Breaking Bad (Habits)
Strap on your sneakers for a daily (and brisk!) stroll.
Here’s a big claim: Most deadly diseases that Americans will encounter are largely preventable with good lifestyle and dietary choices. This means that most disease can be avoided or managed by maintaining a healthy weight and staying active. OF COURSE, there are environmental and genetic factors at play and we can never 100% ensure prevention of any disease. But here’s what we do know: More than 2/3 of US adults are overweight or have obesity. Roughly 31% of the US adult population is overweight (nearly 1 in 3 adults) and 42% of the US adult population is obese (2 in 5 adults). Being overweight is defined as a body mass index (BMI) of 25-29.9 and obesity is defined as a BMI of 30+. You can calculate your BMI with this calculator. We also know that obesity and a sedentary lifestyle are a risk factor in many major diseases.
A few years ago, a Harvard publication called out the “Four Horsemen of the Medical Apocalypse”: coronary artery disease, type-2 diabetes, cancer, and Alzheimer’s. Heart Disease remains the #1 killer in the US, with the other Horsemen close behind. All of these killers are linked to inflammation in the body and have something notable in common: they are positively correlated with being overweight, eating a Standard American Diet full of processed foods and fatty animal products, drinking alcohol, and smoking. What this also suggests: these conditions are largely reversible or preventable!
I’m also going to give a nod here to Metabolic Syndrome, which can be considered a very loud warning bell for impending disease. You can think of it as the borderline criteria for a major irreversible disease (i.e., a Horseman). Metabolic Syndrome is very intimately linked with being overweight and inactive, and is diagnosed when three or more of the following factors are present:
High blood pressure – 130/85 or greater (or drug-treated)
Prediabetes/High fasting glucose levels – 100mg/dL or higher (or drug-treated)
High cholesterol/triglycerides – 150 mg/dL (or drug-treated)
Low HDL cholesterol - < 40 mg/dL (men) < 50 mg/dL (women) (or drug-treated)
Large waist circumference – 40” or more (men) 35” or more (women)
Many of us will have ticked off at least one of these criteria by the time we hit our 40’s. But here’s the good news, which comes through both scientific means and anecdotal evidence: the risk of disease diminishes, and the success of prevention increases, with: regular exercise, a whole foods diet with lots of plants, and abstaining from smoking and drinking alcohol.
Many people have a very hard time accepting the fact that their diets and nightly wine habits contribute to disease. That could be in large part because of our current medical culture. Western medicine tells us these conditions are natural… just things that come along with aging. And don’t worry—we have a pill for that! In essence, Western medicine focuses on easing symptoms and not treating the underlying dysfunction, behavior, or cause. It’s also created a culture of lazy (but well-intentioned!) patients who are trained to look outside themselves for a cure.
In his new book,“Outlive,” Dr. Peter Attia, a Stanford, Johns Hopkins, and NIH-trained oncology surgeon with a longevity practice in Austin, TX, notes this difference. He calls our current medical system “Medicine 2.0,” (Medicine 1.0 being of the Hippocrates-era and informed by guesswork), where we have the technology and means to treat acute illnesses and injuries, but with the focus on the short-term and not prevention. Attia addresses chronic disease and the long game of prevention in what he calls “Medicine 3.0.” Medicine 3.0 is defined by a healthcare system that engages in early testing to identify markers of disease—years before it manifests—and by informed patients who take responsibility for themselves and their health. His #1 recommendation to his patients: EXERCISE. It is the best preventative we have, and the one we can best control.
I find the current research and discussions being led by medical professionals, like Attia, promising. It signals a shift in the medical culture, and one that will (hopefully) empower patients to choose lifestyle changes over pills and to be aware of the signs, symptoms, and markers of potential disease so that it can be managed well before the disease manifests. We want to instill a culture of prevention and stop chasing symptoms with pills or surgery (or wine!).
Whether it’s the Four Horsemen, Metabolic Syndrome, or even symptoms associated with peri-menopause or mood disorders, here is what everyone seems to agree on:
Being overweight and sedentary puts you at risk.
Drinking alcohol or smoking puts you at greater risk.
Chronic stress is a major risk factor.
Sleep deficiency will also increase your risk for disease.
Adopt good habits as your first line of defense:
Exercise—regularly, daily.
Eat a predominantly whole foods/plant-based diet.
Quit—or significantly reduce—alcohol consumption and smoking.
Find ways to manage your stress to better help navigate life’s ups and downs.
Make adjustments to ensure a good night’s sleep.
Understand that a lot of what ails you—if you catch it early on—is within your control to change.
We can’t prevent every disease we might encounter, and… yes… we are all going to die at some point. But we want to feel empowered and mobile and healthy for as many years as we can. We want to avoid hospitals and pills and surgeries as much as we can. And if we want to have juicy longevity, we have a responsibility to stay educated and to make good decisions, always keeping in mind the big picture. This requires an active participation in your lifestyle so that you are consciously, daily, consistently, choosing health and activity over convenience and indolence.
Updated 4/1/2024