A “Natural” Approach to Improving Your Health
America is in a crisis. No, I am not talking about Covid-19 nor am I talking about politics. I am referring to a health crisis of epidemic proportions. As a population, we are as unhealthy as we have ever been. In the U.S. adult obesity rate stands at 42.4 percent, the first time the national rate has passed the 40 percent mark, and further evidence of the country's obesity crisis. The national adult obesity rate has increased by 26 percent since 2008. About 655,000 Americans die from heart disease each year—that's 1 in every 4 deaths. Heart disease costs the United States about $219 billion each year from 2014 to 2015. About 42% of cancer cases and 45% of cancer deaths in the United States are linked to modifiable risk factors – and thus could be preventable – according to a new study from American Cancer Society researchers. These figures, based on data from 2014, translate to:
659,640 cancer cases (out of 1,570,975), and
265,150 cancer deaths (out of 587,521).
The researchers came up with the estimates by calculating how much certain lifestyle factors contributed to 26 different cancer types among adults ages 30 and older. These risk factors included:
Diet low in fruits and vegetables, dietary fiber, and dietary calcium
6 cancer-associated infections – Helicobacter pylori, hepatitis B virus (HBV), hepatitis C virus (HPC), human herpes virus type 8 (HHV8), human immunodeficiency virus (HIV), and human papillomavirus (HPV)
All the diseases mentioned share a predominantly common variable, they are due to lifestyle choices. Americans and residents of other first world countries are increasingly becoming victims of their own wealth. We eat for comfort and pay little attention to the nature of the food and focus more on how it tastes. Many of our advances serve to allow us to be more sedentary than ever before. Think about this: Most of us have to make a conscious effort to schedule a time to go out of our way to physically exert ourselves, aka, exercise. We also spend less and less time on leisure activities cultivating our passions, building relationships, and stimulating our minds with healthy hobbies. We have used technology to free our time up so we can fill it with more and more work, stress, and other pursuits that have only served to make us more unhappy, anxious, and depressed than we have ever been.
In the past few years, we have been increasingly inundated with clever marketing everywhere we turn telling us that our health problems can be fixed by various supplements, homeopathic remedies, or alternative medicine approaches. All these approaches agree that we have a crisis in the health of our population. We have an epidemic of obesity, diabetes, high blood pressure, heart disease, chronic pain, anxiety, and depression. These approaches promise a more natural and safer alternative to traditional medicine that has been led by physicians and has been wrongly labeled as a philosophy of taking pills for everything that ails us. Technically, anything you put in your body is a medicine. Whether it is made by a pharmaceutical manufacturer, a “natural” supplement maker, or a homeopathy remedy, it is not natural. It is only your perception (influenced by marketing) that differentiates it. Traditional medicine has been increasingly attacked on all fronts by clever entrepreneurs who prey on people's weaknesses including fear and the natural tendency to look for the path of least resistance to fixing our problems. We are taught that this is not our fault, but in fact someone else’s or no one’s fault. It is not politically correct to take personal responsibility for our problems in society. We are consciously and subconsciously taught to believe that we are powerless and must rely on someone or something else to fix the problem.
All the various alternative approaches have a common equation: they will validate the struggle thereby building rapport and trust and acting as a sort of confirmation bias, since most of us seek to look elsewhere for solutions instead of looking within ourselves for the solution. They offer a new approach and recommend strange and very scientific sounding tests. They even market products with words like "essential" in the title. They often prescribe some obscure vitamin deficiency (despite normal testing sometimes) and recommend an expensive one-of-a-kind supplement that they conveniently offer for sale at a profit. Most people do not have a vitamin deficiency if eating a relatively balanced diet, as most malabsorption issues are found quite early in life. There are a few common deficiencies that we do see, such as vitamin D. I treat that often and at minimal expense to the patient. It is a simple test and a cheap remedy. A good reputable and affordable multivitamin is often all that is needed for most with vitamin concerns. Studies have shown that the longer and more difficult the name of a supplement, medicine or treatment, the more the patient believes it will help. (See Goldacre’s book mentioned below). They will provide a diagnosis and tell us that the problem is not with our lifestyle choices, but instead is an external one and that they have the solution, the safer, natural, holistic, alternative solution. They promise us an answer, therefore we will ignore their profit motive, we will buy their supplement, continue to come back for the prescribed number of therapeutic visits, if only to believe that we can be fixed by a pill, supplement, treatment, or some other remedy. Unfortunately, most of the remedies have either no benefit, are placebo only, or are temporary improvements with no lasting benefit. Why? Because at its core, the problem is a lifestyle problem.
I would encourage any patient to critically think and ask on what basis do these natural or alternative providers claim a solution will work. Is there any evidence? Nonbiased evidence? What is the quality of the evidence? Was there a conflict of interest, such as a supplement maker paying for a study showing their product worked? Was anyone without a profit motive able to replicate the results? Was the data manipulated to show or exaggerate an effect that is not truly relevant or even present? In general, if you don’t have the time to address these questions, just look or ask the "provider" for a meta-analysis or systematic review regarding whatever treatment is being provided. If it is valid and has good evidence for it, then it will usually have a systematic review or meta-analysis. They should be able to provide the written evidence. If they resort to complicated explanations and big sounding words to explain it but cannot give good corroborating evidence, then you should be very suspect and hold tight to your wallet.
There is an excellent book written on the predatory tactics I have briefly mentioned called “Bad Science: Quacks, Hacks, and Big Pharma Flacks” written by Ben Goldacre. I encourage everyone to read this book. In it, he explains in simple and entertaining ways how we (patients and consumers) are preyed upon, by corporations, alternative healthcare providers, and he even takes traditional medicine to task. He is fair and calls out everyone.
I am a traditional medical doctor. I went into medicine with dreams of helping those who are sick. I went into primary care so I could build relationships and affect change through a relationship built on trust and mutual respect. In the past several years, I have seen an erosion in the trust and respect towards physicians in general. Due to some bad actors, some of the distrust is warranted, but fortunately the bad actors are a small minority. For the rest, our job has never been more difficult. With everyone selling a “magic cure” and promising an easy or external solution, traditional medicine is old news. You would be surprised to hear that prescribing pills is the last thing that I want for any of my patients. I would unscientifically estimate that 80% of the problems I treat in my practice, stem from poor lifestyle choices. And as such, the solution is to focus on lifestyle changes as the solution. Research has shown Among U.S. adults, more than 90 percent of type 2 diabetes, 80 percent of CAD, 70 percent of stroke, and 70 percent of colon cancer are potentially preventable by a combination of nonsmoking, avoidance of being overweight, moderate physical activity, a healthy diet, and moderate alcohol consumption (Willett 2002).
I have come to the realization in the past few years, that it is not just enough for me to diagnose and prescribe a treatment for a health problem. I now must become a coach, a motivator, a facilitator of change. The problem is that my message is not easy. In fact, it is a difficult road to follow. It takes dedication, patience, and accountability. Behavior change is never easy. You see, my message is one of taking personal responsibility for your health. Any solution that does not first and foremost cause you to evaluate your patterns of behavior and lifestyle is doomed to fail. We all need realize that change comes from within not without.
My message is to focus on eating a healthy diet. Eat the way God intended for us and provided for us in our environment with vegetables, fruits, lean meats, nuts, fish, etc. The more modified or manmade it becomes, the unhealthier it becomes, in general. Processed foods and refined sugars are shining examples. We need to focus on portions. We need to prepare our foods naturally. The most effective diet for years, has been the Mediterranean style of eating, as has the DASH (Dietary Approaches to Stopping Hypertension) diet. These diets at their core, teach us to eat more naturally and in moderation. Even healthy things when taken to excess can be unhealthy.
Exercise is another important variable and driver in our health. Research unequivocally shows us that our bodies are meant to be in motion. There is no easy way around this one. We must put in the time. As little as 30 minutes of aerobic exercise 5 days per week, has been shown to increase energy, improve sleep, lower weight, lower blood sugar, lower cholesterol, lower blood pressure, improve mood, improve pain, and improve sexual dysfunction, among many other benefits.
There are other lifestyle variables that are also important. Appropriate sleep is critical to a sense of wellbeing. Sleep affects your energy, mood, hormones, and has various other positive effects. We need to prioritize how we take care of our body, which includes giving ample rest and consistent patterns of sleep. Relaxation is also necessary, and meditation is one important form. This can come in the form of exercise for some. Others may go fishing or hunting and thereby calm their mind. For others it may be reading a good book or taking a long walk. The point is to find what calms your mind and make it a daily habit.
When it comes to treating chronic disease, do I prescribe pills? Yes. It is a last resort. I will prescribe pills for one of two reasons. The first being that the person’s health issue is at such elevated risk that to not recommend a medication would be doing harm. I prescribe lifestyle change as the primary treatment for appropriate health conditions, and hopefully the medication is temporary and used to help lower the immediate risk of adverse outcome while they implement lifestyle change, or the medicine is to help improve their quality of life so they can better make lifestyle change. Often, in the setting of chronic diseases, medicine can treat a symptom and lower risk, but they are no substitute for lifestyle change. Unfortunately, when patients leave my office, they go back to the same environment, cues, and behavior patterns that make it difficult for them to undo the behaviors they have had for years. Therefore, I do prescribe evidence-based medicines and therapies that modify their risk in a positive way. My job is to give advice and use my training to evaluate therapies and evidence to recommend treatments to help maintain or improve a patient’s quality of life. I can’t force the lifestyle change on them. Unfortunately, many choose the pill. I made a solemn vow to help patients through any valid means possible. Medicine is just one option.
I am on the same team as my patients and always want the safest, most natural fix possible for them. Pills are a last resort, as they should be. For most of the health problems that ails modern America, the good news is that the solution is free. You don’t need some expensive supplement, lotion, potion, or dubious treatment to fix a lifestyle issue. You just need one-part motivation, one-part dedication, one-part dietary change, one-part exercise, one-part sleep, and one-part accountability.
When it comes to lifestyle problems, if you don’t change the underlying behavioral problems that are leading to the disease, then there is no alternative solution that will ever give any lasting cure. There is no shortcut. There is no external person or fix to be found.
I know it is tempting to be drawn to the latest quick-fix fad, but please don’t fall for it. The only thing that gets lighter is your wallet. No one can make money on recommending a healthy diet or exercise, which is why they all find it necessary to add some proprietary ingredient that only they can provide. The only real lasting solution is looking at you in the mirror.
You are the Cure and the Cure is Free!
Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones by James Clear
The Power of Habit by Charles Duhigg
Bad Science: Quacks, Hacks, and Big Pharma Flacks by Ben Goldacre
Lies, Damned Lies, and Science: How to Sort through the Noise Around Global Warming, the Latest Health Claims, and Other Scientific Controversies by Sherry Seethaler
How to Lie with Statistics by Darrell Huff
Why Don’t Zebras Get Ulcers by Robert Sapolsky
The Obesity Code by Jason Fung
The Complete Mediterranean Cookbook: 500 Vibrant, Kitchen-Tested Recipes, for Living and Eating Well Every Day by America’s Test Kitchen
Never Binge Again: How Thousands of People Have Stopped Overeating and Binge Eating – and Stuck to the Diet of Their Choice! By Glenn Livingston Ph.D.
The Dash Diet Weight Loss Solution: 2 Weeks to Drop Pounds, Boost Metabolism, and Get Healthy (A Dash Diet Book) by Marla Heller MS, RD