Some widely promoted health measures, on the other hand, don't make the list. Despite nationwide campaigns for prostate cancer screening, the benefits remain uncertain, so no recommendation. Nor do vitamin supplements help those who eat a healthy diet. "They aren't cheap," Nundy said. "They aren't covered by insurance. It's just an extra pill."

What he does recommend is an annual visit to the doctor, ideally while healthy. Most people don't go to the doctor unless they're sick. They come when they feel lousy, he said, so diagnosis and treatment trump prevention. "If you come when you're well, for a prevention visit, there's a huge value that accumulates over time."

Although not in the book, he's now tackling the next issue: how can doctors persuade patients to heed their collected advice. Nundy and colleagues are testing a report-card system in patients at risk for cardiovascular problems. The report focuses on five key contributors to heart disease: blood pressure, cholesterol, smoking status, diabetes and weight.

"We give them a simple little table that lists where they are now, how they compare to others their age, where they need to go, and how we're going to get them there. They take this home and put it on the fridge. So the implications of what they are, or are not, doing cross their path at every meal. It seems to make an impact."

How does a medical resident, who works 80 hours a week and maintains a preventive health blog find time to produce a book? Nundy has a history of extracurricular productivity. As an undergraduate at MIT, he started a part-time clinic to provide free care for 2500 people in a small village outside of Kolkata, India. It's still in operation. The experience reinforced his decision to go into medicine, and gave him "a profound appreciation of what we all are capable of achieving."

The experience also drove home the benefits of low-tech medicine tied to simple but effective communication.

Every year, he said, billions of dollars goes into developing new drugs or new technology to treat advanced disease, much of which we could have prevented. "We need new and better drugs," he admitted, "but we also need new and better methods to transmit a few simple, basic messages to people in a way that they can understand and follow. That, and the notion that it could help people like my mom, helped me finish this project."

Source: University of Chicago Medical Center

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