Practicing Preventive Medicine

Practicing Preventive Medicine

“The greatest medicine of all is to teach people how not to need it.”

–  www.clinicalpearl.com

 

Animals in the wild don’t seem to suffer from obesity, diabetes, heart disease, allergies, or any of the many illnesses that plague people.  They don’t consult cookbooks, attend nutrition school, have personal trainers or seem in any way confused about what to eat or how to lead healthy lives.  Animals, including people, are biological creatures that come fully programmed to know how to take care of themselves.  They know what to eat and drink, where to find it, and what to do when they are not feeling well.  People, as we have become more civilized, have moved away from that innate biological knowledge.  We have become re-programmed to respond to immediate satisfaction, marketing cues, round-the-clock availability, suggestive nutritional “information” and food options that more often than not are of greater benefit to the corporations’ financial health, than to our own.  As a result, we have become a society rife with illness characteristic of the “western lifestyle” including the over consumption of refined, processed and chemicalized foods and the underutilization of our bodies.

 

“These days, the majority of serious health problems that we are experiencing in the United States can be traced back to a poor diet.  As a matter of fact, unhealthy eating habits, lack of exercise, and smoking are now the three leading causes of chronic disease and death in most parts of the industrialized world.  It has been estimated that at least 80 percent of medical cases involving heart disease, stroke, and type II diabetes and 40 percent of cancer cases could be avoided by following a healthy diet, participating regularly in physical activity, and avoiding tobacco (Miller, p.9-10).”

 

In order to stay well and avoid illness, we need to reconnect to our biological core, and to rediscover our innate wellness intelligence.  Practicing preventive medicine, involves a belief in the body’s ability to keep itself healthy and heal itself when other forces push it out of balance, as well as the awareness to recognize and respond to the clues our bodies send out.  It requires a shift from treating or curing illness, to an intention of preventing it.  There are no guarantees, but with a preventive approach, mind, body and spirit function together within a strategy of maintaining wellness, which includes a longer lifespan and an enhanced healthspan. Given half a chance, the body will work to heal itself.  It is designed as a dynamic self-regulating, self-repairing system. 

 

Looking to traditional cultures’ lifestyles and diets, it is apparent that preventive medicine is an age-old concept.  Dr. Weston Price’s research in the 1930s shows that traditional societies were “free of chronic disease, dental decay and mental illness; they were strong, sturdy and attractive; and they produced healthy children with ease, generation after generation (Fallon, p.xi).”  In modern society, the emphasis has veered away from individual prevention at home, in favor of professional treatment of illness in doctors’ offices and hospitals.  As the cost of care rises and patient satisfaction declines, there has been a renewed interest in health self-sufficiency, with a growing demand for information and support around wellness and prevention of illness.  “The responsibility for healing can never be truly handed to another.  Healing comes from within and is an intrinsic aspect of being alive.  While healing is rarely a conscious act of harnessing inner energy, it is always an expression of our inner power (Hoffmann, p. 349).”

 

Diet is a significant player in the preventive approach.  Although the particular components of traditional diets around the world vary greatly, the underlying dietary rule is the same: eat whole, fresh, local foods.  Taking this as our foundation, we can adjust our modern diet in the direction of a more biologically-appropriate one and thereby realign ourselves with our innate wellness knowledge.

 

A diet for prevention includes wholesome nutrition from fresh, local, seasonal, real foods.  Ideally, all foods would be organic, but perhaps more importantly is that our food be in the form that nature created them, or as close as possible.  Eating whole foods from nature, as opposed to from boxes, eliminates the dubious ingredients (artificial colors, flavors, preservatives, MSG, high fructose corn syrup, etc.), as well as the unwanted added sugar, salt and processed fats so common in our modern diet of, as Michael Pollan describes it in his recent book, In Defense of Food, “edible food-like substances.”

Whole foods offer the body a well-designed, time-tested, vital compilation of nutrients complete with the necessary co-factors.  In our civilized society, more often than not, whole foods are no longer whole when we eat them.  Instead, they have been milled, processed, refined, industrialized, sometimes even chemicalized, and then packaged and stored, frequently for long periods of time.  In that process, the food has lost many, if not all, of its original vitamins and minerals.  Instead of gaining nutrients, our body now needs to borrow from nutrient stores in order to digest and assimilate processed foods.  Eating whole foods gives us more nutrients, brings us closer to nature, and grounds us.

 

The appropriate balance of macronutrients (protein, fats and carbohydrates) along with plenty of micronutrients (vitamins, minerals, amino-acids and essential fatty acids) is relatively easy to achieve with a wide variety of whole grains, vegetables, fruits, legumes and their products such as tofu and tempeh, nuts, seeds, culinary herbs and seasonings and perhaps some additional protein from fish, eggs, dairy or meat. It is preferable to reduce overall animal food consumption, than to consume larger amounts of defatted dairy products. 

 

A preventive diet does not necessarily have to be a vegan or vegetarian diet, however, Physicians Committee for Responsible Medicine (www.pcrm.org), Dr. Dean Ornish’s work (www.ornish.com) and others have demonstrated the positive health effects of plant-based diets.  Many people are concerned that reducing animal foods will result in a lack of protein.  Protein deficiency, however, is very rare in our society and many people would benefit from having less protein.  Carefully consider heritage, blood type, gender, age, and level of physical activity in order to determine the appropriate type and amount of protein, experiment with less, and bear in mind that the World Health Organization estimates that we need only 4.5 percent of total calories to be from protein (Holford, p.53).  Most animal foods available to us today are no longer of the quality our ancestors ate.  When selecting animal foods, look for organic, free-range, pasture-fed or wild game, in order to avoid the artificial hormones, antibiotics and questionable feeding and caging practices common at most feed lots.

Eating larger quantities of whole grains, vegetables, fruits and culinary herbs than is common in the standard western diet provide the body with much needed fiber and antioxidants.  These two nutrients are recognized for their far-reaching preventive health benefits, from digestive disorders, overweight, cancer, diabetes and heart attacks, to protection against environmental, stress and age-related diseases.  They are plentiful in traditional whole foods diet, but dangerously lacking in typical western diets.

 

Ideally our food would fulfill our daily nutritional needs, since it would be grown locally, organically and freshly available from fertile soil.  Unfortunately, our soils, air and water are not as nutrient-rich as they once were.  They have been depleted of nutrients through overuse, while they have been supplemented with chemical pesticides, fertilizers, contaminants, toxins and pollution. In addition to foods being grown with fewer nutrients, much of our modern food supply consists of “empty calorie” junk food.  Even with the best intentions, there are days when we are not able to eat as well as we would like.  Additionally, the daily stress of modern live also takes a toll on our nutritional reserves. Taken together, it has become a good insurance policy to take a high quality multivitamin and mineral supplement every day. The top nutrients to consider for supplementation include antioxidants to fight free radical damage, vitamin B complex to provide energy and manage stress, vitamin D which is commonly deficient, and essential fatty acids to fight inflammation and support heart and brain health. 

 

You come into the world with a particular constitution, which is difficult, if not impossible to change, and a condition, based more on your diet and lifestyle after birth.  Condition is constantly being created and changed, and with conscious effort, can be used to improve a health situation and prevent others.  The general dietary guidelines for prevention have been covered, but one particular diet does not work for everyone.  Because of each of our unique biochemical individuality, genetic predisposition, and environmental factors, we must do some experimenting to find the right combination of foods, which work best for us.

 

There are several methods, which can be used to determine which combination of foods is best for you.  You may have philosophical or religious reasons to avoid all or some animal foods.  You can try Dr. Peter D’Adamo’s “Blood Type” dietary guidelines for the four blood types: A, B, O and AB.  Metabolic Type testing is another method used to determine the appropriate ratios of protein, carbohydrates and fats in your diet.  In Ayurvedic Medicine, there are three main and several combination types or “doshas” called Pitta, Kapha and Vata, each with its own specific set of dietary recommendations.  Alternatively, you can look at your ancestry, and steer your diet in the direction of the foods of that part of the world.  While you experiment to find the right diet for you, it is important to remember not to become too rigid.  It is healthful to find the maintenance diet that works best for you, while remaining flexible as the seasons change, as activity level changes, as you age, and as health issues come up for which you may need to use a therapeutic diet for a period of time.

 

Many people are not aware of the high and increasing incidence of food allergy and sensitivity.  Unrecognized sensitivities may be wearing you down or be at the root of a chronic health condition.  Common irritants are milk, eggs, peanuts, wheat, soy, tree nuts, corn and shellfish, as well as food additives such as MSG, aspartame, artificial coloring, and sulfites.  Many nutrition experts now believe humans are not meant to consume dairy products beyond the age of seven, when many of us stop producing the necessary enzymes to digest milk, yet the vast majority of us have many servings every day.  According to PCRM, as many as 95% of Asian Americans, 74% of Native Americans, 70% of African Americans and 53% of Mexican Americans are lactose intolerant.  If you are intolerant, continuing to consume these foods can damage the digestive tract and result in additional food sensitivities as well as declined mental and physical health. Becoming aware of possible food sensitivities, and strictly avoiding those foods for a period of time, gives the body the opportunity to heal itself, frequently resulting in dramatic health improvements and the ability to slowly reintroduce the offending food(s) back into the diet.

 

In addition to food, water is also essential.  The human body consists mostly of water.  In order to keep all systems running smoothly, this water needs to be replenished on a daily basis.  Hydration is more important and more frequently overlooked than most people realize.  Over time, we have lost our ability to clearly distinguish between thirst and hunger.  As a result, we frequently think we are hungry, when what we actually need is water.  Additionally, we often reach for coffee or alcohol as a beverage, but these drinks pull water out of our systems instead of replenishing it.  Many health issues, such as headaches, joint pain, asthma, allergies, constipation, lethargy and mental confusion can be easily avoided simply by drinking enough pure water every day.  The highest quality water to drink is mineral water in glass bottles, since, as the name suggests, it gives you essential minerals as well as hydration. Other options include spring water, reverse osmosis, distilled or filtered water.  Filtered water allows you to clean your own tap water without having to buy bottled water, however not all contaminants are necessarily filtered out (such as chlorine, fluoride, and sometimes lead), while some of the healthy minerals are. Bottled water generally comes in plastic, and the may contain carcinogenic molecules which have leached out of the bottles.  Regardless of the type of water you drink, the best course of prevention is to give yourself 6-8 glasses of water a day.

 

Since eating and drinking are major determinants of health, it is important to pay attention to not only what, but when and how we eat.  Our modern society has suggested eating almost all of the time, has made snacks available to us just about everywhere and has moved toward having more meals behind the wheel of the car, while working on the computer or watching television, than sitting at the kitchen table with the family.  Sometimes we eat on the sly; other times to fill emotional needs.  There seems to be a subtle, but not insignificant, positive impact that comes from creating healthy eating environments as well as healthy dishes.  According to Dr. Andrew Weil, Mireille Guiliano, Michael Pollan and others, it is good for you to enjoy eating, to make time for it, to set the table, to invite others to join you, to make the presentation delightful, to relax while eating, to make it a fulfilling social and cultural activity, and not just a quick, caloric one.

 

Next to good food and clean water, regular physical activity is an important part of prevention.  It should include stretching, strengthening and aerobic training.  Exercise can work wonders to lower stress, promote relaxation, and increase mobility, strength, flexibility, balance, stamina and an overall sense of well being.  It is not only good for muscles, but works many body systems, from bringing additional blood and oxygen to the brain, to stimulating the digestive system to help move bowels regularly, to strengthening the heart, lungs and bones, to improving sleep, managing weight and improving length and quality of life.  When done outside, it comes with the added benefit of fresh air and sunlight, which the body converts to vitamin D.

 

Another essential component of a preventive lifestyle is sleep.  Regular, sound, rejuvenating sleep, in a dark, comfortable place, starting before midnight (according to Ayurvedic medicine, the hours before midnight count as two) is essential for mental, physical and emotional health. Eating well, avoiding stimulants, establishing a regular sleeping pattern, exercising during the day, and practicing relaxation before bedtime can all work to enhance sleep quality. On the other hand, regularly catching only a few hours of sleep can hinder metabolism and hormone production in a way that is similar to the effects of aging. Chronic sleep loss functions much like stress, and may speed the onset or increase the severity of age-related conditions such as type II diabetes, high blood pressure, obesity, and memory loss. Therefore, daily rest and 6-8 hours of sleep should not be thought of as a luxury, but as a necessity.

Effective stress management also serves to prevent illness. Ayurvedic doctor John Douillard estimates as much as 80% of all disease has stress at its core.  Although stress is a normal function, too many and too frequent bouts of stress can overpower the body, encouraging it to store fat, draining energy from nonessential parts of the body, reducing the ability to digest and assimilate food and desensitizing the body to the feelings of pleasure. In the long term, the accumulated impact can lead to illness, adrenal exhaustion, and chronic health conditions. In order to prevent these detrimental effects, attention must be paid to proper stress management.  This can be done in many different ways, from regular warm baths, massage, meditation, stretching, time outdoors, engaging in hobbies, spending time with friends and laughing, to using holistic therapies such as biofeedback, guided imagery, yoga or Qigong, herbal remedies, aromatherapy or acupuncture.

 

Electromagetic fields (EMFs) are becoming more prominent as our dependence upon computers, cell phones, electronic appliances and wifi zones increases. While they might be helpful to our productivity, EMFs do not benefit our health.  The research is still young, but initial studies find that EMFs increase the stress burden on our systems and may negatively impact immune function, mental state, and ability to learn.

 

A lifestyle of prevention also entails avoiding toxins, pollutants, molds, and contaminants as much as possible. Doing so completely is no longer possible in today’s world, yet with increased awareness, we can focus on organic foods, natural cleaning products, chemical-free personal care products, indoor filters for air and water, organic cotton linens and clothing, and so on.  When toxic build-ups have occurred, a detoxification program is highly recommended.  Dr. Elson Haas describes various options for regularly cleansing your insides in his book Staying Healthy with the Seasons.  Traditional Chinese Medicine, Ayurvedic Medicine, homeopathy and chelation therapy also offer detoxification programs.

 

Smoking, as well as regular use of recreational drugs, is not a part of a preventive lifestyle.  The health risks of both are widely known, and quitting those habits will greatly improve overall health.  Helping someone to quit who is endangering you with second-hand smoke, will improve the health of both of you.

 

Another important component of staying healthy is maintaining a positive attitude.  Establishing an up-beat approach to life that translates into how you care for yourself and those around you contributes to wellness.  For some, this attitude will stem from a religious conviction, for some it may be connected to a less formal spiritual practice, and for others it will originate somewhere else.  Either way, the radiation of positive energy will help nourish yourself and those around you.  Therefore, it is important to make sure that you are getting joy and satisfaction from your daily activities: your job and career, your hobbies, other responsibilities, your family and other relationships, your time for yourself, for physical activity and for a spiritual practice.

 

From a health care economics perspective, preventive medicine is the best possible approach, as prevention costs a great deal less than trying to cure.  However, this is not apparent in our current system of heath care, which seems to be more about sick care.  In a different time and place, doctors were paid to keep patients well.  It was considered their job to help people maintain wellness, so when they did this well, they were paid, but when people got sick, the doctor had not performed well, and therefore did not deserve payment.  In the current construction of the American medical model, prevention does not pay. Treatment pays, and so treating (and often treating again) is what keeps the industry healthy.  Nonetheless, a growing number of people is no longer satisfied with this model and has started to reclaim health and wellness as a personal responsibility by improving diet and lifestyle and looking to holistic therapies for additional support.

 

Just as a plant will turn its leaves towards the sunlight, people are created to prefer healthful foods to health-depleting ones, but we need to make more of those options readily available and return to our innate messages calling out for them.  Anthropological nutritionist, Dr. Harriet Kuhnlein is director of the Center for Indigenous People’s Nutrition and Environment at McGill University, has found that, “indigenous diets are born when a group of people use their traditional knowledge to make a complete diet using local foods.  These diets have slowly evolved in a natural setting and have stood the test of hundreds of years…. They are all (almost by definition) nourishing because they rely on fresh, in-season ingredients (Miller, p.24).”

 

The body is an exceptional self-regulating, self-healing organism, well designed to know how to rejuvenate itself.  Given the correct fuel within an optimal environment, the body is able to avoid the need for much, if any, medical intervention.  With a nutritious diet and a health-supportive lifestyle, one can rely on the body’s innate ability to maintain wellness and resist disease.

 

 

Bibliography:

 

Douillard, John.  The 3- Season Diet: Eat the Way Nature Intended. New York: Random House, 2000.

 

Fallon, Sally. Nourishing Traditions. Washington, DC: New Trends Publishing, Inc, 2001.

 

Goldberg, Burton, Trivieri, Larry, Jr. and Anderson, John W. (editors). Alternative Medicine: The Definitive Guide. Berkeley: Celestial Arts, 2002.

 

Guiliano, Mireille. French Women Don’t Get Fat: The Secret of Eating For Pleasure. New York: Alfred A. Knopf, 2005.

 

Haas, Elson. Staying Healthy with the Seasons. Berkeley, CA: Celestial Art, 2003.

 

Hoffmann, David. Medical Herbalism: The Science and Practice of Herbal Medicine. Rochester, Vermont: Healing Arts Press, 2003.

 

Miller, Daphne. The Jungle Effect: A Doctor Discovers the Healthiest Diets from Around the World – Why They Work and How to Bring Them Home. New York: Harper Collins Publishers, 2008.

 

Planck, Nina. Real Food: What to Eat and Why. New York: Bloomsbury, 2006.

 

Pollan, Michael.  In Defense of Food: An Eater’s Manifesto.  New York: The Penguin Press, 2008.

 

Robbins, John.  Healthy at 100: How You Can – At Any Age- Dramatically Increase Your Life Span and Your Health Span. New York: Ballantine Books, 2006.

 

Rosenthal, Joshua and Tom Monte. The Energy Balance Diet. Indianapolis, Indiana: Alpha Books. 2003

 

Weil, Andrew. Eating Well for Optimum Health: The Essential Guide to Food, Diet, and Nutrition. New York: Alfred A. Knopf, 2000.

 

Willett, Walter.  Eat, Drink and be Healthy; The Harvard Medical School Guide to Healthy Eating.  New York: Simon & Schuster, 2001.

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