Chronic Disease Prevention: What You Can Influence and What You Can't
Chronic Disease Prevention: What You Can Influence and What You Can't
Chronic disease is a term I use frequently in my work as a registered dietitian nutritionist, but it can sound a little abstract.
What exactly makes a disease "chronic"?
And perhaps more importantly, how much control do we really have over our risk?
The short answer is that chronic disease is complicated.
We can influence some things through our everyday habits, including nutrition, physical activity, tobacco use, alcohol use, sleep, and preventive healthcare.
But we also can't control things like genetics, age, our environment, access to healthcare, where we live and work, and other social and economic factors.
Chronic Disease FAQ
What is chronic disease?
Chronic diseases are long-term health conditions that often develop over time and require ongoing management. They include conditions such as heart disease, diabetes, cancer, and chronic respiratory disease.
What are the most common chronic diseases?
Some of the most common include cardiovascular disease, diabetes, cancer, chronic respiratory diseases, and other long-term conditions such as kidney disease and arthritis.
Can chronic diseases be prevented?
Some chronic diseases can be prevented or their risk reduced, but prevention isn't guaranteed. Genetics, environment, access to health care, and other factors also influence health.
What are the biggest risk factors for chronic disease?
Risk factors vary by condition but can include tobacco use, poor nutrition, physical inactivity, excessive alcohol use, genetics, environmental factors, and social and economic circumstances.
Can lifestyle changes reduce chronic disease risk?
Yes. Eating patterns, physical activity, sleep, avoiding tobacco, being mindful of alcohol use, and staying up to date with preventive care can all support long-term health and reduce the risk of some chronic diseases.
Does body weight determine chronic disease risk?
No. Body weight is only one piece of the health picture. People of all body sizes can develop chronic disease or have healthy or unhealthy health markers. Looking at the broader picture gives us a much better understanding of health risk.
Those are all important things to consider.
Chronic disease prevention isn't about making every choice "right." It's about understanding the factors that influence health and identifying what's realistically within our control.
What is a chronic disease?
A chronic disease is generally a condition that lasts a year or longer and requires ongoing medical attention, limits daily activities, or both. Examples include cardiovascular disease, diabetes, cancer, and chronic respiratory diseases.
This is different from an acute illness such as a cold, influenza, or a short-term infection. Acute conditions often have a sudden onset and resolve more quickly. At least relative to chronic conditions.
Chronic conditions tend to develop and progress over much longer periods.
And while some chronic diseases can be prevented or their risk reduced, prevention isn't always possible.
That matters because statements about chronic disease prevention can become overly simplistic.
"Just eat better."
"Exercise more."
"Lose weight."
While nutrition and physical activity can absolutely affect health, chronic disease isn't caused by one behavior or one food. Chronic diseases develop through a combination of genetic, physiological, environmental, behavioral, and social factors.
What chronic diseases are we talking about?
There are many chronic diseases, but some of the major categories include:
Cardiovascular disease, which includes conditions affecting the heart and blood vessels, including heart disease and stroke.
Diabetes, including type 1, type 2, and other forms of diabetes.
Cancer, which is actually a large group of diseases rather than a single condition.
Chronic respiratory diseases, including conditions such as asthma and chronic obstructive pulmonary disease, or COPD.
There are many other chronic conditions as well, including kidney disease, arthritis, osteoporosis, neurological conditions, and others.
These conditions don't all have identical causes or risk factors.
But there is considerable overlap.
That's where prevention gets interesting: many, many things can influence the onset of disease.
Many chronic diseases share risk factors
The World Health Organization identifies several major behavioral risk factors shared across many noncommunicable diseases: tobacco use, physical inactivity, unhealthy diets, and harmful alcohol use. These can contribute to metabolic changes such as elevated blood pressure, blood glucose, and blood lipids.
The CDC similarly identifies tobacco use, poor nutrition, physical inactivity, and excessive alcohol use as major preventable risk factors for chronic disease in the United States.
Think about that.
Eating a nutritious diet isn't just about preventing diabetes.
Regular physical activity isn't just about your heart.
Not smoking isn't just about your lungs.
Getting adequate sleep isn't just about feeling less tired.
Many of the things that support one aspect of health can support several others at the same time.
This is one reason I prefer to focus on overall health behaviors rather than trying to find one magic food or one perfect health habit.
What can you actually do?
Let's start with food.
Build a nutritious eating pattern
No one diet fits everyone. That is a fact.
But some consistent characteristics of eating patterns are associated with better health.
Think about including a variety of:
Fruits and vegetables
Whole grains
Beans and other legumes
Nuts and seeds
Protein-rich foods
Foods containing healthy fats
Dairy or suitable alternatives, when appropriate
At the same time, it can be useful to pay attention to your intake of sodium, added sugars, saturated fat, and highly processed foods.
Notice that I said pay attention.
I didn't say eliminate everything.
Healthy eating isn't about creating a list of foods you're no longer allowed to eat. It's about what your overall pattern looks like most of the time.
This distinction matters because one cookie, one restaurant meal, or one holiday dinner won't determine your chronic disease risk.
Patterns matter more than individual foods, meals, or days.
Get regular physical activity
Physical activity is another powerful tool for supporting health.
The current recommendation for adults is at least 150 minutes of moderate-intensity physical activity each week, along with muscle-strengthening activities on at least two days each week.
But if you're currently doing very little activity, don't look at that number and decide you've failed before you start.
Some activity is better than none.
A walk counts.
Gardening counts.
Dancing counts.
Playing with your kids or grandkids counts.
Taking the stairs counts.
Strength training counts.
And you don't have to do all of your activity in one long workout. You can spread physical activity throughout the week and break it into smaller periods.
The goal is to find movement that works for you and that you can actually incorporate into your life.
Don't smoke or use tobacco
If you use tobacco, quitting is one of the most significant things you can do for your health.
Smoking increases the risk of cardiovascular disease, cancer, lung disease, stroke, diabetes, and other serious conditions. Quitting lowers those risks, even if you've smoked for many years.
And tobacco isn't only about cigarettes.
If you use another form of tobacco or nicotine, including vaping, talk with your healthcare provider about what quitting or reducing use could look like for you.
If you don't use tobacco, don't start.
Think about alcohol
Alcohol is another area where we have to consider several things.
For some people, drinking less or not drinking at all may be an important part of reducing health risks.
Excessive alcohol use is associated with conditions including high blood pressure, heart disease, stroke, liver disease, and several cancers.
This doesn't need to become another opportunity for guilt or an all-or-nothing rule.
It's simply another health factor worth considering.
Get enough sleep
Sleep is easy to overlook when we talk about preventing chronic disease.
It shouldn't be.
The CDC notes that insufficient sleep is associated with the development and poor management of conditions including diabetes and heart disease. Adults generally need at least seven hours of sleep each night.
Of course, getting enough sleep isn't always as simple as deciding to go to bed earlier.
Work schedules, caregiving, stress, health conditions, menopause, medications, sleep disorders, and many other factors can affect sleep.
Again, this is about recognizing what may be influencing your health, not blaming yourself when something is difficult.
Don't skip preventive healthcare
Lifestyle isn't the whole story.
Regular healthcare visits and appropriate screening are also important parts of chronic disease prevention.
Depending on your age, sex, family history, risk factors, and personal health history, this may include monitoring blood pressure and cholesterol, screening for diabetes, cancer screening, vaccinations, dental care, and other preventive services.
Screening recommendations aren't identical for everyone, so talk with your healthcare provider about what is appropriate for you. The U.S. Preventive Services Task Force maintains recommendations for a wide range of preventive services. (More in the link below.)
And don't wait until you feel sick to pay attention to your health.
Some chronic conditions can develop without obvious symptoms.
What about weight?
This is an area where I think discussions about chronic disease can easily become oversimplified.
Body weight can be associated with the risk of some chronic diseases. But weight isn't the only factor, and it isn't a complete measure of health.
People in smaller bodies can develop diabetes, cardiovascular disease, cancer, and other chronic conditions.
People in larger bodies can have excellent blood pressure, blood glucose, cholesterol levels, and other measures of metabolic health.
Genetics, environment, medications, age, stress, sleep, access to healthcare, and many other factors also influence chronic disease risk.
That means we can talk about health-promoting behaviors without making weight loss the prerequisite for caring about health.
Eating well is worthwhile whether or not your weight changes.
Being physically active is worthwhile whether or not your weight changes.
Managing blood pressure is worthwhile whether or not your weight changes.
Getting appropriate screenings is worthwhile whether or not your weight changes.
That's a better way, in my professional opinion, to think about prevention.
What you can influence isn't everything
This may be the most important point I want to leave you with.
We have some influence over our health.
We do not have complete control over our health.
Those are very different things.
You can eat a nutritious diet and still develop cancer.
You can exercise regularly and still have high blood pressure.
You can never smoke and still develop lung disease.
You can do everything that is considered "healthy" and still develop a chronic condition.
That doesn't mean healthy behaviors don't matter.
They do.
They can reduce risk, delay disease development, improve management of existing conditions, and support quality of life.
But prevention isn't a guarantee. And that is critically important here.
And when chronic disease develops, the question shouldn't become, "What did you do wrong?"
It should become:
What do we know about this condition, what can we do now, and what support do you need?
Think bigger than one health behavior
When I talk about chronic disease prevention, I don't want you to leave thinking you need to completely overhaul your life.
Instead, look at the bigger picture.
Could you eat a few more fruits or vegetables?
Could you add more whole grains?
Could you take a walk?
Could you find a form of movement you actually enjoy?
Could you make an appointment you've been putting off?
Could you ask your healthcare provider whether you're up to date on recommended screenings?
Could you work toward quitting tobacco?
Could you make sleep a little more of a priority?
Could you reduce your alcohol intake if that's something you want to change?
These aren't magic solutions.
They're pieces of the bigger picture.
And that's really what chronic disease prevention is about.
Not finding one perfect food.
Not following a restrictive diet.
Not reaching a particular number on the scale.
Not controlling every possible risk.
It's about understanding the factors that influence health and making reasonable choices when you can.
You don't have to control everything to take care of your health.
You just need to know what you can influence and where you may need support.
And sometimes the most important health decision you can make is recognizing that you don't have to do it alone.
Sources and Further Reading:
Centers for Disease Control and Prevention
World Health Organization (WHO)
Real World Nutrition Blogs/Articles
Rice, Potatoes, and Grains: Why Did Carbs Get Such a Bad Reputation?
Your Health Is Not a Number on the Scale – coming soon
What Does Self-Care Actually Look Like? – coming soon
Dietary Approaches for Reducing Chronic Disease Risk – coming soon
Real World Nutrition Refreshed. As nutrition science and perspectives evolve, older blog posts are occasionally updated and republished. This post was originally written in July 2023 and has been refreshed and expanded here.
