LESS MEANS MORE…

Adult preventive services that providers and health care systems must assess the need for and offer to each patient have the highest priority value. These services are considered Level I according to the Institute for Clinical Systems Improvement (www.icsi.org).

All clinic contacts, whether acute, chronic or for preventive services, are opportunities for prevention.

Here there are the recommended preventive services included in Level I category for asymptomatic adults aged 18 and over:

Alcohol abuse (hazardous and harmful drinking screening and brief counseling), Aspirin chemoprophylaxis counseling, Breast cancer screening, Cervical cancer screening, Chlamydia screening, Colorectal cancer screening, Hypertension screening, Influenza immunization, Lipid screening, Pneumococcal immunization, Tobacco use screening and brief intervention (www.icsi.org).

At a glance, the majority of diseases a screening is recommended for could be addressed and managed by lifestyle interventions because they are related with modifiable risk factors.

“The presence of risk factors early in life can be crucial to lifetime risk of CVD” (according to AHA, American Heart Association).

“ In 2009, 40% reduction in death due to Coronary Heart Disease come ½ from prevention and ½ from innovation, technology and treatment, mostly more effective anti-platelet therapies” (AHA).

With the increasing prevalence of chronic degenerative diseases in a context of escalating health care costs, it seems that a preventive orientation in health care and public health system is imperative.

Health Promotion and Disease Prevention programs proved to be a profitable “health investment” because they result  not only in reducing the burden of expenses for health care, but also in improving the quality of life for the patients.  In other words, one ounce of prevention means more than saving money….

Epidemiological and clinical trials call attention to the Nutrition therapy as one on the most important Lifestyle interventions for the more prevalent chronic diseases: Diabetes, Coronary Artery Disease, Hypertension, Stroke, Cancer etc.

I think that with basic Nutrition education much more of the burden of these diseases could be lowered.

What if the people would choose to have a well planned diet with optimal amount of the nutrients in their daily diet?  I just read about warning information for Health Care Professionals transmitted by FDA (United States Food and Drug Administration), posted 11/02/2009 regarding BYETTA (Exenatide) and Renal Failure. Byetta, an incretin-mimetic, is approved as adjunct to diet and exercise to improve glycemic control in adults with type 2 Diabetes Mellitus. Very simple, the same outcome could be from a menu with the recommended type and quantity of dietary fiber. With this “fabulous fiber” there is no need to monitor patients carefully for the development of kidney dysfunction…

What if patients would be informed about statins versus plant sterols when screening for dyslipidemia?

I am just wondering who would like to develop liver dysfunction or myalgia or myositis after HMG-CoA Reductase Inhibitors for improving their serum lipid profile. Who would be willing to pay for Coenzyme Q as supplement when under Statins, if they would be informed about the lipid-lowering effect or Short Chain Fatty Acids from beans…

These are two examples of how people benefit from Nutrition Therapy.

The general principles of medical nutrition therapy must be very well understood by physicians in order for them to support their patients in adopting healthy eating behavior. This will promote the health care team approach in lifestyle diseases where the nutritionist or registered dietician plays a unique role.

To educate, motivate and empower people with self-management tools for living a better lifestyle is the greatest challenge for the health professionals today.

For physicians committed to excellence in their medical practice, it is my intention to provide reliable information regarding Nutrition as Lifestyle intervention through this website. In the same time, the patients can benefit from theoretical and practical issues regarding nutrition as therapy. To implement a healthy lifestyle is a matter of knowledge, willingness and readiness to change, all based on a high motivation.

Actually, wellness depends mainly on what people are willing to do for themselves…

Dr MargiAnne Isaia, MD MPH