It is an unpleasant reality that the “doctor of the 21^st century” is dealing with issues for which many are unprepared. Today’s medicine has become mostly the management of chronic disease, in which lifestyle plays up to 95 percent of the causative role. Yet in medical school most doctors are taught how to manage acute situations, not lifestyle-induced chronic disease states that are presenting in their offices. This can be clearly seen with objective outcome measures: diabetes is out of control; obesity and weight-related problems plague upwards of 66 percent of the population; heart disease and strokes are rampant; and if one of those issues doesn’t get us, it is likely cancer will. 

If modern-day doctors’ treatment protocols do not include proactively addressing lifestyle factors, they are greatly missing the point. To fight 21^st century diseases, we must plan ahead. It may take years and sometimes decades for something to show up as a diagnosable disease; however, it is much easier to catch something early if doctors know what to look for. There are four basic lifestyle issues every doctor should test or ask about at every visit (unless the patient doesn’t smoke).

Smoking: Smoking is still one of the top killers in the U.S. Around half of the people who smoke will die from it. However, it is still unknown how many people who smoke will die from another problem caused by their smoking, whether directly or indirectly. 

Exercise: Exercising in some way every day is key; it doesn’t have to be a CrossFit workout to be effective. A doctor needs to ask and record what we are doing. Everyone needs to do  something daily, whether it is weight training, stretching, walking for 20 minutes after a meal, yoga or another form of exercise.

Lean Body Composition: This is more multi-factorial. In the past, being lean was enough. Nowadays, we have a phenomenon called “skinny fat”, which is major hormonal imbalance and deficient muscle in relation to our frame mass. This is something that can be measured and quantified. This is in addition to the 66 percent of the population that is overweight or obese. Obesity, excess fat and hormonal imbalances contribute to almost all disease processes. 

Diet: Diet has to be addressed; the standard American diet is pro-inflammatory. Inflammation is the underlying cause of many chronic conditions, if not all of them. The 21st-century doctor needs to be able to read through all the diet research and guide people to a healthy lifestyle. For some people, this will be a more ketogenic diet while other patients need a more Paleo or plant-based diet. 

  There are a number of ways to address these areas with each individual patient. Labs and detailed physical assessment are a great starting point for developing an effective and preventive  lifestyle protocol each individual can live with. To deal with the escalating numbers of chronically ill people in our society, it should be incumbent upon all doctors to become proficient in these four categories. 

Kurt Waples, owner of Bluestone Health Group in Stamford, is a chiropractor who uses applied kinesiology and clinical or functional nutrition. Connect at BluestoneHealthGroup.com or 203-220-6488.