According to recent estimates by the World Health Organisation, over 50% of mortality is related to just three factors: air pollution, cigarette smoke, and diet.  At one point we thought genetics would hold the answers to human health and longevity.   The limitations of using genes to predict and prevent disease became apparent pretty early on.  We now know that genetics accounts for less than 10% of human disease and that the remaining causes are environmental.

To put it another way, genes are the loaded gun, but the environment is what pulls the trigger.

Lead singer of The Verve,  Richard Ashcroft sang it well; “When the drugs don’t work, they just make you worse.”  Was he singing about the current healthcare system being ineffective? Does Richard know that it’s not healthcare, and a better description of the current medical system in westernised countries would be “disease management.” 

Don’t get me wrong; the health care system is great for emergencies and trauma care. If you break a bone or get hit by a car, the hospital would be the first place to go. However, promoting health or preventing/treating chronic disease is not what our current medical system is doing, which is by far the biggest problem that we are facing.

When it comes to chronic disease, our current medical system is focused on suppressing symptoms and selling drugs.  If you have high blood pressure or high cholesterol or hyperthyroidism, the first response is to give you a drug that will lower this marker.  There are no questions about your diet, sleep, physical activity, stress or social connections.  The current medical system won’t ask “why” you are experiencing these health issues, they often ignore the cause and throw you the magic pill.

“90% of our health is determined by social, behavioural, and environmental factors.”

Why don’t the drugs work?

  1. Drugs very rarely address the problem and merely treat the symptoms. For example, let's pretend you have a splinter in your finger.  You could take ibuprofen or some other painkiller to reduce the pain, but wouldn’t a better solution be to remove the splinter?

  2. Drugs often come with side effects. For example, non-steroidal anti-inflammatory (NSAIDs) like ibuprofen can be useful in relieving pain, but they also reduce blood flow to cartilage and increase sodium retention.  This can lead to an increase in blood pressure in some people.[1]

    Blood flow is important for carrying nutrients and immune substances to the tissues for repair. Ironically, taking painkillers can worsen the problem because they actually reduce the body’s ability to heal. [2]

  3. Drugs cause other problems.  Drugs can interfere with many of the natural chemical processes that occur in our body and therefore cause side effects.  Drugs often have unintended consequences that can outnumber the intended effects.  Drugs can lead to other health issues that were not present before the drugs were introduced.

    The human body is a very complex organism that adapts to its environment in both positive and negative ways.  Histamine is a prime example. Histamine works as a transmitter in the nervous system that links basic homeostatic and higher brain functions, including sleep-wake regulation, circadian and feeding rhythms, immunity, learning and memory in health and disease. 

    If you have an insect bite or a rash, it can often be mediated by histamine. However, histamine actually increases the function of brain neurons. By taking an antihistamine to suppress an allergic rash, for example, you will affect histamine receptors in the hypothalamus and down-regulate the function of neurons which will lead to drowsiness [3], lower our immune system and impacts our memory and learning capacity. [4]  

Emphasises healthcare over disease management

Imagine taking your car to a mechanic and saying: “My car is not running properly.”  The mechanic takes a quick look and says “I think your car has not-running-properly syndrome and it can not be fixed.  Just put this stuff in with the petrol and it may help it keep running a little longer.”  The mechanic didn’t even take the time to figure out why the car is not running properly; he just diagnosed it and sent you on your way with a temporary bandaid fix.  This is how our current medical system treats chronic disease.

An excellent example of this is Dr. Terry Wahls who has multiple sclerosis (MS) and was treated by the latest conventional medicines only to see her condition deteriorate.   She took it upon herself to change her environment and lifestyle factors which lead to a remarkable improvement in many of her symptoms.  She went from being in a wheelchair unable to move, to be able to walk and function again.

We honestly need a new approach to medicine, one that emphasises healthcare over disease management.   What would this look like?  Chris Kresser's Unconventional Medicine lays down the idea that a new healthcare system would:

  1. Recognise the impacts of our environment including:

    1. The food we eat

    2. The water we drink

    3. The air we breathe

    4. Our physical activity

    5. The chemicals we are exposed to at home and work

    6. Our social interactions

    7. Our lifestyle choices

    8. Inherent metabolic and cellular activity

    9. The microbiome

    10. Our inflammation levels

    11. Our hormones

    12. Oxidative stress

    13. etc..

  2. Embrace an ancestral perspective.  All organisms adapted to survive and thrive in a particular environment, and when that environment changes faster than the organism adapts, a mismatch occurs.  Our genes have not adapted to our environment.  For 66,000 generations, humans ate primarily meat and fish, wild fruits and vegetables, nuts and seeds, and some starchy plants. We were physically active. We didn’t sit for long periods. We lived in sync with the natural rhythms of light and dark in direct contact with nature and in close-knit tribal and social groups.  Our hunter-gatherer ancestors were fit, lean, and remarkably free of chronic disease.  They were superior to us in fitness, BMI,  blood pressure, insulin sensitivity, oxygen consumption, eyesight, and bone density.  They didn’t have obesity, heart disease, diabetes, gout, hypertension or cancers.

    Where did it all go wrong? What transformed us into a sick, fat and unhealthy population? The first blow was agriculture, as soon as humans settled down and started farming there was a major shift in what we were eating.  Our average intake of carbohydrate increased while our average protein intake decreased. The quality of protein we ate decreased as the animals became grain-fed instead of grass-fed.   The nutrient density of the food we were eating also decreased as the soil quality was not the same as it was in the wild.  Our new diet contained far less variety as it was based on a limited set of crops such as wheat, rice and corn and it was lower in more nutrient-dense animal products.

    The second punch in the guts was the Industrial Revolution.  It gave us white sugar, flour, and vegetable oil, which now makes up over 50% of the calories in the average western diet. The industrial revolution made us more sedentary than we’ve ever been before, thanks to machinery that now does all of the hard labour for us. We are chronically sleep deprived as we no longer go to bed when the sun goes down and we spend the majority of our day looking at blue light screens.  Our stress levels are off the charts. We don’t feel like we have enough time to relax or play and even when we do take a holiday we continue to check email and social media accounts.

    Our genetic heritage and our modern environment are profoundly mismatched and it’s hard to argue that this is not responsible for the modern disease epidemic. Many of us now work and live in isolating and alienating social environments that are more disconnected than ever before.  We eat a low nutrient dense diet, we don’t get enough sleep, we are overworked and stressed up to the eyeballs and we are moving less. And yet, we put our faith in the medical system to solve our illnesses because we fail to admit that we are living an unhealthy lifestyle.

  3. Apply a functional medicine approach to care.  Functional medicine treats symptoms which leads to more profound and longer-lasting results by addressing the root of the problem. Functional medicine is patient centred and focuses on lifestyle, diet, sleep, stress, social connection, and physical activity. The patient is respected, empowered, educated and encouraged to play an active role in his health span.

In no way am I suggesting that you stop taking your medication, this post aims to make you start thinking about “why” you need the drugs in the first place? What lifestyle and environmental factors have to lead to the symptoms you are experiencing? Are you eating a well-balanced diet? Are you exercising regularly? Are you getting 7+ hours of quality sleep per night? Are you implementing stress management tools like meditation, journaling, or a gratitude log? Do you have a meaningful social connection and a support network?

Making behaviour changes can be hard work and having people to support you, motivate you, and hold you accountable is essential. If your ready to start making healthy behaviour changes and you're not sure where to start maybe health coaching is something that could help?

REFERENCE:

  1. The effect of nonsteroidal anti-inflammatory drugs on blood pressure in patients treated with different antihypertensive drugs. Morgan T, et al. 2003

  2. Drugs that delay wound healing. 2013

  3. Histamine in the regulation of wakefulness. Mahesh M. Thakkar. 2012

  4. The role of histamine on cognition. Alvarez EO. 2009

  5. Unconventional Medicine, Chris Kresser, 2018

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