Lessons from 007
In his 1961
book, “Thunderball”, Ian Fleming’s first chapter is titled “Take It Easy, Mr.
Bond. “ James Bond has been living a
very unhealthy lifestyle, is run down, and just wants to treat himself with aspirin
so he can keep going. M then replies:
“That’s just
where you’re making a big mistake, James.
Taking medicine only suppresses these symptoms of yours. Medicine doesn’t get to the root of the
trouble. It only conceals it. The result is a more highly poisoned
condition which may become chronic disease.
All drugs are harmful to the system.
They are contrary to nature. The
same applies to most of the food we eat—white bread with all the roughage
removed, refined sugar with all the goodness machined out of it, pasteurized
milk which has had most of the vitamins boiled away, everything overcooked and
denaturized…there is no way to health except the natural way.”
Wow! That is pretty astounding stuff, right? The American health system, by and large,
still does not embrace food as medicine.
Yet, back in 1961, the author of the James Bond novels had a great grasp
of how to be healthy. Ian Fleming was
not a physician, he was a writer of action novels, but he got it. Why are we so far behind?
There was an
article published last year in the Journal of the American Medical Association
(JAMA) titled, “The Paradox of Disease Prevention: Celebrated in Principle, Resisted in
Practice.” It listed twelve obstacles to
prevention. I will highlight several of
them.
- Success is invisible: There is really no way to document that an individual’s prevention efforts improved his or her health, because it is rather difficult to prove that they didn’t get something based on what they did (like eating a healthy diet, not smoking, exercising, etc.)
- Lack of Drama: There are no TV shows about preventative medicine. If there were, they would probably not have much of a plot line. Instead, we love shows about the emergency department or dramatic rescues. We need to stop getting into health messes, rather than waiting for someone to save the day.
- Long Delays Before Rewards Appear: Delayed gratification is not a trait that is often valued in our society. Our expectations typically revolve around the quick fix, often involving medication or surgery rather than lifestyle change.
- Benefits Often Do Not Accrue to the Payer: Insurance companies have a difficult time wanting to pay for programs that will not give them short term payout. Likewise, hospitals can’t make any money if patients are healthy and no longer need to be admitted.
- Changing or Inconsistent Advice: We all hear in the news about changing preventative guidelines, such as with the age when mammography screening should be started. The public wants hard and fast rules. There is a ton of research about the benefits of good nutrition, but the food industry and government guidelines muddy the waters.
- Persistent Behavior Change May Be Required: In order to really benefit, people must adhere to healthy choices day after day.
- Double Standard in Evaluation of Prevention as Compared with Treatment: When studies compare a new medication treatment to non-treatment, the result is judged by whether the treatment made a difference in the outcome. Prevention is looked at differently. Prevention must be efficacious and cost-effective, but also produce net savings in resources. This means that prevention is judged on different merits than treatment.
- Commercial Conflicts of Interest: This one seems rather obvious to me. The American medical system is an industry. Industries exist to make money.
The author
goes on to discuss possible strategies to overcome these obstacles including: paying for prevention, making prevention
cheaper than free, involving employers, trying to reengineer ways to reduce need
for individual action, using policy to make the right choices easier, and using
the media to help reeducate the public.
I agree with these in principle, but I currently don’t have a lot of
faith that our leaders will ever agree on enough points to make meaningful
public health policy changes.
So, it is
likely going to come down to people (like you) making informed decisions for
their own health and wellness. This is
unlikely to ever be resolved from the top down.
If you are reading this on my website then you are likely already well
on your way to thinking in a preventative manner. Spread the word! Share articles with friends. Share recipes and insight. Form health communities. You know that there is value in
prevention. If you are making good
choices, you will benefit. This is not
rocket science: an author in 1961 knew
that nutrition matters, I know it and base my practice on it, and you know it
too. Let’s apply what we know. Poor nutrition drives chronic disease. There is no reason to wait for the wonder
drug to be developed. You can prevent
disease with the choices you make each day.
Health begins with your fork.
