Prevention, they say, is better than cure. And that forms the basis of preventive medicine, a proactive approach aimed at getting ahead of the potential causes of diseases by promoting healthy behaviours and screening for diseases with the aim to keep people from becoming sick in the first place rather than treating diseases when they eventually occur.
Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices and are dynamic processes that begin before individuals realize they are affected (source: Wikipedia).
Preventive medicine can be practiced by governmental agencies, primary care
physicians and the individual himself, according to E. A. Clarke, an assistant professor in the Department of Epidemiology and Biometrics at the School of Hygiene, University of Toronto, Canada.
“In the past, many diseases have been conquered by doing things for the individual. The present challenge of preventive medicine is to motivate the individual to practice his own prevention. Possible means of achieving this motivation…require the active participation of the primary care physician,” Clarke said.
Prevention can be primary, secondary, or tertiary. Primary prevention deals with manipulating the environment (clean water and air or immunization), secondary prevention is all about preventing the spread of disease to non-affected groups or persons, while tertiary prevention has to do with improving treatment and recovery and the consequences of the disease state through therapy and rehabilitation.
In a recent Clubhouse Room on reinventing preventive healthcare, medical and scientific experts looked at the factors responsible for the growth of preventive medicine, the place of sleep and fasting, problems facing the practice, and the way forward. Many believed that disease prevention has a long way to go, but were optimistic that some of the key points recapped below would be of use to the wellness community.
There are some factors that make the practice of preventive healthcare an absolute necessity and they are hereunder discussed.
Wikipedia defines a gene as a basic unit of heredity and a sequence of nucleotides in DNA or RNA that encodes the synthesis of a gene product, either RNA or protein. Some genetic traits are instantly visible, such as eye color or the number of limbs, and some are not, such as blood type, the risk for specific diseases, or the thousands of basic biochemical processes that constitute life.
So, genetic testing is necessary to understand the relationship between genetic factors and diseases in order to live a healthy lifestyle.
On the one hand, it is heartwarming to see that some people are very knowledgeable about their condition and how genetics has contributed to that and they are really willing to know what might happen to their children or to the next generation.
On the other, sometimes these people do not know enough about their genetic makeup, or the physicians or the healthcare providers themselves are not fully aware of the most recent updates in this field. This is against the backdrop that these days the number of actionable genes are increasing that cause the genetic mutations known to be influencing diseases.
A healthy lifestyle can promote longevity but poor lifestyle choices are one of the surest ways of getting diseases. While our genes "load the gun," it is really "our lifestyles that are going to pull the trigger. If we do not get to the underlying causes as to why certain genes have been turned on, then we are going to constantly have that gene triggered."
So, it is really important not to lose sight as to why diseases turn on later in life and not just having them from day one of when we were born.
There is a correlation between proper nutrition and good health. So, the kind of food we eat determines, to a great extent, our state of health. If we eat healthily, we will live healthy. If we do not eat well, then we will easily fall sick.
Where we live can affect us in one way or the other. It can make us healthy or sick. It does not matter how many supplements we are going to take, or how many tests we are going to do. So, it makes sense to look at our immediate environment and within ourselves. Sometimes, we may just have to move out of our immediate surroundings, or from some negative or toxic people around us because they can all affect our health.
Sleep and fasting play a very important role in preventive healthcare.
The benefits of sleep in preventive medicine and the hormonal imbalances poor sleeping habits can cause, from snoring to having poor airways, cannot be overemphasized. Sleep facilitates healthy living but lack of it can cause daytime sleepiness, impede studying and understanding for kids in school, or lead to fatigue.
Kids with sleep-disordered breathing such as mass breathing, snoring, upper airway resistance syndromes, and sleep apnea can show signs of attention deficit hyperactivity disorder, a condition (mostly in boys) characterized by behavioural and learning disorders. For these kids, they are tired, wired and deprived of oxygen but adults can also show excessive or daytime sleepiness.
Absence of sleep, lack of oxygen, or inability of getting into our deep stages of sleep, which is our reparative stage, can disrupt the normal functioning of the body, leading to an increase in cortisol, a decrease in insulin, weight gain, heart issues, or inflammation.
While snoring and sleep apnea may not show during a test, looking at these issues early on can help in nipping them in the bud.
Fasting upregulates pretty much every function. It is not just for weight loss. It can promote longevity, hormone optimization or gut rebalance and turn off bad genes. It can also help to bring our body back to where it can regain balance.
Despite the belief that prolonged fasting can sometimes decrease immunity, variation is key when it comes to fasting to limit this unwanted outcome. For extended fasting, everyone is going to be slightly different and individuals with higher amounts of body fat are going to be able to fast for longer than other individuals.
However, fasting can be inappropriate for some people. So, it is advisable to see a knowledgeable and reputable healthcare provider before digging into fasting because there can be harmful effects inherent in it.
There are a lot of problems facing the practice of preventive medicine, most of which are lack of time and poor socioeconomic background.
In our healthcare model today, there is very limited time to spend with patients. Oftentimes, practitioners have very small or short appointment times. And it is very difficult to really offer preventive care in this case.
This may be as a result of how many sessions insurance allows practitioners to offer patients for specific disease states and how long those sessions can be.
People come from different socioeconomic backgrounds. And while some are wealthy and can afford medical care, others are poor and cannot afford to take care of themselves. Finances, therefore, have been and can definitely be a roadblock for individuals to essentially access holistic care or alternative care in order to reverse or stabilize their current disease or condition.
A lot needs to be done in order to prevent diseases before they occur. They include, but are not limited to, the following:
Over the years, people have abdicated responsibility for their own health. They have left it up to fate or in the hands of physicians and other people rather than take responsibility for their own situation, their diet, their level of exercise, and the various ways they take care of themselves. But preventive medicine offers a new glimmer of hope for these set of people to know how to keep themselves healthy and out of the hospital. They should understand that genetics is not their future. They can still change some of its makeup.
The provision of healthy food alternatives in healthy food options in hospitals is of paramount importance. So, instead of putting patients back into hospitals and into their beds, giving them food that empowers them and heals them from the inside should be prioritized.
More should be done in the area of legislation and there should be enabling laws all over the world that will make the health of patients a topmost priority because they are there in the hospitals to get healed.
Enough time should be given to practitioners to enable them to spend quality time with patients in order to get to the root causes of their problems and be able to prescribe things like nutrition, sleep, stress management, movement and medication if the need arises.
There is a need for people to go for genetic counseling and seek the help of genetic counselors in order to understand some of the genomic nuances and get a more personalized plan when it comes to diet supplements and lifestyle.
Disease prevention is something that is really important and something that we need to emphasize, given how much disease is prevalent in our society right now. So, taking a public health and grassroots approach by tackling the situations from a community perspective is the way to go. People should be taught how to take care of themselves to prevent diseases.
The next step would be collaboration among health coaches, doctors, and all kinds of practitioners. They should all work together to see that the kind of care patients push for is working.
All in all, preventive medicine is going to be the future of medicine. It is just a question of time.
Clarke EA. What is Preventive Medicine?. Can Fam Physician. 1974;20(11):65-68.
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