Are We at Fault?

Not long ago, a report linking antibiotics to breast cancer dominated the headlines. Researchers in Seattle had found that women who took the drugs for more than 500 days, or about 25 individual prescriptions over 17 years, had twice the risk of developing the disease as those who never took them. When I read that, I began some panicky calculations. It didn’t take me long to realize I was screwed. That’s just a little more than one prescription a year. Great, I thought. Now if I get breast cancer, I’ll always wonder if I brought it on myself.

As a veteran health reporter, I know it’s unlikely that antibiotics cause cancer. In fact, some experts speculate that the underlying cause might be a weakened immune system, increasing your susceptibility to both everyday infections and cancer. But the idea that our behavior influences our health has become so woven into the fabric of our culture, we’re only too willing to accept such news — and the self-blame that goes along with it.

Over the past 30 years, dozens of long-term studies into the causes of the leading killers have pointed a finger squarely at our behavior — at the virtues of exercise and a healthful diet, and the dangers of smoking and saturated fats. But these days, fresh evidence of our culpability arrives like clockwork with the hourly news: Poor oral hygiene has been linked to heart disease; atherosclerosis (preventable with diet and exercise) has been implicated in Alzheimer’s; more than one alcoholic drink a day may increase the risk for breast cancer.

Spreading the good word about prevention has become a mission for the media — an approach that’s hard to fault. Experts estimate that unhealthful eating and physical inactivity are responsible for more than 400,000 premature deaths each year. (Only tobacco use causes more.) Even so, I sometimes wonder if the message behind these reports — that it’s our own fault if we get sick — doesn’t encourage us to go overboard; if, in our zeal to do what’s right, we’re not confusing prevention with perfection, expecting more of diet and exercise than they can deliver, and feeling like failures if our daily choices don’t always meet the high standards we set for ourselves.

Take my friend, Tracie. At 40, she’s been cancer-free for five years, but she still blames herself for the malignant, pea-sized tumor that she found in her right breast.

"Since I don’t have any family history, I’ve always believed — and felt that everyone else believed — that my poor eating habits during my 20s and 30s caused it," she says.

In the year following her mastectomy, Tracie revamped her diet, tracking her intake of nutrients, eating only organic produce, and cutting out alcohol. For a while, the health scare still fresh, she was able to stick to it. But as the years slipped by, she wanted to distance herself from that fearful experience.

"Now I try to eat well, but there are lots of days when I don’t," she admits. "I’ll lie in bed at night, thinking, ‘Why did I have that candy or that extra glass of wine?’ But I know why. Because I’m tired of being a breast-cancer survivor. I just want to be like everyone else."

Self-Induced Stress

If good physical health is the heads side of the prevention coin, then guilt is the tails — the emotional scourge of our overachieving generation. For women who have faced a life-threatening illness, as did Tracie, guilt is a constant companion. For the rest of us, it’s a recurrent visitor, slipping in and out of our lives like a shadow, casting a pall over good times and making simple activities such as buying groceries, working out, and packing kids’ lunches emotionally fraught.

"I’ll go to several stores to find soup that doesn’t contain corn syrup, tons of sodium, and chemicals," admits my 42-year-old friend Christina, one of the most health-conscious women I know, who hikes or does yoga almost every day. "It’s made grocery shopping way more stressful and time-consuming."