Guest Column: Lifestyle Changes May Save Your Life

With the legitimate concerns about pandemics of AIDS and avian flu, it's easy to forget that cardiovascular disease is the biggest pandemic of all time and that diabetes and obesity aren't far behind. Today's children may be the first to have a shorter life span than their parents. However, these chronic diseases can be prevented, even reversed, in most people just by making sufficient diet and lifestyle changes.

The problem is that most insurance companies pay only for drugs and surgery. Despite all the talk about evidence-based medicine, we really live in an era of reimbursement-based medicine. As P. Diddy sings, "It's all about the Benjamins" ($100 bills).

Last year, for example, more than 1 million coronary angioplasties and more than 400,000 coronary bypass operations were performed in the United States at a cost of more than $100 billion. Yet a remarkable study published in the journal Circulation, reviewing 11 randomized controlled trials of angioplasty, found the procedure does not reduce the risk of a heart attack or prolong life in most patients with stable coronary heart disease. Bypass surgery prolongs life only in a small percentage of those who receive it. These operations may reduce the frequency of chest pain, but that can also be accomplished through diet and lifestyle changes.

The landmark INTERHEART study of 30,000 men and women in 52 countries found that nine lifestyle factors accounted for almost all the risk of a heart attack: smoking, cholesterol, hypertension, diabetes, obesity, diet, level of physical activity, alcohol consumption and psychosocial issues like emotional stress and depression. In other words, the disease that kills the most people each year is almost completely preventable just by changing diet and lifestyle.

You have a spectrum of choices. If your cholesterol is too high, try moderate changes in diet and lifestyle first. If that isn't sufficient, consider bigger changes before beginning a lifetime of cholesterol-lowering drugs. Some health plans offer disease-management options that your doctor may not know about. If you've been prescribed a new drug or surgical procedure, ask to see the scientific evidence that these will help you. Get a second opinion. Your body often has a remarkable capacity to begin healing itself when the underlying lifestyle causes are addressed rather than just literally or figuratively bypassing them.