Living Long

David Katz, M.D.: The Cup of Life: Medical Science and Genomic Disappointments: In 1993 "'Actual Causes of Death in the United States' was published in the Journal of the American Medical Association by Drs. William Foege and J. Michael McGinnis. McGinnis and Foege revealed the obvious we had all overlooked: when someone dies of, say, a heart attack, it is not very illuminating to cite the cause as disease of the cardiovascular system. What we all really want to know is: what caused that?

Such answers were readily available. Overwhelmingly, premature death and chronic disease were attributable to just ten behaviors, each of us ostensibly has the capacity to control:

tobacco use
dietary pattern
physical activity level
alcohol consumption
exposure to microbial agents
exposure to toxic agents
use of firearms
sexual behavior
motor vehicle crashes
illicit use of drugs

That list of ten was, in turn, much dominated by the top three - tobacco use, dietary pattern, and physical activity level - which alone accounted for nearly 800,000 premature deaths in 1990."...

..."The investigators surveyed over 23,000 German adults about four behaviors...

Those with all good answers - not smoking, eating well, staying active, and being lean - as compared to those with all bad answers - had roughly an 80% lesser likelihood of experiencing any major chronic disease. Flipping the switch from bad to good on any one of the factors was associated with a 50% reduced probability of chronic disease. Any drug with a faction of such potential would be a blockbuster.

And finally, to make the tale entirely current, a group of researchers from Norway and England found much the same thing in a study of over 5000 adults in the U.K., reported in the Archives of Internal Medicine in April of this year."...

..." By far the greater shame - measurable in years lost needlessly from life, and life lost needlessly from years - is our failure to use the knowledge we already have - and have had since 1993 at least - about the overwhelming influence of lifestyle on health. Feet, forks, and fingers are, indeed, the master levers of medical destiny. This is unlikely to change, no matter what secrets our genomes ultimately reveal."

Fascinating and amazingly important changes in medical purpose and practice are upon us.