Over the last 30 years we have seen the rise of preventative health. Three recent articles shine a spotlight on this and raise good questions.
A US study questions the cost effectiveness of certain health programs. In Germany, experts suggest that many “preventative” health programs may do more for doctors’ wallets than patients. Along the same theme, experts raise questions over the value of routine bone density screening.
A UK study showed that simple lifestyle changes would reduce rates of bowel cancer far more than screening programs (testing blood in the stool). An Australian bowel cancer screening program was in disarray due to problems with lab results. Mass skin cancer screening in Australia has seen the ratio of spots removed per cancerous spot go from 1 in 4 (1980) to 1 in 30 today.
The issue with most public health and preventative medical care campaigns is that they focus on trying to detect or prevent specific diseases. There is rarely an emphasis on keeping people healthy overall.
Now, lets be clear, it is better to find disease early than late. However this is not the same as not getting disease and certainly not the same as focusing on being healthy.
In slow aging we are seeking to keep ourselves disease-free by focusing on what we need to do to stay healthy rather than on what not to do to avoid getting sick. The two are not the same.
There are unintended consequences of this “disease specific” approach.
Skin cancer and vitamin D
For example, skin cancer campaigns that urge people to stay out of the sun may be partly responsible for a staggering increase in vitamin D deficiencies. This may be causing more cancers (bowel and breast cancer, for example) than it is preventing. Vitamin D deficiency is also possibly linked to diabetes.
Since the late 1970s, there has been a big push to reduce fat intake. This has come about because of concern that cholesterol in the blood stream leads to heart disease.
Interestingly, the original study (Frammingham) that sparked this whole reduced-fat movement never actually concluded that circulating cholesterol levels were the problem. It was always to do with the build up of cholesterol plaque in certain artery walls and even more to the point, the rupture of this plaque.
The reasons why this occurs in certain individuals and not others has always remained a mystery.
Indeed, there are populations around the world who have very high levels of cholesterol and very low levels of heart disease, and vice versa. And up to 40% of people with heart disease have none of the “common risk factors”.
Nevertheless, the “fat is bad” mantra gained traction.
The proverbial baby has been thrown out with the bathwater, as many people may not get enough good fats. Omega-3 and omega-6 are called essential fatty acids because the body needs them but can’t make them.
Also in a push to lower fat intake, consumers sought out low-fat foods. What people didn’t think about was these foods were, in general, very high in carbohydrates (sugars) and refined carbohydrates in particular. These foods also don’t provide provide much nourishment and often leave you feeling hungry two hours later.
If the body gets excess calories, it will store them. As it can’t store them as sugars, it stores them as fat. So regardless of how many low fat foods a person eats, the body converts the excess calories to fat.
The gradual result of this over 25 years has been an increase in obesity rates. People have been eating less fat but guess what happened? They have been getting fatter.
The next knock-on effect has been an increase in the rate of diabetes.
Obesity has skyrocketed since the mid 1980s – all under the watchful eye of the public health and preventative disease authorities.
By focusing on trying to prevent one illness, a whole range of other effects was overlooked. The messages are not bad or negatively intended in any way, but too narrow in trying to stop one particular disease.
The solution of course is to focus on being healthy, rather than trying to prevent specific diseases, especially when trying to prevent one disease can lead to developing another.
This is the essence of slow aging and of DIY Health.
The best way not to get sick is to be healthy.
Dr Joe Kosterich is a doctor who actually talks about health and is the author of Dr Joe’s DIY Health.