Today our population is faced with a big challenge regarding the overall state of our health. We currently live in a world where the status quo is carrying around excess weight, having regular doctor visits for updated prescriptions or surgeries, and dealing with the burden that comes with long lists of medications and their side-effects. With the current expectation to spend the second half of our lives dealing with the multitude of health problems that come our way, along with the general acceptance that our bodies will slowly break down on us until that one diagnosis takes our lives – with all of this, it is very plain to see that we have been doing a terrible job of effectively addressing modern disease.
The reason we can’t seem to conquer this problem is, in my opinion, not for lack of caring or effort, but rather, a lack of perspective. This lack of perspective arises from the inability to shift from how we addressed simple, linear diseases of the past (e.g. this bacteria causes this disease; kill this bacteria and cure the disease) to the complex, non-linear progression of modern disease.
The human body cannot be understood fully by using a linear, reductionist mindset, and in turn, modern disease cannot be understood nor addressed from this traditional perspective. Unfortunately, as disease has been traditionally addressed with a reductionist perspective, the current clinical processes in place to diagnose and treat modern disease lag far behind what is possible given all the information that has been uncovered.
To understand how the non-linear, dynamic systems supporting the human body combine to form complex networks, and to understand how these complex networks break down over time, resulting in the arising of clinically relevant symptoms, we need a new approach. This approach must address the chronic, complex form of modern disease – that is, illness that arises not from one specific pathogen or event, but rather, arises from the slow deterioration of the systems that make up the human body.
What does this look like?
Let’s look at an example of one of these common modern diseases. Type II diabetes (TIID) arises from the slow breakdown of the body’s ability to regulate energy levels, and the disease itself manifests in the form of the failure of the pancreas to supply enough insulin and the subsequent rise of blood sugar.
The ultimate question is, of course, how do we address such a disease? The traditional method is to look at the physical manifestations of the disease (e.g. high blood sugar) and address that one component (e.g. by administering external insulin). However, the actual cause of that problem really has little to do with that high blood sugar, and instead, it has everything to do with the overall dysfunction of an entire system – a system that has been designed to maintain tight control over blood sugar levels, yet has broken down such that this control has been lost.
The root cause of TIID has nothing to do with direct control over blood sugar. Rather, it lies somewhere within the breakdown of the many sub-systems that work together to effectively regulate energy levels within multiples systems (one of these sources of energy within one particular system is elevated blood sugar).
Therefore, if we want to effectively address TIID, we need an approach that takes into account the effect of each input on each sub-system, along with the overall outcome on the entire system (e.g. systemic elevated blood sugar).
In turn, if we want to effectively address modern disease – if we want to make significant advancements with our healthcare – we have to move towards an approach that looks at the system as a whole.
How is this done?
When it comes to putting an approach into practice that addresses the entire scope of the problem, there are two main methods that I see as possible. The first approach deals with fully understanding the many intricacies of the entire system. It requires a complete understanding of each of the major components involved in the dysfunction and works to create treatments that address each of the underlying disruptions while ensuring that the system, as a whole, gets fixed.
This is the solution our medical system must move towards. Modern disease will only be conquered when we can develop treatments that focus on the entire scope of the problem. This will include understanding each individual’s genetic and epigenetic programming, any relevant environmental factors, and that individual’s lifestyle patterns. It will then have to fully integrate all this information with the current state of that individual’s body in order to create an individualized treatment plan. Of course, that individual would then have to be monitored as the treatment unfolds. These treatments would not resemble a simple medication, but rather, a more intensive lifestyle change combined with possible medications or other clinical treatment until the underlying issues are resolved.
Take a moment to understand the magnitude of this task. Each disease arises due to any number of disrupted components, and when these components work in a complex, biological network, arising out of an individual’s unique genetic make-up and life circumstances – well, of course it is going to take a superpower much greater than that of a doctor to design a treatment for each individual.
Getting to this place is going to take a lot of work, a lot of time, and a lot of resources to achieve. It will take the full force of any number of scientists (geneticists, biochemists, lipidologists, and others) to uncover the underlying science. On top of this information, it will take a shift in the medical industry to develop treatments used to address underlying conditions and long term solutions. It will take the field of nutrition science to step away from outdated, reductionist philosophy and address modern, biocomplexity-based principles. Then, it is going to take a shift in the clinical field to move away from 7 minute face-to-face time with patients and a prescription pad and to move towards addressing disease with a full understanding of the multi-factorial causes and chronic conditions.
Most significantly, it is going to require a shift in each individual’s perspective from seeking a quick and easy fix from the doctor (e.g. a surgery or a pill), towards a willingness to adopt new practices and make lifestyle changes that will address the actual causes of each illness.
As you can see, there is a lot of work to be done.
The good news for us, right now, is that there is a second approach, one that lies in an entirely different ballpark when it comes to the time and resources needed. This second approach is not tied to shifting a trillion-dollar, multi-faceted industry. Instead, it relies on just one individual – that individual, of course, being you.
With the rest of this post, I will discuss this method so that you can begin to think about how to approach your own health. While we won’t be able to fully conquer chronic disease without a complete makeover of the medical industry, there is still great progress to be made by taking your health into your own hands, utilizing this systems approach.
With that, let’s get to it.
The Reprogrammed Systems Approach
One way to approach a complex, dynamic problem is to understand each and every underlying component, how each component interacts, analyze each feedback loop, and comprehend how all of these components interplay to create the entire (dys)functional system. This method would be ideal; however, it is not feasible.
A second method is to take a step back, look at the entire system, and use some critical thinking skills combined with basic testing to figure out what makes the system work, along with what has caused it to malfunction.
This second method is the approach we are going to focus on because it allows us control over our own bodies. More specifically, it allows us to manage the amount of information we are capable of understanding and to make up the gap using some simple testing.
To use this second method, we will use a basic systems engineering approach. With this approach, we will address the system not by immediately breaking it down into its individual parts, but rather, by approaching it as what us engineers would call a black box.
A black box is a system of which we may not understand fully; yet, when it comes to addressing this black box, we can use a process for gaining greater and greater insight into its inner workings by testing inputs and measuring what happens to the system (outputs).
Let’s see how this approach works in practice as The Reprogrammed Systems Approach.
We begin by viewing the body as a complete black box. This begins with just a minimal understanding of the system, which may include some basic information regarding the context of how the system tends to work well, along with what tends to drive the system towards dysfunction.
This creates a solid starting place where you can begin experimenting with inputs to optimize for outputs. There is no need to understand much at all about what is actually happening inside the system with this approach, as important information may be gathered simply by testing inputs and measuring outputs.
We can later expand on this by working to unravel the underlying mechanisms driving the system. This provides additional information that can prove useful when deciding what to do to optimize the functioning of the entire system. That is, when we know more about the pathways within the black box, we can make better educated decisions, while still being conscientious about the resulting state of health (the output).
However, we have to be careful with this second approach to ensure that, by breaking down that system to learn about what exists on the inside, that we do not lose the larger meaning – that being the overall functioning of that system as a whole.
Because, no matter how far we journey along on our own path to understanding the system that is our own bodies, we must always keep in mind that the complexity of the system is beyond the capacity of our mere human minds to fully comprehend.
Of course, we can gain great insight into its inner works and continuously improve our ability to make decisions that optimize for its best health; however, we must never get ahead of ourselves in thinking that we can completely control its destiny. That outcome will always, ultimately, be up to the systems supporting each of our own bodies
Using the Reprogrammed Systems Approach
Right now we can get to work with our own process of understanding how our decisions impact the health of our own bodies. We can start simple with basic principles and practices that tend to lead to good health for most individuals, and then if we choose, we can improve upon our ability to make healthy decisions by examining physiological principles guiding pathways of good vs. poor health.
To get started, we will begin with some background information on the design of the human body, using this information to establish basic practices for creating good health. From there, you can then decide whether it is worth it, for you, to put in the extra time to work towards unraveling the black box that is your own body.
Step 1: Understand the general design of the system. In this case, this involves understanding basic design principles of the human body, including how it has been designed to function over millions of years of evolutionary pressures.
Step 2: Understand some of the key underlying mechanisms driving the health or disease state of the human body and put these into context with how the body has been designed to function.
In order to use our Reprogrammed Systems Approach, we must first understand several things about the system we are dealing with. It will do no good to enter this blindly, knowing no information about our black box. While we don’t need much information to begin testing various inputs into our system, it would be unwise to do blind testing when what we are dealing with is the health of our own bodies.
Therefore, before we go any further, some crucial details about our system must be established.
First up, as any engineer knows, before going anywhere we have to define our system. If we don’t have an established frame in mind, things are bound to get mixed up and confused down the road.
The system, as a whole, will be the entire body and its interaction with the environment. We focus on the body, as a whole, because optimizing the health of our entire body seems like a good idea if we want to keep living our lives as we desire.
We can also zoom in on specific sub-systems in order to work towards more precise results. This will allow for greater control over tying our decisions to specific pathways. For example, we can learn about excess fat accumulation in adipose tissue to understand how our decisions can lead to an excess amount of energy being stored as fat in adipose tissue. Or, we can learn about how the loss of ability of muscle tissue to manage energy sources plays a role in system-wide energy regulation.
However, when we do so, we must use caution so that we do not lose sight of the bigger picture that is the health of the body, overall.
Second, we have to have a general understanding of how the body has been designed – that is, how it operates optimally in its natural environment. A few important notes here:
- By this I do not mean to imply that the human body was designed with any sort of intent of an ideal design. We do not want to approach this problem thinking that the human body has been designed to function properly given proper resources and cues; rather, a better way to approach it is as an optimization problem given what nature happened to create.
- By this I do mean that the body has evolved over millions of years by selective pressures that select for particular traits. These traits are selected for because they enhanced the ability to survive within that particular environment.
- While we cannot study the optimal functioning of the human body in each and every environment, we can look at the set of data we do have on evolutionary history and epidemiology and make some logical assumptions about how the human body functions best, generally speaking.
Moving Forward:
Now that you understand the general idea, including why a systems approach is necessary and what this approach looks like, let’s look at how we can begin taking action.
I’ll see you over there in the next article.