Why should physical exams screen not only for disease but also for lifestyle?

  In addition to congenital and hereditary diseases, many diseases can be described as lifestyle diseases, where poor lifestyle plays a role in contributing from a pre-disease or sub-healthy state to a disease state. This includes: smoking, excessive calorie intake, reduced physical activity, etc.  1, excessive calorie intake: when I was a child is a weekly or monthly to eat a meat, now almost three meals a day after the chicken, duck, fish, meat and eggs. In the past, a copper coin was placed on the oil bottle for frying, but now a whole pot and a whole spoon of oil is used for frying. A burger and a Coke has almost more calories than a meal. Previously, carbohydrates rice bun is the main, now protein and fat is the main. And the heat production per unit weight of fat is about more than twice that of carbohydrates. Total calorie intake exceeds calorie consumption, in the form of fat accumulation in the abdomen under the skin and viscera, resulting in what we see as “beer belly” and “general belly”. We can give patients simple nutritional counseling, tell them how many calories ordinary food contains, such as an egg 50g, can provide 70kcal calories. 100g rice can provide 120kcal calories, 100g lean pork can provide 140kcal calories, etc.  2, less physical activity: the consumption of calories in addition to the brain needs energy to think, digestion and absorption of food needs energy, in addition to the skeletal muscle movement to consume energy. Now, in addition to a slight increase in physical activity during leisure time, other forms of physical activity are on a significant decline. Studies show that in 2006, total physical activity decreased by 27.8% for men and 36.9% for women compared to 1997. There was also a significant increase in the amount of time children spent sitting still in front of the television compared to the 1980s. Proper exercise helps reduce weight, lower blood sugar blood pressure and lipids, healthy heart and lung function, and also improves one’s mental state, improves sleep, and reduces depression and other emotions.  In the physical examination, we should pay attention to ask the nature of the patient’s work, the approximate daily intake of food types, portions, the time and intensity of exercise to make individualized recommendations.  3, smoking: China’s cardiovascular disease annual report shows: China’s 15 years and older men now smoking rate of 52.9%, women now smoking rate of 2.4%, 15 years of age and older smokers reached 356 million. 1996 to 2010 survey shows that China’s recent decade of secondhand smoke exposure level increased. 2002 China’s non-smokers secondhand smoke exposure rate of up to 51.9%, passive smokers reached 5.4 million. Passive smokers reached 540 million. There are no health benefits to smoking, except for refreshment and tension relief. How to persuade people to quit smoking is a big question involving psychology and sociology.