Importance Of Data
Kenneth H. Cooper, M.D., M.P.H.

In 1970, with a young daughter and pregnant wife, I left a promising career in the military to open a private practice in Dallas, Texas, a city in which I had never lived. My first book, Aerobics had become a national bestseller and I was convinced that all I needed to do was open the doors and the patients would flock in.

Boy, was I in for a shock!
Times were much different then than they are now. The concept of “preventive medicine” was very foreign, especially to the medical community. We had always been taught to treat disease, not prevent it. The response from the majority of my medical colleagues was less than enthusiastic.

Many of them asked how a young doctor could come to town and expect to earn a living by keeping people well? I was told time and again, “There’s no profit in the prevention of disease, only in the treatment of disease.”

With the advantage of 20-20 hindsight, I can now understand their position. At the time there was little, if any, scientific evidence that lifestyle choices, like diet and exercise, had any positive benefits.

I was convinced of the power of fitness because I had spent 13 years investigating its impact. I had worked with thousands of enlisted military personnel, along with officers and NASA astronauts, and had seen the beneficial results first hand.

SHOW ME THE DATA!
Nevertheless, scientists, including most medical doctors, have a need for scientific validation. The presence of peer-reviewed research that preferably has been published in a recognized scientific journal, is almost mandatory before anything new is universally accepted. In fact, Dr. Conrad Earnest, the director of the exercise physiology lab at The Cooper Institute, closes most of his correspondence with, “Deo credimus sed alius omnis demonstrada sunt data!” That is Latin for, “In God we believe, by all others data must be shown!” Even then it sometimes takes a while for the medical/scientific community to become convinced.

I realized that for the concepts of exercise and fitness to be accepted as important factors in gaining and maintaining health that I would have to overwhelm my colleagues with data. I actually chartered The Cooper Institute (a nonprofit, 501C3 organization) before I opened the doors of Cooper Clinic.

Since 1970 the Institute has developed the largest objective data-base on exercise in the world, with over 750,000 person years of data. They have also published over 500 articles in scientific journals including the Journal of the American Medical Association, Circulation, and the Annals of Internal Medicine.

That type of track record obviously takes time but it is well worth the effort. Dr. Canconi, an internationally recognized exercise physiologist from Italy, on a recent visit to our campus, made the comment, “When you say something about exercise, the whole world listens.” That is because we have the data.

WHAT IS NEXT?
I share this history because I feel we are now on the verge of a huge break through in understanding and treating heart disease. Cardiovascular disease (CVD) is by far our nation’s number one killer. It also happens to be a very complicated, multi-factorial disease. As an example, close to half of the patients who have heart attacks have either average, or below average cholesterol. Certainly cholesterol is a major coronary risk factor but it is by no means the only one you should be concerned about.

One of the hottest topics in medicine right now is inflammation. Having an ever present, low-grade inflammation throughout your body is associated with heart disease, stroke and diabetes. Almost weekly there is at least one article in the scientific press linking inflammation with disease. The data is becoming far too impressive to be ignored.

One of the best measures of this inflammation is a protein level called C-reactive protein, or CRP. CRP, which can be measured via a simple blood test, is manufactured throughout the body and becomes elevated for a number of reasons. A bee sting, stress, an allergy, or an ulcer can help elevate CRP. So can underlying disease.

Dr. Paul Ridker of Boston’s Brigham and Women’s Hospital is a leading researcher of CRP. He estimates that between 25 to 35 million healthy middle-aged Americans have normal cholesterol but above-average CRP’s, putting them at unusual risk of heart attacks and strokes.

There was also a recent article published in the journal Pediatrics that found overweight children as young as 8years old with elevated levels of CRP. CRP could prove to be a very important piece of the puzzle, potentially becoming a better predictor of heart disease than cholesterol.

WHAT CAN I DO?
At Cooper Clinic, the measurement of CRP is a part of our regular blood profile. I suggest that your have your physician measure your CRP level, if he/she is not doing so already.

It is known that the statin drugs, which are used to lower cholesterol (Lipitor, Zocor, Mevicor, and Pravacol), will also lower CRP. Other published research indicates that both aspirin and vitamin E have a positive effect on lowering CRP levels.

If you take vitamin E, I recommend using the natural rather than synthetic form. Natural, which is better absorbed, will be listed as d-alpha tocopherol. Synthetic is dl-alpha tocopherol. If there is no fine print on the label to indicate the source (i.e. only “vitamin E” is listed) then assume it is synthetic.

The Cooper Institute has data that has been submitted for publication, which shows the multivitamin formula Cooper CompleteÒ has a significant impact on lowering CRP. That research was presented before a congressional meeting in Washington, D.C. this past July.

Losing weight, moderating alcohol consumption, not smoking, and lowering blood pressure will also help lower CRP levels.

ACTIVITY, ACTIVITY, ACTIVITY
One other factor that will influence your CRP level is exercise. The Centers for Disease Control and Prevention published the results of a study of almost 14,000 in the journal Epidemiology in June, 2002 (Vol. 13 No. 5). This study, which looked at various levels of activity, showed that “leisure-time physical activity was inversely associated with C-reactive protein concentration in a dose-response manner.” That means the more you exercise, the lower your CRP.

The Cooper Institute presented results at the May 2002 American College of Sports Medicine conference that shows a similar relationship of fitness levels and CRP, independent of body weight. Again, this underscores the incredible power and benefit of exercise.


THE TAKE AWAY MESSAGE
What I would like you to remember is that good science takes time, effort and resources. Even then, there is often a lag time between the data and the acceptance of the data. We now have significant research to support the importance of CRP testing. Do not hesitate to get it done!

I encourage you to be proactive with your health. Remember that it is no ones’ responsibility but yours.

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