Today is the Youngest You’ll Ever be Again —Start Early Prevention
I don’t want to talk about treatment and the never-ending ever-elusive search for cures because then, we’re going to be here all day talking about it, making diagrams with straws. I want to talk about now and what you can do today to prevent what you can’t change in the future, but what will change you forever
A few years ago, I babysat a boy and a girl — Jada and Jamal (names have been changed to protect the privacy of individuals) They were a mere 7 and 8 years of age but spoke like 40 years old in their second-round at life.
I would take them from 73rd street Manhattan where their school was located to Flatbush in Brooklyn. It was an hour-long subway ride and the conversations we would share were usually about the newly released Fortnite game, who solved the Rubik’s cube faster than the other, and also death. Their father had recently passed away — unexpectedly due to heart issues — and they were still confused with the concept of mortality since so far they had only known the concept of life as birth and youth and not so much as the end of it.
One day, I was timing Jamal with his Rubik’s cube when Jada looked up to me and asked, “Why do people die?” She looked at me with such an unperturbed expression and with such nonchalance that the question took me off guard. After a moment, I told her that death was a part of life and people’s health normally deteriorate with age — the usual euphemisms and expressions used to describe death to children.
As I wrapped up my speech in haste, she looked me dead in the eye and said, “Well, it wasn’t normal at all, the way he died. People die when they are super super old, and he wasn’t super old.” Her lips were tightly pursed, her dilated pupils piercing me as if challenging me to say otherwise. I could see in between the fidgeting of her hands and the slight quiver of her bottom lip that she wasn’t going to let this one go.
At that moment, the train turned with a violent shake throwing some people off their feet while those clinging on to the nearest pole passed the bump unshaken. The asymmetrical formation of the train tilting against one rail seemed to almost forebode the simple element of probability that not everyone is going to die when they are ‘super super old.’ We let the rumble of the subway train, screeching in our ears, drown down the thoughts in our head.
She was right, there was nothing normal about her father’s death in that many of the deaths related to health failures can be prevented through minimization of risk factors. We need to stop normalizing and correlating chronic diseases as a natural process of aging.
An estimated 56.4 million people passed away worldwide in 2015, and 68% of them were due to diseases that progressed slowly. If we look at the number of worldwide deaths by cause in 2017, we can see that cardiovascular diseases topped number one on the list, followed by cancer, respiratory diseases, and dementia. Yet many of these chronic diseases are preventable, as they’re closely connected to poor diet, harmful habits, and lifestyle choices including smoking, excessive alcohol consumption, and inadequate physical activity.
Risk factors describe agents that increase a person’s chances of developing a disease. Common modifiable risk factors are the main triggers of chronic disease. Each year at least 4.9 million people die as a result of tobacco use, 2.6 million people die as a result of being overweight or obese, 4.4 million people die as a result of raised total cholesterol levels, and 7.1 million people die as a result of raised blood pressure. If we were to eliminate some of these risk factors, the chances of one being inflicted with a disease substantially decreases.
It is far more effective to prevent diseases than to treat people after they get sick. Additionally, prevention offers the most cost-effective long-term strategy for the control of chronic diseases.
Today we will take a look at some risk factors and preventive measures for the four most common chronic diseases in the world.
1. Cardiovascular diseases
The leading cause of death in the world is Coronary Artery Disease (CAD). CAD occurs when the blood vessels that supply blood to the heart become narrowed which leads to reduced blood flow to the heart. The major causes of CAD are known, and if these risk factors were eliminated, at least 80% of all heart disease and strokes could be prevented.
Some risk factors of CAD include unbalanced diets or diets high in fats and cholesterol, poor physical activity, high blood pressure, smoking, heavy drinking, diabetes, and being overweight.
Some prevention measures you can take are staying away from foods containing saturated or trans fat and cholesterol, and instead choosing foods high in polyunsaturated fats, such as those with omega-3 fatty acids. Avoiding salt can lower a person’s blood pressure, which is a major contributor to cardiovascular disease. Exercising regularly can prevent blood vessels from becoming narrowed and can induce active blood flow to the heart.
2. Lung diseases
COPD is a long-term, progressive lung disease which can lead to cancer or even death. COPD patients have an increased susceptibility to respiratory infection which can lead to an exacerbation of the disease.
Risk factors include infection, poor air quality, or frequent exposure to lung irritants such as environmental toxins, smoking, a weak immune system and asthma. Household pollutions such as fuels and mold also contribute. Solid fuel emissions account for 17% of lung cancer deaths in men and 22% in women.
Since most exacerbations of COPD are caused by respiratory tract infections, one of the best preventive measures for minimzing respiratory infections is getting the flu shot every year. Washing your hands to avoid transmitted bacteria and avoiding any type of infection is a must. The best ways to prevent COPD are to stop smoking and to avoid secondhand smoke and other lung irritants.
3. Diabetes
Diabetes is a group of diseases that affect insulin production and use. In type 1 diabetes, the pancreas can’t produce insulin. In type 2 diabetes, the pancreas doesn’t produce enough insulin, or insulin can’t be used effectively.
Risk factors for type 2 diabetes include being overweight, high blood pressure, older age, lack of exercise, and an unhealthy diet.
Some preventive measures one can take are exercising regularly, maintaining good nutrition, and keeping an eye on your weight. Additionally, adding more fiber to your diet can help with controlling your blood sugar.
4. Alzheimer’s disease
Alzheimer’s is a progressive disease that destroys memory and interrupts normal mental functions. Though there are currently five drugs on the market that can slow Alzheimer’s-related memory loss, none are very effective and despite numerous attempts, scientists have failed to discover a new drug in the last 15 years.
The only effective solution available as of now is prevention and early intervention through early diagnosis. Since during the earliest stages of Alzheimer’s it is difficult to detect minor changes in cognitive health, it is crucial to closely monitor cognitive symptoms before the damage is done.
Risk factors for Alzheimer’s disease include age, genetics, harmful lifestyle habits, depression, lack of cognitive interaction, and mild cognitive impairment. The older you are, the more likely you are to develop dementia. However, dementia is not a natural part of aging.
Last year, the National Academies of Sciences published a report on the merits of diet, exercise, and social interaction when it comes to Alzheimer’s prevention. For example, studies in humans and mice have shown that exercise can reduce the risk of developing Alzheimer’s. Other longitudinal studies have suggested that social interaction and cognitive training can help prevent dementia. According to the NHS, by eliminating modifiable risk factors, our risk of dementia could be reduced by around a third.
We usually regard health with binary terms — sick or healthy — but diseases exist on a spectrum. The line dividing sick people from the healthy ones is arbitrary and if health is neglected, those in the low-risk spectrum can easily be relocated to the high-risk spectrum.
Over the past 50 years, advancements in medical technology have allowed us to decipher a lot about possible causes of chronic diseases such as heart disease, cancer, and diabetes. This is crucial because once we know the risk factors, we can prevent such diseases. Yet instead of enforcing preventive strategies, we spend the majority of health dollars on treatment and a never-ending, ever-elusive search for cures.
As of now, we are using two types of strategies to curb disease: the clinical strategy and the population strategy. Our current medical system disproportionately invests in the clinical strategy (treatment and cures) — it consumes over 95% of our health dollars. That leaves only 5% for population strategies to tackle the risk factors that serve as the root cause of said diseases. The problem with investing so much of our health dollars in the clinical strategy is that it targets care for the high-risk population when the majority of cases of a disease come from a population at low or moderate risk of that disease.
This fragile threshold is generating an endless migration of people from low to high risk. This counterintuitive concept is called the prevention paradox. To end this cycle of damage, we need to implement universal prevention in our community and it starts with us, the individuals.
‘Today is the oldest you’ve ever been, and the youngest you’ll ever be again.’ Now is the time to start prevention and now is never too early.
Sources
https://www.medicinenet.com/script/main/art.asp?articlekey=537
https://www.who.int/chp/chronic_disease_report/part1/en/index3.html
https://www.cdc.gov/pcd/issues/2019/18_0625.htm
https://www.who.int/chp/chronic_disease_report/part1/en/index3.htm
https://www.who.int/cancer/prevention/en/#:~:text=Between 30–50% of all,for the control of cancer
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109209/#:~:text=Other combinations%2C e.g.%2C dietary (57%25%20and%2040%25).&text=In%20women%2C%2095%25%20of%20diabetes,were%20eliminated%20(Table%205
https://www.who.int/news-room/fact-sheets/detail/dementia
https://qz.com/1282482/why-the-pharmaceutical-industry-is-giving-up-the-search-for-an-alzheimers-cure/
https://www.who.int/news-room/fact-sheets/detail/dementia
https://www.who.int/cancer/prevention/en/#:~:text=Between 30–50% of all,for the control of cancer
https://www.sciencedaily.com/releases/2020/07/200730123651.htm#:~:text=Summary%3A-,Forty percent of dementia cases could be prevented or delayed,factors throughout life%2C experts say
