If individual choices for their health influence the fate of the NHS

by Gianni Zuccheri


Dear manager,
the need for health services of a population is significantly correlated to the number of those suffering from chronic and cancerous diseases, which is increasingly on the rise, hence the relative increase in economic and social costs. Added to this are the suffering of the patient and the relative repercussions on the family. The growing costs of energy and materials negatively affect the management of the health and care facilities of the NHS. A recent article published on LANCET highlights that in 2019 almost 50% of cancer cases were caused mainly by behavioral risk factors: smoking, alcohol abuse, unsafe sex and dietary imbalances; hence the suggestion to counteract behavioral risk factors, to effectively reduce the cancer burden globally [1].

I would now like to present some of my reflections on behavioral habits that are harmful to health, also linked to the environment in which one lives. The insurmountable number of requests for health care is comparable to the condition of being faced with a heap of dirty dishes to wash, related to the high number of courses consumed by an exponentially growing number of guests. So, to get rid of the work, the staff will first begin to proceed in a frantic manner and then will be distracted by fatigue, with the risk of doing damage (superficial or inadequate health services) or collapsing. In this scenario, the waiting times to receive healthcare services will increase, causing delayed diagnosis and therapies: these same delays will cause harmful consequences on the health conditions of patients, with further increase in costs!

In the long term, to prevent the health system from going towards the risk of default, it is therefore necessary to invest in prevention. First, let’s think about the factors that make up the Lifestyle. A) Quality and quantity of food. In the Italian population up to the 1960s, the limited availability of food affected health: the careful management of food resources in family life has allowed many over eighty to be in good health today, without serious metabolic-degenerative pathologies; these diseases, caused both by the excessive caloric intake and by the high presence of salt in the diet, now afflict younger and younger age groups. I often find myself sensitizing those who sell bread, to give the possibility to choose products with a smaller quantity of salt, since sometimes focaccias with grains of coarse salt on the surface are sold. This is a simple example, but by adding all the “masked” sodium chloride in the various packaged foods, plus what the individual adds to it, we understand how many cases of arterial hypertension would be avoided.

To this end, the FDA recently published guidelines for reducing salt in foods in the United States. Along with NaCl, flavor enhancers such as sodium glutamate must also be considered. In those who consume these components, combined with foods of unspecified quality, especially meats and sausages, irreversible damage to the kidneys, the cardiovascular system, with strokes and district arteriopathies are more easily created. Caloric excesses cause an increase in obesity since childhood and the onset of glycemic changes, already around the age of 40, with related degenerative diseases.

To this is also added the component of pollutants, including the various Endocrine Destructors, synthetic chemicals that mimic both the effects and the receptor characteristics of many hormones. These are found in the materials used for the preparation of food and drinks (eg Bisphenol A, glyphosate, etc.), but also in some products in contact with the body, sometimes present in products for early childhood. B) Constant physical activity and in the right measure for your conditions. Correct posture in study and work, with the help of the lectern: useful for avoiding fatigue and osteoarticular overloads of the spine (eg headache from cervical spine) but also to counteract the onset of changes in vision and ocular motility. Finally, equip yourself with a “dishwasher”.

New technologies and Artificial Intelligence make it possible to increase the delivery of health services, reducing costs, without forgetting the final supervision by health personnel: I cite an example applied concretely for the screening of Diabetic Retinopathy. It is performed through the photograph of the Fundus (Retinography) which is analyzed by an Artificial Intelligence application; therefore, a first provisional response will then be validated or corrected by the ophthalmologist. In this way, it is possible to satisfy the requested health services in a shorter time, also reducing the time spent by patients in medical clinics and storing the report directly in the electronic diabetic record. [2].

Gianni ZuccheriOutpatient specialist ophthalmologist in ASL of the Piedmont Region

[1] GBD 2019 Cancer Risk Factors Collaborators. The global burden of cancer attributable to risk factors, 2010-19: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2022 Aug 20; 400 (10352): 563-591. doi: 10.1016 / S0140-6736 (22) 01438-6. PMID: 35988567; PMCID: PMC9395583.

[2] Plates A, et al. Diabetic Retinopathy Screening with Artificial Intelligence: A Pivotal Experience in Italian Healthcare System – Preliminary Report. Diabetes Obes Int J 2022, 7 (S1): 000S1-008.

05 September 2022
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