Lifestyle and Disease Prevention: Your DNA Is Not Your Destiny

Michael Greger M.D. FACLM · September 27, 2021 · Volume 55

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Treating the underlying cause of chronic lifestyle diseases.

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Transcript

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

More than 2,000 years ago, Hippocrates declared, “Let food be thy medicine and medicine be thy food.” Except, he really didn’t. It doesn’t appear that he ever actually said those words. Now there’s no doubt about the relevance of food in health and disease in his writings. But who really cares? That was 2,000 years ago, when disease was thought to arise from a bad sense of humors.

Now, we have science, and there is an overwhelming body of evidence illustrating the dramatic impact of a healthy lifestyle on reducing all-cause mortality—meaning death from all causes put together—and preventing chronic diseases, such as coronary heart disease, stroke, diabetes, and cancer. But wait . . . don’t these diseases just run in your family? What if you just have bad genes?

According to the esteemed former chair of nutrition at Harvard, for most diseases contributing importantly to mortality in Western populations, we’ve long known that non-genetic factors often account for at least 80 to 90 percent of risk. We know this because rates of the leading killers like cardiovascular diseases and major cancers vary up to 100-fold around the world. And when people migrate from low- to high-risk countries, their disease rates almost always change to that of the new environment. Currently, for example, we have been able to identify modifiable behavioral factors, including specific aspects of diet, overweight, inactivity, and smoking that account for over 70 percent of your risk of having a stroke or getting colon cancer, more than 80 percent of coronary heart disease risk, and more than 90 percent of risk for type 2 diabetes. All that disease can be prevented by our own actions.

If most of the power is in our own hands, why do we allocate massively more resources to treatment than prevention? And even preventive strategies are heavily biased towards pharmacology rather than supporting improvements in diet and lifestyle that could be more cost-effective. For example, treating high cholesterol with statin drugs could cost tens of billions a year, only to have a modest impact on the incidence of heart disease. The inherent problem is that most pharmacologic strategies don’t address the underlying causes of disease, which are not drug deficiencies.

Ironically, the chronic diseases that are most amenable to lifestyle treatment are the same ones most profitably treated by drugs––because if you don’t change your diet, you have to pop the pills every day for the rest of your life. So, the cash-cow drugs are the drugs we need the least. “Even though the most widely accepted, well-established chronic disease practice guidelines uniformly call for lifestyle change as the first line of therapy, physicians often fail to follow these recommendations.” “By ignoring the root causes of disease and neglecting to prioritize lifestyle measures for prevention, the medical community is placing people at harm,” or at least so say folks like this guy.

Traditional medical care relies primarily on the application of drugs and surgery after the development of illness, whereas lifestyle medicine is primarily the use of optimal nutrition (a whole foods, plant-based diet) and exercise in the prevention, arrest, and reversal of chronic conditions that would otherwise lead to premature disability and death by concentrating on the underlying causes of illness.”

Dr. Adriane Fugh-Berman, director of a wonderful organization I’m proud to support called PharmedOut, wrote a great editorial entitled “Doctors must not be lapdogs to drug firms.” “The illusion that the relationship between medicine and the drug industry is collegial, professional, and personal is carefully maintained by the drug industry, which actually views all transactions with physicians in finely calculated financial terms.” Big Pharma “is happy to play the generous and genial uncle until physicians want to discuss subjects that are off limits, such as the benefits of diet or exercise, or the relationship between medicine and drug companies.” “Let us not be a lapdog to Big Pharma. Rather than sitting contentedly in our master’s lap, let us turn around and bite something tender.”

Please consider volunteering to help out on the site.

Sources

Acknowledgements

Video production by Glass Entertainment

Motion graphics by Avo Media

Topics

Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.

More than 2,000 years ago, Hippocrates declared, “Let food be thy medicine and medicine be thy food.” Except, he really didn’t. It doesn’t appear that he ever actually said those words. Now there’s no doubt about the relevance of food in health and disease in his writings. But who really cares? That was 2,000 years ago, when disease was thought to arise from a bad sense of humors.

Now, we have science, and there is an overwhelming body of evidence illustrating the dramatic impact of a healthy lifestyle on reducing all-cause mortality—meaning death from all causes put together—and preventing chronic diseases, such as coronary heart disease, stroke, diabetes, and cancer. But wait . . . don’t these diseases just run in your family? What if you just have bad genes?

According to the esteemed former chair of nutrition at Harvard, for most diseases contributing importantly to mortality in Western populations, we’ve long known that non-genetic factors often account for at least 80 to 90 percent of risk. We know this because rates of the leading killers like cardiovascular diseases and major cancers vary up to 100-fold around the world. And when people migrate from low- to high-risk countries, their disease rates almost always change to that of the new environment. Currently, for example, we have been able to identify modifiable behavioral factors, including specific aspects of diet, overweight, inactivity, and smoking that account for over 70 percent of your risk of having a stroke or getting colon cancer, more than 80 percent of coronary heart disease risk, and more than 90 percent of risk for type 2 diabetes. All that disease can be prevented by our own actions.

If most of the power is in our own hands, why do we allocate massively more resources to treatment than prevention? And even preventive strategies are heavily biased towards pharmacology rather than supporting improvements in diet and lifestyle that could be more cost-effective. For example, treating high cholesterol with statin drugs could cost tens of billions a year, only to have a modest impact on the incidence of heart disease. The inherent problem is that most pharmacologic strategies don’t address the underlying causes of disease, which are not drug deficiencies.

Ironically, the chronic diseases that are most amenable to lifestyle treatment are the same ones most profitably treated by drugs––because if you don’t change your diet, you have to pop the pills every day for the rest of your life. So, the cash-cow drugs are the drugs we need the least. “Even though the most widely accepted, well-established chronic disease practice guidelines uniformly call for lifestyle change as the first line of therapy, physicians often fail to follow these recommendations.” “By ignoring the root causes of disease and neglecting to prioritize lifestyle measures for prevention, the medical community is placing people at harm,” or at least so say folks like this guy.

Traditional medical care relies primarily on the application of drugs and surgery after the development of illness, whereas lifestyle medicine is primarily the use of optimal nutrition (a whole foods, plant-based diet) and exercise in the prevention, arrest, and reversal of chronic conditions that would otherwise lead to premature disability and death by concentrating on the underlying causes of illness.”

Dr. Adriane Fugh-Berman, director of a wonderful organization I’m proud to support called PharmedOut, wrote a great editorial entitled “Doctors must not be lapdogs to drug firms.” “The illusion that the relationship between medicine and the drug industry is collegial, professional, and personal is carefully maintained by the drug industry, which actually views all transactions with physicians in finely calculated financial terms.” Big Pharma “is happy to play the generous and genial uncle until physicians want to discuss subjects that are off limits, such as the benefits of diet or exercise, or the relationship between medicine and drug companies.” “Let us not be a lapdog to Big Pharma. Rather than sitting contentedly in our master’s lap, let us turn around and bite something tender.”

Please consider volunteering to help out on the site.

Video production by Glass Entertainment

Motion graphics by Avo Media

Doctor's Note

The organization I mentioned is PharmedOut, a project of Georgetown University Medical Center.

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