The Disease Proofing Myth

Spending your life in human body is—among other things—a risky endeavor. So much can go wrong. Cells can misbehave and start growing into tumors. Arteries can narrow until blood can no longer flow through them. Brain cells can start to shrink and die. Immune cells can start to attack our own tissues. Reproductive organs can stubbornly refuse to do their jobs.

If we could just figure out what factors lead to or contribute to these unfortunate developments, perhaps we could prevent them. Accordingly, society spends billions of dollars and medical researchers devote their lives in an attempt to find the factors that cause disease. And we consumers hang on every press release and pronouncement, always looking for that pill or program that will allow us to cross whatever scary thing we’re most anxious about off our worry list.

Our understandable desire to avoid disease and disability, coupled with the need for researchers to publicize and fund their work, has given rise to something I call the Disease Proofing Myth.

What Do We Really Know About Preventing Disease?

There are a whole slew of books and programs that tell you how to reduce your risk of various diseases by adopting certain diet and lifestyle habits. In previous podcasts, I’ve reviewed protocols that can claim to reduce your risk of Alzheimer’s, cancer, diabetes, infertility, and more.

Virtually all of these programs draw heavily on epidemiological evidence to determine what type of diet and lifestyle habits are common in people who do—and don’t—get these diseases. In other words, what are the positive and negative risk factors for this disease?

For example, people who eat more leafy greens and fish have lower rates of Alzheimer’s. People who drink more than one alcoholic drink a day have higher rates of cancer.  Usually, these findings simply parallel recommendations for a healthy diet. Sometimes, however, things get a little weird. Eating cheese may increase your risk of Alzheimer’s but decrease your risk of infertility.

Few of these protocols have been tested in controlled experiments. They are mostly the product of mining big sets of data about what people eat and what happens to them.  Nonetheless, it’s what we’ve got. And so these observations (or correlations) are massaged into disease-specific protocols: Eat fish twice a week. Exercise daily. Eat more strawberries. Watch your alcohol intake.  Eat more cheese. Eat less cheese.

Statistically speaking, following these recommendations reduces your risk of these diseases. And this is a perfectly reasonable thing to do. I just wish experts would stop packaging risk factor reduction as disease proofing.

Disease Happens

Books are published with titles like the Breast Cancer Prevention Diet, the MIND Diet, the Fertility Diet, and Disease Proof. And these aren’t books by random quacks—although there is no shortage of disease-proofing books from that sector. No, these are books by some of the most well-known and respected doctors, researchers, and institutions out there. They are full of good science and good advice.

But to the average reader, they also suggest that preventing disease is simply a matter of doing the right things—which sort of implies that if you do get sick, you have no one but yourself to blame. And I don’t think that’s true—or helpful.

Lowering your risk does not guarantee that you won’t get a given disease, any more than being at higher risk ensures that you will. If you are a smoker, you are much more likely to develop lung cancer than a non-smoker. But some smokers don’t get lung cancer–and some non-smokers do.

A Sane Approach to Risk Reduction

Prudent diet and lifestyle choices can reduce our risk of disease. But not to zero. You can do everything "right" and still be diagnosed, because there are so many other factors in play, including several that we don’t really have any control over, such as our age, sex, environment, genetics, and just plain luck of the biological draw.

Personally, I think the most sanity-preserving response to this unsettling reality is to do what you reasonably can to reduce risk, and then accept the fact that your health is not 100% within your control. Because there are no guarantees, I think it’s really important to strike a balance between lowering your risk and maintaining your quality of life. Or, as my friend Dr. Yoni Freedhoff says, “Live the healthiest life you can enjoy living.”

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