Wellness and Preventive Health: Start Before You Get Sick

The word "wellness" is used to sell a lot of things these days, from vitamin drips to blood panels with dozens of tests. So I'd like to start with a simple question: "What actually helps us live long and live well?" Most of the answers are not glamorous, but they work, and many of them you can start on your own today.

What is wellness, and how is it different from treating disease?

Wellness, or preventive medicine, means looking after your health while you are still well. The goals are to find risks early, prevent the diseases that can be prevented, and keep your body, mind, relationships and sexual health in good enough shape to live the life you want.

From a family physician's point of view, wellness doesn't come in separate pieces. A patient may come in about poor sleep, but once we really talk we find high blood pressure, stress at work and problems with intimacy with their partner. Good care has to look at the whole person, which is the heart of family medicine.

Sexual wellness is health too

The World Health Organization defines sexual health not just as the absence of disease, but as including safe and pleasurable sexual experiences, free of coercion, discrimination and violence.

This matters medically too. For example, erectile dysfunction (ED) in a middle-aged man can be an early warning sign of heart disease or diabetes. Low sexual desire may come from depression, medication or hormones. Being willing to talk about sex with your doctor is nothing to be embarrassed about; it is another kind of health check. Read more in What is men's sexual health, and where to start.

The five pillars with the strongest evidence

Before we talk about tests or supplements, check these basics first, because long-term research supports them more clearly than anything else.

1. Sleep enough. Most adults need 7–9 hours. Chronic short sleep is linked with weight gain, high blood pressure, mood swings and low testosterone.
2. Move your body. At least 150 minutes a week of moderate activity, plus strength training 2 days a week to preserve muscle and bone.
3. Eat real food. Focus on vegetables, fruit, whole grains, adequate protein and healthy fats. Cut down on sugar, processed foods and salt.
4. Don't smoke, and drink as little as possible. Both damage blood vessels, including the ones needed for erections.
5. Look after your mind and relationships. Loneliness and chronic stress affect health about as much as physical risk factors do.

Wellness

Sleep enough

• Most adults need 7–9 hours

Move your body

• ≥ 150 min/week at moderate intensity
• Strength training 2 days/week

Eat real food

• Vegetables, fruit, whole grains
• Cut sugar, processed food, salt

Smoking, alcohol

• Don't smoke
• Drink as little as possible

Mind and relationships

• Reduce chronic stress
• Don't let yourself get lonely

Test for your risks, not for the sake of testing a lot

A good health check should be chosen according to your age, sex, family history and lifestyle: for example blood pressure, blood sugar, cholesterol, evidence-based cancer screening, and STI testing when there is a risk. The details are in Health checkups for working-age adults: what to test.

On the other hand, some popular package tests, such as tumor markers in people without symptoms or measuring every vitamin, usually don't help and can cause worry or unnecessary follow-up tests. Read why in Tumor markers: can they really screen for cancer?

Test by risk

• Blood pressure, sugar, lipids
• Evidence-based cancer screening
• STI tests when at risk
• Chosen by age, sex, family history

Usually no help without symptoms

• Tumor markers
• Testing every vitamin level
• May cause worry and needless further tests

vs

Adult vaccines: the part people forget

Many people think vaccines are for children. In fact adults have vaccines they should get too, for example:

• Influenza vaccine, once a year
• Pneumococcal vaccine (against pneumonia) for older adults and people with chronic conditions
• The non-live shingles vaccine, for people aged 50 and over
• HPV, hepatitis B and hepatitis A vaccines, depending on risk

See the details in Influenza vaccine and HPV vaccine for women and men.

Supplements: let's be straight

Supplements are genuinely useful in people who are deficient: for example vitamin B12 in strict vegans or people who have taken the diabetes drug metformin for a long time, or vitamin D in people who get almost no sun. But for healthy people who eat a varied diet, several large studies have found that taking vitamins regularly does not meaningfully reduce heart disease, cancer or death, and some are harmful in excess.

How Dr. Kris Clinic can help

At the clinic I help you build a personal prevention plan: assessing your risks, choosing the tests you actually need, reviewing your vaccines, checking whether the medicines and supplements you take are necessary or overlapping, and talking about sexual health and hormones without judgment. You can book a visit at the clinic in Surat Thani or consult online, with English-speaking consultations available.

See a doctor promptly, without waiting for a checkup appointment, if you have any of these: chest pain or tightness, unusual breathlessness or tiredness, unintended weight loss, blood in your stool, an unusual lump, or thoughts of harming yourself (call 1323, Thailand's free 24-hour mental-health hotline; Thai language, ask for English support).