Big Pharma Wins When You Stay Sick
Lasting Habits Series Part 10: Preventive Care (Screenings + Long-Game Longevity)
Dear members, welcome to the latest post in our Lasting Habits Series.
A once-a-week series of practical, doctor-designed health upgrades you can actually stick with.
This has been the roadmap:
Week 1 (sleep and recovery) explains how poor or fragmented sleep is often the real reason behind low mood, strong cravings, low energy, and feeling like you “lack willpower.” We covered why late nights and 3 a.m. wake-ups happen, how sleep regulates hunger, blood sugar, stress, and emotional resilience. The solution: a 7-day sleep reset plan, a step-by-step wind-down builder, troubleshooting guide for the most common patterns, and printable sleep reset toolkit.
Week 2 provides you screen boundaries and a brain protection plan. It explains how constant screen use trains the brain to stay in urgency and interruption mode, draining focus, impulse control, sleep, and emotional regulation. We talked about how screens overstimulate the stress system, exhaust the brain’s self-control center, worsen cravings and nighttime restlessness, and undo the benefits of better sleep. The solution: a step-by-step screen boundaries builder, a 3-part “phone rules” system, a dopamine-friendly replacement list, a troubleshooting guide for the most common problems, and a printable screen boundaries brain protection plan.
Week 3 is for people feeling wired, tired, and on edge. It explains why many people feel unable to relax even when nothing is “wrong”: their nervous system is stuck in a half-activated stress state from constant, low-grade demands. We talked about how chronic stress load builds up in the body, disrupting mood, sleep, cravings, and focus, and why this isn’t a willpower issue but a recovery problem. The solution: step-by-step stress resilience reset, a “turn off the alarm” strategy, the 3 most effective nervous system levers (and how to use them depending on your stress type), a stop-the-spiral protocol, and a printable nervous system reset plan you can keep visible—so you don’t have to remember what to do when you’re overwhelmed.
Week 4 covers how aging accelerates when you’re dehydrated (which is most common than people think). It explains how chronic, mild under-hydration can disrupt brain function, digestion, energy, and cravings—and may even be linked to accelerated aging over time. We talked about why thirst is an unreliable signal, how hydration hormones influence metabolic and cardiovascular stress, and why many “I feel off” symptoms improve when fluid intake is stabilized.
Week 5 breaks down why cravings aren’t a discipline failure but a predictable brain response to an ultra-processed food environment designed to keep you on autopilot. We talked about how portion distortion, misleading serving sizes, and hyper-reward foods hijack the brain’s reward system faster than true hunger signals can respond—especially when you’re stressed, tired, or distracted. The solution: a craving loop map to identify your main driver in minutes so you use the right fix instead of guessing (and failing), a troubleshooting guide for the most common patterns, and a printable 7-day autopilot breaker (small daily moves that retrain the default).
Week 6 shows how one simple habit has shaped human survival, from scurvy prevention in the 1700s to wartime “Victory Gardens.” You’ll discover about how fruits and vegetables stabilize appetite hormones, steady blood sugar, support gut–brain signaling, and are linked to lower risks of cardiovascular disease, cancer, depression, and early mortality. The solution: a personalized Mood and Satiety Plan designed around your goals, cravings, schedule, and real-life constraints. You answer targeted questions, and you receive a clear, practical plan that fits your day—so mood feels steadier and meals more satisfying without dieting.
Week 7 reframes strength as independence insurance, the habit that protects your ability to carry groceries, climb stairs, lift suitcases, and keep saying yes to normal life as you age. We’ll talk about how resistance training strengthens not just muscles but your nervous system, balance, mood stability, and long-term health. The solution: a step-by-step Lasting Strength Setup based on adherence strategies that showed promise in randomized controlled trials.
Week 8 shows that it’s never too late to rebuild your cardiovascular engine. Through the story of 92-year-old marathon finisher Mathea Allansmith, we talked about how cardio remains trainable at any age and why longevity depends more on consistency than intensity. The key idea: cardio helps you live longer, strength helps you live better—and the real challenge is building habits that survive real life. The solution: a practical Fitness Tracker that helps you define your starting point, set clear goals, track workouts, steps, body measurements, progress photos, and 30-day and 12-week challenges—so cardio and strength become a routine you can rely on.
Week 9 shows how repeated habits with alcohol and nicotine reshape your sleep, stress response, and reward system over time. Your brain learns the loop stress → substance → relief → repeat. Over time, that loop can destabilize mood, recovery, appetite, and long-term health. The solution: a simple 7-Day “Remove the Saboteurs” Experiment designed to reset your baseline. By testing small boundaries you interrupt the automatic cue-relief cycle and observe how sleep, mood, and cravings shift when your nervous system finally gets a steadier foundation.
Today’s post: In week 10 we talk about how prevention and early detection can dramatically change health outcomes, from removing precancerous polyps before cancer forms to reversing prediabetes and protecting brain, heart, and bone health long before damage becomes irreversible. The solution: knowing which preventive tests matter and monitoring key risk factors early. Combined with the daily habits from this series, these screenings give you the leverage to detect problems early, reverse risks sooner, and protect the decades ahead instead of reacting when disease finally shows symptoms.
If you’re done managing symptoms on repeat, you’re in the right place. This is the habit foundation most people never get.
The System Profits When You Stay Sick
I didn’t study medicine to help Big Pharma get richer while people keep getting sicker. Period.
I’m tired of watching people suffer after being handed prescription after prescription, only to find that none of it truly addresses the root cause.
And please, please, don’t get me wrong, this is not about blaming doctors at all. Many are doing their best inside a broken model. The problem is the system itself: a “healthcare” model heavily shaped by industries that make more money when people stay sick than from genuine prevention or recovery. That truth is hard to ignore and painful to witness.
That’s exactly why I chose to step outside that system and help people differently. My mission is to share the evidence, tools, and perspectives that go far beyond pills, so people can make informed decisions and take back control over their health.
Sorry, Big Pharma, your influence finally ends here.
Prevention Is Bad for Business
A patient who learns how to eat better, sleep better, move better, regulate stress, improve metabolic health, and address root causes is far less profitable than a patient stuck in the cycle of symptoms, prescriptions, side effects, and more prescriptions.
We live in a world where billions are poured into medications, yet far less attention is given to the daily habits that shape health long before disease appears. People are taught how to manage illness, but rarely how to build health. They are given prescriptions, but not always the knowledge, tools, or support to prevent the problem in the first place.
Most of the conditions that shorten lives begin in silence.
High blood pressure has no symptoms. Prediabetes has no symptoms. Early-stage colorectal cancer has no symptoms. And that is exactly what makes these conditions, and many more, so dangerous. Disease rarely announces itself. It builds quietly over years, and often decades, before producing a symptom.
“Feeling fine” has become the reason millions of people skip the one thing that could change what their next decade looks like: EARLY DETECTION.
Our medical system can be good at treating disease once it arrives. However, when it comes to preventing disease that’s not profitable.
We’re stuck in a system that profits from our symptoms, not our healing.
Screening Gaps and Early Prevention
A screening gap is the difference between the preventive tests people should be getting and the ones they actually complete—often leading to missed opportunities for early detection, later diagnoses, and worse health outcomes.
And this gap is one of the clearest examples of what is broken in modern healthcare.
If a system were truly designed to keep people healthy, prevention would be front and center. Screenings would be easier to access, easier to understand, and emphasized as often as prescriptions. People would grow up knowing when to check their blood pressure, when to test their blood sugar, when to get a colonoscopy, when to monitor cholesterol, and why those simple steps matter long before symptoms appear.
But that is not the world we live in.
Instead, many people are left uninformed, under-screened, and falsely reassured by the fact that they “feel fine.” And that false sense of safety can be incredibly expensive. Not just financially, but physically, emotionally, and sometimes fatally.
This is why screening gaps matter so much. They leave the door open for disease to grow quietly in the background while people assume everything is fine. By the time symptoms appear, the window for the easiest, earliest, and most effective intervention may already be closing.
Early prevention changes that story.
It gives us the chance to identify risk before it becomes damage. It allows us to catch silent problems while they are still reversible, manageable, or far easier to treat. It shifts the focus from reacting to disease to staying one step ahead of it.
That is exactly why today’s post matters. Because when you understand where the biggest screening gaps exist, you give yourself something powerful that the system too often fails to offer: a real chance to prevent disease before it steals years from your life.
I’ll be covering five of the most common diseases that can often be prevented or detected early: cancer, cardiovascular diseases, prediabetes, dementia, osteoporosis and fractures.
But if there’s another condition you’d like me to write about, please let me know in the comments, I’d be very happy to cover it in future posts!
1. Cancer
Colorectal cancer is the second most deadly cancer in the US.
Caught at the earliest stage, the five-year survival rate exceeds 90%.1
Caught at stage IV, it drops to 14%.1
The American Cancer Society and USPSTF both recommend colonoscopy starting at age 45—not 50. The same logic applies to cervical cancer—now one of the most preventable cancers because of routine Pap smears and HPV testing—and to lung cancer in high-risk patients, where low-dose CT (a low-dose computed tomography scan, which is a type of imaging test that uses X-rays to create detailed pictures of the lungs) has been shown to reduce mortality by detecting lesions before symptoms appear.2
40% of US cancer diagnoses are linked to modifiable risk factors: weight, inactivity, alcohol, smoking, and diet.3
The habits in this series are functioning as long-term cancer prevention.
What makes colorectal cancer particularly preventable is that it almost always starts as a polyp—a small, benign growth on the colon wall. Polyps take years, sometimes a decade, to become cancerous. A colonoscopy removes the polyp before it ever becomes cancer.
Breast cancer screening finds cancer early. Colonoscopy can prevent colorectal cancer from forming at all.
For breast cancer, mammography screening starting at age 40 is now recommended for average-risk women based on a guideline updated in 2024, moving the start age down from 50.
For skin cancer, annual skin checks matter especially for those with a history of sunburns, fair skin, or a family history of melanoma.
What you can do now: Get your colorectal screening at 45. If you smoke, ask about low-dose CT lung screening. Women: stay current on Pap smears and HPV testing.
2. Cardiovascular Diseases
Heart disease and stroke are the leading killers in the US. The damage builds silently for years before any symptom appears.
Atherosclerosis (the gradual hardening of arteries) can begin in your twenties, and high blood pressure can persist for years with no warning signs.
The USPSTF recommends blood pressure screening from age 18 and lipid screening from age 20.4
The mechanics matter here.
Atherosclerosis builds when LDL cholesterol particles accumulate in artery walls, triggering inflammation that gradually narrows the vessel. For decades, there are no symptoms. Then a clot forms, or a vessel closes, and the result is a heart attack or stroke—events that feel sudden but are the product of years of silent damage.
High blood pressure accelerates this process by putting constant mechanical stress on artery walls, making them more vulnerable to injury and plaque formation.
The numbers that matter most: blood pressure below 120/80 mmHg is considered normal. Between 120–129 systolic is elevated. Above 130 is Stage 1 hypertension—where lifestyle changes become urgent.
For cholesterol, it’s not just total cholesterol that matters. LDL, HDL, and triglycerides each tell part of the story, and a standard lipid panel measures all of them. But depending on your risk, other markers—such as ApoB, non-HDL cholesterol, lipoprotein(a), and blood sugar markers like fasting glucose or HbA1c—can add important context.
What you can do now: Know your blood pressure and cholesterol. Borderline high blood pressure can often return to normal with 20 minutes of daily walking—no medication needed.
3. Prediabetes
Prediabetes is a reversible condition and one of the least-communicated facts in preventive medicine.
There are 96 million adults in the US with it. More than 80% don’t know.5
Without action, a large proportion develop type 2 diabetes, which carries serious consequences: heart disease, neuropathy, blindness, kidney disease, among many others.
The USPSTF recommends screening adults aged 35–70 who are overweight or obese.6
The biology of prediabetes is worth understanding.
When cells become resistant to insulin, the pancreas compensates by producing more of it. Blood glucose stays normal at first, but only because the pancreas is working harder. Fasting insulin rises years before blood glucose does. By the time a fasting glucose test flags prediabetes, insulin resistance has often been building for a decade. This is why catching it early matters so much: the earlier in this progression you intervene, the easier it’s to reverse, and the less strain on the pancreas long-term.
The most effective interventions studied are not complicated: reducing refined carbohydrates and added sugars, increasing daily movement (even walking), and losing 5–7% of body weight if overweight.
In the landmark Diabetes Prevention Program trial, these lifestyle changes reduced progression to type 2 diabetes by 58%—outperforming medication.7
What you can do now: Ask for a fasting glucose test at your next visit. If the result shows prediabetes, the response is not a prescription. It’s a lifestyle change: reduce refined carbohydrates, increase movement, and lose a modest amount of weight. That is often enough to reverse it entirely.
4. Dementia
The Lancet Commission identified 12 modifiable risk factors that account for roughly 40% of dementia cases worldwide:8
Hypertension
Obesity (body-mass index ≥30)
Smoking
Alcohol (>21 units/week)
Depression
Physical inactivity
Diabetes
Social isolation
Hearing loss
Traumatic brain injury
Less education
Air pollution
Nearly every item on that list appears somewhere in this series and newsletter, and if not, will be covered soon!
Cardiovascular health and brain health are the same conversation.
The mechanism behind this connection is blood flow. The brain is the most metabolically demanding organ in the body, consuming roughly 20% of the body’s oxygen despite being only 2% of its weight.
High blood pressure, uncontrolled diabetes, and chronic inflammation all damage the small vessels that supply the brain, accelerating the neurodegeneration that underlies Alzheimer’s and vascular dementia.
What protects your heart—controlled blood pressure, regular movement, limited alcohol—protects those vessels too.
Hearing loss is worth singling out because it’s so frequently dismissed.
Untreated hearing loss forces the brain to work harder to process incomplete sound signals, diverting cognitive resources away from memory and reasoning. Studies suggest it may account for up to 8% of dementia cases—making it one of the single largest modifiable risk factors on the list.
What you can do now: Control blood pressure. Move regularly. Reduce alcohol. If you’ve noticed hearing loss, get it assessed—it’s one of the most underappreciated modifiable dementia risk factors.
5. Osteoporosis and Fractures
Osteoporosis is one of the most underdiagnosed diseases in preventive medicine because it’s usually silent until a bone breaks.
In the US, the age-adjusted prevalence of osteoporosis is 12.6% among community-dwelling adults aged 50 and older, and in women 65 and older it rises to 27.1%.9
A hip fracture is often the beginning of loss of independence, disability, and accelerated mortality. Evidence cited by the USPSTF shows that only 40 to 60% of people who sustain a hip fracture recover their prefracture level of mobility and ability to perform activities of daily living.9
What makes osteoporosis so preventable is that the disease usually gives us years of warning before the catastrophe. Bone loss progresses quietly; the patient feels fine, but then comes the fall, the wrist fracture, the vertebral compression fracture blamed on age, or the hip fracture that changes the rest of life.
That is why screening matters. The USPSTF now recommends screening all women age 65 and older, and screening postmenopausal women younger than 65 who are at increased risk, using clinical risk assessment with or without DXA (dual-energy X-ray absorptiometry).9
In the 2025 USPSTF evidence review, screening higher-risk older women reduced hip fractures and major osteoporotic fractures compared with usual care.10
The clinical trap is thinking osteoporosis begins when the DXA becomes abnormal. It often becomes clinically obvious much later. A fragility fracture in adulthood is already the disease announcing itself.
The Bone Health and Osteoporosis Foundation states that any broken bone in adulthood should be investigated as suspicious for osteoporosis, and that any new fracture in an adult aged 50 years or older signals an imminent elevated risk for another fracture, especially in the following year.11
A recent systematic review and meta-analysis reinforces that message: prior major osteoporotic fractures substantially increase the risk of a later hip fracture.12
This is why a wrist fracture at 58 should trigger bone evaluation, risk stratification, and a prevention plan before the next fracture is the hip.11,12
The practical guidelines are straightforward.
Women should get bone density testing at 65, or earlier after menopause if their fracture risk is elevated.1
For men, the USPSTF still finds the evidence insufficient for a population-wide screening recommendation, but major specialty guidance supports case-finding: the BHOF recommends bone mineral density testing in men 70 and older, in men 50 to 69 with risk factors, and in any adult 50 or older with a fracture.11
If osteopenia is found, FRAX (Fracture Risk Assessment Tool, it’s a calculator used to estimate a person’s 10-year risk of fracture) helps determine whether that “not yet osteoporosis” result is already high risk enough to treat.
In US-adapted BHOF guidance, treatment is generally recommended when the 10-year hip fracture risk is 3% or higher or the major osteoporotic fracture risk is 20% or higher.11
When treatment is needed, ACP recommends bisphosphonates as initial pharmacologic therapy for women with primary osteoporosis, and suggests them for men with primary osteoporosis as well.13
Across randomized trials, osteoporosis therapies reduce vertebral and clinical fractures, with anabolic agents showing greater fracture reduction than bisphosphonates in some higher-risk postmenopausal populations.13,14
Lifestyle still matters, but here it should be framed correctly. BHOF guidance recommends adequate calcium intake, vitamin D sufficiency, weight-bearing and resistance exercise, smoking cessation, moderation of alcohol, fall-risk assessment, and annual height measurement.11
Resistance training is particularly useful because it improves physical functioning and quality of life in adults at risk of fracture, even if fall reduction data are less consistent.15
The key point is this: osteoporosis is often detectable before the first fracture, treatable after detection, and too often ignored until the event that permanently changes a person’s life. Screening is not about finding a low T-score, it’s about preventing the fracture that begins the decline.9,10,11,13,14,15
What you can do now: Women: schedule a DXA at 65, or earlier after menopause if you have risk factors. Men: if you are 70 or older, or over 50 with a prior fracture or major risk factors, ask whether bone density testing is appropriate. Any adult over 50 with a wrist, vertebral, hip, pelvis, or proximal humerus fracture should be evaluated for osteoporosis, not just treated for the fracture. Make sure calcium intake is adequate, do resistance and balance training, stop smoking, limit alcohol, do not ignore height loss or a “minor” fracture, and maintain vitamin D sufficiency.9,11,13,15
This is the vitamin D supplement I use and recommend to my patients. (Important with K2! Together, they increase bone mineral density by directing calcium to your bones. and reduce the risk of coronary artery disease by preventing calcium buildup in arteries.
I truly hope you found this post, and this series, helpful.
To your zenith within,
Sara Redondo, MD, MS
References:
American Cancer Society. Colorectal Cancer Facts & Figures 2023–2025. Atlanta: American Cancer Society; 2023.
Krist AH, Davidson KW, Mangione CM, Barry MJ, Cabana M, Caughey AB, et al.; US Preventive Services Task Force. Screening for lung cancer: US Preventive Services Task Force recommendation statement. JAMA. 2021;325(10):962–970. doi:10.1001/jama.2021.1117.
Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, et al. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin. 2018;68(1):31–54. doi:10.3322/caac.21440.
Krist AH, Davidson KW, Mangione CM, Cabana M, Caughey AB, Davis EM, et al.; US Preventive Services Task Force. Screening for hypertension in adults: US Preventive Services Task Force reaffirmation recommendation statement. JAMA. 2021;325(16):1650–1656. doi:10.1001/jama.2021.4987.
Centers for Disease Control and Prevention. National Diabetes Statistics Report. Atlanta: CDC; 2022.
Davidson KW, Barry MJ, Mangione CM, Cabana M, Caughey AB, Davis EM, et al.; US Preventive Services Task Force. Screening for prediabetes and type 2 diabetes: US Preventive Services Task Force recommendation statement. JAMA. 2021;326(8):736–743. doi:10.1001/jama.2021.12531.
Diabetes Prevention Program (DPP) Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002 Dec;25(12):2165-71. doi:10.2337/diacare.25.12.2165.
Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413–446. doi:10.1016/S0140-6736(20)30367-6.
US Preventive Services Task Force. Screening for osteoporosis to prevent fractures: US Preventive Services Task Force recommendation statement. JAMA. 2025;333(6):498-508. doi:10.1001/jama.2024.27154.
Kahwati LC, Kistler CE, Booth G, Sathe N, Gordon RD, Okah E, et al. Screening for osteoporosis to prevent fractures: a systematic evidence review for the US Preventive Services Task Force. JAMA. 2025;333(6):509-531. doi:10.1001/jama.2024.21653.
LeBoff MS, Greenspan SL, Insogna KL, Lewiecki EM, Saag KG, Singer AJ, et al. The clinician’s guide to prevention and treatment of osteoporosis. Osteoporos Int. 2022;33(10):2049-2102. doi:10.1007/s00198-021-05900-y.
Ariie T, Yamamoto N, Tsutsumi Y, Nakao S, Saitsu A, Tsuge T, et al. Association between a history of major osteoporotic fractures and subsequent hip fracture: a systematic review and meta-analysis. Arch Osteoporos. 2024;19(1):44. doi:10.1007/s11657-024-01393-4.
Qaseem A, Hicks LA, Etxeandia-Ikobaltzeta I, Shamliyan TA, Cooney TG, Cross JT Jr, et al. Pharmacologic treatment of primary osteoporosis or low bone mass to prevent fractures in adults: a living clinical guideline from the American College of Physicians. Ann Intern Med. 2023;176(2):224-238. doi:10.7326/M22-1034.
Händel MN, Cardoso I, von Bülow C, Fracture Guidelines Working Group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO), et al. Fracture risk reduction and safety by osteoporosis treatment compared with placebo or active comparator in postmenopausal women: systematic review, network meta-analysis, and meta-regression analysis of randomised clinical trials. BMJ. 2023;381:e068033. doi:10.1136/bmj-2021-068033.
Ponzano M, Rodrigues IB, Hosseini Z, Ashe MC, Butt DA, Chilibeck PD, et al. Progressive resistance training for improving health-related outcomes in people at risk of fracture: a systematic review and meta-analysis of randomized controlled trials. Phys Ther. 2021;101(2):pzaa221. doi:10.1093/ptj/pzaa221.
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Many thanks for stressing prevention. Improving health literacy is hugely important. At least across Europe & the UK many medics & scientists are involved in this. Pharmacology itself is a very big science field. Over the past decades chemoprevention has become a very big field too and in many of your posts you discuss it as well. As Hippocrates always said, Everybody is oneself their best physician.