91原创

Skip to content
Join our Newsletter

The Doctor Game: Lifestyle change the best treatment for pre-disease

Samuel Johnson once remarked, 鈥淣othing sharpens the wit so much as the knowledge you鈥檙e going to be hanged in the morning.

Samuel Johnson once remarked, 鈥淣othing sharpens the wit so much as the knowledge you鈥檙e going to be hanged in the morning.鈥 So if a doctor says: 鈥淵our blood sugar is borderline for diabetes鈥 or 鈥測our bones are getting fragile,鈥 he鈥檚 giving you a pre-disease warning. But does it ring the bell of trouble ahead unless you do something about it? 聽

Dr. H. Gilbert Welch, professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice, is also the author of Less Medicine, More Health.

Welch says we should keep in mind that, 鈥淰irtually everyone, as they get older, develops some sort of pre-disease.鈥 The outward appearance of wrinkles and greying hair are for all to see. But kidneys, hearts and all the other hidden organs also age. So Welch warns there鈥檚 a tendency for doctors to over-prescribe pre-diseases that can be corrected by other means.

According to a report in Consumer Reports on Health, about 37 per cent of adults in North America have pre-hypertension. Studies show that if you鈥檙e overweight, smoke, drink too much alcohol, rarely exercise and have a family history of hypertension, you鈥檙e more likely to develop borderline BP and finally hypertension.聽 聽

So what should you do about it? First, make sure you have bone-fide increased BP. Some people on medication show 鈥渨hite coat hypertension鈥 due simply to being in a doctor鈥檚 office, or having just consumed caffeine. To prevent a lifetime of medication, test your BP in a pharmacy, or buy a blood pressure cuff to take readings at home.

Today, there is no convincing evidence that treating pre-hypertension by drugs prevents the development of high blood pressure. But studies show that dropping nine pounds will lower blood pressure 4.5 points.

Health authorities also stress that it鈥檚 important to exercise moderately three to four times a week. It also helps to consume no more than 1,500 milligrams of sodium daily, a little more than half a teaspoon, and to limit alcoholic drinks to two a day for men, and one for women. And to follow a diet rich in fruits, vegetables, whole grains, low fat dairy products, fish, skinless poultry and lean meats. Pre-diabetes is now a major problem and affects 38 per cent of North Americans. It鈥檚 present when the average blood sugar over a period of three months, or a fasting blood sugar, is higher than normal.

One would think that this diagnosis would get people鈥檚 attention. But according to the Centers for Disease Control and Prevention, up to 30 per cent don鈥檛 make lifestyle changes and eventually develop Type 2 diabetes.

This is a huge mistake. Calorie reduction and exercise can decrease the risk of Type 2 diabetes by 59 per cent over a three-year period. Reversing this trend also means a decreased risk of heart attack, stroke, kidney failure, blindness, foot damage and possibly Alzheimer鈥檚 disease.

Let鈥檚 end with some good news. It鈥檚 estimated that in North America 45 million people have osteoporosis. But, according to a study in the New England Journal of Medicine, most of the time osteopenia is best treated with diet high in calcium along with 800 IU of vitamin D, and weight-bearing exercise such as walking. Authorities say the evidence that osteoporosis drugs help during this stage is inconsistent.

Dr. Marvin Lipman, medical adviser on Consumer Reports, states that about 30 per cent of older adults are reported to be suffering from advanced chronic kidney disease and have received needless drug treatment. In effect, doctors should realize that kidneys age, but it鈥檚 a slow process, and not to over-treat.

Others over 65 are often taking thyroid medication to treat an underactive thyroid. But unless there are symptoms such as dry skin, fatigue, severe constipation and weight gain, they may not need it.

Knowing you have a pre-disease is a great benefit.

It provides time to get serious about one鈥檚 health and prevent a full-blown disease with all its complications. Prevention will always be better than cure,
particularly when it鈥檚 possible to treat pre-disease by lifestyle changes.

Isn鈥檛 this better than facing a lifetime on prescription drugs?