Stop Trouble Before It Starts: How To Get 4 ?Prediseases? Under Control

The saying, ?An ounce of prevention is worth a pound of cure,? is never more true than when it comes to preventing diseases like diabetes, high blood pressure, osteoporosis and obesity. Yet far too few of us take that well-worn advice to heart. The result? Far too many people are eventually diagnosed with one or more of these life-threatening conditions.
   To stem the rising tide, health experts have identified ?prediseases,? the point at which blood sugar or blood pressure is a little high, bone is beginning to thin or the scale has crept up by several pounds. And they have issued recommendations for treatment, even labeling the conditions as diseases in their own right, as with prediabetes and prehypertension.
   Identifying prediseases and tackling them before they become full-blown conditions is the best way to protect your long-term health. Here’s what you need to know about four prediseases.


Why It’s Important: A whopping 54 million American adults have blood glucose that’s higher than normal, but not high enough to be diabetes, putting them at greater risk for developing type 2 diabetes and heart disease.

How to Identify: A fasting blood glucose of 100 to 125 or a blood glucose of 140 to 199 two hours after drinking a special sugar solution means you have prediabetes. Chances are your fasting blood glucose was measured the last time you had a checkup. Ask your doctor if you need a ?post-prandial? test.

How to Prevent Progression: Getting type 2 diabetes is not inevitable for those with prediabetes. Losing weight and getting active are key to preventing that.
   The Diabetes Prevention Program, a clinical trial of 3,230 overweight people with prediabetes, pitted weight loss (via exercise and diet) against the diabetes drug metformin to see if either could prevent or delay the onset of type 2 diabetes. Exercise and diet won by a long shot, lowering the risk of diabetes by 58% versus 31% with metformin. The lifestyle changes worked especially well in people over age 60, reducing their risk of diabetes by 71%.
   Weight loss was the main factor that reduced risk, which dropped 16% for every two pounds lost. Additionally, being physically active for at least 2 ? hours a week reduced the risk of diabetes by 44%, even if weight loss was minimal.


Why It’s Important: About one-third of Americans have prehypertension, which increases the risk of hypertension (high blood pressure) and doubles the risk of heart disease. According to the Atherosclerosis Risk in Communities study, prehypertension especially ups the odds of heart disease among African-Americans, obese people and those with diabetes.

How to Identify: You have prehypertension when your systolic blood pressure (the top number) is 120 to 139 or your diastolic (the bottom number) is 80 to 89.

How to Prevent Progression: Strategies for controlling prehypertension are similar to those for treating high blood pressure. Weight loss is a priority, as each two-pound loss lowers blood pressure by about one point. Follow a diet moderate in fat (30% of calories), low in sodium (no more than 2,300 milligrams a day) and rich in fruits and vegetables (eight to 10 servings a day) and low-fat dairy (three servings a day)?known as the DASH diet. Regular physical activity also helps.


Why It’s Important: Approximately 34 million Americans over age 50 have the precondition called osteopenia, putting them at risk for osteoporosis. Although women are at greater risk, it also affects men. Osteopenia has no symptoms, but as bones get thinner, the risk of fracture increases. Without a bone density test, a broken hip may be your first clue that osteopenia has progressed to osteoporosis.

How to Identify: Bone density that is lower than normal, but not low enough to be considered osteoporosis, is called osteopenia. It is best diagnosed with a bone mineral density test that uses dual-energy X-ray absorptiometry (DEXA).

How to Prevent Progression: Eat a diet rich in bone-building nutrients plus take a multi plus a calcium supplement with vitamin D (for a total of 1,200 to 1,500 milligrams a day of calcium and 800 to 1,000 IU of vitamin D). Be sure to engage in weight-bearing exercise like walking to maintain strong bones, plus resistance exercise with rubber bands or machines, as well as stretching exercises like yoga or tai chi to improve balance. (Exercise at least 30 minutes on most days.)
   Calcium is important for bone mass and vitamin D is crucial to help absorb calcium. Smoking and excess alcohol are off limits since they can reduce bone mass and increase the risk of fractures.


Why It’s Important: Not only is overweight the forerunner to obesity, a known risk factor for many diseases, just being 5% to 10% overweight increases your risk of chronic disease, making overweight a predisease of sorts. In a 2001 study of middle-aged adults from both the Nurses? Health Study and the Health Professionals Follow-Up Study, being overweight increased the risk of developing diabetes, gallstones, high blood pressure, heart disease, colon cancer and stroke. The risk rose in proportion to the degree of overweight.
   It’s of little surprise then that research suggests being overweight may affect the risk of dying. In a recent study of 186,000 healthy nonsmokers, being overweight at age 50 increased the risk of death by 20% to 40%; obesity doubled or tripled it. 
   The risk of disease is affected not only by body weight but also by the location of body fat. Abdominal fat (apple-shaped body) poses a greater health risk than fat in the hips and thighs (pear-shaped).
   However, warns Barbara Moore, Ph.D., obesity expert and president of Shape Up America!, ?If you gain weight, eventually the risk of disease will escalate, no matter where the excess fat is located.?

How to Identify: According to the National Institutes of Health, someone with a Body Mass Index (BMI) over 25 is considered overweight. Find out your BMI at or calculate it yourself: 1) take your weight in pounds, 2) divide that by your height in inches squared (your height multiplied by itself), 3) multiply that number by 703.
   Example for someone who is 5 feet 5 inches tall (65 inches) and 140 pounds: 140/4225 = 0.033 x 703 = 23 BMI.

How to Prevent Progression: ?The most effective defense is lifestyle change,? says Moore. ?Diseases that worsen with excess weight will improve with weight loss.? To lose weight, control your portion sizes, while eating more fruits, vegetables, whole grains, beans and legumes. To be more effective losing weight, increase your physical activity to 60 to 90 minutes most days of the week.

The Bottom Line. Though the specific advice varies a bit from one condition to another, dietary changes and regular physical activity are the most effective strategies for treating all of these prediseases. That includes a nutritious diet that’s moderate in fat, low in sugar and sodium and contains adequate amounts of fruits, vegetables, low-fat dairy, lean protein and whole grains. If you are overweight, reduce the number of calories you take in every day.
   Becoming active and staying active are essential. And if your doctor prescribes medication, it should complement?not take the place of?your lifestyle changes. Remember, it’s better to take preventive action now, so you won’t have to pay with your health later.


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