Six ways to ‘prevent, treat, and often reverse’ chronic diseases
All the medications ever invented can’t put America’s health back together again. Not because drugs never work, but because we individuals and our health care system at large have come to rely on pharmaceuticals far too heavily, at the expense of simple behaviours known to prevent and battle many of the deadliest and most debilitating diseases.
Here’s where dependence on medications has brought us: 60% of U.S. adults have at least one chronic disease and 40% battle two or more, according to a comprehensive new analysis by 58 medical doctors and research scientists that estimates 90% of all U.S. health care dollars are spent treating largely preventable diseases. Yet rates of hypertension, cardiovascular disease, Type 2 diabetes, and dementia are rising at alarming rates, the report concludes.
“Too many physicians and patients alike may believe they are victims of their genes, and they are destined to become chronically ill and dependent on pharmaceuticals,” three experts write in a summary of the report.
The report calls bunk on the country’s backward approach to health care and aims to flip the entire medical profession on its ear, by encouraging “lifestyle medicine,” rooted in six behaviour changes proven to help “prevent, treat, and often reverse” many of the most common chronic ills — including Type 2 diabetes, heart disease, cancer, autoimmune diseases, and Alzheimer’s.
The analysis, a project of the American College of Lifestyle Medicine (ACLM), includes 22 articles published in the Journal of Family Practice.
“There is rapidly growing demand for lifestyle medicine interventions among patients who want help making sustainable behaviour changes that allow them to take control of their health and live their healthiest, fullest lives,” ACLM President Cate Collings, MD, says in a statement. The advice, dubbed six pillars of lifestyle medicine, is aimed at doctors and other health care professionals.
But don’t wait for a prescription.
These are healthy habits you or your loved ones — especially kids who haven’t yet developed a chronic disease — can lean into right now, and I’ve provided links that explain exactly how for each one.
Plant-heavy, whole-food eating patterns
“What people eat, and fail to eat, is the leading cause of disease and death,” the new report states, citing a 2019 study of mortality in 190 countries. Among the big culprits: Too much salt and too little fruit and whole grains.
The new report’s recommendation, then, comes as no surprise and is in line with the government’s dietary recommendations: Aim for “a whole-food, plant-predominant eating pattern, a diet consisting predominantly or exclusively of whole plant foods such as fruits, vegetables, legumes, whole grains, nuts, and seeds.”
If you’re like me, knowing what’s good for you doesn’t always translate into doing what’s best. So, it’s nice that the recommendations offer some wiggle room. A “plant-predominant eating pattern” doesn’t exclude red meat, chicken, or fish, but it suggests some moderation, and it encourages real food as close to natural as possible, meaning “whole food” over anything processed.
Physical activity
You’re probably sick of hearing this one, but: “Getting enough physical activity could prevent 13% of breast and colorectal cancer, 8% of diabetes, and 7% of heart disease, as well as 1 in 10 premature deaths,” the report states. Here are just some of the diseases that physical activity has been shown to help prevent or treat (often in combination with other remedies):
- Renal disease
- Sleep apnoea
- Osteoarthritis
- Hypertension
The report encourages not just aerobic exercise, such as a good walk, but also activities that build strength and flexibility — as simple as push-ups or yoga. If you’re not a fan of exercise, or otherwise need a little motivation, check out either of these two pieces.
Restorative sleep
Eating well and exercising will help you sleep better, which is why experts have long suggested that doctors should actually prescribe both. But the reverse is true, too.
Good sleep “is also the foundation upon which other lifestyle therapies, such as diet and exercise, are improved,” the report states. And what if you don’t get enough? “Accumulated effects of disordered sleep include premature mortality, cardiovascular disease, hypertension, obesity, metabolic syndrome, diabetes and impaired glucose tolerance, immunosuppression, inflammation, cancer, cognitive impairment, and psychiatric disorders such as anxiety and depression.”
Positive social connections
Recent research has found loneliness to be a growing problem, particularly among young people, with an acute increase during the pandemic. We all know it can feel lousy to be lonely, but less attention is paid to the effect of loneliness on health.
“Social connection is a well-established determinant of mental and emotional well-being, physical health outcomes, and longevity,” researchers write in the report. “Humans appear to be ‘wired’ for social connection, which is why the social isolation and associated loneliness due to Covid-19 lockdowns have been such a concern. In the context of stress management, social support can buffer the negative effects of stress on mental and physical health.”
Odds are good you know someone who is seriously lonely, even if you’re not aware. I wrote recently about the actions you can take to curb your own loneliness or that of someone around you:
Avoidance of risky substances
You know the things you should avoid: smoking, drinking, chocolate cake. The list is long. But it’s hard! These unhealthy substances trigger the release of chemicals that make us feel good and can sometimes help curb anxieties, creating positive reinforcement of ultimately negative behaviours.
“For example, with positive reinforcement, if we see a piece of cake (trigger), eat it (behaviour), and it tastes good (reward), we learn to repeat the behaviour through dopamine firing in the reward centres in our brain,” writes Judson Brewer, MD, a Brown University researcher who studies how to change habits. “The same is true for negative reinforcement: if we are stressed, eat a piece of cake, and feel better, we learn to repeat that behaviour as well, because we distracted ourselves and/or enjoyed eating the cake, which reduced the negative feeling of the stress.”
Whatever your vice, Brewer suggests recognizing this “habit loop,” then pay close attention to how you really feel after the initial pleasure of the junk food fades. Then focus on the bigger payoff of a healthier habit, such as how eating good food can give you more energy throughout the day and cut down on indigestion.
One strategy for improving our destructive habits is to swap one bad behaviour for one good one. Donuts for bananas, anyone? Here are some other tactics:
Stress management
“Stress is unequivocally linked to poor health outcomes… due to both its physiologic and behavioural effects,” the report states. “Accordingly, the provision of stress management techniques constitutes an integral component of leading lifestyle medicine interventions.”
Chronic stress grates on your mind and body much like a rock in your shoe wears on your foot. It must be removed. Stress stresses everything from your heart and your nervous system to the functioning of your gut and your immune system. I could offer some quick tips, but here’s what you really need to manage stress not just in a given moment but for the rest of your life:
The upshot: These six pillars are solid suggestions, at any stage of life, to up the odds of living longer and increasing health span — years spent living with good mobility and mental capabilities. The sooner you start, the greater the potential benefit.
“Starting preventive and healthy lifestyle strategies early in life is the most effective and efficient way to accomplish the goals of expanding health span, while further expanding life span,” writes one of the study’s authors, Koushik Reddy, MD, a cardiologist and researcher at the University of South Florida. “Children and young adults provide a window of opportunity to promote health and prevent disease.”
