We have incontrovertible evidence, reaffirmed many times over the past several decades, that the major determinants of premature death and chronic morbidity are tobacco use, poor diet and the lack of physical activity. Or as I like to put it: feet, forks and fingers.
We also have proof that even moderate improvements in diet and exercise can prevent Type 2 diabetes in nearly 60 percent of high-risk adults. Additional lifestyle upgrades could prevent more than 80 percent of all incidences of heart disease and as much as 60 percent of all cancer diagnoses.
In other words, the right application of lifestyle as medicine could, for all intents and purposes, make us disease-proof.
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The trouble is we have for too long propagated the view that we must choose between the food we love and the health we desire. And since food provides immediate gratification, while good health is a long-term investment, food tends to prevail.
So the pursuit of good health tends to lean on willpower alone — and to lean on it so hard that will doesn't stand a chance. You can examine the results for yourself.
We eat, drink and make merry — and defer worrying about it. But the bill eventually comes due, all too often in the form of a serious chronic disease that need not have occurred. As such conditions develop at ever younger ages and our life spans grow ever longer, the percentage of our lives encumbered by illness is rising. We pay dearly.
Build Skill, Not Will
There are two remedies to all of this.
One is for the world to change in all the ways necessary to make good health lie on a path of much lesser resistance for us all. We may be able to make that happen eventually, but you sure don't want to hold your breath.
The other is what I call "skill power." Stacey Colino and I wrote our book, Disease Proof, in response to a simple epiphany: We knew how to achieve good health, relying on a simple set of skills that everybody should have. We could pay forward what we knew.
So what do I mean by skill power?
Let's imagine you have a sweet tooth, as most of us do. Trying to file it down to size so it doesn't become a sweet fang is usually hard. It can be done by giving up your favorite sweets and just toughing it out. That's the willpower approach, which generally fails. When it does, we beat up ourselves and sometimes each other for not having enough resolve.
Willpower does matter, but when even a mountain of it isn't enough, we need a different approach.
What if instead of giving up your favorite desserts, you gave up gram after gram of sugar by swapping out other foods that don't need to be sweet in the first place? You won't miss the sugar in your pasta sauce if you move to a different brand or make it yourself. You won't miss it in crackers, either. These are stealth sugars, hidden in foods we don't consider sweet, and there are a lot of them in our diets.
The good news is that when you develop your ability to identify these sugars, you can drop them and easily trade up to choices in the same categories that don't have added sweeteners, without spending much more money.
Retrain Your Taste Buds
The news gets even better: Your taste buds happen to be very malleable little fellas; they learn to love the foods they're with.
That's why you probably love sugar and salt so much — our taste buds have been corrupted by the unnecessary processing of the modern food supply. But that same food supply also provides really good options in every category and they are all you need to rehabilitate your taste buds.
You really can learn to prefer, and love, the foods that will love you back.
There has long been evidence that our taste perception is influenced by our food intake. The long-term Iowa Women's Health Study, for instance, has shown that women who transition to a plant-based, lower-fat diet over a span of months actually acquire aversions to many of the processed or fast foods they liked at the start.
Over 20 years of clinical care, I have witnessed that transition innumerable times. One of the most straightforward swaps involves milk.
People accustomed to whole milk inevitably find that skim milk tastes like dishwater. But if, in an effort to reduce their intake of saturated fat, they switch to skim milk, their taste buds adjust, usually in no more than two weeks. If they stick with skim milk a bit longer and then retry whole milk, the drink they used to love suddenly tastes like wallpaper paste. There may be exceptions, but I have seen this in many patients, both adults and children, and the results are impressively consistent.
The same basic principle applies to other foods. Familiarity is a potent driver of dietary preference; we tend to like what we're used to. Much of this is cultural: Infants in Mexico learn to like spicy food, while Inuit children develop a taste for seal. But genetically, we are far more alike than different.
In the U.S., we have grown overly familiar with sweeter, saltier, ever-more-processed foods. Bathe your taste buds in sugar, salt and chemicals all day long and they will become insensitive to those influences. Eat pasta sauces more concentrated in added sweeteners than ice cream topping and you lose your sensitivity to sugar. Eat breakfast cereals more concentrated in added sodium than potato chips or pretzels and you lose your sensitivity to salt.
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But this process can be reverse engineered. Taste buds can be rehabilitated. The potential health and weight benefits of trading up to more nutritious foods are nothing short of incredible.
After a taste bud rehab mediated by skill power, you can reject dessert with no special exertion of will simply because you don't like it anymore. Your newly rehabilitated taste buds will tell you it is too sweet and you'll leave it untouched.
That's what skill power can do.
(MORE: Fiftysomething Diet: Healthy Food Swaps)
We do not have to mortgage our health for culinary delight any more than we have to give up culinary pleasure to pursue health.
For too long, we've tended to think we have to choose between good food and good health. It's not so. With the right skill power, we can love food that loves us back. We can disease-proof ourselves and those we love, without deprivation.
With a will for health and the right set of skills, we can pretty much have our no-longer-excessively sweet cake and eat it, too.