Taking Charge of Your Health

Routine blood work for health insurance came as a wake-up call for Amanda back in 2019. The results showed she was pre-diabetic. “I was scared,” she recalls. “I was too young to feel my best years were behind me.”

At the time, she was thirty-three years old with three small children—and a family history of diabetes. “I knew I had to do something. There would never be a perfect time to deal with it; life wasn’t going to slow down.”

Amanda implemented changes to her eating and other habits and increased her activity. She was gratified to see an improvement in her numbers within six months. “My body started to say thank you,” she says. “I had more energy. I showed up better as a mom and as a wife.”

With continued effort, Amanda lost nearly sixty pounds—but she appreciates most what she gained in the process. “I learned that nothing would change if I didn’t take ownership of my own health,” she says. “I’m breaking a generational cycle [of unhealthy habits].”

She notes that with two additional pregnancies in the intervening years, while she hasn’t kept off all the weight she lost, prioritizing her health is a journey that has positively affected her family.

With all the pressures that come along with leading a frum life, preventive health care often takes a back seat, according to the directors of JOWMA, the Jewish Orthodox Women’s Medical Association, which provides free health education to the Orthodox Jewish community. Many people are lax about taking care of their health, from cultivating healthy habits to staying on top of routine doctor visits and medical screenings.

“In general, the Orthodox Jewish community is really good at reacting,” says Dr. Jennie Berkovich, a Chicago-based pediatrician who serves as JOWMA’s director of education. “When someone is sick, we’ll get referrals to the top specialists and stop at nothing to get the best care.” But, she adds, when it comes to preventing illness in the first place, “it’s hard to prioritize.” In her role at JOWMA, she dedicates her time to educating the Jewish community about how to make good decisions when it comes to health. JOWMA is part of the fourth cohort of the OU’s Impact Accelerator, a program that helps advance promising Jewish nonprofits.

Admittedly, says Dr. Berkovich, this is not a uniquely Jewish issue. In fact, the US Department of Health and Human Services has launched the “Healthy People 2030” initiative to encourage millions of Americans to get recommended preventive health care services that will reduce their risk for diseases, disabilities and death.

Dr. Berkovich says that when it comes to well visits at the doctor, most people are good about bringing in babies. “After that, the trends show parents bring kids to the pediatrician in years when schools require paperwork,” she explains. “Then we often stop seeing adolescents and college students unless something is wrong.”

As adults, women often visit an obstetrician/gynecologist regularly, whereas men may not see a doctor until they have symptoms they can’t ignore. “In general, there is a feeling that men are not as attentive to routine medical care as women,” says Elana Silber, CEO of Sharsheret, a national organization supporting Jewish women with cancer.

As a starting point, Dr. Berkovich recommends that everyone establish a good relationship with a primary care provider. “The PCP relationship is critical for preventive health care,” she says. “There is value in the routine exam because symptoms often start when a disease has already progressed. An earlier diagnosis typically leads to a better outcome.”

Are We Getting Enough Screen Time?

Although people may not be visiting their doctor as often as they should, when it comes to getting recommended medical screenings, the Orthodox Jewish community is doing a pretty good job, according to Silber. “We’re seeing women taking the lead and getting annual mammograms after age forty,” she says. “Unfortunately, Covid slowed that down, but we at Sharsheret are reminding people to continue.”

With all the pressures that come along with leading a frum life, preventative health care often takes a back seat.

In addition to routine screenings, Silber recommends that people understand their family medical history, which may point toward other preventive measures. “Someone is at greater risk if a family member has had cancer,” she explains. Silber notes that “people can definitely be afraid” of facing these issues. “But we are very fortunate in this country to have excellent medical care. If you’re proactive, you can prevent cancer or catch it when it can be cured.”

Sharsheret, which is based in Teaneck, New Jersey, educates and guides women about genetic risk factors and how to access testing and understand their results. “As many as one in forty Jews—women and men—carry the BRCA gene mutation,” says Silber. This is especially significant among Orthodox Jews, who tend to marry within the community, perpetuating genetic mutations.

Silber notes that with some prophylactic surgeries, there is close to a 100 percent success rate of not developing cancer—which is especially significant for diseases like ovarian cancer that can be hard to catch early. “Where it’s talked about, women are taking these proactive measures,” she says. “Families who have seen a family member suffer are more likely to get tested and take action.”

Sharsheret encourages women to be proactive in learning what steps they can take to preserve their health. One of the challenges, Silber explains, is that the medical community has information and new modalities, but they’re not out there marketing it to regular people. Sharsheret tries to bridge that gap, getting the information out there and helping women navigate their options.

Silber wishes there was a greater sense of urgency about the topic in the Jewish world. “The cancers related to BRCA are plaguing our community.” But, she adds, “there are things people can do to save their lives now.”

According to Cleveland Clinic gastroenterologist Dr. Michael (Meir) Pollack, while genetic screenings are becoming more common, people often don’t know what to do with the knowledge they have been handed. “I’ve seen young people who come over to me with a printout, asking, ‘What do I do with this information?’” he says. “They now know there are 100 genes they’re carriers of, which might indicate they’re at higher risk for certain diseases.”

Dr. Pollack recommends that people who do these screenings have their results reviewed by a professional. “It could save your life,” he says. He recalls speaking to a man in his thirties whose genetic test showed he was at higher risk of colon cancer. “He had no symptoms and no family history,” Dr. Pollack says. “I recommended a colonoscopy, but when I saw him a few months later, he hadn’t done it yet. He finally had the colonoscopy, and they found a malignancy.” Fortunately, it was caught at an early stage, and the man was completely cured.

When I got to the end of the race, I cried. So many of us have a destructive inner voice saying, ‘Why bother doing this?’ I saw that I could go beyond my self-imposed barriers.

Dr. Pollack notes that studies have proven that people of Ashkenazic Jewish descent are twice as likely to have Crohn’s or colitis—which in turn increases a person’s risk for colorectal cancer. However, he doesn’t see people from the Jewish community keeping up with medical recommendations at higher rates than the general population. “Most people know about getting a colonoscopy starting at age fifty,” he says. “However, current guidelines actually recommend doing so beginning at age forty-five. And people don’t know that there are other tests that are less invasive that have been shown to be quite accurate.” So while 65 percent of people over fifty are getting colonoscopies, “that means 35 percent of people don’t do anything,” he says. “If they feel fine, they think they’re fine.”

Dr. Pollack worries that people are not aware of the long-term health ramifications of what they consider to be “normal” digestive discomfort. “You’ve got people popping Tums without thinking about it at all,” he says. “But over many years, chronic acid reflux is a risk factor for Barrett’s esophagus, which is premalignant,” he explains. “For people with chronic reflux, an upper endoscopy screening is recommended. Then we would check again every three years to make sure nothing’s changing.”

Overall, Dr. Pollack understands that people are busy and for various reasons—whether it’s laziness or poor insurance coverage—preventive screenings are neglected. “Unfortunately,” he says, “no one stops and says, ‘How can I preserve myself to live a long life in good health so I can continue doing the things I love to do?’”

Keeping Healthy Kids Healthy

Dr. Hylton Lightman, a pediatrician who has served the Orthodox Jewish community for more than forty years in his Far Rockaway, New York, practice, says his guiding principle is “prevention is better than intervention.”

He recommends regular well visits every year. “It’s important for a pediatrician to assess a child, not just physically but also their context,” he explains. “This allows us to understand what is going on for the child and to prevent later difficulties of the body.”

A significant step parents can take to proactively help their children remain healthy is staying up to date on vaccinations, according to Dr. Lightman. As a native of South Africa who practiced medicine in that country before coming to the US, he is especially dismayed that there are many people within the frum community who are reluctant to do so. “This is foolish and dangerous,” he says. “Vaccines are tools Hashem gave us to prevent disease. I’ve seen these diseases up close and they are debilitating and devastating,” he asserts.

Like many pediatricians, Dr. Lightman has seen children become more sedentary and spend less time outdoors in recent years, in addition to growing rates of obesity among children. The increase in childhood obesity has been well documented in the general media. In fact, in January, the American Academy of Pediatrics released its first comprehensive guidelines for evaluating and treating children and adolescents with obesity. The recommendations were met with controversy, as they focus on weight loss as the best path to health and suggest putting children as young as age two on diets. For teens, the guidelines include weight loss medications and even bariatric surgery referrals.

Dr. Lightman strongly cautions people to be careful when encouraging weight loss in children. “As a frum society, we pay too much attention to appearance and weight, especially in females,” he says. Teens can develop eating disorders as a result. “We have to convey a message to our children of respect for our bodies and for each other,” he maintains.

In general, Dr. Lightman believes Orthodox parents are trying their best to do what’s right for their children. “But they are overwhelmed with the responsibilities of life,” he says. He stresses that adopting a healthy lifestyle is “absolutely imperative to the well-being of children and adults.”

What’s Eating Us?

According to Silber at Sharsheret, society in general is embracing the importance of healthy eating and exercise, thanks to both traditional and social media. “We’ve also seen significant reduction of tobacco use, which is amazing,” she says. Interestingly, Silber notes, “people seem less willing to eliminate alcohol” in response to medical recommendations.

Within the Orthodox community, however, experts note that certain factors in Jewish life contribute to unhealthy behaviors. “Our lifestyle focuses heavily on food,” says Dr. Berkovich of JOWMA. “We’re also largely sedentary. We walk to shul, but only on Shabbos—and then we try to ensure we don’t have to walk too far.”

Dr. Pollack agrees that frum society is hyper-focused on food. “This isn’t new; it’s part of our culture. Our ethnic Jewish foods are very fatty—cholent, kishka, kugel. Many of us enjoy these things at a kiddush and then come home and do it all again for lunch.” He stresses that it’s not bad to enjoy any particular food, but “everything in moderation.” Dr. Pollack feels this is “the biggest issue” plaguing the Jewish community when it comes to health. “Screenings? Yes! But what’s killing our people is obesity,” he says. “Obesity is a risk factor for cancer, heart disease and stroke.”

In addition to poor eating habits, a lack of physical activity compounds the issue. “I don’t know if Orthodox Jews tend to have a more sedentary lifestyle than anyone else in 2023,” notes Dr. Pollack. “But many are busy with families, work, carpools, errands, hosting, et cetera, and we don’t prioritize our health. Then suddenly, you’re sixty years old with big problems.”

I don’t know if Orthodox Jews tend to have a more sedentary lifestyle than anyone else in 2023,” notes Dr. Pollack. “But people are busy with families, work, carpools, errands, hosting, et cetera, and we don’t prioritize our health. Then suddenly, you’re sixty years old with big problems.”

Lifelong bad habits around food and activity—and the emotional baggage that goes with them—are common themes Chaim Loeb hears from his clients at Fit Yid Academy. Based in Phoenix, Arizona, Loeb offers virtual personalized coaching to Jewish men who want to achieve fitness or health goals and learn how to sustain a healthy lifestyle. He has worked with approximately seventy men in the three years since he began Fit Yid Academy, with the majority of his clients in their thirties and forties. “The main thing I hear is, ‘I don’t have time,’” he says. “For most of us, fitness and health are very important but not urgent. It’s hard to create time for it when we tend to live within the box of dealing with what’s urgent.”

Loeb adds that he sees a common “all-or-nothing” perspective among Orthodox men. “We have to teach people to work on consistency over perfection,” he says. “Plus, people want quick fixes. But our goal should be to build regular habits, which takes time and effort.”

He says he gets calls from men who were told by a doctor they’ve got certain risk factors or are headed in a certain direction. “Unfortunately, most people who hear this do nothing,” he says. But joining a gym or an exercise program or signing up with a coach can lead to significant improvement. “We’ve seen real changes in [people’s] numbers. It’s beautiful.”

When it comes to eating, Loeb avoids referring to foods as “bad or “good”—or even “healthy” or “unhealthy.” What we eat, he says, can be either “supportive or not supportive of our personal goals for our well-being.”

For Rabbi Aryeh Markman, executive director of Aish LA, being physically fit is part of avodat Hashem. “I once heard that there is a lot of spirituality in being a healthy human being,” he says. “It allows us to do more. We want to be able to build our sukkah, clean for Pesach, fast on fast days and even get our grandchildren out of their car seat without pulling out our backs.”

While he has always considered himself to be in shape, Rabbi Markman ran his first half marathon with RabbisCanRun in 2019 in Jerusalem. “When I got to the end of the race, I cried,” he recalls. “So many of us have a destructive inner voice saying, ‘Why bother doing this?’ I saw that I could go beyond my self-imposed barriers.”

RabbisCanRun was founded in 2017 by running enthusiast Meir Kaniel to enable rabbanim to improve their health and inspire others. Participants train for and run their first 10K, half marathon, or full marathon race. Roughly eighty-five rabbis, from communities across North America and Israel, have participated to date.

Rabbi Markman, who has since run several marathons, truly believes anyone can find a way to become more active that works for them. “It’s like anything you do in Torah,” he says. “Learning five minutes a day is going to impact your life; you’ll grow as a person. Similarly, incorporating some exercise into your day will help your body improve for the better.”

One of the unexpected side benefits of his long-distance running was seeing how his commitment has affected his entire family, Rabbi Markman notes. “My children were encouraging,” he says. And his wife began exercising too. “My working out gave her ‘permission’ to take the time out of her own busy schedule to make her health a priority,” he says.

Similarly, Amanda, who lost sixty pounds during her pursuit of health, has been thrilled to see the ripple effect of her efforts. “My husband was always supportive of my health journey,” she shares, “but I always felt like I was on my own.” While she worked hard to change her lifestyle, her husband kept up his “poor habits,” she says, which eventually led to high cholesterol and foot pain. “This past year, he made some conscious changes on his own. The pain went away, and he got his cholesterol numbers down without medicine.”

Knowing that she’s being a role model for her own family has made her efforts to embrace a healthier lifestyle all the more worthwhile. “There are still challenges along the way,” Amanda says, “but there’s no going back to how things were.”

Rachel Schwartzberg is a writer and editor who lives with her family in Memphis, Tennessee.

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