Preventive medicine
In brief
Section titled “In brief”- Chronic diseases develop long before the first symptoms
- Traditional screening often misses metabolic dysfunction
- Five pillars: TG/HDL, insulin, VO2max, CAC score, DEXA
- Prevention is not an annual check-up but a personal program
- Health is a trainable skill
The essence of prevention
Section titled “The essence of prevention”Most chronic diseases — cardiovascular disease, type 2 diabetes, cancer and dementia — develop long before the first symptoms.
They arise from metabolic dysregulation, often in people with ‘normal’ blood values and seemingly good health.
Traditional versus modern prevention
Section titled “Traditional versus modern prevention”| Approach | Characteristics |
|---|---|
| Traditional | General advice: eat healthy, exercise more, don’t smoke |
| Modern | Looks deeper — under the hood — at metabolic and cardiovascular functions |
The traditional approach is valuable, but is preventive minimalism. The modern approach looks for factors that predict aging and disease.
Goal: a body and mind that remain fit, resilient and recovering throughout life.
The five pillars of modern prevention
Section titled “The five pillars of modern prevention”1. TG/HDL ratio
Section titled “1. TG/HDL ratio”Simple and powerful marker of insulin sensitivity.
| Value | Meaning |
|---|---|
| Below 1.0 | Optimal metabolic health |
| Above 2.0 | Elevated risk |
2. HbA1c + fasting insulin
Section titled “2. HbA1c + fasting insulin”| Marker | Function |
|---|---|
| HbA1c | Shows glucose damage |
| Insulin | Detects insulin resistance years earlier |
Target values: HbA1c below 35 mmol/mol, insulin below 50 pmol/L (approx. below 7 mIU/L)
3. VO2max or exercise test
Section titled “3. VO2max or exercise test”The strongest predictor of overall mortality and resilience.
- Trainable via endurance and interval training
- Measures cardiovascular and metabolic fitness
4. Coronary calcium score (CAC)
Section titled “4. Coronary calcium score (CAC)”Objective measure of subclinical atherosclerosis.
| Score | Risk |
|---|---|
| 0 | Low risk |
| Above 100 | Elevated risk |
5. DEXA scan
Section titled “5. DEXA scan”Shows:
- Muscle mass
- Fat distribution
- Bone density
Essential for follow-up of strength training and lifestyle interventions.
The life stages of prevention
Section titled “The life stages of prevention”| Age | Focus | Actions |
|---|---|---|
| From age 30 | Start prevention window | Identify metabolic and vascular risks |
| From age 40 | Intervene | Improve muscle mass, insulin sensitivity, aerobic capacity |
| From age 50 | Maintain and reverse | Focus on muscle strength, brain function, vascular health |
Prevention as lifestyle strategy
Section titled “Prevention as lifestyle strategy”Preventive medicine is the core of modern medicine: aimed at maintaining health, not managing disease.
A good prevention plan includes:
Section titled “A good prevention plan includes:”| Pillar | Action |
|---|---|
| Metabolic markers | Regular evaluation (TG/HDL, insulin, HbA1c) |
| Muscle building | Active strength training |
| Fitness | Aerobic training (at least 150 minutes per week) |
| Nutrition | Therapeutic carbohydrate restriction with metabolic dysregulation |
| Recovery | Sufficient sleep, sunlight and stress regulation |
Summary
Section titled “Summary”Veelgestelde vragen
What is preventive medicine?
Preventive medicine aims to recognize, reverse and prevent chronic diseases early. It's not about fighting disease, but about sustainable health, vitality and resilience by monitoring metabolic processes early.
What are the five pillars of modern prevention?
The five pillars are: TG/HDL ratio (insulin sensitivity), HbA1c + fasting insulin (glucose damage and resistance), VO2max (strongest mortality predictor), coronary calcium score CAC (subclinical atherosclerosis), and DEXA scan (muscle mass, fat, bone density).
Why is TG/HDL ratio important?
TG/HDL ratio is a simple and powerful marker of insulin sensitivity. Below 1.0 means optimal metabolic health; above 2.0 indicates elevated risk. It's a better predictor than total cholesterol.
When should I start with prevention?
From age 30, the prevention window starts - identify metabolic and vascular risks. From age 40, intervene via muscle mass, insulin sensitivity and aerobic capacity. From age 50, maintain and reverse via muscle strength and vascular health.
Medische Disclaimer: De informatie van Stichting Je Leefstijl Als Medicijn over leefstijl, ziektes en stoornissen mag niet worden opgevat als medisch advies. In geen geval adviseren wij mensen om hun bestaande behandeling te veranderen. We raden mensen met chronische aandoeningen aan om zich over hun behandeling goed door bevoegde medische professionals te laten adviseren.
Medical Disclaimer: The information provided by Stichting Je Leefstijl Als Medicijn regarding lifestyle, diseases, and disorders should not be construed as medical advice. Under no circumstances do we advise people to alter their existing treatment. We recommend that people with chronic conditions seek advice regarding their treatment from qualified medical professionals.