Columnist Carrie Dennett discusses the role nutrition plays in the three levels of preventive health care.
If mammograms don’t prevent breast cancer, glucose screening tests don’t prevent high blood sugar and slapping on a blood pressure cuff doesn’t prevent hypertension — what is preventive health, exactly? And what does nutrition have to do with it?
Officially, there are three levels of preventive health: primary, secondary and tertiary.
Primary prevention is when you are healthy and disease-free and want to stay that way. Your blood sugar, blood pressure and cholesterol are in the normal range, and you cultivate habits that will help keep them there. For example, eating nutritious food, exercising regularly and maintaining a healthy weight.
Secondary prevention is where screening tests and exams come in. They help you catch problems early when they are generally easier to treat. They may even be treatable with healthy lifestyle changes alone. It’s better to learn you have high blood sugar when it’s still classified as “pre-diabetes.” It’s better to catch a mass of cancer cells when it’s small and has not spread to other parts of your body.
Tertiary prevention is what happens next if your doctor tells you something you don’t want to hear. You have diabetes. You have hypertension. That chest pain you felt was a heart attack. At this point, you’re trying to treat an established health problem and prevent serious complications.
Nutrition plays — or should play — an important role in all levels of preventive health. You could say that an ounce of prevention is worth a pound of cure.
Ideally, that ounce is doled out while you are still in good health. Keeping your body in good working order is easier than trying to undo damage once your health status takes an unwelcome turn.
So what might nutritional primary prevention look like?
It looks just like a healthy diet. High on the list would be lots of vegetables and fruit. It would feature whole grains instead of refined grains, and healthy fats from nuts, avocados, olives and olive oil. A few servings of fish a week, especially oily fish like salmon, would further bump up the healthy fats. Moderate amounts of lean meat, poultry and low-fat dairy products — or vegetarian alternatives. Moderate alcohol, if you choose to consume it.
When we fill our plate with those good foods, we have less room for foods that don’t contribute to good health. A health-promoting diet minimizes heavily processed foods, which are major sources of sodium, sugar, refined grains, unhealthy fats and artificial colors and other chemicals.
What if you’re already trying to put the brakes on pre-diabetes or “borderline” hypertension or high cholesterol? The optimal diet would look pretty much the same. Even after a full-blown diagnosis, diet remains important for managing disease and preventing complications. Medication is not a magic bullet; it may treat the immediate problem, but diet and activity will improve your overall health. In other words, statin drugs are not a free pass to eat as many cheeseburgers and fries as you want.
It’s never too late to start eating for health, but the earlier the better. As Hippocrates said a few thousand years ago: “Let food be thy medicine and medicine be thy food.” Smart guy.
Next time: Summer’s bounty — good, and good for you!