Prevention, Optimal Health, and Longevity: Part 1
This month’s blog post is dedicated to my loving father who lived his life to the fullest.
“An ounce of prevention is worth a pound of cure “
Despite the fact that Benjamin Franklin’s quotation was cited in a different context, it has been often used repeatedly in the field of medicine to emphasize the importance of disease prevention and early detection. The fundamental idea that preventing illnesses before they strike holds major benefits to patients and providers.
My dear Dad just passed away at the tender age of 95! He was a perfect model of someone who constantly worked to achieve optimal health all through his life, despite a few episodes of medical conditions that we were able to handle and often cure at an early stage. He was “a good patient” for me in the sense that he followed to the letter all the recommendations I would give him to improve his lifestyle and secure his good health. Three months ago, he was still the brilliant man that I had known all my life, walking around in his garden (with a walker) and happy to prepare healthy meals for himself.
My wish is to be able to help all my patients live a similar life and my mission as a physician to make all efforts possible to guide them along their journey.
Interestingly when I meet with patients for the first time in my office and I ask them to summarize the reason for their visit, 90% of the time the answer is, “I want to stay as healthy as possible and live a long life.”
In this blog we will review what the term “prevention” means.
In our two next posts we will focus on how each of us can work at optimizing one’s health and what could be the “secrets for longevity.”
Prevention
Under this term I include three levels of medical acts that are all extremely important to consider.
1. The “general prevention guidelines” are defined by the US Preventive Task Force (USPTF) and apply to the general population. Recommendations are given to providers regarding testing and diagnostic evaluation needed at different ages, for each sex, and for various patient risk categories. These recommendations address essentially primary and secondary prevention measures such as basic screening for various diseases and the best attitude to adopt if the disease is present to slow down its process.
These guidelines are based on statistical medical evidence and regularly revised as new information becomes available. Being board certified in Preventive Medicine, I make the point to stay informed of any change in these recommendations, and I try to make sure that our patients undergo the appropriate testing adapted to their age.
Examples of these guidelines address testing for various cancers at different ages, cardiovascular follow up, counseling for lifestyle changes, and more. The entire list can be found on the USPTF website.
2. The second level of prevention is more personalized and takes into consideration all the specific risks of an individual. The risk of developing certain conditions varies for each of us; limiting the act of prevention to the USPTF guidelines would be largely insufficient.
We need to dig deeper and consider all the personal risk factors that could impact one’s health in the future. This is our work at VitaLifeMD: we perform a risk stratification for several medical conditions for each patient who comes to us and identify what could threaten him/her in the future.
It starts with a good past personal and family history; this can clinically indicate some genetic areas at risk. Environmental factors (socioeconomic situation, toxin exposure, stress level, night-shift work, etc.,) are considered and evaluated as particular reasons to check for elements that could contribute to certain diseases.
Various blood tests and diagnostic tools are ordered that go beyond the classic laboratory order usually included annually in the standard of care protocols. As an example, the Galleri® multi cancer test offers a revolutionary screening tool that can detect signals of DNA modifications in 50 different organs in the body allowing the diagnostic of potential cancer at an early stage.
Another new test could be particularly helpful, the OMICm biological age test which was developed by TruDiagnostic in partnership with Harvard University and offers an in-depth look at the biological age-related risk of developing various diseases and health issues including cancer, heart disease, stroke, diabetes, depression and even death.
This test identifies some epigenetic markers at the DNA level that can contribute to certain conditions in the future. This allows us, the providers, to recommend urgent lifestyle changes and guidance for the best treatment plan in order to prevent the disease from developing fully.
We can also recommend some sophisticated imaging studies targeting the individual risk of each patient such as the new Cleerly test for cardiovascular disease or the Zero Rad MRI test to identify any organ abnormality that could be a threat for the future.
3. The third level of prevention is often ignored and yet so important to avoid dramatic situations. I will call this “negligence or mistake avoidance.” Let me explain what I mean by this:
So many times, in my physician’s life, have I seen medical conditions turn badly that could have been avoided with a better sense of communication between the health care providers and the vigilance of everyone involved in one’s care. It consists sometimes of one message not given on time or one omission or oversight in the transmission of care, not to mention negligence and carelessness in some cases, to make a condition of an individual go the wrong way when it could have improved.
Except in a case of emergency, no medical decision or choice of care should be made in a rush and precipitation. All pros and cons, benefits and risks must be weighed carefully to avoid heavy consequences for the health of the patient.
It requires all the sense of anticipation and the attention of the providers to envision what could happen if all precautions are not in place to protect the patient. I personally place extra care in this part of my job as a physician. Examples are: to always mention the risk of fall when patients are transferred to a facility, to make sure that all the data are communicated clearly when collaborating with other healthcare providers (allergies and side effects of medications, etc.,) and even more importantly, to educate my patients about their own personal risk so that they are empowered to act as their own advocate for their health in the future.
In this category we could also include the need to start prevention early in life with a good lifestyle and early education of both parents and children. The importance of good nutrition is not strengthened enough in preconception counseling. How many mothers do not know the risk of adding too much sugar to the diet of their children? How many young girls 20 years old that are “on a diet” ignore the risk they run to develop osteoporosis later in life by lacking essential nutrients to build strong bones and good teeth in their twenties? And it gets even worse if they are told that dairies should be eliminated from their diet!
There is a French proverb that says: “Un homme averti en vaut deux.” The translation could be: “The man who has knowledge is worth two men!”
This will be a good conclusion for this chapter. Rendez-vous next month for the second post of our series. It will be on the following topic: the best ways to achieve optimal health.
