ESSENTIAL STEPS TO PREVENTING DISEASES

Heart disease, cancer, and stroke cause more than half of all deaths in the US each year, and many could have been prevented. Research shows that 45% of cancer deaths are linked to such factors as poor diet and lack of exercise, for example. The science of prevention is showing how many serious illnesses can be avoided by adopting a healthy lifestyle or by taking medications and having surgical interventions when necessary.

Of course, there are no guarantees. The road to good health is not completely predictable and involves a complex interplay among lifestyle, genetics, and the environment. But knowledge is power, and the health suggestions outlined on the following pages can help anyone lower the odds of serious illness, regardless of age, family health history, or personal risk factors. We pored over research and interviewed dozens of top medical experts to bring you this guide to reducing your risk of getting 10 of the deadliest diseases in America.

Image Source: Pixabay

Heart disease

Heart disease is a general term that refers to conditions affecting the structure or function of the cardiovascular system, including heart rhythm problems, heart muscle damage, malfunctioning heart valves, and poorly functioning or clogged blood vessels.

WHO IS MOST AT RISK

Smokers, people with diabetes, and those with high cholesterol, high blood pressure, or high blood sugar. Being overweight or physically inactive can increase risk, too. “We need to pay attention to how we live,” says Mary Ann Bauman, an internist and a spokesperson for the American Heart Association.

According to a study published in the New England Journal of Medicine, a man’s risk of dying of heart disease by age 80 plummets from 30% to 5% if he has no more than one of four major risk factors (smoking, diabetes, high cholesterol, high blood pressure) by age 55. A woman’s risk of dying by age 80 declines similarly if she has none or one of these risk factors by 55.

HOW TO PREVENT IT

Don’t smoke. Smoking has a huge impact on the heart, with more smokers dying of cardiovascular disease than of cancer every year. Tobacco smoke raises blood pressure, increases hardening of the arteries, and causes blood vessels to constrict. Secondhand smoke is a danger, too. One study found that the number of heart attacks dropped by an average of 13% in communities that banned smoking in public places.

Keep blood pressure in check. Lifestyle improvements are the first course of action to lower blood pressure. If it remains high in spite of the changes, prescription medication may help. Thiazide diuretics (sometimes known as water pills), calcium channel blockers, angiotens in converting enzyme inhibitors, and angiotens in receptor blockers can help lower pressure and reduce heart disease risk.

Minimize dietary salt. Experts recommend consuming no more than 2,300 mg of sodium a day, with 1,500 per day considered ideal. Foods that seem healthy may contain surprisingly high amounts of salt. A whole wheat bun could have 300 mg of sodium, for example.

Keep potassium levels high. Research shows that sodium and potassium may work together to maintain healthy blood pressure. Avocados, bananas, spinach, and sweet potatoes are all rich in potassium.

If you’re at high risk, talk to your doctor about taking aspirin or statin drugs. Aspirin can prevent blood clots, Bauman says, while statins can block cholesterol from forming in the liver and reduce the amount of cholesterol that circulates in the blood. Statins can also help stabilize the plaques that adhere to blood vessel walls and can lead to heart attacks if they rupture.

If you do develop cardiovascular disease, you may eventually need bypass surgery, which improves the supply of blood and oxygen to the heart and can reduce the risk of a heart attack.

Respiratory illnesses

Respiratory illnesses include the serious lung conditions grouped together as chronic obstructive pulmonary disease: emphysema, chronic bronchitis, and some forms of asthma. COPD inflames the airways and in some cases may lead to destruction of the lungs’ air sacs, causing air to become trapped. Severe cases may even require lung transplants. Lung infections, such as pneumonia and flu, can also be deadly in patients with impaired lung function.

WHO IS MOST AT RISK

Smoking is a major risk factor, but 25% of COPD sufferers have never used tobacco. Having a job that causes you to breathe in large amounts of dust and smoke can increase risk, as can inhaling fumes from burning wood.

Other factors that likely contribute to the development of COPD include childhood exposure to secondhand smoke or polluted environments and having multiple respiratory infections, says MeiLan Han, an associate professor of pulmonary medicine at the University of Michigan and a spokesperson for the American Lung Association.

Pneumonia and flu are most serious in the elderly, young children, smokers, and those with impaired immune systems or poor lung function.

HOW TO PREVENT THEM

Quit smoking and limit exposure to secondhand smoke. 

Decline in lung function slows within 5 years of stopping, says Charles S. Dela Cruz, a professor and director of the Center for Pulmonary Infection Research and Treatment at Yale University.

Steer clear of air pollution.

Heed local warnings about air quality and try to stay indoors on days when the air is bad. To avoid the impact of smog in heavily polluted areas, Dela Cruz recommends wearing a filtered air mask. The masks typically sold in grocery stores may help with large air particulates (such as dust or dirt) but are usually not effective at filtering out invisible pollution or smoke from wildfires. Specialty N95 masks, if fitted properly, are a better choice. Breathing through these masks can be harder, though, especially for the elderly and those with lung diseases.

Pay attention to early symptoms of COPD, including shortness of breath, chronic coughs, and recurrent respiratory infections. “Don’t assume shortness of breath is normal and you’re just getting older,” Han says, pointing out that roughly half of all those living with COPD are undiagnosed. A spirometry breathing test (in which you blow into a mouthpiece attached to a sensor) can identify the condition.

Get vaccinated.

Everyone should get the flu vaccine each year. Those over age 65 should also have the pneumonia vaccine, which protects against the most common form of bacterial pneumonia. People with diabetes, chronic heart disease, and chronic lung diseases such as asthma may need to have the pneumonia shot before age 65, Dela Cruz says.

Reduce your exposure to germs.

Stay away from sick people, wash your hands frequently, and keep your hands away from your face.

Lung Cancer

This form of cancer, which kills more people than breast and colon cancers combined, occurs when cells in the lung grow rapidly and out of control. The most aggressive type is smallcell lung cancer, while the most common kind is non small cell cancer, which afects about 85% of patients and spreads more slowly.

WHO IS MOST AT RISK

Smokers, those with a family history of the disease, and people exposed to air pollution, asbestos, radon, or secondhand smoke. Although cigarette smoking accounts for more than 80% of lung cancer cases, many nonsmokers get the disease, too, and their numbers are on the rise. “All you need to get lung cancer are lungs,” says David Cooke, head of general thoracic surgery at the University of California, Davis.

HOW TO PREVENT IT

If you smoke, quit. 

And avoid exposure to secondhand smoke. Cigarette smoke contains a toxic brew of such chemicals as arsenic and formaldehyde that lead to changes in the lungs’ cells and structures, says Cooke. The more smoke you inhale, the greater your risk. Even nonsmokers are at significant risk from secondhand smoke, says Cooke, cautioning that air purifiers aren’t adequate protection.

Once smoke exposure stops, though, the lungs begin to recover and health risks begin to dissipate. When smokers quit and abstain from tobacco for 10 years, their risk of developing lung cancer can drop by as much as 50%, the US Surgeon General found.

Pay attention to air quality alerts. 

Heed community warnings to stay inside on days when levels of pollutants such as ozone or wood smoke are high. Some California towns call these “Spare the Air” days.

Check that radon levels in your home are low. Radon, an invisible radioactive gas, is the second-leading cause of lung cancer after smoking. Homeowners can get their houses tested for this gas, which can seep into foundations from decaying rocks, soil, or water. If radon levels are high, ask a certified radon mitigation contractor for help. These contractors, who can be found through state offices of the Environmental Protection Agency, may seal cracks, use underground pipes, or install exhaust fans to get rid of the deadly gas. The work typically costs about $1,200.

Eat plenty of produce.

Studies have linked 8% of lung cancers to low consumption of fruits and vegetables, says Otis Brawley, chief medical oicer of the American Cancer Society. The antioxidants in produce appear to help protect against cancer.

Request a low dose CT scan if you’re a smoker or ex-smoker. 

While the screening test doesn’t prevent cancer, it can detect the disease earlier, when it’s more treatable. Studies show that the tests can reduce lung cancer deaths by 20%, compared with screening with a conventional chest x-ray.

Stroke

Often called brain attacks, strokes occur when blood vessels to the brain either burst or get blocked. In ischemic strokes, the most common type, a clogged vessel or artery impedes blood low to the brain, causing brain cells to die rapidly. In hemorrhagic strokes, brain cells die after vessels or arteries burst and blood leaks into the brain.

WHO IS MOST AT RISK

Smokers and people with heart disease, diabetes, high blood pressure, blood vessel inflammation, or a family history of strokes. In addition, people who have atrial fibrillation, a type of racing, irregular heartbeat, are at especially high risk: They’re 500% more likely to have a stroke than the general population, according to the National Stroke Association.

HOW TO PREVENT IT

Follow a heart healthy lifestyle.
Eating a healthy diet, getting plenty of physical activity, and avoiding smoking can keep blood vessels open and reduce the risk of blood clots.

Get checked for A-fib.

Since the condition  which can cause blood clots to form in the heart and travel to the brain often has no symptoms, an estimated one-third of Americans who have it aren’t aware that they do. People can check themselves using the FDA-approved Kardia smartphone app and phone clip, which capture a medical grade electrocardiogram in 30 seconds. But the diagnosis then has to be confirmed with another EKG.

Consider preventive medication. 

People diagnosed with A-ib can have their condition treated and stroke risk reduced with prescription blood thinners. Aspirin also thins the blood and may be recommended for stroke prevention, but no one should start an aspirin regimen before first checking with their physician.

Keep your weight, blood pressure, blood sugar, and cholesterol in check. General guidelines recommend a BMI between 18.5 and 25, blood pressure no higher than 120/80, and total cholesterol at 200 or less.

Know the symptoms of a transient ischemic attack. While TIAs generally don’t cause permanent damage, they temporarily block blood low to the brain and are a strong indicator of future stroke risk. (About one-third of people with TIAs have a stroke within a year.) The American Stroke Association’s BEFAST acronym can help you remember stroke symptoms: balance problems, eye problems (speciically, not being able to see out of one eye), face drooping, arm weakness, slurred speech, and time a reminder that time is of the essence. If you have any of these symptoms, call 911.

Get medical help fast.

Even if a stroke occurs, quick action can often prevent brain damage. Treatment with intravenous drugs within the first 4½ hours can dissolve the blood clot and in some people with large blood clots, IV drugs can help up to 24 hours after the event, says Sanjeeva Reddy Onteddu, a vascular neurologist at the University of Arkansas medical school and director of the medical school’s stroke program.

Alzheimer’s disease

Alzheimer’s is a progressive disease of memory loss and thinking difficulties. It involves protein fragments called plaques and tangles, which are suspected of disrupting communication among nerve cells in the brain.

WHO IS MOST AT RISK

People over age 65, those with a family history of the disease, and those with certain genetic mutations, including in a gene called APOE. Mild cognitive impairment, severe head trauma, and a lack of social and intellectual engagement appear to raise risk, too. There’s also evidence that the odds of getting the disease increase with unhealthy behaviors such as smoking or being sedentary.

HOW TO PREVENT IT

Maintain a healthy heart. “A heart-healthy lifestyle is a brain healthy lifestyle,” potentially reducing Alzheimer’s disease symptoms by as much as 40%, says Pierre Tariot, director of the Banner Alzheimer’s Institute in Phoenix and a professor at the University of Arizona medical school. The goal is to lower inflammation to keep blood vessels and brain cells healthy, since “the cardiovascular system provides the pipes that provide blood to our brain,” says Tariot.

Follow the MIND diet.

The Mediterranean DASH Intervention for Neurodegenerative Delay approach to eating focuses on 10 brainhealthy foods, including beans, berries, fish, nuts, vegetables, and whole grains. The diet developed by Martha Clare Morris, a nutritional epidemiologist at Rush University’s medical school, along with several colleagues emphasizes the importance of eating these foods while severely limiting consumption of butter, cheese, and fried and fast foods. One study showed that this diet can lower the risk of developing Alzheimer’s by 53% if followed rigorously.

Exercise regularly and maintain normal blood pressure. 

Physical activity increases blood and oxygen low in the brain, while high blood pressure can damage small blood vessels there.

Get enough sleep. Aim for 7 to 8 hours a night. 

Beta-amyloid, one of the proteins associated with Alzheimer’s, diminishes during sleep. Plus, “the brain literally clears itself out” during sleep, says Rudolph Tanzi, a neurology professor at Harvard University and director of Massachusetts General Hospital’s Genetics and Aging Research Unit.

Try brain training exercises. 

The recent Advanced Cognitive Training for Independent and Vital Elderly study, funded by the National Institute on Aging, found that cognitive activities that help enhance reasoning, memory, and speed of processing showed promise in keeping Alzheimer’s at bay.

Adopt a variety of preventive measures, rather than picking and choosing. When Finnish researchers tested a wide-ranging program of preventive measures in a study of 1,260 people considered at risk of dementia, they found that a combination of measures improved overall mental functioning by 25% in 2 years.

Be on the lookout for new drug approvals. 

Preventive drugs are currently being tested for high-risk patients with no symptoms, Tariot says. These include an active immunotherapy drug that works like a vaccine to neutralize amyloid protein fragments and brain plaques characteristic of Alzheimer’s disease. Passive immunotherapy drugs, also being studied, work a bit like a vacuum cleaner, removing various forms of amyloid proteins from the brain, Tariot says. There are also oral medications that block production of new amyloid proteins.

Diabetes

This metabolic disorder disrupts the way the body produces or metabolizes the hormone insulin, which is necessary for maintaining blood sugar levels and processing food for energy. In type 1 diabetes, the pancreas produces little to no insulin. In the more common type 2, the body produces insulin but cannot use it properly. In both types, high blood sugar if the disease isn’t managed makes people more susceptible to heart disease, nerve damage, blindness, kidney failure, and stroke.

WHO IS MOST AT RISK

It’s not known why people develop type 1 diabetes, which accounts for about 5% of diabetes cases, although genetic susceptibility plays a role. But type 2 diabetes tends to strike people who are overweight, have high blood pressure, are physically inactive, or have a family history of the disease. It’s estimated that 1 of every 3 American adults now has prediabetes, a precursor to type 2 diabetes (although most are unaware they have the condition).

HOW TO PREVENT IT

Adopt a healthy lifestyle.

A Diabetes Prevention Program study, funded by the National Institutes of Health, has found that type 2 diabetes risk can be dramatically slashed with physical activity and moderate weight loss. People diagnosed with prediabetes who lost 7% of their body weight lowered their risk of developing diabetes by up to 58%.

Join a prevention program. 

There are more than 200 community prevention programs run by YMCAs (ymca.net) across the United States. The program, based on the study above, coaches participants to improve their diet and increase physical activity.

Consider medication.

Metformin is a popular drug that can prevent and manage diabetes. The National Diabetes Prevention Program study found that people who took metformin lowered their disease risk by 31%.

The drugs liraglutide and pioglitazone also show potential for preventing the disease, though questions remain about possible side efects. “I would not recommend these new drugs for general use,” says William C. Knowler, a physician in Phoenix who conducts diabetes research for the National Institutes of Health.

Colon Cancer

The second deadliest form of cancer develops slowly in the colon’s inner lining, almost always starting with a growth, called a polyp, that becomes malignant.

WHO IS MOST AT RISK

People who are overweight, don’t get much exercise, eat a lot of red meat, drink alcohol heavily, or smoke. Having a history of colorectal polyps, inflammatory bowel disease, family members with the disease, or certain genetic mutations can also raise risk.

HOW TO PREVENT IT

Get a colonoscopy if you’re age 50 or older. 

This procedure is both a screening test and a preventive measure. In a colonoscopy, a slim tube with a camera is passed through the rectum into the colon to examine the walls for polyps, which may be benign but are at risk of turning malignant. Once detected, these suspicious polyps can be removed before they turn cancerous.

The general recommendation is for most men and women to start getting colonoscopies once a decade starting at age 50. But individuals at high risk may be advised to begin having colonoscopies earlier or to undergo the test more frequently.

Consider a biannual stool test. 

A colonoscopy is the most widely used tool for colon cancer screening and prevention, but more than 40% of people who should be getting them avoid them. For those people, stool tests which check for tiny amounts of blood in the stool that can indicate cancer can be a good alternative, says Otis Brawley, an oncologist and chief medical officer for the American Cancer Society. Having a stool test every year, he says, can be just as effective at detecting cancer as a colonoscopy.

Tests for stool DNA are also effective at finding colon cancer. If this test indicates the possibility of cancer, patients will need a colonoscopy to remove polyps or a biopsy to confirm the disease.

Consider more detailed stool tests.

Some patients should get their stool screened with a quantitative fecal immunochemical test, which not only can detect blood that may indicate the disease but also can help predict when polyps are likely to recur, says Joel Levine, a gastroenterologist and cofounder of the Colon Cancer Prevention Program at UConn Health. These tests may be recommended even for people who have regular colonoscopies, since a substantial number of colon cancer cases develop in the years between once a decade colonoscopies.

Rethink your diet.

Foods that help move stool through the colon more quickly help reduce the risk of cancer, Brawley says, because some of the substances the body produces to help with digestion are actually carcinogenic. Bile, which is produced by the liver to help digest fats, for example, can mutate the DNA of colon cells it comes in contact with, he says.

High fiber foods and grains can decrease bowel transit times, as can exercise. Also helpful: foods high in resistant starch, such as lentils, green bananas, and cold potatoes, which ferment slowly in the intestine, improving the bacterial composition of the microbiome and reducing inflammation that causes DNA mutations. These foods also reduce insulin resistance, a medical condition that can lead to diabetes and raise the risk of some cancers.

Kidney Diseases

The kidneys filter blood to produce urine, regulate blood pressure, and help make red blood cells. Disease in these organs affects the body’s ability to filter impurities and excess water from the blood. Uncontrolled kidney disease can lead to heart problems, anemia, and bone weakness
and ultimately to kidney failure.

WHO IS MOST AT RISK

People with diabetes, high blood pressure, and a family history of the disease. Being over 60 is also a risk factor, as kidney function naturally declines with age.

HOW TO PREVENT IT

Follow a kidney friendly diet. The National Kidney Foundation recommends the DASH (Dietary Approaches to Stop Hypertension) diet, which is rich in fruits, vegetables, beans, whole grains, fish, and poultry. Studies show that the similar Mediterranean diet can also keep kidneys healthy and prevent or postpone kidney disease.

Monitor salt intake.

Limiting sodium can lower blood pressure, a key cause of kidney disease. Nearly 20% of people with high blood pressure eventually develop the illness. Since salt is hidden in so many foods, it’s important to be aware of what you’re eating, says Joseph Vassalotti, chief medical offer of the National Kidney Foundation. He’s a fan of Healthwatch 360, a research-based app that tracks food composition and customizes eating plans for specific medical conditions.

If you have diabetes, keep blood sugar levels in check. Nearly 40% of people with type 2 diabetes develop kidney disease.

Stop smoking. 

The National Kidney Foundation warns that smoking reduces blood low to the kidneys and can worsen kidney disease. It may also impair the effectiveness of medications used to treat high blood pressure, a leading cause of the disease.

Limit nonsteroidal anti-inflammatory drugs.

These painkillers, which include ibuprofen (Advil) and naproxen (Aleve), can reduce blood low to the kidneys. While sporadic use may be safe, patients should talk to their doctors about alternatives if they need to take these drugs for more than 4 days in a row, Vassalotti says.

Give up soft drinks.

A National Health and Nutrition Examination Survey study found that consumption of more than two sodas per day was linked to kidney damage. And the Nurses’ Health Study found that consuming two or more diet sodas per day was linked to a drop in the glomerular filtration rate, an important measure of kidney function.

Breast Cancer

The disease occurs when cells in the breast ducts start to grow out of control, eventually forming a tumor. Most breast cancers are estrogen driven and begin in the lining of the milk ducts.

WHO IS MOST AT RISK

Women get most breast cancers, though men can get them, too. Because estrogen and progesterone play a role in both normal breast tissue development and breast cancer development, women who began menstruating relatively young (before age 12) and/or go through menopause relatively late (after 55) are at increased risk because they’re exposed to high levels of estrogen for a longer time.

Women who never had children, never breastfed, drink a lot of alcohol, are overweight, or take hormone therapy after menopause are also at higher risk. Family history is also a factor. Women who have the BRCA1 genetic mutation, for instance, have a 55 to 65% chance of developing breast cancer, compared with 12% for women who don’t.

HOW TO PREVENT IT

Keep your BMI between 18.5 and 25. 

Excess weight may be a problem because fat produces estrogen, especially after menopause.

Evaluate your risk. An online breast cancer risk calculator (cancer.gov/bcrisktool) developed by the National Cancer Institute can help.

Consult a genetic counselor if you have a family history of the disease. 

These specialists can provide advice about testing and help interpret genetic test results. With only about 5 to 10% of breast cancers thought to be genetic, testing doesn’t make sense without a strong family history, says Susan Love, a patient advocate and chief visionary officer of the Dr. Susan Love Research Foundation.

Think twice about prophylactic mastectomies.

Even women who carry dangerous genetic mutations may not need these procedures, Love says. “Having a mastectomy does not always give you a guarantee, as breast tissue doesn’t come in a nice package. It’s hard to know if you’ve removed it all.”

Consider preventive medication. 

If you’re at high risk, talk to your doctor about taking tamoxifen or raloxifene, which have been shown to reduce breast cancer risk, Love says. These drugs block estrogen in the breast tissue, helping to prevent or reduce tumor growth. Side effects can include menopausal symptoms such as hot lashes.

Participate in research.

Most breast cancer research is conducted on rats and mice, which don’t get the disease naturally. Love’s foundation sponsors the Army of Women initiative (armyofwomen.org), which informs people about studies that are looking for female participants. The more research that’s conducted on breast cancer in women, the more scientists will learn about how to prevent and treat the disease.

Depression

A common mood disorder, depression causes persistent sadness, feelings of worthlessness, and a loss of interest in regular activities. Some people with depression have trouble concentrating or making decisions. They may overeat or lose their appetite, suffer from insomnia or sleep too much. Two-thirds of people with depression also report physical symptoms, such as increased aches and pains. Many may contemplate suicide. Symptoms need to last for at least 2 weeks before the negative moods are diagnosed as depression.

WHO IS MOST AT RISK

People who are experiencing major stress or life changes or who have a family history of depression, as well as people who have been repeatedly exposed to abuse, neglect, or violence. People who have had previous bouts of depression also have a much higher risk of future episodes, says Philip R. Muskin, a psychiatry professor at Columbia University Medical Center. Scientists still don’t know exactly what’s happening in the brain during a depressive episode.

HOW TO PREVENT IT

Consider psychotherapy.

“Speaking with a mental health professional can change how someone interacts in personal or professional relationships that may be problematic and can help reduce the factors that precipitate depression,” says Muskin. Psychotherapy can also help people who have experienced depression in the past to recognize and deal with triggers that may cause another episode. Research shows that cognitive behavioral therapy can reduce the risk of depression by as much as 50%.

Learn cognitive behavioral skills on your own. 

Mind Over Mood, a popular book and website (mindovermood.com), contains worksheets that teach ways of thinking that fight depression, says Steven D. Hollon, a psychology professor at Vanderbilt University.

Try meditation and mindfulness.

These techniques can help with letting go of negative thoughts, Hollon says. They also help people manage their stress levels, which is an important skill, given that stress can trigger depression.

Exercise regularly.

Physical activity can cut the risk of depression by 12%, Muskin says. Studies show that as little as an hour of moderate exercise a week can be helpful.

Adopt a depression fighting diet.

Healthy food is crucial for preventing depression, says Drew Ramsey, a psychiatrist with the Columbia University College of Physicians and Surgeons and founder of the Brain Food Clinic. Ramsey recommends eating lots of leafy greens and seafood, especially clams, mussels, and oysters, which are high in iron, selenium, zinc, vitamin B12, and anti inflammatory omega-3 fatty acids. Following the Mediterranean diet can also be beneficial, as studies have linked this way of eating to a 30 to 50% reduced risk of depression.

Ask your doctor about the Fisher Wallace Stimulator.

This headband device (fisherwallace.com) uses electrical pulses to stimulate the brain to produce serotonin and other neurochemicals that help improve mood. Because the device treats anxiety, a risk factor for depression, Muskin says it may help prevent depressive episodes.