Prevention and Treatment are NOT the same things
Preventing disease is usually fairly straightforward. Prevention is never perfectly guaranteed to work (nothing in medicine is), but most of the time, we can prevent lung cancer by avoiding smoking and air pollution. We can prevent pregnancy by using reliable contraception. We can prevent paralysis from polio by getting a polio vaccine. However, preventing disease is not the same thing as treating disease.
Treating disease is usually much more difficult than preventing it in the first place. We will not cure our lung cancer by simply stopping smoking. It will help slow the progression of the disease (which is a great thing during treatment) but smoking cessation isn’t the cure – it’s not the solution to magically reverse the damage. The treatment for pregnancy is not contraception. The treatment for polio is not a polio vaccine.
Once a disease has settled in and taken root, you have to work harder and differently than you did to prevent it in the first place. You have to use different methods.
Preventing chronic lifestyle diseases (including obesity) is fairly straightforward.
Eat Real Food
Not Too Much
We have loads of data showing that populations that follow a Mediterranean eating pattern or a whole-food, plant-based eating pattern or something similar to that have very low rates of metabolic disease and obesity. (I don’t like to refer to these as diets because, in the US, the word diet has become synonymous with deprivation and restriction!)
When we refer to this type of eating pattern, you have to look at the whole picture. You can’t pick out pieces and leave others behind and expect the same results. A Mediterranean eating pattern involves eating a lot of olive oil, fish & seafood, and vegetables along with some whole grains, a little meat, and a little wine. If you don’t eat fish and rarely eat vegetables but focus on the olives, grains, meat, and alcohol – it’s no longer a Mediterranean eating pattern!
From what we know of studies, the healthiest eating patterns look like this:
If you want more information about how to follow these eating patterns, they have been written about extensively. For more information, check out:
It’s very important to keep in mind that all of these eating patterns are designed to prevent chronic disease. Populations that follow these eating patterns have very low rates of heart disease, diabetes, fatty liver, and obesity.
However, these eating patterns alone are usually not treatment for people that have these diseases. As we mentioned earlier, prevention and treatment are two different things. Adopting an eating pattern like one of these is a great idea – just like smoking cessation during lung cancer treatment is a great idea – but for most people, it won’t be the cure. Remember, treating disease is harder than preventing it.
Treating Metabolic Syndrome: Treating metabolic disease is more complicated than preventing it. Treating metabolic disease is something that should be done while under the care of a healthcare professional. Treatment sometimes involves medications (not just medications to treat symptoms, but medications to address the underlying problems).
Most importantly, because metabolic syndrome is primarily caused by a poor dietary pattern, it involves changing that dietary pattern to something aimed at reversing the problem. Under no circumstances can we cannot expect the foods that caused the metabolic disease in the first place to be the cure. We aren’t going to get very far eating less of the same things that made us sick in the first place.
The standard American diet causes the standard American diseases – or metabolic syndrome. And the standard American diet looks like this:
The standard American diet pattern is made up of mostly processed foods with some animal products and very little plant-based foods. And, of this 12% of our diet that is made up of plant-based foods, sadly, half of those calories are coming from french fries. That means that only 6% of the nutrition coming from the standard American diet is coming from fruits, vegetables, whole grains, nuts, and seeds. That’s a far cry from the pyramids we looked at above!
If we want to have different results, we have to change our diet. We have to change what we are eating. Not into something bad or scary or crazy complicated – but something different. We have to dispose of the standard American diet. Then, we have to modify those healthy eating patterns to swing them toward disease reversal. Once the metabolic disease and/or excess weight is reversed, we can swing back to one of the pyramids to prevent disease recurrence.
Changing Dietary Patterns Can be Challenging: Changing what you eat isn’t always easy. In a world where most people are eating poorly most of the time, improving your diet to improve your health can feel abnormal. However, keep in mind that normal isn’t the same thing as good or right. Sometimes normal is just normal because it is – because it’s culture. Thirty years ago it was common to see people smoking in airplanes & restaurants – it was normal. Heck, there was even a smoking lounge in the hospital when I was in medical school. Today’s food culture or food environment – what we think of as normal – causes normal problems. Normal problems like high cholesterol, high blood pressure, excess weight, prediabetes, and diabetes. Think about it. It’s normal to have these things. When people say they have high cholesterol, others don’t gasp in shock at that news. The standard American diet causes metabolic syndrome. Eating an unhealthy diet today is completely normal. Having metabolic syndrome today is completely normal. Maybe it’s time to be a little abnormal.
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Courtney Younglove, M.D.