Reaction vs. The Current Idea of Prevention vs. True Prevention: Take Your Pick

If you have been surprised, or even shocked, by the announcement of a chronic disease diagnosis, you are astutely aware of what it means to be in “Reaction” mode.  If a diagnosis, such as one of diabetes or that of a certain cancer has turned your world upside down because you could never have imagined that such a disease might happen to you – you are also in Reaction mode.  “Reaction” simply means that because you had been well for most of your life, you subconsciously presumed that you would always be well – for the rest of your life.  Thus, you had no pro-active plan in place to do all you may have done consciously to prevent the disease you have now been diagnosed with.  This is not intended as a guilt-trip, but only as a statement of fact.  Neither do you presently have such a plan to prevent any disease(s) that may occur in the future.  Further, even if you did want to adopt a pro-active plan to prevent as many future diseases as possible, would you be sure as to whom you could authoritatively turn to for help with such a plan?  If this describes your predicament, relax…you have company.  Those who have experienced “Reaction” constitute 90% or more of those who receive a first-time chronic disease or other life-threatening diagnosis.  As a matter of fact, I have lost track of the number of individuals who have shared with me thoughts to the effect of, “I never could have imagined I would have a heart attack at age 39…” and so on.  

A second category of individuals is that of those who are certainly not oblivious or “asleep at the wheel” with respect to their journey on the road to health.  Rather, these individuals are practicing prevention from the perspective of “catching their disease early,” when it in fact occurs.  In medical terms, this translates to “early detection” – whether this applies to detecting diabetes, cancer, heart disease, or another condition.  Individuals in this group are generally health conscious.  They usually undergo an annual physical and other screening tests, and may even have purchased one or more health/diet book(s) in an effort to educate themselves about health and wellness.  They do what they think is best for their health more or less on their own, but often feel that they don’t have a rock-solid assurance that the health-related choices they are making are authoritatively correct.  These individuals are “doing prevention” in the sense in which prevention is commonly understood, or following what may be called, “The Current Idea of Prevention.”

Regrettably, “The Current Idea of Prevention” has many failings.  While it may be argued that there are certainly undeniable benefits to catching and treating a disease early, two profound problems remain with this approach: 

1.  If you do indeed “detect” a disease, it clearly means that the disease has already occurred.  Research suggests that a disturbed biochemistry always precedes an observed pathology.  In simple language, this means that a window of time almost always exists in which disease builds in the body prior to the moment it becomes overtly manifest.  Thus, when we wait to “detect” or “catch a disease early,” we inadvertently lose the window of time in which we may have pro-actively and systematically utilized strategies to improve our chances of preventing the disease from occurring in the first place.  Sadly, “doing prevention” on your own, even with the help of a good book or two, does not constitute a solid and objective disease prevention strategy.

 2.  Generally, the “post-detection” period involves a resignation to lifelong dependence on maintenance drugs, especially for conditions such as diabetes, heart disease, and many others.  This is because by the time an individual is diagnosed with an acute disease or crisis, the underlying condition has usually progressed to the point where pharmaceutical/other medical intervention becomes obligatory.

 While following the strategy of “early detection” (coupled with doing your best on your own with a health book or two) is superior to the “Reaction” non-strategy, I propose that it is time, indeed past time, that we considered another strategy, one that I call, “True Prevention.”

 The concept of True Prevention is one that is radically different from the commonly understood idea of “prevention.”  This is not a matter of mere semantics.  Here is why:  I believe that True Prevention is prevention that can and should occur long before the possibility of disease detection.  This is prevention that involves a deliberate, systematic and conscious evaluation of one’s eating and living habits and their correction, as needed, in line with recommendations that take into account factors unique to one’s specific needs and that are based on a body of solid evidence-based science rather than on guess-work.  This is an approach that involves early nutritional and lifestyle interventions for pro-actively and deliberately doing all you can to prevent disease from occurring in the first place.  Ideally, this means that as early as possible in the course of your life, you start building the foundation for good health both for yourself and for your children (if this applies) consciously.  In order to undertake prevention of the nature I am describing, you would need to be under the guidance of one or more qualified health professionals, ideally a physician who is sympathetic to such an approach and a nutritional epidemiologist or a competent certified nutritionist.  Furthermore, prevention of this kind does not dispense with “early detection.”  Rather, it maintains that a systematically planned strategy for chronic disease prevention combined with early detection is better than early detection alone.

 True Prevention is thus prevention in its most full-orbed, all encompassing sense.  It is the full measure and scope of what prevention should be, and involves a systematic, fully-invested approach to prevention — relative to which, the hap-hazard efforts most of us make to achieve lasting health on our own are often a far cry.  Notwithstanding our well-intentioned efforts, the reality is that even the best of us can benefit from professional guidance when it comes to learning how to reliably prevent certain chronic diseases. 

But, the question remains — Can we really prevent heart disease, diabetes, certain cancers, and other common chronic diseases, even with True Prevention?  If so, to what extent can we do so?  The answer to that question is this:  The weight of scientific evidence that has emerged especially in the last two to three decades from academic centers globally has convincingly and unequivocally established the potent link between nutritional/behavioral choices and good health.  Given this evidence, it would be folly, in fact, even fatal for us to ignore what True Prevention-based efforts can do for us.  Dr. Walter Willett, Professor of Nutrition at The Harvard School of Public Health recently stated, “With careful attention to the foods we eat, combined with not smoking and regular physical activity, we find that over 80% of heart attacks and greater than 70% of certain cancers can be avoided.¹”  So, while we may not be able to wipe out all of cancer with the strategy of True Prevention, we ought to wipe out the 70% of cancer that we can, and so also obviate the 80% of heart attacks that are preventable.

 True Prevention will not guarantee that disease will never occur.  But, it will help you maximize your chances for preventing chronic disease to the extent it is possible to do so with the power of soundly proven, evidence-based choices.   By utilizing this strategy, we do not presume that disease is inevitable.  Rather, in light of a rational overview of research-based data and real-life experience, we proceed with the understanding that the majority of common chronic diseases are in fact preventable.  And, preventing disease to the maximum extent possible is all that any of us can reasonably ask for.

 In the final analysis, the over-arching objective of the strategy I am presenting here is not merely disease prevention.  Rather, its larger purpose is to help you envision and real-ize (that is “make real”) an uncommon, even exhilarating level of health and well-being, the innate potential for which – though available to all – lies untapped, undeveloped and dormant for most.  It is simply not possible to achieve an outstanding, even exhilarating level of lifelong wellness with only a half-hearted effort.  The attainment of health and wellness of this nature is possible only with our full, whole-hearted investment in creating the health we desire, to which end True Prevention is perhaps the most bankable means. 

Now, ready for the coup de grâce?  What I am asking of us all is ultimately not a matter of making an optional choice.  We dare not bestow upon ourselves the luxury of such a delusion.   For, if we choose not to make a choice for True Prevention, a choice is made for us by default.  The reality is that ALL remaining choices simply do not involve doing all that is possible to do to truly prevent disease.  Thus, if we choose not to choose True Prevention, we are, sooner or later (and generally, sooner rather than later) doomed back to Reaction.  You see, in this decision, there is not one of us that is permitted to “opt-out” or “get away” without casting a vote.  

The choice is ineluctable.  The choices are before us.  What will be yours?

Notes

¹ Third Annual Great Issues in Medicine and Global Health Symposium, 2006.  Linking our Food Choices to Cancer Risk, Dartmouth Hitchcock Medical Center.