Why Don’t More Doctors Practice Prevention?

Why don’t more doctors practice preventive cardiology? Time availability is a reason frequently cited by physicians, but if you probe a little deeper, the number one reason given, was their perception that patients fear being deprived of all the junk their eating. Can you imagine a doctor saying, “I’d like to tell my patients to stop smoking, but I know how much they love it”?

Changes in diet to reduce cholesterol levels are often assumed to result in reductions in quality of life. Do we get to live longer or is it just going to feel longer? “Contrary to popular belief, one study found no apparent reduction, but rather an improvement in some measures of quality of life and patient satisfaction using medical nutrition therapy” as opposed to drugs for high cholesterol. Whereas people taking cholesterol-lowering drugs don’t feel any different, this study found that those using dietary changes reported significantly better health and satisfaction, and better life in general. More positive feelings and fewer negative. In the Family Heart Study, for example, those placed on a cholesterol lowering diet showed significantly greater improvements in depression as well as a reduction in aggressive hostility.

Another barrier to preventive cardiology is that doctors don’t realize how powerful dietary changes can be. The importance of diet for patients’ health remains underestimated by doctors. Even the new drug-centered cholesterol guidelines emphasize that lifestyle modification should be the foundation for the reduction for atherosclerotic cardiovascular disease risk. Despite this, more than half of physicians may skip over lifestyle change completely and jump straight to their prescription pad doubting that cholesterol goals can be reached with lifestyle changes alone.

According to the Director of the famous Framingham Heart Study, the best way to manage coronary artery disease is to lower patients’ LDL cholesterol and other atherosclerosis causing particles. “You can achieve this with diet plus drugs, but if you can do it with a vegetarian diet, it works even better.” In the Framingham Heart Study, those running in the Boston Marathon achieved the goal of getting their total to good cholesterol ratio under 4, but the vegetarians did even better.

And if you go all out, putting people on a very high fiber, whole-food vegetable, fruit, and nut diet, you can get a 25 percent drop in the bad to good cholesterol ratio within one week and a 33 percent drop in LDL. That’s the cholesterol-reduction equivalent to a therapeutic dose of a cholesterol-lowering statin drug.

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of DeathMore Than an Apple a Day, and From Table to Able.

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Nina S.
Nina S2 years ago


Siyus Copetallus
Siyus Copetallus3 years ago

Thank you for sharing!

Sarah Hill
Sarah Hill3 years ago

I always hear that the doctors get kick backs from all those drug companies who parade through their offices.

Fi T.
Past Member 3 years ago

Let's help ourselves out

Nikki Davey
Nikki Davey3 years ago

American doctors don't practice prevention because it doesn't pay.

mac c.
mac C3 years ago

Sadly, doctors don't have the time they need with each patient. They have about just enough time to take out their prescription pad and write a prescription. I also agree with the article that doctors underestimate the power of a good diet in their patients lives. Thank you for posting the aritcle.

Helga Ganguly
Helga Ganguly3 years ago

There are many nuts and all of them are good.

Yuliya Grishina
Yuliya Grishina3 years ago


Elena Poensgen
Elena Poensgen3 years ago

Thank you

Teresa W.
Teresa W3 years ago