Heart Disease, Cancer, Diabetes – Past Time to Address Primary Causes

What are the actual causes of death in the U.S. and in the Western nations?  What is it that actually kills us?  If you were to ask most anyone that question (including health professionals), chances are that the answer you would receive would be:  Cardiovascular disease, Cancer, and Diabetes are our top three killers.  But, are they really?  Has that come to be the “expected” answer, or is it really the most accurate answer?  In this post, I challenge you to delve a little deeper into understanding better the actual causes of death in the Western nations.

Cardiovascular disease, cancer, and diabetes may indeed be listed in any database as the top three killer diseases in the West.  But, as one studies research carefully, it starts to become evident that these diseases are in fact NOT the Primary Causes of death; rather they represent what may be called the Secondary Causes of death in the vast majority of cases.   What does this mean?  In simple language, this means that if someone dies of a heart attack and we consequently conclude that the cause of death was heart disease – we are engaging in what may be called “circular reasoning.”   The REAL question we must ask and answer is this:  What was the Primay Cause or Causes of the heart disease in the individual who died?  What caused heart disease to happen in the first place?  And the same questions must be asked for cancer, diabetes, and other diseases.  Why do this?

Here is the answer to the above question:  There is mounting evidence to indicate that the vast majority of the actual causes of death (what I am here referring to as Primary Causes) are factors that are often well within our control.  In 1993, a publication in The Journal of the American Medical Association (JAMA) concluded that of the more than 2 million deaths that occurred each year in the U.S. (around that time), more than half – or greater than one million -were occurring prematurely as a result of 10 specific behaviors that included the following:

• Tobacco use
• Poor diet
• Lack of physical activity
• Alcohol abuse
• Exposure to infectious agents
• Expsoure to toxins
• Unsafe sex
• Unsafe driving
• Illicit drug use

Of the one million deaths due to the above causes, more than half a million deaths were accounted for by the top three causes alone, i.e., tobacco use (smoking), being physically inactive, and eating poorly.

Since 1993, other scientific publications have appeared that have ratified the link between a poor diet, sedentary behavior and premature death.  In 2000, another paper published in JAMA by the Centers for Disease Control indicated that tobacco use still remained the leading cause of death accounting for greater than 400,000 deaths that year.  Another 350,000 deaths were attributed that same year to the combination of eating badly and being inactive.   The question is: Does the link between the causes listed above and premature death still hold today?

Indeed it does.  In 2008, researchers from Harvard published a paper in The British Medical Journal entitled, “Combined impact of lifestyle factors on mortality: prospective cohort study in U.S. women.”  This study followed 80,000 women between the ages of 34 and 59 for more than 24 years.  During that period, there were 9,000 deaths in this cohort – of which nearly 2,000 were attributed to heart disease, and 4,500 to cancer.  But again, these could be called the Secondary Causes of death.  What were the Primary Causes?   In studying this sample, researchers found that 5 specific behavioral risk factors were the underyling actual causes of premature disease and death in these women.  The 5 factors were these:

• Smoking
• Inadequate physical activity
• Poor diet quality
• Weight gain/obesity
• Alcohol intake outside of the recommended light to moderate range

Investigators concluded that the combination of the above 5 risk factors increased the overall risk of death more than four-fold in their sample; increased risk of cancer death by more than three-fold, and increased the risk of cardiovascular death more than eight times!   These results can be restated as follows:  The combination of not smoking, being physically active, eating sensibly and well, drinking within recommended guidelines, and maintaining a close to optimal weight is associated with a markedly lower mortality that is equivalent to a nearly 90% reduction in risk of death from heart disease, a 2/3rd or 66% reduction in the risk of cancer, and greater than 75% reduction in risk of death from any cause. 

These numbers suggest that while it is true that we may not have absolute or 100% control over our destinies vis-a-vis our health, we are decidedly far from helpless.  Indeed, it might not be an exagerration to say that what we are able to do with what we already know to influence the state of our health positively far exceeds any major medical breakthrough we may make tomorrow.  This is not an argument against the benefit(s) of future medical research; rather, it is a call to action to energize ourselves to do all we can with what we already know.

At present, greater than two-thirds of Americans (165 million plus) are overweight, of which 30% are clinically obese.  Similar trends are occurring all across other Western and Westernized nations.   As an example, the World Health Organization recently stated that by 2010, 76% of men and 67% of women will be overweight in Australia.  These numbers are equivalent to roughly three-quarters of the entire Australian population!   There is no disputing the fact that overweight and obesity are closely related to heart disease, diabetes, and even certain cancers.  Consequently, rates of these diseases are expected to be  high wherever people are overweight or obese.   Today, any way we look at it, the majority of those living in the West or in the Westernized world are sick.  We are mired in an epidemic of overweight, obesity, and deadly chronic diseases.

So, what is our way out of this quagmire?  Perhaps one way out is for us to start by clearly stating and distinguishing Primary from Secondary Causes of both illness and death.  Is doing so really that essential?  Yes, it is.  Establishing and understanding the Primary Causes of disease is crucial to coming to terms with how much influence we truly have over disease and the state of our health.  In the great majority of cases, heart disease, cancer, and diabetes don’t just “happen” to us.  We are not completely helpless against these diseases.   The reality is that we can exert tremendous influence over the state of our health as well as the quality and the duration of our lives.  That statement is not mere opinion; it is a research-based fact.  

Now, it is true that with our poor diets, our stress-filled hurried lifestyles, and our sedentary habits, many of us who live in the U.S. or other Western nation have been our own worst enemies for a long time.  But, I am convinced that if we decide to, we can just as easily be our own best friends.  Don’t you think its time?

Notes

Combined Impact of Lifestyle Factors on Mortality: Prospective Cohort Study in U.S. Women