Over my professional life, research has persistently provided evidence that collections of seperate diseases shared common features and some origins. This gave rise to the concept of the ‘common soil’ origins of certain diseases.In cardiology for a long time we have known that some inflammatory diseases were more prone to CHD. Diabetes mortality was predominantly CHD. OWOBs tended to become diabetic, but had a tendency to CHD independently, not as marked as diabetes. High blood pressure was more common in OWOBs, which seems linked to elevated insulin levels in most. With time chronic inflammation, insulin resistance, microalbumin, arose or became apparent in these pathologies. Nutrition linked these diseases, except for the inflammatory diseases like Rheumatoid arthritis and tabacco inhalation.
A large European Cancer study found the type of nutrition we value as ‘protective’ for CHD, was similarly so for many cancers. So the two leading killers of our species appear to share many common origins. At this stage my thesis, the nutrition changes that had their origins at the Neolithic period, set up a template for the degenerative diseases, atheromatous vascular disease,(CHD), OWOB and diabetes, may well have done so for many cancers also.
Reavan an endocrinologist, assembled the known abnormalities of the time with obesity and labelled the patient as having the ‘Metabolic Syndrome’ if you had three of these. It was originally known in the US as Syndrome X. Decades ago I labelled the collection of abnormalities of the Pacific Island immigrants to NZ, as the ‘Immigrant Syndrome’. As a clinician I see little advantage in this labelling as each entity needs attention. Its rare to have purely one item or pathology and the collection indicates a worsening prognosis. The collection from which the Metabolic Syndrome emerges are, abdominal fat, OWOB, diabetes, CHD, CVD(Cerebrovasc d) Hypertension, a lipid abnormality and insulin resistance. Inflammation is sometimes added.Having a full hand in this game of life poker, means you leave the round prematurely.
The Public program to focus on OWOBs has merit generally, but unless you are reviewed by your doctor, independently attempting to reduce your mass, you can ignore your accompanying risk factors, which you cannot detect yourself like hyperglycemia, insulin resistance, CHO dyslipidaemia, inflammation and microalbuminuria. These risk factors need attention, usually asymptomatic and too often present in a patient who may or may not be attempting to reduce weight and told in the public media they are living longer!!
Providing an annual ‘screen’ consultation with your doctor will be financially and disease cost effective. Too often Public programs are not perceived as serious or life threatening. Sudden death from CHD is common. CHD is ‘silent’ for decades. Without symptoms, there is no case to investigate. BUT, risk factors are easily found by your doctor and there could be a collection that can be attended to. That changes your prognosis significantly, from a morbid and mortal point of view. You may not ever experience symptomatic CHD or CVD. If you have risk factors you are at risk now, not in some distant future.The good news is you can have your risk factors found or excluded by your doctor and treated if required.Advising the public about obesity is different to advising them to stop smoking.
Screening for disease has some merit, supported by epidemiologists, but is not as simple or as effective, as it is too often portrayed. I discuss this in my post on screening for CHD. Screening for breast cancer, cervical cancer and now bowel cancer have some merit. The slogan is this could ‘save your life’. Well that is biologically impossible, but it may lengthen it. Why does the proletariat agitate for cancer screening and Governments agree, when mortality from CHD is 5-6 times more common than bowel, breast and cervical cancer together!!! Its identical to the logic we have to deal with from ‘corporate’ managers and polititians in medicine to day, when as human biologists we know their decisions are determined by their anxiety, inadequacy, fear, fearful ignorance, personality, religion, no informed knowledge.In have labelled this the ‘Dumbing Down of Medicine’.
Screening for CHD will give much more value for your morbidity and mortality buck, than the cancer screening operating now.