The unsurprising key to health and longevity

I always like to remind you about the lifesaving power of preventive medicine. And sadly, that makes today’s topic that much more infuriating…

According to a new study, doctors decide which preventive strategies to discuss with their patients based on time constraints and their own preconceived notions about which ones actually work to improve quality or length of life. And guess what?

Most don’t prioritize talking about lifestyle changes like diet and exercise.

Docs don’t prioritize properly

This survey and analysis used a mathematical model to examine how closely doctors’ prevention priorities lined up with strategies that would actually be likely to increase two hypothetical patients’ life expectancies.

The first “patient” was a 50-year-old, obese, white woman with type 2 diabetes, high blood pressure, high cholesterol, a personal history of smoking, and a family history of breast cancer.

Most doctors said if they had a 40-minute visit, they would discuss around 11 preventive services. In a shorter 20-minute appointment, that number would drop to just five. And the top three priorities the doctors set for this patient specifically were quitting smoking, blood pressure control, and blood sugar control.

The second “patient” was a 45-year-old, obese, black man with high cholesterol, high blood pressure, a personal history of smoking, and a family history of colon cancer. Doctors identified quitting smoking, blood pressure control, and colorectal cancer screening as the top three priorities.

In this case, they would discuss 9 preventive services in a 40-minute visit, and a median of four in a 20-minute visit. (But let me remind you that the average doctor’s appointment in the U.S. is only around 20 minutes—and often, it’s much shorter than that.)

But the worst part? Only a little over one-third of the doctors surveyed talked about weight loss, diet, or exercise as their top three priorities for either hypothetical patient.

True prevention takes time

I think we can all agree that this finding is typical. But it’s also really, really sad.

Especially when you consider the research couldn’t be any clearer. These three strategies—weight loss, diet, and exercise—are among the most likely to improve life expectancy.

That’s because they address the underlying cause of all of these hypothetical patients’ ailments in one fell swoop!

Unfortunately, though, Americans like specific interventions: “do this” or “don’t do that”. In other words, most patients like very black and white recommendations—especially when it comes to dieting.

They like to see certain foods demonized, and others deified. Meanwhile, there is rarely any thoughtful discussion about differences in quality, processing, or preparation. (All of which are incredibly important considerations that I routinely talk to you about—right here in my Reality Health Check, in my monthly Logical Health Alternatives newsletter, and even in my new “Cooking with Dr. Fred” show. Follow me on Instagram and subscribe to my YouTube channel so you never miss a cooking demo in the future!)

Truth is, with the glaring exception of sugar, nutrition is a very complex, “gray” topic. And Americans don’t like gray—which might explain why we can’t stop fighting over the “right” way to eat.

Most physicians operate within this black-and-white system, too. Which doesn’t help them to prioritize preventative strategies at all. And even if they did, most doctors and patients alike don’t want to be bothered with them anyway. They’d rather take a drug to “manage” their condition and be done with it, instead.

But prevention is key. And the best approach is always to teach people what to do (and how to do it) before disease or chronic conditions set in. Of course, that requires enough time and attention for a sustained and trusting relationship between doctors and patients. And really, how much time do you ever get to spend with your doc? (I rest my case.)

So I’ll leave you today with these resounding pieces of advice: eat well (say “yes” to healthy, whole foods and “no” to processed and fast foods), and exercise daily (aim for at least 20 minutes daily, and get up and move throughout the day as much as possible). Those two simple strategies will make the biggest difference in your health—no matter what issues you’re trying to combat… or avoid altogether.


“Physicians overlook some preventive services tied to longer life.” Reuters Health News, 08/06/2020.