This article in the NYT asks a big question. Now that major studies have dismissed Low Fat diets, HRT and Calcium supplements as the answer to health, what are women going to do to have a healthy life?
Well maybe, the answer is to stop looking for the Silver Bullet. The truth is that our health is not a matter of one pill or one vector but it is a "Whole".
Is it really olive oil or is it the interactive and high intensity lifestyle of Italians that makes the difference to health? Is bone density really about eating more calcium or is it really about having an active life that includes a lot of load bearing? Is diabetes driven by our genes or more driven by what we eat?
Are we machines that can be "fixed" or are we living beings that have to take care? If we accept that we are humans and not machines then there can be no fix. As living beings, we are complex systems. Being a complex system, many factors not one, act upon us to make us more or less healthy? So what do we have to know and then what are our choices?
I am working with a bunch of scientists in the field of health (The BioAlliance of PEI) and here is their answer to these deeper questions. All their wisdom is focused in a simple equation. Like e = mc2, it is a small equation but in shows us how our health really works. In so doing, we can start to explore what we can do to take charge.
G + E
-------- = U
B x C
Translated into English this means
Our (G)enes plus our (E)nvironment factored by our (B)ehaviour which is affected by our (C)ulture drives our health.
So let's take Alzheimer's disease and see it through this prism. Only 5% of us are condemned by our Genes to get Alzheimer's. For the rest of us, it will be how we live our life that will mean that we will develop the symptoms or not. What we eat, how active our mind is and how flexible our world view is are all important factors in holding off dementia. Genes are only the starting point.
Let's take Type 2 Diabetes. 50 years ago it was a rare condition. Now it is an epidemic and people from Non European stock, especially native Americans and Canadians, are especially in jeopardy. Is there a genetic link? Of course, but if the issue was only genes, diabetes would have been around for all of time. It has become an epidemic because of factors other than genes - the genes simply make the group vulnerable. Many of the people who are most at risk come from cultures that until recently ate a much healthier diet but who now live off junk food. The real driver is what people do in their lives, what they eat etc and how they feel about their place in the world.
Let's look at TB. TB is on the rise. Bill Gates has announced that the Gates Foundation will invest $600 million in finding a cure. Yes TB is an infectious disease. Yes it is resistant to many drugs now. A new drug may help. But the "cure" has been known Bill for 50 years. It is called good living conditions. You don't believe me?
This chart shows the death rate per million from TB. You will see that it was almost wiped out by the time that antibiotics were first introduced. Drugs did not make the difference - public health, better diets, better housing and a narrowing of the gap between rich and poor did. Why is TB on the rise again today? Because the gap between rich and poor has widened so much in such a short time. Because the revolution of life as we know it today is robbing many of their identity and self worth. Because in many parts of the wealthy world, people have given up hope.
We forget that the great advances in health occurred at the end of the 19th century when massive programs of public health such as water and sewer systems, public schooling, labour codes, better access to good food and clothing were introduced. We forget all of that and have instead become fixated on silver bullets and on single items.
Take smoking for instance. I am not advocating you take it up again. But I am saying that as a risk, smoking is a small one when compared to where you fit in the hierarchy. If you give up smoking you will live longer. But if you live a life of a drone in a large bureaucracy you will be more at risk than any other health factor.
Basically this slide tells us that the more control you have in life, the healthier you will be.
This is a hard slide to read at first - so this is how it works. The bar on the far left is the death rate of the admin class = Deputy Minister in Canada. On the far right are the low level civil servants in the UK civil service. These are all well educated people and would be considered lower middle class. Data was obtained for 25 years from the entire British Civil Service. The study is called the Whitehall Study and was conducted by Sir Michael Marmot. You can see on the right that if you are at the bottom of the pile, you are 4 times more likely to die of Coronary heart disease than if you were at the top. You will also see that things we feel are the main causes of the disease, such as smoking cholesterol etc are insignificant factors for those on the left and make up only a small part of the causes on the right. By the way cholesterol is off the chart. Yet there is a huge industry that has convinced us that it is the killer.
So what then is the unknown factor that is the real problem? We think that it is related to our immune system itself. When we feel that we have little control in our lives, as most who live in the middle or in the lower ranks of bureaucracies, then this sets up a stress that affects our immune system.
Modern life itself with ever more extreme differences between rich and poor, with most people slogging away down the corporate or social ladder, is the driver of a poor immune system and hence our likelihood of developing diseases that are derived from a suppressed immune system.
This is really what I mean by looking more closely at our immune system. If you were a wildebeest, the lions are always there. When it is our time the lions take us. When do they take us? When we are very young or when we are weak. This is the story of our immune system. The bacteria and the viruses are always there. When our immune system is weak, they take us. They key is not to get rid of the viruses or the bacteria. The issue is to make our immune system strong.
You don't believe me? For most viral diseases, when you get the disease, it has you. If you express the symptoms for rabies, you are going to die. But if you are inoculated prior to symptoms, your immune system will kill it off. Our immune system is exceptionally powerful and we are only now starting to understand it well.
I think that we stand on the edge of a new revolution in how we see health. The scientists who will lead that revolution are in the field of the immune system.
The primary issue for having good health is to understand our immune system better and live the life that keeps it strong. But this is not what we do or where we invest. In Canada and in the US, health has been defined as access to the healthcare system. A giant industry tells us that we are only a pill away from health. But most of what drives our health are factors that can be seen as environmental. So instead of looking at how we live, we look for a new silver bullet. Instead of looking at our choices, we become helpless. Instead of taking charge, we blame.
Does that mean that we are helpless? We are immersed in this powerful culture of the consumer world, where we have largely become as domesticated as the poor animals that provide our food. We too live in large pens, called cities. We have stopped moving. We eat the same processed junk that we feed them.
So what can we do? What information is out there that we can trust? In the next few months I will be talking about what these scientists have told me about how we can take charge. We will look at how the immune system works. We will find out what to do to take charge of our lives more. We will discover how we can now test for many diseases such as diabetes years in advance of it bursting out so that we may have a chance of healing ourselves before it is too late. We will see how medicine can move towards being more precise and more preventative. We will see what foods really do make a difference.
We will see how we can break free from the grip of the consumer society and the grip of those that offer us the silver bullets.
Technorati Tags: BioAlliance, Health, Healthcare, Immune System, Michael Marmot, Diabetes, Alzheimer's, TB, Whitehall Study
