Cynics of healthy lifestyles like to collect anecdotes of the ironic deaths of health advocates. This helps them cope with the fact that they can't walk up a flight of steps at age 45 without losing their breath.
Throw another pork chop on the grill, honey, while I pop a Viagra; look what smarty-pants health nut just died.
Topping their list is running advocate Jim Fixx, who died of a massive heart attack at age 52 after a long run. Then there's Aveline Kushi, co-founder of the macrobiotic diet said to ward off and even cure cancer. She died of cancer at age 78. Mark Hughes, founder of Herbalife, a company that advocated for so-called natural cures, died in his sleep at age 44.
And last week Alice Coltrane, widow of famed jazz saxophonist John Coltrane and an accomplished avant-garde pianist herself, died at age 69 of respiratory failure. Founder of a sprawling 48-acre mountain ashram retreat where dozens of students studied ancient Eastern spiritual texts, she was a vegetarian in the Hindu tradition for many decades—as was John Coltrane, who died at age 40 in 1967 from liver cancer.
But what the cynics are confusing is the difference between risk reduction and health guarantees.
No silver bullet
Americans have come to expect instant cures, solutions that can bottled, prescribed and swallowed with water. There's good reason for this: Many of the diseases our parents or grandparents grew up with, such as polio or smallpox, have disappeared with the introduction of a simple vaccine, pill or vitamin fortification.
Yet as any country grows wealthier and more technologically advanced, communicable and childhood diseases are replaced by chronic diseases such as cancer, diabetes and circulatory disease. There are no preventive cures for chronic diseases, only methods to reduce risk.
Risks are established in health studies. For example, doctors will study thousands of patients with circulatory disease and look for commonality. They find that many of these patients have high levels of a certain kind of cholesterol or fatty acid in their blood, have high blood pressure, or smoke.
Through medication or lifestyle change, a patient can lower these risks but never eliminate them. Conversely, these risks are merely known indicators; the absence of these indicators doesn't mean disease won't develop.
Risk reduction is the essence of public health. The message goes out to stop smoking, to eat more vegetables and to exercise more in order to reduce risks across the entire population. Nationwide, the rate of circulatory disease will fall. But that doesn't mean you won't get it if you follow the marching orders. For example, most adults with diabetes are overweight. So, sure, lose weight. But skinny people do get diabetes.
Risk and risk reduction
John Coltrane's spiritual conversion and subsequent adoption of a vegetarian diet surely extended his life. This positive change in the late 1950s was, perhaps, not enough to counter two high risk factors for liver cancer: his alcohol and heroin abuse through the 1940s and early 1950s.
Jim Fixx helped turn jogging from a cult exercise in the 1970s to a phenomenon so popular today that marathon organizers in many cities have to turn away would-be participants. As Fixx documented in his books, when he started running in the late 1960s at age 35, he weighed about 220 pounds and had just given up his two-pack-a-day smoking habit. Within ten years he had lost 60 pounds.
What of his early death? His father had had a heart attack at age 35 and died of one at age 43. Fixx would have likely suffered the same fate. He had major blockages in his arteries and a sky-high cholesterol level, perhaps from a combination of genetics and diet. Jogging reduced but could not eliminate the heart attack risk.
This lesson shouldn't be lost on vegetarians, either, some of whom think they are somehow immune to disease. Meat won't kill you, and complete avoidance is no guarantee of a long, healthy life, as attested by Alice Coltrane, who has perhaps found that Universal Consciousness she was searching for.
Christopher Wanjek is the author of the books “Bad Medicine” and “Food At Work.” Got a question about Bad Medicine? Email Wanjek. If it’s really bad, he just might answer it in a future column. Bad Medicine appears each Tuesday on LIveScience.
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