The ideal time to take action is before you have a full-blown chronic illness.

Which would you prefer, staying healthy through diet and exercise, or growing steadily sicker and weaker from a long-term illness?

If you’re one of the millions of Americans with a “pre-disease,” then the first choice may still be an option for you, and that’s great news.

The pre-diseases include prehypertension, prediabetes, and osteopenia (preosteoperosis). Having one of these means you’re headed down the road toward chronic illness, but you still may have time to reverse course.

The trick is to know you’re at risk. “Silent” chronic diseases, such as high blood pressure (hypertension), diabetes, and osteoporosis, rarely show any symptoms in their early stages. Only a health screening can sound the warning while you still have time to avoid the full-blown illness.

“That’s why routine health screenings are so important,” says endocrinologist Larry C. Deeb, M.D., immediate past president of medicine and science for the American Diabetes Association in Atlanta. “Knowing you have a pre-disease is almost like a free lunch. You’ve heard the warning, but there’s a whole lot you can do to keep from getting sicker.”

Here are a few things to know about pre-diseases.

Prediabetes
YOU KNOW YOU HAVE IT IF: Blood sugar tests reveal higher-than-normal blood sugar levels, but not so high they can be classified as type 2 diabetes.

WHY YOU SHOULD CARE: If you have prediabetes and don’t take steps to manage it, you’re likely to be diagnosed with type 2 diabetes in as few as 10 years. Even by itself, prediabetes can cause long-term damage to the heart and circulatory system.

TO HELP PREVENT OR CONTROL IT:

• Maintain a healthy weight.
• Start managing your blood sugar levels through healthy eating, exercise, and weight control.

Prehypertension
YOU KNOW YOU HAVE IT IF: Several blood pressure checks over time consistently show readings between 120/80 and 140/90. Normal blood pressure is considered to be below 120/80; high blood pressure starts at 140/90.

WHY YOU SHOULD CARE: If you’re among the approximately 30 percent of adults with prehypertension and you leave it untreated, it’s likely to progress to high blood pressure. Even slightly elevated blood pressure has health risks, such as an increased risk for heart attack, stroke, and heart failure.

TO HELP PREVENT OR CONTROL IT:

• Exercise regularly, maintain a healthy weight, and eat a healthy diet.
• Reduce your sodium intake.
• Limit your alcohol consumption.
• If you smoke, quit.

Osteopenia
YOU KNOW YOU HAVE IT IF: A bone mineral density test reveals you have bone loss that puts you at increased risk of developing osteoporosis over time.

WHY YOU SHOULD CARE: People who develop osteoporosis have weak and brittle bones. This common disease can bring a risk for bone fracture even from low-stress activities, such as coughing, bending over, or lifting. Spinal fractures often lead to severe back pain.

TO HELP PREVENT OR CONTROL IT:

• Get plenty of weight-bearing exercise.
• Consume adequate calcium and vitamin D.
• If you smoke, quit. Tobacco use contributes to weak bones.
• Ask your doctor about medication options.

In every case, the important first step is to have the recommended health screenings.

“We live life by the numbers,” says Deeb. “What’s your blood pressure level, your blood sugar level? When those numbers are good, it’s a potential indication of a long and healthy life. Importantly, if the numbers aren’t good, lifestyle changes and medical treatments can bring those numbers to where they should be.”

3 Ways to Prevention

STEP UP YOUR PHYSICAL ACTIVITY.
Regular physical activity can help lower your blood pressure and reduce your risk for prediabetes and diabetes. At younger ages it helps to strengthen growing bones; as you grow older it helps to slow bone loss. Regular physical activity burns calories and is essential to controlling your weight.

Aim for 30 minutes of moderate physical activity per day, such as brisk walking, cycling, or swimming. Include daily weight-bearing and strength-training exercises to help keep bones strong and healthy throughout life.

CHOOSE HEALTHY FOODS.
To lower your risk for prediabetes and diabetes and help control your blood pressure, choose foods low in calories and fat—especially saturated fat—and eat plenty of fruits, vegetables, and whole grains.

To maintain healthy bones and reduce your risk for osteopenia, include adequate calcium and vitamin D in your diet. The amount of calcium you need depends on your age; ask your doctor or pharmacist how much is right for you.

LOSE EXCESS POUNDS.
Every little bit of weight loss helps. If you’re overweight, losing just 5 to 10 pounds can lower your blood pressure; and losing 5 to 10 percent of your body weight (10 to 20 pounds if you weigh 200 pounds) can lower your risk for prediabetes or diabetes.

The secret to lasting weight control is to focus on making permanent, healthy changes to your eating and exercise habits.

Polly Turner spoke with Larry C. Deeb, M.D., immediate past president of medicine and science for the American Diabetes Association, director of the Diabetes Center at Tallahassee Memorial Hospital, and a pediatric endocrinologist in private practice in Tallahassee, Fla.

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