Our health care system relies a lot on disease prevention. From drugs to prevent osteoporosis, heart disease and stroke, to mastectomy to prevent breast cancer, to genetic testing for Alzheimer’s and diabetes, preventing disease is a mainstay.
However, one of the basic wellness principles I was taught is that preventing disease is not the same as improving health. This is especially true when disease prevention is done with medications. Wellness is concerned with improving the overall health of the patient. This naturally prevents most diseases, especially the very common “diseases of civilization,” including Type 2 diabetes, heart disease, stroke, obesity, high blood pressure and dementia. This is quite different from taking a medication or eating a specific diet to prevent disease.
Let’s take a look at a common recommendation: taking a daily low-dose aspirin to prevent a heart attack or stroke. The idea is aspirin “thins the blood” — actually, it slows the clotting process — so you are less likely to form a clot that can travel to the heart or brain.
The problem is aspirin produces other effects, one of the most common being heartburn and bleeding from irritation of the lining of the stomach. According to medical statistical website The NNT, using aspirin to prevent stroke is only effective 0.01 percent of the time and causes a “major bleeding event” — usually from the stomach — in 0.03 percent of patients.
Not very great numbers, especially when you consider heartburn can lead to esophageal cancer. Many long-term aspirin users are prescribed heartburn meds to ease the heartburn as well as to prevent this cancer. So a treatment to prevent stroke leads to an increased risk of a different disease, for which another drug is given. Heartburn meds are associated with an increased risk of osteoporosis — luckily we have drugs to prevent that.
If you are looking to prevent stroke, nothing comes close to living a healthy lifestyle. A Swedish study of 31,700 women compared the frequency of stroke to five lifestyle factors: a healthy diet, not smoking, limiting alcohol use, exercising regularly and not being overweight. The women who had all five of these had a whopping 62 percent reduction in stroke — any one of them alone caused a 28 percent drop.
Another example is using certain foods to prevent obesity. This is based on the view that obesity is caused by eating too many calories, so if you eat foods that have fewer calories, you will control your weight. Because fats are “calorie dense,” a low-fat diet is recommended. Also, zero-calorie sweeteners, such as Splenda or aspartame, are used instead of sugar.
That is a great theory, but it certainly isn’t wellness based. When patients ask me what to eat to lose weight, I don’t give them a special diet, just the usual dietary advice: eat whole foods; avoid highly processed foods such as soda, pastries and sweeteners of any type; and limit carbohydrates. The problem with low-fat diets and artificial sweeteners is they interfere with your appetite. Many patients never feel full when eating them. One patient using this diet described eating so much her stomach hurt, yet she still didn’t feel full. Once she got away from the overly processed foods and started eating based on the wellness ideas, she actually felt satisfied after eating.
I’m sure some treatments are more effective at preventing disease than the ones I discussed, and certainly a wellness lifestyle will not prevent all diseases, but we need to stop our reliance on medical treatments to prevent diseases and turn to the only true prevention: a wellness lifestyle. There are not enough drugs available to prevent every known disease, especially when you add in the “extra” diseases that are side effects of the medications themselves.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at noonanchiropractic@gmail.com.