I was taught that wellness and preventive care have only one purpose: to restore health. They should not worsen your health or have dangerous side effects, and it goes without saying that they should not cause the very condition they are supposed to prevent.
But insurance companies and medical groups use the terms quite differently. They routinely list screenings and medical treatments as prevention and wellness. For example, we have all seen programs for “breast cancer prevention,” where money is raised for women to get mammograms. However, if I really wanted to prevent breast cancer, I certainly wouldn’t have my breasts irradiated. In fact, a report released by the Radiological Society of North America states that repeated mammograms appear to be a cause of breast cancer in women who genetically are sensitive to X-rays.
According to the stricter definition I was taught — because they really do nothing to prevent the disease and can even cause breast cancer — mammograms don’t qualify as “preventative care.” Early detection of a disease isn’t the same as true prevention.
Disease prevention also isn’t the same thing as wellness. For example, medical providers have recommended that older Americans take a low dose “baby” aspirin to prevent heart attack and strokes from clots. But aspirin has serious, occasionally fatal side effects. In fact, one article that reviewed several studies suggests you are twice as likely to be harmed from daily aspirin than you are to benefit. And while there was a 10 percent reduction in cardiovascular events, namely stroke and heart attack, there was no reduction in deaths from these conditions.
Also, the blood-thinning effect of aspirin, which slightly reduces the risk of a stroke from a blood clot, actually increases the risk of a bleeding type of stroke. One study showed a 44 percent increase in this type of stroke in aspirin users and a 45 percent increase in serious stomach bleeding.
Compare that to a healthy lifestyle. One study found 47 percent fewer strokes in women and 35 percent fewer in men who did not smoke, kept their weight under control, had a good diet, exercised and did not drink alcohol in excess. And, unlike aspirin therapy, it made these huge improvements in stroke risk without causing other diseases — and without lining the pockets of the drug manufacturers. To me, that sounds a lot more like wellness.
Of course, the centerpiece of prevention and wellness care is considered to be the annual checkup or “physical.” But a study published by the Cochrane group, in which they reviewed 16 previous studies on the regular medical physical, called the effectiveness of these exams into question. They found no improvement in deaths or overall disease rates in those getting regular checkups, including no drops in heart disease or cancer. The researchers commented they were not looking at what they called “surrogate outcomes,” meaning that they did not rely on improvements in a patient’s lab results — such as lower cholesterol or blood pressure — because they can be “seriously misleading.” Instead they relied only on outcomes such as mortality, later hospitalizations, lost time from work and additional doctor visits.
True prevention or wellness is not found in a test, a procedure or a drug. It starts with living a healthy lifestyle, such as choosing whole, natural foods, and avoiding the often highly processed “heart friendly” low fat diets. Regular exercise and some form of stress control also are very helpful. These simple changes will go a long way toward preventing most of the chronic diseases of today and, to me, are true wellness — far better than taking a drug or a screening.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at noonanchiropractic@gmail.com.