"Lifestyle and Disease Prevention: Your DNA Is Not Your Destiny"
More than 2,000 years ago, Hippocrates declared,
"Let food be thy medicine and medicine be thy food."
Except he really didn't.
It doesn't appear that he ever actually said those words.
Now there's no doubt about the relevance of food in health
and disease in his writings, but who really cares?
That was 2,000 years ago, when disease was thought to arise
from a bad sense of humors. Now we have science,
and there's an overwhelming body of evidence illustrating the dramatic impact
of a healthy lifestyle on reducing all-cause mortality---
meaning death from all causes put together---and preventing chronic
diseases such as coronary heart disease, stroke, diabetes, and cancer.
But wait . . . don't these diseases just run in your family?
What if you just have bad genes?
According to the esteemed former chair of nutrition at Harvard, for most
diseases contributing importantly to mortality in Western populations,
we've long known that non-genetic factors often account
for at least 80 to 90% of risk. We know this because rates
of the leading killers like cardiovascular diseases
and major cancers vary up to 100-fold around the world,
and when people migrate from low- to high-risk countries, their disease rates
almost always change to that of the new environment.
Currently, for example, we've been able to identify modifiable
behavioral factors, including specific aspects of diet,
overweight, inactivity, and smoking that account for more than 70%
of your risk of having a stroke or getting colon cancer,
more than 80% of coronary heart disease risk,
and more than 90% of risk for type 2 diabetes.
All that disease can be prevented by our own actions.
If most of the power is in our own hands, why do we allocate
massively more resources to treatment than prevention?
And even preventive strategies are heavily biased towards
pharmacology rather than supporting improvements
in diet and lifestyle that could be more cost-effective. For example,
treating high cholesterol with statin drugs could cost tens of billions a year,
only to have a modest impact on the incidence of heart disease.
The inherent problem is that most pharmacologic strategies don't address
the underlying causes of disease, which are not drug deficiencies.
Ironically, the chronic diseases that are most amenable to lifestyle treatment are
the same ones most profitably treated by drugs, because if you don't change
your diet, you have to pop the pills every day for the rest of your life.
So the cash cow drugs are the drugs we need the least.
Even though the most widely accepted, well-established chronic disease practice
guidelines uniformly call for lifestyle change as the first line of therapy,
physicians often fail to follow these recommendations.
And by ignoring the root causes of disease and neglecting to prioritize
lifestyle measures for prevention, the medical community
is placing people at harm, or at least so say folks like this guy.
Traditional medical care relies primarily on the application of drugs and surgery
after the development of illness,
whereas lifestyle medicine is primarily the use of optimal nutrition
a whole foods, plant-based diet, and exercise in the prevention, arrest,
and reversal of chronic conditions that would otherwise lead to premature
disability and death by concentrating on the underlying causes of illness.
Dr. Adriane Fugh-Berman, director of a wonderful organization I'm proud
to support called PharmedOut, wrote a great editorial entitled
"Doctors must not be lapdogs to drug firms."
The illusion that the relationship between medicine and the drug industry
is collegial, professional, and personal is carefully maintained
by the drug industry, which actually views all
transactions with physicians in finely calculated financial terms.
Big Pharma is happy to play the role of generous and genial uncle
until physicians want to discuss subjects that are off limits,
such as the benefits of diet or exercise,
or the relationship between medicine and drug companies.
Let us not be a lapdog to Big Pharma.
Rather than sitting contentedly in our master's lap,
let us turn around and bite something tender.