What is “healthy” and would you know it if you saw it?
From nature, we gather our understanding of life and how our environment affects us. We develop insights or “laws” – of gravity, entropy and heavenly bodies, through the observations we make in the world around us.
At its essence, a law is a concept that is simplified, universal and expected. If I dropped my cellphone as I was trying to put it into my pocket, I would expect that it would fall down not up. The same goes with any sized object and from any height. In health, for a law to exist, we would expect that it would be, at its core, an explanation that could be applied to any living organism with consistent results. Even as we gain a greater understanding of molecular structure and other chemical signals that interface with health and disease, a law would be further enhanced through these discoveries, not broken.
We are at a crossroads in our understanding of health, which I believe will take us to a time where more people will be able to realize better health and enjoy a long and productive life. Can our understanding of “healthy” form a basis of how to construct health promotion and disease prevention efforts? For example, wouldn’t it be better to determine a patient at risk for a stroke, than for s/he to have one and offer therapy afterwards? Although many doctors already see patient with behavior challenges in their clinics – those who continue to smoke or do harm to themselves that do not want to change. We already know that our current health system is “problem-focused” and limited in scope, since addressing disease is a palliative effort compared to preventing it and assisting in behavior change. Still pharmaceutical companies spend millions of dollars on research and earn millions more on medications for depression, diabetes, heart failure and erectile dysfunction.
What is “healthy” and would you know it if you saw it?
The motif of nature and the four seasons and how it resonates in understanding our lives has been the subject of much writing and poetry. We are born, as a seed germinates, then develop and ripen to our sweetest and most active forms before we begin to diminish, wither and die. Nature is also a biologic mirror as well to the story and structures of our bodies…which takes me to a contemplative walk in the park to think of these questions.
Does nature provide lessons to us about our health?
When I am out in the park, I take a look at the oak trees and think about their components from most peripheral to most internal: the leaves, the branches, the trunk, the bark, and the roots.
The branch formations of the oak tree are vaguely familiar to our bronchiole system
In the spring, I look around and see the trees and their outstretched branches with blossoms in full bloom and small leaf buds starting to develop and grow into what will become full leaves in summer. Each leaf shows veins that make patterns not unlike the branches of a tree itself. The leaf identifies the tree and vice versa. Using a magnifying glass, I see how complex the patterns are. I realize that each leaf is fulfilling a role for the entire tree. Is optimal growth and functioning a clue to what it is to be healthy as humans?
Our respiratory system reminds me of the trees and branches that I see outside on my hikes. I read that if you were to take the segments of our lung airways and place them end-to-end, it would measure 1500 miles! That is a lot of detail inside our chest. The characteristic of branching patterns that display self-similarity is the definition of a fractal. This complexity seems inherent in what it means to be healthy.
It is also interesting and not coincidental that our lungs represent the pathway of oxygen into the bloodstream, while the leaves are the surface, in which carbon enters the tree and oxygen exits.
How does outside interact with inside? With a tree, there are two routes: from the immediate outside – that which the leaves and branches comes directly across and from within the network of roots that connect the outside soil to the trunk, branches and leaves.
It is fascinating to see how a seed that may have been carried by the wind or a bird was able to germinate – in otherwise desert of volcanic rock where only lichens are seen.
The trunks of some trees that I see have either small knobby areas or oval-like structures which are known as a callus. It occurs when something happened to the tree that disrupted the bark. The tree heals like what would happen if we had an injury to our skin – our skin heals with a scar. Does that tell me about what happens to our health?
My mother was diagnosed with diabetes when I was in medical school. I learned that blood in her circulatory system became thicker and overburdened by too much sugar, as insulin secretion was diminished or was made less effective by adipose tissue. Even the process of the decay in insulin production is tied to a similar disease process. In this setting, the sugar could get through the entire system and cause changes from within the circulatory beds that can affect one’s vision, kidney function and sensation – their ability to feel what they are touching and more. This could lead to skin ulcers on their feet and legs. What initially starts in the circulatory system leads to damage to the other systems and affects the body as a whole.
So, health seems to relate to the natural design of our body and how it adjusts to the outside environment. Like the root system in a tree, maybe our gastrointestinal system serves that purpose in our bodies, by breaking down the food we eat and absorbing the nutrients, proteins, sugars and fats in food. Our liver is a filter system with a series of tubes that allow detoxification of the blood to be secreted as bile in the intestines.
How can we see the health of the trees and our body from the outside in?
When I look at nature and analyze the trees, I notice that some of the trees don’t look completely upright or as healthy as others. What happened in the lives of those trees? When I see how leaves change color in the fall, the color changes occur along the areas of the venations or are initially small areas where chlorophyll pigmentation has altered
I notice people who are overweight and wonder what is happening in their bodies to cause them to gain weight. Is it just a question about what types of food one is eating that leads to this weight gain. Maybe it is like a plant that deals with a specific type of soil nutrient – it continues to work, even if the soil may not be right, until it can later improve. Only we are putting in the wrong food source.
Does the body work better when it is a specific weight?
A tree is capable of making its own food source through photosynthesis using the light of the sun, chlorophyll and water. As the food is created by the tree, it is directly used in growth. Any unused sugar is transported from the leaf through the phloem to be stored in the trunk or roots as a starch. It can then be converted back to sugar for growth during the next spring.
This process is not unlike what is planned in our bodies with the excess sugar. We take in food – sometimes in disequilibrium, which is utilized for maintenance and functioning of the body. Any excess sugar will be stored in the adipose tissue as triacylglycerols to be used for growth or in a state of starvation (such as in between meals).
The process of storage in adipose tissue continues providing there is a trigger – and it comes in the form of excess carbohydrates in the diet. In one way glucose is a energy source for the body; in another way, it is toxic to the blood in high levels. Insulin’s role then is to transport sugars out of the bloodstream to be used as energy – including energy storage. This leads to deposits in adipose tissues and weight gain. It is only with a shift in diet toward lower carbohydrates, that these stores can be utilized and weight loss can occur.
Excess adipose tissue hinders movement and body mechanics, alters pressures and challenges metabolism, thereby affecting normal processes. The adipose tissue makes it harder for the heart to beat and the lungs to aerate properly.
To some extent, the body adapts – but only up to a point. Complex organisms are able to adapt, the term homeostasis. When my father was diagnosed with high blood pressure, he was told that it might get better with weight loss. He fueled himself with a mostly plant-based diet and at one point lost weight. Even with as little as five to ten pounds, blood pressures improve. These changes seen in weight normalization are far greater than the activity of any pill.
How does our food intake affect our health?
I observe how leaves and other vegetables are so complex and whether that is the way our food should be – more complex in structure.
Romanescu Broccoli, a natural fractal
In Sicilian, things that are good are measured up to bread. “As good as bread!”
Look at the foods above: the top is Romanescu broccoli and the bottom is sliced bread. Compare the inherent complexity of spinach leaves, cauliflower and cabbage with that of processed foods, originally harvested from nature. The very act of processing food releases some of the most important constituents of food – the fiber – to create a food more akin to Euclidean geometry – the square piece of bread, the round cookie or biscuit. These foods are composed of simple and complex sugars.
It seems that these simple foods that we eat may be the wrong types of food for our complex bodies. The foods are held by loose bonds that break upon entering our mouth. There is no further digestive component needed, and the sugar is absorbed into the portal bloodstream through the jejunum. The liver meets it head on and attempts to detoxify the glucose. Insulin shifts the sugars to be stored as glycogen and fat in the liver, and once a critical threshold is met, complexed sugar spills out into the bloodstream as triglycerides. They trigger inflammation in the blood vessels contributing to atherosclerosis or otherwise get stored in adipose tissue. What was taken from the outside is processed in the body and enters into the bloodstream to affect our our entire body. The spikes in insulin and products of bacterial fermentation of sugar in the gut lead to important biological changes including creating pleasure and craving with foods higher in sugars, to the further detriment of the organism. It is only further compounded by liquid sugar found in sodas and juices.
How about getting older?
As we grow older, our structure changes – we shorten in stature because our bones demineralize and desiccate (dry up); our skin wrinkles and fingers and toes get colder; we can’t see or hear as well as our eyes and ears change. My patients remind me that even our ability to taste decreases – and might lead some to choose sweeter foods. Do these changes represent the tip of an iceberg about what is happening in our entire bodies?
When we look at the season of autumn – when the leaves start to dry up and change color. A close look at a leaf with a magnifying glass reveals that these changes in color and appearance of the leave occur in small fragments congregating around the venations of the leaf prior to the confluent color change. Similarly, the changes of the skin – a decrease in collagen production – that produces wrinkles occurs over time, as we move toward a phase of wilting.
Depending on how warm the climate is, the leaves on some trees stay viable toward the month of December, while the trees in colder climates are bare of leaves by then. Are there ways to reduce the process of aging in our bodies?
It also reminded me of our experiment with Protozoa, single-celled organisms. As a child, I remember a class experiment with Paramecia, where we put a dropper full of concentrated saline (salt) solution into the fluid where the Paramecia were swimming around. Immediately, they swam away in the opposite direction from where the solution was coming. Does our body have a way to protect itself from these changes?
The acid-base buffering system of our body is an example of how dynamic our bodies are. If there were an ingestion of acid (like a poisoning of aspirin, causing metabolic acidosis), our body would be able to balance that effect without killing us – up until a point. It wouldn’t be the same with the Paramecia – they would die with a little perturbation. Our bodies are able to adapt to the environment and that dynamic ability is a picture of health.
Think about how our heart beats – is it like clockwork? It actually isn’t. The system adapts to changes in position, respiration and other stimuli to allow for the dynamic sinus arrhythmia. Studies have found that when pulsations are less dynamic, there is an increased risk for mortality.
Is the “climate” in our bodies something we can control – and can this extend the time of our healthy years? It reminded me of my grandfather who a lot of people thought was younger than his age. You and I have seen people in the gym, thriving, working out and keeping up with others decades younger – and the looks of disbelief when they reveal their age.
Think about the natural cycle of nature – starting with the blossoms and leaf buds of the spring, proceeding to the fully developed leaves of the summer, then with the changes and eventual death of the leaves during the autumn and the slow state of the tree during the winter time.
Do we also become less complex as we go through this process of dying?
What is health and how can I tell it when I see it?
That brings us back to the first question. I am observing what is happening in front of me, though it proceeds as it has for decades and centuries. Trees stay alive even during the winter – the main structures that die are the leaves, only to grow back next spring. Even this process is happening in our bodies, as we shed hair, skin and cells in our gut – up until a point – some of which is programmed and some of which is modifiable. We are interested in the modifiable.
As I see it, health is a state that is far from static – it is the ability of an organism to withstand the environment, to harness it and to grow and maintain itself – to thrive. We have organs in us similar to filter system or a root system which allow us to take in nutrients needed for growth and metabolic operations and use what is in the environment. Just like the when you cut a tree you don’t see the soil inside it, so too does our blood work with what is absorbed after the liver detoxifies it – up until a point.
Our bodies are a reflection of what is inside and how it relates to what is outside. A diabetic may have numbness in their legs; a person with high blood pressure may have swelling in their legs; a person with a bad liver will develop jaundice. As our bodies change, our structure changes and inherently our function changes. We do have some control over this. I am reminded of some of my patients, after they were diagnosed with diabetes, who started an exercise program and began to eat healthy food: they were able to lose a significant amount of weight and reduce or stop insulin and other diabetic medications.
Ultimately what is in play is a shift from our more complex, functioning, dynamic lives to one where complexity diminishes, either slowly, from the blunting and structural changes in aging, or more rapidly, with the damage that occurs with disease. The change in complexity to simplicity reaches a threshhold when we die – and even then our bodies further disintegrate into the various chemicals that were holding our lives in place.
1. Health requires the interplay of multiple complex structures that provide protection, buffering and dynamic adaptation to the host.
2. Disease can occur by way of external (injury or trauma) or internalized toxins (via the gastrointestinal system). Chronic metabolic disease occurs in the bloodstream and works its way through the entire body via the bloodstream.
3. Food should be complex, largely plant-based to balance short and longer term energy needs, while avoiding excess of simplified, processed foods that are easily broken down and enter the bloodstream.
4. Aging and disease represent forms where the complex structure begins to be blunted or simplified largely as a result of inflammation and scarring, such that a change in structure leads to a diminishment of function. These changes are in part modifiable.
5. The body external is a window to the body internal and We achieve dynamic stability as we approach being “healthy”.
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