We spend a lot of time and money looking for disease. Every year there are thousands of mammogram screenings for breast cancer, colonoscopies, blood work for high cholesterol, etc. It does seem logical that detecting a disease early will greatly reduce the number of deaths, especially after several years.

But many of these screenings have not lived up to their promises. A review of screening mammograms by the medical website The NNT shows there is no reduction in breast cancer deaths from this procedure, and in fact there is some harm done by aggressive therapy for treating patients with findings that may not develop into a true cancer.

One study of almost 90,000 women followed over 25 years showed no reduction in deaths from screenings, but “overdiagnosis” and overtreatment for one out of every 424 women who were screened.

The same has been found for some other types of screening, such as prostate cancer screening.

I’m not saying there is no place for screenings; some, like screening for blood pressure or diabetes, seem to be effective. But like so much of our health care system, they are based on disease, rather than health.

As a wellness provider, I am trained to look for the causes of these chronic diseases and address them. The most important “screening” I do with my patients is to look at their lifestyle. Besides the obvious factors — smoking and alcohol or drug use — I ask if they are active on a regular basis. Also, are their diets full of whole, minimally processed, real food? And are they connected to other people, with a good social life and support system? I care a lot less about a patient’s cholesterol level or osteoporosis screening results than I do about these factors. I prefer to monitor a patient’s health by how they rank in the actual causes of disease, rather than “by the numbers.”

And the final “lifestyle” question is : How many medications are they on? Anyone on three or more meds is more likely to have poor health outcomes, such as depression, fatigue, etc. I agree with the American Society of Consulting Pharmacists, whose website states, “Any new symptom in an older adult should be considered a drug side effect until proven otherwise.”

There are so many natural treatments for the common conditions that we currently use meds for. Does the patient choose to control their chronic pain with drugs, or do they use acupuncture, chiropractic and herbs? Are they relying on statins to artificially lower their cholesterol levels, or improving their diet, exercising more and controlling stress? One study shows statin users tend to have worse diets than those who are not taking them.

Are they using drugs to lower their blood sugar, or are they greatly limiting sugar and carbohydrates in their diets? Do they actually ask their doctor if the drug they saw on TV is “right for them”? Do they get their advice on treating heartburn from Larry the Cable Guy, or are they looking for non-drug alternatives?

For example, if you are looking to prevent a stroke, there is nothing that 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; limited alcohol use; exercising regularly; and not being overweight. The women who had all 5 of these healthy habits had a 62% reduction in stroke; any one of them alone caused a 28% drop.

And what side effects would be expected from these lifestyle changes? None that I can think of.

So to me the most effective screenings have nothing to do with disease. Lifestyle changes are the single most important steps you can take to prevent the chronic diseases that are so prevalent in our seniors, including heart attacks, diabetes, osteoporosis, and stroke. Patients who are focused on their health tend to do so much better than those who are focused on disease.

Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at noonanchiropractic@gmail.com.