Feature Article: May 2020 – Are Medical Students Being Prepared for the New Era of Health Maintenance?

Are Medical Students Being Prepared for the New Era of Health Maintenance?

Isabela M. B. David, M.D., Laura B. David

The “new era” in nutrition is closely related to the conclusion of the Human Genome Project. More than lead to cures for diseases, as expected, it brought about the understanding of genetic expression and, therefore, what we can do to avoid having our bad genes express themselves and, on the other hand, what to do so that the good genes show up and bring us better health and longevity.

In our context, diet assumes an important role. Nutrigenetics, Nutrigenomics and Epigenetics came to explain a lot about how what we eat influences our genes and how our genes influence our response to what we eat. Shakespeare’s words were never so accurate: “You make your choices and your choices make you”.

The concept of the 5P Medicine1 (more Preventive, more Predictive, more Personalised, more Proactive and more Participatory) was being delineated step by step, and the “science of maintaining health” defined itself along the way.

Now it is clear that we have knowledge and technology to optimize our health and live better and longer, squaring the healthspan curve.2 For that, we can not accept the “decline” which was before taken as unavoidable in the process of aging.3 In fact, the concept of aging described as “molecular damage accumulation over time”4 makes it easier to picture that we are effectively able to detain, delay or even reverse this damage, which, by the way, are common biochemical processes closely related to food and dietary supplements, such as inflammation, oxidation, glycation, acidification and submethylation. Needless to say that other factors influence the whole “scenario”, such as sun exposure, irradiation, ambiental toxins and pollution, drugs, stress response, stem cell exhaustion, and so on.4

Laura David, who shares the authorship of this article with me, is a medical student in Brazil and, from what she says, diseases are still the main actors in the teaching scenario. They learn the definition of the disease, who are prone to it, how to diagnose it and how to treat the patients, basically. She is in her third year at university, but she was never told by her teachers anything related to Age Management and how to be proactive to maintain health. Prevention is barely spoken to, although it has already been in the news for a while that Preventive Medicine is the medicine of the 21st Century. Surely a lot has already to be done to reach far beyond the “status quo”. Certainly, we have a long way ahead of us and much is needed to prepare these young medical doctors to include these concepts in their practice, truly and honestly, for the better. For that, inspirational, diversified, invigorating, interactive and challenging teaching, as proposed by Age Management Medicine Group, has to touch their heart and make them realise that they have a key role so these proposals come really true in the long run.

It is important to reinforce that Age Management Medicine is not a new speciality, but only a new “look” into the whole process of aging. That the new Preventive Medicine has its focus on health maintenance, but, certainly, all specialities will still be necessary because things will not change totally in one or two decades. Let’s let it flow and see what happens, but, in all ways, all young medical doctors should be aware that Predictive Medicine means to identify what each person is prone to and act before the diseases manifest themselves. That Personalised Medicine means that we have to make use of genetic tests and all technologies that explore the secrets of our DNA, including quantum physics with its new proposals, all to help reach our goal to maintain health. That Proactive Medicine means that both doctors and patients must act systematically to control the parameters of damage and work objectively to reach health optimization. And, finally, that Participatory Medicine include many professionals working together so that our dreams come true and we will be able to liver longer, but with quality of life.


  1. Gardes, J., Maldivi, C., Boisset, D., Aubourg, T., Vuillerme, N., & Demongeot, J. (2019). Maxwell®: An Unsupervised Learning Approach for 5P Medicine. Studies in Health Technology and Informatics, 264, 1464–1465.
  2. Larrick, J., & Mendelsohn, A. (2010). Applied Healthspan Engineering. Rejuvenation Research, 13, 265–280.
  3. Giacomoni P. Ageing, science and the cosmetics industry. EMBO Rep 2005; 6: 45-48.
  4. Mark T. Mc Auley, Alvaro Martinez Guimera, David Hodgson, Neil Mcdonald, Kathleen M. Mooney, Amy E. Morgan, Carole J. Proctor; Modelling the molecular mechanisms of aging. Biosci Rep 28 February 2017; 37 (1): BSR20160177.

Isabela M. B. David, M.D. is a Clinical Nutrition Practitioner in the Post-Graduate Program in Health Sciences, Universidade do Sul de Santa Catarina. Av. Pedra Branca, 25. Palhoça SC, 88137-270, Brazil. (2017)

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