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Prevention

The birth of modern medicine provided countless benefits, but it also created a society
dependent on the quick fix treatment. The obesity epidemic only increased these tendencies,
as people turned to pharmacological and sometimes surgical interventions searching for their
idea of health. These kinds of solutions are necessary for some, however they can be
expensive and not always as effective as they could be. This has led to a shift in thought
towards prevention and treatment through lifestyle modification, particularly nutrition and
physical activity. There is strong evidence suggesting that improving diet and increasing
physical activity can successfully prevent and treat chronic disease, therefore these
interventions should be implemented in both at risk and sick populations where there is any
potential benefit. Diseases where this may be appropriate include obesity, type-2 diabetes, and
cardiovascular disease.
Of all common chronic diseased states, obesity has the potential to have the most
benefit from lifestyle interventions. Obesity is also a risk factor for other diseases and health
issues, making it an opportunity to prevent multiple poor outcomes. Prescribing a diet low in
saturated fat and sodium and high in fruits, vegetables, whole grains, and fiber, has been
proven to improve health (Katz & Meller, 2014). Many diet trends have appeared over the last
50 years, but evidence supports the idea that any diet can provide weight loss as long as there
is a sufficient calorie deficit (Sacks et al, 2009). While this is important, research has shown that
in order to lose weight and keep it off over time, a plant-based diet is the most successful
approach (Turner-McGrievy, 2007). Combining these diet recommendations with a physical
activity regimen can be extremely helpful in prevention and treatment of obesity.
The rates of type-2 diabetes have increased dramatically, and continue to do so. Many
factors may lead to this including genetics, a sedentary lifestyle, being overweight, and high
consumption of processed foods and sweetened beverages. All diabetics receive nutritional
counseling and are recommended diet interventions based on their individual case. In at risk

populations, a main argument for prevention through a healthy lifestyle lies in the related health
care expenses. Those who are pre-diabetic will already pay about $450 more than others, and
the costs continue to rise as the disease progresses (Zhang et al, 2009). In terms of treatment,
diet therapy can have significantly positive effects and can even cure type-2 diabetes. Some of
the most eye-catching information came from the Diabetes Prevention Program Research
Group study, which found that diet and physical activity interventions reduced the incidence of
diabetes more than pharmacological interventions (Diabetes Prevention Program Research
Group, 2002). The evidence proves that diabetes is highly preventable.
Cardiovascular disease (CVD) and its consequential health outcomes is one of the
leading causes of death in America. This is not surprising since a main risk factor for CVD is
being overweight or obese. Drugs for hypertension, dyslipidemia, and diabetes (other risk
factors of CVD) are some of the most widely prescribed pharmacological treatments in the US.
However, an overwhelming amount of research has concluded that diet and physical activity
play major roles in prevention and treatment of these health issues. One specific example is the
DASH diet, which in one study was found to reduce systolic blood pressure by 13% and also
reduce risk of CVD significantly (Siervo et al, 2014). By eating a diet specifically low in sodium
and saturated fat plus meeting recommendations for physical activity, onset of CVD and its risk
factors can be pushed to a later age or prevented altogether.
The future of health care in this country needs to rely heavily on primary and secondary
prevention methods. So far, treating chronic disease with drugs after diagnosis has been
generally unsuccessful in improving the health of the general population. Despite the strong
evidence illustrating the importance of nutrition and exercise prescriptions, this failure should be
reason enough to aggressively promote lifestyle interventions. Between the more successful
outcomes and lower costs of medical treatment, adopting healthy behaviors both before and
after disease strikes is the best strategy currently available.

References
Diabetes Prevention Program Research Group, 2002. Reduction in the Incidence of Type 2
Diabetes with Lifestyle Intervention or Metformin. N Engl J Med, 346, 393-403
Katz DL & Meller S. 2014. Can we say what diet is best for health? Annu Rev Pub Health, 35:
83-103.
Sacks, F., Bray, G., Carey, V., Smith, S., Ryan, D., Anton, S., Williamson, D. 2009. Comparison
of Weight-Loss Diets with Different Compositions of Fat, Protein, and Carbohydrates.
New England Journal of Medicine N Engl J Med, 859-873.
Siervo, M., Lara, J., Chowdhury, S., Ashor, A., Oggioni, C., Mathers, J.C. 2014. Effects of the
Dietary Approach to Stop Hypertension (DASH) diet on cardiovascular risk factors: a
systematic review and meta-analysis. Br Jr Nutr, 28, 1-15.
Turner-McGrievy G, Barnard N, Scialli A. 2007. A Two-Year Randomized Weight Loss Trial
Comparing a Vegan Diet to a More Moderate Low-Fat Diet*.Obesity,15, 9, 2276-2281.
doi:10.1038/oby.2007.270.
Zhang, Y., Dall, T.M., Chen, Y., Baldwin, A., Mann, S., Moore, V., Le Nestour, E., Quick, W.W.
2009. Medical cost associated with prediabetes. Popul Health Manag, 12, 3, 157-63.

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