fazer parte do trajeto a pé? Você pode subir escadas ao invés de pegar o elevador, evitar ficar muito tempo sentado, fazer reuniões ao caminhar, deixar o carro na garagem, limpar a casa, praticar jardinagem, e assim por diante. Para nortear suas próximas escolhas, aqui está uma tabela relacionando a quantidade de passos por dia e o grau de atividade.
PASSOS POR DIA | GRAU DE ATIVIDADE |
< 5000 passos | Sedentarismo |
5000 a 7499 | Baixa |
7500 a 9999 | Moderada |
> 10000 | Alta |
> 12500 | Super! |
Um corpo que se movimenta com frequência ganha mais força, flexibilidade e equilíbrio, ítens fundamentais à medida que envelhecemos para a prevenção de sarcopenia (espécie de alzheimer do músculo) e quedas, uma causa importante de mortalidade em idosos.
Alimento: No livro “A dieta personalizada”, baseado no estudo sobre como a alimentação influencia a saúde, os autores destacam a importância de observar os efeitos que cada alimento causa no organismo – o que te dá mais energia ou sono, por exemplo? Essas descobertas podem ser feitas com maior precisão por meio de exames laboratoriais e principalmente, do uso de biossensores implantáveis para monitorar os picos de açúcar. Entre as dicas do livro estão: mantenha um cardápio variado no dia a dia, porque assim poderá garantir todos os nutrientes de que precisa; coma fibras, uma vez que elas servem de alimento para as bactérias “do bem”; equilibre as porções alimentares; coma menos, pois quanto menor a quantidade, maior a longevidade; e por fim, experimente. Vale a pena continuar provando coisas novas para ter uma relação melhor com a comida.
Pensamento: Qual é a qualidade dos seus pensamentos no dia a dia? Você tem mais pensamentos positivos, que te trazem alegria e bem-estar, ou seus pensamentos te trazem raiva e tristeza? Estresse, devaneio, ruminação, pessimismo, hostilidade, contrariedade e hiperconexão digital impactam o tamanho dos nossos telômeros. E quanto menor o telômero, mais rápido envelheceremos. Portanto, toda vez que você estiver com pensamentos ou na presença de pessoas “tóxicas”, lembre-se que suas células estão sofrendo! A dica aqui é praticar o silêncio naquele momento em que você fica a sós com você mesmo. A meditação, ou alguma outra técnica antiestresse entre as mais de 100 validadas cientificamente são dicas valiosas aqui. Ainda, para um cérebro mais feliz e longevo, busque seu propósito de vida; crie um círculo virtuoso, realizando atividades que proporcionem bem-estar físico e espiritual; não se culpe tanto; faça atividades prazerosas para gerar dopamina, substância cerebral responsável pela sensação de bem-estar. Hiperconexão digital, álcool e açúcar aumentam a dopamina, mas em contrapartida elevam a inflamação e reduzem os telômeros. Concentre sua energia em fatos que realmente merecem sua atenção e viva o momento presente. A dica prática é começar já a contar a sua respiração todos os dias por pelo menos três minutos. Com o tempo você vai perceber uma forte conexão entre essa prática e seu estado mental.
Para colocar tudo em prática, o Dr. Pedro propõe o programa MAP de combate à inflamação que consiste em sete semanas de aumento gradual de cada uma das letras desta sigla criadora de saúde. Vale a pena conferir essas e outras dicas detalhadas no livro Medicina do Amanhã, experimentar o programa e conhecer a plataforma LifeLab Med (lifelab.med.br).
Se você está em crise, ou acha tudo isso demais, saiba que essa palavra vem do grego e quer dizer mudança. E já reparou quanta mudança, quanto progresso, quantas novas soluções e olhares surgem dessas crises? Que tal aproveitar o momento e começar já?
Você pode começar a monitorar sua saúde fazendo o upload dos seus exames, vacinas e lembretes de medicamentos e consultas no DocHealth, app que criamos para te auxiliar no gerenciamento da sua saúde, disponível tanto para Android como para iOS. Estamos preparando uma plataforma para que você possa monitorar sua saúde como um todo.
Gostou do texto? Conta pra gente nos comentários o que achou, quais atividades você já pratica, e quais vai começar a praticar a partir de AGORA.
DocHealth, sua saúde na palma da sua mão.
183 comentários em “Construindo a medicina do futuro – por Fernando Sydor”
Excelente iniciativa. Parabéns
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