I was privileged to speak to hundreds of healthcare colleagues at a Lifestyle Medicine summit in Nashville, TN yesterday. I was even more privileged to give the keynote address that closed out the conference, although there are some liabilities attached to being the last thing between a restless audience and their freedom.
As the conference "closer," I obviously spoke after all the others who populated the sessions for two days prior. Inevitably, I followed speakers who presented theories and epiphanies competing with the theories and epiphanies of other speakers (at this conference, and all the rest). There were authors of books that refute everything in all the other books that in turn refute everything the audience heard in the session just preceding. There were claims, counter-claims, and contentions about this food and that; this nutrient and that; this supplement and that.
Business as usual, in other words, in the world of health promotion -- or what passes for it in our culture.
I won't belabor the particulars of what I had to say; those of you who visit here often already know. I will instead simply share one fundamental point I consider the take-away from my talk, and then ask something of you.
The one point is this: we know enough.
Believe it or not, when the parsing and peddling, back-peddling and back-stabbing are all done -- it's a fact established and reaffirmed over a span of decades that we know enough! What we know about health promotion, disease prevention, sustainable weight control, and lifestyle as medicine IS ENOUGH to prevent 80 percent of all chronic disease and premature death. We already know enough, and have known enough for literal decades, to add years to life routinely; and add life to those years.
No one refutes this; the evidence is too strong, too consistent, too often replicated. The iconoclasts don't refute it. The renegade geniuses don't refute it. Those with competing theories to sell don"t refute it.
They simply ignore it, and pretend that the focus should be on what we don't know; what can be made (to seem, at least) controversial. They ignore it, and pass on to the one particular thing they want you to believe, buy, or berate.
They ignore it.
Which leads to what I am asking of you. Please don't ignore it. Please don't let anyone else ignore it. Please don't look on passively at a culture fiddling while Rome burns. And please, don't add your own fiddle to that orchestra.
This isn't a column; it's a campaign. I am calling it the let's #UseWhatWeKnow campaign. I am asking you to share, tweet, pin, and email that moniker -- and help me agitate a movement.
Imagine letting a building burn to the ground while debating the best particular kind of fire hose (e.g., length; caliber; materials; etc.); the best kind of water (e.g., soft; hard; etc.); and the best way to handle and direct the spray. Imagine, far worse, that there are people in the building while the debate rages along with the fire. Imagine our collective horror at discovering that the bickering and parsing lasted until there was nothing but ash and body bags.
This, folks, is our culture. We are bickering over what may even be legitimately debatable at times, but doing so while failing to use all that we already know -- and let preventable chronic diseases reduce lives to ash and cinder. It is a tragedy; it is a travesty. We could put an end to it any time we decide to #UseWhatWeKnow.
Admittedly, if we #UseWhatWeKnow, we could only save about 80 percent of such buildings. We could only save eight out of every 10 people in such buildings. But right now, the hyperbolic claims compete for our attention as the flames take them all.
Let the parsing continue, for that competition is healthy if it helps us do something about the residual 20 percent of all chronic disease we don't already know how to prevent. But let us not squander what we do know while working to learn what we don't. Let us not subordinate the tried and true to the new and titillating. Let us not ignore what we know and count the cost in years lost from life, life lost from years. Let us recall that we all have skin in this game -- our own, and that of the people we love. The next time one of these metaphorical buildings catches fire, one of us, or one of them, could well be in it.
Knowing more is always good. Bring on the next Nobel Prize! But we know enough to do an astonishing amount of good right now; good we would all see and feel. Good we squander every day.
Please help spread the word. Please help put out the fires. Please -- let's #UseWhatWeKnow.
David L. Katz, MD, MPH, FACPM, FACP is the founding Director of Yale University's Prevention Research Center at Griffin Hospital in Derby, CT; and President of the American College of Lifestyle Medicine. He dreams of, and works toward, a day when everyone lives in a Blue Zone; but in the interim does the best he can to share the skillpower that will enable everyone to #UseWhatWeKnow. He and his wife, Catherine, have five children. In other words- he's got skin in the game.
Author, Disease Proof