The skills you need to slash your risk of heart disease, cancer, diabetes, and more—by 80 percent
Though we may not realize it, our behavior has tremendous effects on our health, well-being, and even gene expression. In Disease-Proof, renowned preventive medicine specialist Dr. David Katz reveals that we can reduce our risk of any chronic disease by an astonishing 80 percent—more than any drug or intervention could ever hope to do.
Abundant scientific evidence shows that four simple things—not smoking, eating well, being active, and maintaining a healthy weight—play an enormous role in our health. Drawing upon the latest scientific evidence and decades of clinical experience, Dr. Katz arms us with the skills to make lasting changes in each of these areas. Disease-Proof equips readers with the knowledge to manage weight, improve immune function, reprogram our genes, and prevent and reverse life-altering illnesses.
Groundbreaking and timely, this book is for readers of The End of Illness by David Agus and Anticancer by David Servan-Schreiber.
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DAVID KATZ, MD, MPH, FACPM, FACP, is an internationally renowned expert in chronic disease prevention and weight management, recognized in 2012 as one of the most influential figures in health promotion. He is a specialist in preventive medicine, and the founding director of Yale University’s Prevention Research Center. The author of twelve books, he lives in Connecticut.
STACEY COLINO’s writing has appeared in the Washington Post Health Section and in dozens of national magazines including Newsweek, Real Simple, Health, Prevention, Parents, Cosmopolitan, Glamour, Self, Shape, Woman’s Day, Good Housekeeping, and more. She lives in Maryland.
When it comes to health, have you ever noticed how the media have a tendency to focus on the latest scary risk factor, a gimmicky new solution, or the bright and shiny promise of a cure (when there never really is one)? That’s because diet and health advice in magazines and on TV is, for the most part, designed to get us to read the issue every month or tune in to the program every day. The constantly changing news and advice can leave us feeling downright baffled, but it doesn’t bother editors or TV producers in the least. I know this, because I have a bit of insider experience.
In addition to my work as a preventive medicine specialist, I have worked as a columnist for national magazines and as a medical expert for national news shows. One evening several years ago, I was preparing a segment about a new diet study for a TV program the following morning. During a phone call with the writers and producers, we were zipping through the content in a very routine fashion— until I shared what I thought the “punch line” should be. At that point, the senior producer, who had been listening silently, suddenly chimed in, “You can’t say that!”
“Why not?” I asked.
“Because you were on the show last week and you said the same thing,” she explained. “It will be boring if you repeat the same conclusion.”
“Maybe,” I replied, “but it happens that fruits and vegetables are still good for people!”
This is hardly an uncommon situation; I’ve encountered it many times in my work. The point here is there’s a constant tension in the media between what’s new and what’s true, what makes for sound science and what makes for provocative headlines or intriguing sound bites. Although I’m sympathetic to the media’s challenge to keep their audience engaged, dressing up dull scientific findings to make them sexier, fresher, or more surprising sometimes changes them to the point where the truth can be very hard to recognize.
This phenomenon reminds me of the riveting courtroom scene in the movie A Few Good Men, where Tom Cruise’s character (a Navy lawyer) is grilling Jack Nicholson’s character (a crusty Marine colonel) about whether he ordered a Code Red. At one point Cruise’s character hollers that he wants the truth, to which Nicholson’s character famously replies, “You can’t handle the truth!”
The notion that people can’t handle the truth if it isn’t wrapped in a pretty package is prevalent in the world of health and medicine, too. Can you handle it? This is an important question, because if the answer is yes, then you can take control of the master levers of your medical destiny. We can exert incredible power over both the number of years in our lives and the quality of those years. We can help ourselves sidestep illness and health risks and help our children do the same. We can even untwist the implications of our DNA in our favor. The master levers of your personal medical destiny are truly powerful and within your reach.
In the European Prospective Investigation into Cancer and Nutrition (EPIC) Potsdam study, published in 2009, researchers examined four factors— smoking, body weight, physical activity, and diet— among 23,153 German participants, ages thirty- five to sixty- five, and tracked their health effects over the life span. Each healthy lifestyle factor— never smoking, having a body mass index (BMI) lower than 30, performing at least three and a half hours of physical activity per week, and eating a nutritious diet (a high intake of fruits, vegetables, whole- grain bread, and low red meat consumption)— was associated with a decrease in the risk of any chronic disease. Flipping the switch from bad to good on any one of these lifestyle factors was associated with a 50 percent reduced probability of chronic disease. But what was most eye- opening is that participants who had all four healthy factors at the start of the study had a nearly 80 percent reduced risk of developing any major chronic disease. The reduction in diabetes risk alone was 93 percent. There simply is— and in my opinion, there never will be— a drug to rival that. And to use lifestyle as medicine . . . well, no prescription is required!
It’s important to remember that science is all about the slow accumulation of evidence and the gradual evolution of understanding, which sometimes involves confirming time- honored truths. (Yes, fruits and veggies really are good for us, just like they were last week and will be next week.) If you put too much stock in the latest media report about what is or isn’t good for you or what truly increases or decreases your risk of developing a particular disease, you may end up with a terminal case of health information whiplash. At some point, you may throw up your hands in frustration and tune out the messages entirely, even when they’re valid. Clearly, that’s not the way it should be.
Contrary to what common assumptions and the media sometimes lead us to believe, our genes do not determine our weight or future health. What they do is to tell us about our risks of developing certain diseases. It’s about possibility; nothing is set in stone. Our DNA simply cannot forecast that we will get a particular disease, unless it’s one that’s caused specifi cally by a genetic mutation (such as Huntington’s disease, cystic fibrosis, or sickle cell anemia). We are actually the ones driving the bus on our journeys toward wellness or illness, so don’t blame your genes for the future of your health.
Most diseases are not random occurrences but the consequences of the things people do every day. They are the intermediate step between lifestyle habits and infirmity or death. This means that the leading causes of death and disease are largely within our control because they result from what we do or don’t do with our feet, our forks, and our fingers— namely, whether we are physically active, consume a healthy diet, or smoke— on a daily basis. With few exceptions, that is the new rule that’s been established by groundbreaking research— and it is the central premise of this book. As you’ve just read, there is now abundant evidence that getting just four things right— not smoking, maintaining a healthy weight, being active, and eating well— could reduce the risk of all chronic diseases by 80 percent. That’s right: 80 percent! (There are four things on the list, but by eating well and being physically active, you will set yourself up for a healthy weight— so you really need to focus only on three things, with the final one being not smoking.) It’s a realization that could, and in my opinion should, remake the way we play the game of life, by inspiring us to make better lifestyle choices. If you do it right, you can write a new story for your future right down to the genetic level. To a preventive medicine specialist like me, this is of profound importance, because apathy and fatalism are among the biggest enemies of health and healing.
Becoming a doctor was a natural choice for me. My father is a doctor, and I knew I wanted to do something that mattered, that felt challenging and rewarding. During my training, I spent a lot of time trying to figure out what kind of doctor I really wanted to be, and I couldn’t help but notice that roughly eight out of ten hospitalized patients had serious illnesses, all of which could have been prevented by exercising, eating well, or not smoking. It seemed tragic to me that these people were suffering and shortening their lives— when a more healthful lifestyle could essentially have immunized them against such misery. It was then that the path to my life’s work became clear: I started investigating how a doctor becomes an expert in using lifestyle as medicine and how best to leverage nutrition, in particular, to help people avoid getting sick in the first place. The rest, as they say, is history. I have been an internist and a preventive medicine specialist ever since. I rely on both aspects of my training to take care of existing patients— and to try to help as many people as possible avoid becoming my (or any other doctor’s) patients in the first place!
Rewrite Your Future
The fact is healthful behaviors create an opportunity to reshuffle the genetic deck in your favor. After all, genes don’t affect your health because they’re there; they represent a recipe for biological material— including specific proteins that turn those genes on or off— that needs to be made in order to set a disease course into motion. You can change the behavior of your genes, essentially dialing their expression up or down, by modifying your lifestyle. Just because you carry a gene that makes you vulnerable to colon cancer or lung cancer, for example, doesn’t mean you’ll inevitably develop the disease. If you exercise regularly, stick with a healthy diet, avoid smoking, and maintain a healthy weight, you stand a much better chance of never developing those illnesses, even if other members of your family do.
There are only so many parts to the human body— we can’t expect to discover new bones or organs— and the same is true of the skills that will save your life and promote better health and well- being. There is a skill set some people have that enables them, in spite of all the conflicting news and opposing societal forces, to stay lean and maintain good health. They weren’t born with this skill; they learned it at some point in their lives, and you can learn it, too. Think of it as an essential tool kit you didn’t even know you needed: Once you have it and you master the use of the different tools, you’ll have the skills for life.
An 80 percent reduction in the incidence of all chronic disease would certainly count among the most stunning advances in the history of public health. While it’s unquestionably a compelling result, it’s still just a statistic, and statistics are generally dull, dry, bland— and anonymous. So how can we get passionate about the implications of this idea? Let’s consider the personal context of how these risks are playing out in your own world. Have you or any loved ones suffered from a heart attack, a stroke, cancer, or diabetes? Visualize their faces, say their names, and recall what it felt like the day you heard the news that they had developed a life- threatening disease. Remember how upsetting that was?
Now, imagine the faces of friends, colleagues, neighbors, and others as they picture the faces of their loved ones who received similar diagnoses. Think about how they must have been feeling. You probably won’t like what you’re seeing.
But wait: Now imagine if eight out of ten of us who are reflecting on that personal anguish never got that dreadful news because it never happened. Mom did not get cancer. Your close friend or colleague did not have a heart attack. Grandpa did not have a stroke. You didn’t develop diabetes. That’s a far more upbeat and inspiring picture, isn’t it? Even more inspiring: It’s possible, if we all do our part individually, to reclaim control of our feet, forks, and fingers. The key is to transform what’s now known about the potential to combat chronic disease into action, because knowledge isn’t power unless it’s put to good use.
Your Body’s Second Chance
When I ask my patients why they’ve come to see me, the answer is always to get better if something is wrong, or to get advice about staying healthy if nothing’s currently bothering them. My second question is “Why do you care about being healthy? What is health for?”
Usually these questions are met with silence. No one really thinks about the fact that health is for something, but it is. It’s for living the life you want and deserve, for feeling good and functioning at your best. It’s not a trial, a penance, or a punishment. It’s a reward and a return on your investment in yourself (a return that more than justifies the investment, by the way). That’s true of the money we put aside to secure our futures or pay for our kids’ educations, and it’s certainly true of the eff ort devoted to improving our health. After all, your life will be better if you have good health. And if you pay it forward by sharing your health- promoting, disease- fighting strategies with loved ones, your life will be better still because the people you love will share good health with you.
It requires eff ort and practice to make these skills automatic, especially given the world we live in. We didn’t choose to be born into an environment that promotes obesity, but here we are, nevertheless. We did not choose to find ourselves in a world awash in highly palatable, energy- dense, convenient foods. And while we did not choose to be among the first generation of Homo sapiens that could count on technology to do everything for us, in areas ranging from work to recreational pursuits, once again, here we are. You don’t need to be gluttonous to overeat or lazy to underexercise and gain weight in the modern world; you simply need to live in the modern world, which is why obesity and chronic disease are not exceptions— they are now the norm.
There’s a place for both personal responsibility and public policy in fixing what ails our collective health. While you’re waiting for the world to change, it is possible to steer the course of your own and your family’s health in a better direction, and this book will show you how. Part call to action, part blueprint for healthy living, this book examines the specific factors that are contributing to the epidemics of obesity and chronic diseases in our culture and, most important, provides the tools that will empower you to make health- promoting changes so that you can better manage your weight, bolster your natural immunity, nip life- altering illnesses before they even have a chance to bud, and possibly even undo previous damage from existing disease. For the first time ever, you will gain an entire tool kit that will enable you to seize control over your medical destiny for good. It’s like riding a bicycle: once you know how, you never forget.
In the chapters that follow, you will learn how to fortify your willpower and build the skills that will help you improve your eating habits at home and on the road, your food- shopping and cooking habits, and your level of physical activity. You’ll learn how to retrain your taste buds to prefer healthier foods, discover physical activities you enjoy and fi t them into your life, and embrace the gift of physical vitality. And you’ll find out how to improve other aspects of your lifestyle— including your sleep, stress, pain, and social connections— so they can enhance your eating and exercise habits. Best of all, you’ll be able to tailor a plan that’s specific to your situation and needs. Let’s get started!
The Power to Nurture Nature
n our culture, we tend to refer to hospitals, clinics, physicians, nurses, and other clinicians collectively as a “health care system.” Th is may cause you to think that someone or something else— perhaps a doctor, or a drug or other treatment— has the ultimate control over your health. But that’s just not the case. By and large, the system in place is a “disease care system,” not a health care system. Disease care is important when you are sick and in need of treatment. But only ...
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