Think different: from reactive sick care to proactive healthcare

door Nexuzhealth op 23.9.2025

Medicine has achieved extraordinary progress over the past century. Vaccines, antibiotics, therapies and procedures have transformed our lives and significantly extended our life expectancy. “In the Western world, we now live on average forty years longer than in 1900. That is an undeniable triumph of medical science. And yet it is time we start thinking differently about healthcare,” said Professor Carlos Van Mieghem, cardiologist and specialist in Lifestyle Medicine, during the Nexuzhealth Summit, where he shared his personal vision on the healthcare of today and tomorrow.

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Professor Carlos Van Mieghem

Our life span may have increased, but our health span still lags behind. “The gap between the years we live and the years we spend in good health averages twenty years. That means many of us will spend the last decades of our lives with chronic conditions and limitations. And let’s be honest: that is not an appealing outlook,” Professor Van Mieghem warned.

A care system from another time

To have better comprehension, we need to go back to the origins of our current healthcare model. After World War II, the focus was mainly on tackling infectious diseases and treating acute injuries such as fractures and bleeding. The system was reactive by design: you consulted a doctor or a nurse only when you were ill or injured.

“That system worked very well,” Professor Van Mieghem noted. “It even contributed to adding several decades to our average life expectancy. But the challenges we face today are very different. We are growing old with chronic illnesses. And our current healthcare model was never built for that.”
“We cannot prevent life from being finite, but we can ensure that we spend more years in good health. With current insights, ninety can become the new sixty.”
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Professor Van Mieghem

Cardiologist and Specialist Lifestyle Medicine

The rise of chronic diseases

In 1920, life expectancy in Belgium was about 47 years. At that age, conditions such as type 2 diabetes, Alzheimer’s or certain cancers rarely developed. Today, we live on average 82 years, which gives these diseases far more opportunity to emerge.

The statistics speak for themselves. Cardiovascular disease remains the number one cause of death, followed by various forms of cancer. At the same time, neurodegenerative disorders like Alzheimer’s and Parkinson’s are on the rise, along with metabolic conditions such as type 2 diabetes.
 
“In Belgium alone, more than 200,000 people live with Alzheimer’s, and that number will keep increasing due to ageing,” Professor Van Mieghem emphasised. “The case of type 2 diabetes is even more telling. It is now the leading cause of kidney failure and dialysis. Remarkable, isn’t it? Especially when you consider that the vast majority of cases can be prevented. Almost everyone can avoid type 2 diabetes by making conscious choices in diet, exercise and lifestyle.”

Health as an investment

To make his point, Professor Van Mieghem draws a striking comparison with retirement savings. “We all put money aside to ensure we can remain self-sufficient in old age. Yet we don’t invest in our health, even though it is at least as important. What good is a comfortable pension if the last twenty years of your life are limited by one or more chronic illnesses?”

According to him, we must learn to think differently: health should be seen as an active, long-term project. “And that project should begin around the age of 25, when people generally feel fit and rarely think about their future health.”
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From normal to optimal

This shift also requires a move from ‘normal values’ to ‘optimal values’. In today’s medical practice, reference values are often based on averages. But being “average healthy” is not the same as being optimally healthy.

Professor Van Mieghem illustrates this with an example from his own practice: “With a DEXA scan, we measure bone density, muscle mass and abdominal fat. While it is often used to detect osteoporosis, I use it in a broader context. If a 50-year-old man has an average muscle mass compared to his peers, that is considered ‘normal’. But optimal muscle mass means reaching at least the 90th percentile. By building that reserve early, starting at 25, you reduce the risk of fractures and functional decline later in life. The same principle applies to visceral fat, which significantly increases the risk of cardiovascular disease, cancer and neurodegenerative disorders. Measuring and visualising this early on allows preventive action and real health gains.”

A mission for the future

The COVID-19 pandemic triggered deep reflection for Professor Van Mieghem on the future of healthcare. “I want to make it my mission to move from sick care to healthcare,” he said. “The key lies in prevention, nudging, and using data through technology.”

Hospitals hold vast amounts of data, but much of it remains underused. By connecting this information with insights on lifestyle and prevention, it becomes possible to deliver personalized advice that truly motivates people. “Numbers alone are not enough. The patient’s own motivation and involvement are crucial. Without that, there is no lasting change.”
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Nexuzhealth Summit 2025

From sick care to healthcare

Demographic trends are clear: by 2080, 29% of the Western European population will be over 65. “Without a fundamental shift in our thinking, the gap between life span and health span will only widen,” Professor Van Mieghem concluded. “We cannot stop life from being finite, but we can ensure more years are lived in good health. With today’s knowledge, ninety could become the new sixty. But achieving that requires a transition: moving from reactive sick care to proactive healthcare, with prevention and optimal values as the foundation. That is where the future lies.”
Topics: Digitalization

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