Is Preventive Medicine Its Own Health Risk?
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aeon.co
As you would suspect, the United States has significantly fewer acute diseases than India, which in turn has significantly less acute disease than Kenya. BUT for chronic conditions, the numbers (relative to population size) are pretty much the same across the board. The distribution of chronic disease is slightly different depending on wealth (diabetes vs obesity vs malnutrition vs heart/lung disease like cancer vs liver disease from alcohol, etc) but they are almost entirely preventable often with "just" some life style changes (I'm oversimplifying, but the vast majority of the conditions are considered very preventable). With the United States spending nearly a fifth of its GDP on medical care we STILL have just as big a problem with chronic disease as Kenya, a country where the average income is under $10/day.
Preventive medicine is almost definitely its own health risk but when you look at what we're trying to combat and just how intractable the problem is here in the US, let alone globally, it starts to look like a very acceptable risk.
Exercise moderately and eat healthier are probably the most important "preventive" means of health care. Even for conditions that aren't directly related to being overweight or lacking exercise, it can help immensely to correct those two issues.
I'd love to hit he market every other day and have lots of good home cooked meals. But my wife and I work 50-60 hours, and need to have the 2 year old in bed by 8:30. That means out the door at 7, home by 5:30, dinner on the table by 6:30.
I'd love to cook awesome meals and play old man basketball. When do I do that?
I think I am missing something.
Are you saying you'd rather be in Kenya, where you have almost zero options for improving your quality of life, given a disease that is for all intents and purposes permanent?
It was the only good non-industry source I could find on the Jupiter study.
And while I'm not so influenced by "the drug company paid for it!" bit, Crestor's situation is special, it was introduced when earlier well studied statins had gone generic (or nearly so). It had to muscle its way in, so to speak. So I view it with extra jaundice in my eye (tempered by the fact that it's brand name, so you know you're going to get the real stuff at the right dose, and in my recent study of statins it's clear that bad side effects are very strongly correlated with inadvertent overdosing).
Anyway, if an iffy source says something, as long as you can track down what it claims to be quoting then you shouldn't dismiss it out of hand. Given that it's peppered with links to PubMed....
I myself am looking at statins (for primary prevention, pushed by my doctors with some justice) with a jaundiced eye, based on how far their target is from actual cholesterol production. They interfere with a lot more than that.
http://www.quackwatch.com/11Ind/mercola.html
http://www.alternet.org/personal-health/four-biggest-quacks-...
http://rationalwiki.org/wiki/Joseph_Mercola
http://www.sciencebasedmedicine.org/joe-mercola-quackery-pay...
http://www.sciencebasedmedicine.org/more-breast-cancer-aware...
http://www.sciencebasedmedicine.org/mercola-gardasil-and-toy...
http://www.sciencebasedmedicine.org/9-reasons-to-completely-...
http://scienceblogs.com/insolence/2012/08/03/15-years-of-pro...
We know now that only some types of LDL are dangerous, but how often are people given an LDL particle count?
According to Michael Pollan, the whole Fat/Cholesterol thing started when the government found some weak evidence that beef is bad for you, but they blamed it on cholesterol so as not to single out a particular industry. But is beef even bad for you? Or is it something in how hamburger meat is processed? Or what?
But considering the saturated fat and cholesterol in eggs, they have been considered harmful. Are they?
Good question. The author of Living Low Carb[1] argues that it's not "saturated fat" in general that's bad for you, but rather more specifically "trans-saturated fat", or saturated fat consumed along with simple carbs (sugar, etc). He also argues that most dietary cholesterol passes through your system unprocessed, and that serum cholesterol is largely driven by cholesterol manufactured by your liver.
[1]: http://www.amazon.com/Living-Low-Carb-Controlled-Carbohydrat...
It's bizarre that people have been convinced this stuff is deadly poison.
Same thing for sodium chloride
No, they are not. There's plenty written on both sides of the argument, though.
Just today came across a surprisingly well-referenced article on nutrition myths. It covers cholesterol, saturated fat and eggs (in top position) among others.
http://www.businessinsider.com/the-11-most-destructive-nutri...
Here is another well-referenced source
First of all, it is plain that screening test programs that are not based on "hard endpoints" (actual reductions in all-cause disease or death) often end up being discovered to be wastes of time and money and the cause of needless patient worries. There is a group blog, Science-Based Medicine, with participation by multiple medical doctors, pharmacists, lawyers, and even reformed chiropractors, which examines the issue of the usefulness of screening tests from time to time.[1] An informed patient might well decline many currently offered screening tests, and might also well decline some preventive treatments, for example statin drugs.
But the second bit of context to look at is that whatever is being done in public health and medicine in the developed world appears to be working in part, as life expectancy at age 40, at age 60, and at even higher ages is still rising throughout the developed countries of the world.[2] Chances of surviving to healthy old age from middle age have been increasing steadily in the United States and in the whole developed world throughout my lifetime, so I may have to get ready to live as long as some of my aunts and uncles, who are now well into their nineties and still living independently.
[1] "Recent Developments and Recurring Dilemmas in Cancer Screening: Colon, Lung, Thyroid" 18 November 2014 http://www.sciencebasedmedicine.org/recent-developments-and-...
"A Skeptical Look at Screening Tests" 23 July 2013 repost http://www.sciencebasedmedicine.org/a-skeptical-look-at-scre...
"Screening Tests - Cumulative Incidence of False Positives" 30 June 2009 http://www.sciencebasedmedicine.org/screening-tests-cumulati...
[2] http://www.nature.com/scientificamerican/journal/v307/n3/box...
"Whatever" is a pretty broad statement. What if we found out that the biggest factor is nutrition and health care while young: in other words, maybe poor health and nutrition while young leaves "scars" of a sort that come back to bite us as we age?
I'm not saying that that's the case. I'm just saying that "whatever" is too broad a statement. The piece is about the comparatively superfluous effect of so-called preventative medicine in late middle-age. If we just grant that point, for the sake of argument, then that's a whole bit of "whatever" that we could save our money on and do without.