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Protection Against Chronic Diseases
We recently suggested that the practice of dietary approaches to the prevention of chronic diseases like cancer beget more frugal medicine and can serve rich and poor alike. Dietary delivery of protective phytochemicals makes good sense and chemoprevention by whole foods, or simple extracts of whole foods, presents unprecedented opportunities to solve unmet global problems. They are intuitively the most logical, sustainable, ethical, and responsible way to deal with the epidemic of chronic and degenerative disease. They may also be among the most cost-efficient, certainly compared to treatment of frank disease. This is a frugal and realistic strategy that is economically sustainable in the U.S. and in the underserved and economically deprived populations that are already moving toward more chronic illnesses.
A very straightforward starting point for this paradigm shift is for physicians to prescribe preventive diets for their at-risk patients. The food system in the U.S. can readily facilitate the delivery of such diets, but our medical and graduate schools must do a far better job of teaching new physicians and biomedical scientists about human nutrition and the role of diet in disease prevention, and those newly trained professionals must in turn be proactive with their patients and counselees. They must make prevention as much the order of the day as cure. Food—chemopreventive diets—should be, and can be, the daily “multivitamin” of our immediate future.
The challenge for the next decade(s) and for new health professionals is how to convey the learnings directly to their patients and to the general public. Social scientists, the entire spectrum of stakeholders in the food industry (e.g., from farmers to retailers), medical, nursing, and public health schools, government (e.g., regulatory and research branches), and primary and secondary school educators will all need to become invested and involved. The new drivers of this revolution will be not the drug companies but the food and agricultural interests because they will stand to profit greatly from introduction of new foods, new plant cultivars, and the reintroduction of “old foods” into new markets. They should thus be expected to provide a larger share of the funding for chemoprevention research as well as for effective public outreach. The road to longer healthspan will of course be rocky, but we cannot afford to ignore a strategy of diet-based prevention without putting our health care system in even more severe jeopardy than it already is.
Excerpted from: Fahey JW and TW Kensler (2013) American Medical Association Virtual Mentor 15(4): 311-318.