Hello, Doctor Friends. Today, I want to talk about something that can change your life and extend your lifespan for those of you in your 20s to 40s. Specifically, those in their 30s and 40s—what kind of story am I referring to? It’s about the condition that doctors fear the most and that leads to the most terrifying outcomes. This is a question for all of you as well. I believe it’s a situation that our parents' generation faces. They may no longer be healthy, but they think they are. This is also related to the idea of being unaware of one’s health status or existing conditions. However, this is even more common among those in their 20s, right? Especially when young people develop diabetes, high blood pressure, or high cholesterol, they face two paths. If I realize that I have these conditions, then ultimately, it's my responsibility, and I...

There are many places where you can get help, and there are really good solutions available, allowing many people to live healthier lives. However, I might not be aware of this, and as a result, I may end up living with diseases from my 20s or 30s for another 10 or 20 years. It’s like being trapped, right? Because I don’t know, I can’t understand. 

So, what are the characteristics of chronic diseases and metabolic disorders? There is a concept called the golden time. When blood vessels start to deteriorate, there is a point where the damage is still reversible. If you miss that time, however, it becomes irreversible, and no matter how much treatment you receive, you can’t go back to the way things were. This is because it leads to dysfunction in our bodily functions. Even if we try to recover from the damage, we can only restore the information to a certain extent; we can’t return to the previous state. So...

It is important to know my condition, but recent data shows that as of 2021, 87.1% of people over 70 are aware that they have high blood pressure. However, in their 40s, only half are aware, and in their 30s, only one in four knows. This means that among 100 adults in their 30s, only 10 have high blood pressure, and out of those, seven or eight do not realize they have it. If a person is 31 years old, then it is likely that 50% of those in their 40s are also unaware. When they turn 50, that will be 20 years later. How will they receive a diagnosis? They may end up with irreversible conditions such as a stroke or myocardial infarction. The same goes for diabetes. Although we talk a lot about diabetes, only half of people in their 30s and 40s are aware that they have it. Many think, I'm still young and healthy, and therefore skip health check-ups.

Fasting blood sugar is something that is often overlooked. For those whose levels rise later, morning fasting is usually fine. Originally, diabetes requires complex testing, right? It would be good to have at least a monthly check-up, but if the results show a level that is between diabetes and normal, the usual advice is to see a doctor. However, since it doesn't clearly indicate diabetes, it might seem like a pre-diabetic stage for the next year. Then, after a few years, you find out that you actually have diabetes, but in reality, you may have been in a diabetic state for ten years already. The world has changed dramatically; the rules around food have shifted significantly. What are the cheapest ingredients in today's world? Refined broth and processed foods. Commercially, these can be incredibly addictive, comparable to the addiction caused by alcohol and cigarettes. So, these factors are important to consider.

We eat a lot, and if you look at the current generation in their 20s and 30s compared to our parents' generation, the level of activity has changed dramatically. There are so many cars now, and there are no buildings without elevators. In the past, we used to have these huge parties, and even if there were elevators, they would often break down, forcing us to walk. Nowadays, we can't stand that. Back in the day, we wouldn't even press the button for the second floor in an apartment. The environment itself has changed, the rules around eating have changed, and the level of activity has changed significantly. Even insomnia has become more common; just having the lights on can increase insomnia. Steve Jobs gave us smartphones, and this has caused irreversible damage to our sleep. People in their 20s, 30s, and 40s use smartphones a lot, and with all the shorts and reels, the highly stimulating content makes us more impulsive.

As people age, their preference for ultra-processed foods increases. This is because when they are stressed, they crave sweet and fatty foods. However, they tend not to move much. As our environment changes, the prevalence of metabolic diseases has risen dramatically. The generation in their 20s to 40s has been particularly hard hit. There is a lot of talk about how this generation may be less healthy than their parents, and there are actual predictions of declining average life expectancy. The more concerning issue is that while health span may be similar, the time spent being active and moving around may decrease. This is because those in their 20s and 40s have a risk of vascular diseases that could manifest in their 60s and 70s, potentially leading to around 10 years of being bedridden. Therefore, the 20s to 40s generation is facing obesity and related issues.

The behavior has changed dramatically, but only 10 to 40% of people in their 20s and 30s are aware of their metabolic disorders. This is extremely serious. They are much less informed than I thought. In fact, if we feel a bit unwell, we should be aware so that we can exercise and adjust our diet. However, it's difficult to suddenly start exercising purely on willpower. There needs to be a trigger or motivation. So, how much is this affecting them? Fortunately, those who are aware are still in the minority. Over the past decade, the number of young people in their 20s receiving treatment for hypertension and diabetes has increased by about 96% to 129%. It has nearly doubled, yet there are still many who are unaware of their conditions, indicating an exponential increase. The prevalence of these disorders has skyrocketed. If this continues, what kind of news will we see in the next 10 to 20 years? Young people are still experiencing strokes and heart attacks.

I have come across news that strokes are rapidly increasing. Nowadays, the age of onset for cancer is also getting younger. This is what I hear. In their 20s and 40s, people think it is completely natural to live their daily lives alone; it would be stranger if it were not the case, right? However, when I realize that being able to manage my daily life independently is actually a very valuable thing, it hits me. It can be quite frightening to face situations where I need help with physical functions. It significantly impacts one's self-esteem. The costs can become unmanageable because, at a young age, one cannot engage in productive activities. However, to live my life, I need the help of places and people. There seems to be no clear answer, and the time it takes can be long. This can lead to very frightening outcomes, which is why the Disease Control Center is involved.

If you have changed your lifestyle and gained some weight, it's essential to know your vascular numbers. There is a campaign promoting this idea. What are vascular numbers? They include my blood pressure, blood sugar, and cholesterol levels, specifically LDL, HDL, and triglycerides. I also undergo a health check-up every year, but I don't think I memorize my vascular numbers. The goal is to make people aware of these numbers, so they become interested in their test results during that period. When it comes to metabolic diseases, treating them within the golden time increases the chances of remission. Especially for younger individuals, what does remission mean? It means that even though I have diabetes, I can manage my blood sugar well without medication. This is often considered a complete cure by many. Achieving that is much easier, and it reduces the likelihood of needing insulin in the future.

Insulin levels drop overwhelmingly. Just because I say this doesn't mean you need to refuse insulin injections. If it's necessary, you should get them quickly; it can actually improve your condition. It's very important to receive insulin because it can protect your pancreatic function, and of course, it can increase your lifespan. In our country, people tend to avoid it, especially those who need it. That's why even individuals in their twenties should consistently monitor their blood pressure, blood sugar, and cholesterol levels. Starting from there is the beginning of this campaign and seems to be the most important point. The ripple effect of this lifestyle is quite significant; it acts like a metabolic domino effect. There are small dominoes at the front, such as weight gain, a chaotic lifestyle, and lack of sleep, which can lead to insulin resistance. But from here...

When a domino falls, there is one behind it, then two, three, and four, and they all topple over, leading to various outcomes like strokes, kidney failure, amputations, blindness, and cancer. However, before this domino effect progresses, we can intervene to significantly reduce the probability of these outcomes occurring. Moreover, if it passes by, it's over. Once the dominoes start to fall, our options become very limited. So, while we still have the chance to stop this, we can even set up one or two dominoes in front. We can no longer set up the hundreds of dominoes behind it. Up to this point, we can still manage. It is crucial for those in their 20s to 40s to understand this, as it will allow them to live happily and healthily for the rest of their lives.

We are currently conducting this vascular health campaign at the Centers for Disease Control, which makes it very meaningful. I hope you all understand this and that our society can prevent the impending crisis together.

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