We are taking a break this week from a series of columns on Dr. Greger’s daily dozen, because in the June 15^th Post Independent there was a pink insert advertising health screening by a company called Lifeline Screening, which has been coming to our area for years. People will be asking their primary care providers if they should sign up for this testing, which takes place on June 28^th, costs $159 and is not covered by insurance or Medicare.

It is always best to prevent disease, and it’s estimated that 80% of the chronic diseases that Americans suffer and die from would be prevented if everyone simply ate more vegetables, fruit, whole grains, nuts and seeds —and moved about more. Next best is catching disease early, when it can be treated and often reversed. Let’s look at the tests being offered by Lifeline Screening:

CAROTID ARERTY (PLAQUE) SCREENING: Heart attacks and strokes — caused by hardening of the arteries (atherosclerosis) are the leading cause of death in the U.S. and are major causes of disability. According to Bale and Doneen in their recently released, evidence-based book “Healthy Heart, Healthy Mind,” essentially all heart attacks and most strokes are preventable. They recommend that everyone should have screening for atherosclerosis at age 40, and several years younger if they have risk factors such as smoking; high cholesterol; obesity (especially extra weight around the middle); pre-diabetes or diabetes; sleep apnea; family history of heart disease or strokes; or inflammatory diseases including chronic dental issues. The best test to assess artery health is the $200 carotid IMT test — a special ultrasound test of the carotid arteries in the neck, available at Compass Peak Imaging. Second best is a coronary calcium score — a CT scan of the heart, also costing around $200, available at most imaging centers. Lifeline Screening offers a carotid duplex ultrasound, which checks for major blockages. If mild disease or worse is found on this test, further investigation is indicated, but a negative test can be misleading. Because it’s not a very sensitive test, the carotid duplex scan offered by Lifeline Screening is not recommended for assessment of artery health.

SCREEN FOR ATRIAL FIBRILLATION: This arrhythmia is dangerous, because clots can form in the atria (the small, upper chambers in the heart) and go to the brain, resulting in an embolic (caused by a clot originating somewhere else) stroke. Most people with atrial fib know they have a heart irregularity but not all. If Lifeline Screening shows this condition, you should see your physician right away; if it is not present, it could be because the arrhythmia occurs intermittently.

ABDOMINAL AORTIC ANEURYSM SCREENING: The left ventricle of the heart pumps blood through the aorta, the largest blood vessel in the body. In some people, a weak spot develops in the abdominal portion of the aorta, resulting in a bulge called an abdominal aortic aneurysm (AAA). Most people with this condition don’t realize they have it until it bursts, at which point it’s too late to do anything about it because of massive acute blood loss — and some 30,000 Americans die every year from a ruptured AAA. If the bulge is caught early through a screening ultrasound, the weak spot can be repaired. Medical guidelines for screening vary, but Bale and Doneen recommend that everyone have a screening ultrasound for AAA at age 50, and at age 40 if they have risk factors such as smoking, hypertension, the 9P21 gene or a family history of AAA.

PERIPHERAL ARTERIAL DISEASE (PAD) SCREENING: PAD is atherosclerotic plaque in the arteries of the legs, which can result in leg pain with walking. Surgery to bypass the blockages and even amputation are sometimes necessary. Furthermore, if disease is found in leg arteries, it is bound to be present in other arteries such as those in the heart and brain.

OSTEOPOROSIS RISK ASSESSMENT: In our society, it’s common for people — especially women — to develop brittle bones as they age, causing increased risk for fractures. A DEXA scan, which measures bone density in the wrist, lumbar spine and hip is recommended for all women at age 65 and men at 70. It is available locally and is recommended at a younger age if risk factors are present such as smoking, heavy alcohol use, use of medications such as cortisone and certain stomach acid blockers, and history of fracture occurring without severe trauma. The test offered by Lifeline Screening is an ultrasound of the shin bone, which is of questionable value.

To answer the question of whether you should sign up for Lifeline Screening, if you’re younger than 40, any benefit is unlikely. If older than 40, certain of the tests could be helpful, with caveats noted above. If you decide you want to get this screening, pre-registration is required (call 888-763-4154).

Dr. Feinsinger is a retired family physician with special interest in disease prevention and reversal through nutrition. Free services through Center For Prevention and The People’s Clinic include: one-hour consultations, shop-with-a-doc at Carbondale City Market and cooking classes. Call 970-379-5718 for appointment or email gfeinsinger@comcast.net.