Now that we understand what it means to be a complex, biological system, we can move forward learning to make healthier decisions that:
- Move away from the need to control each factor and mechanism that makes up these systems
- Focus on supporting the functioning of these systems, knowing that they are well-equipped to take care of themselves if only given the proper resources and maintenance of a proper stress balance
Listen to the audio recordings and/or read the text below.
Note there are two audio recordings for this lesson.
Establishing this framework for making health-conscious decisions is what we will be focusing on in this Part 2 of this course, applying the principles discussed in Part 1 to this important task.
Note that there is a potentially important later step that sometimes becomes applicable for certain individuals, and that is to carefully dive back into the specific pathways and mechanisms involved in specific health challenges (the ones that aren't automatically resolved with the first piece). However, that is out of the scope of this course as it is an advanced step that only applies to some individuals down the road.
To be able to support the functioning of key systems supporting your health, we will take these underlying principles describing the functioning of your body and put them to use in a framework for making healthy decisions.
At this point, you are familiar with how you can think about your behavior impacting any particular sub-system supporting your body.
Let's pull that framework back in now.
Image 1: Our base model, linking specific behaviors to the impact on key complex systems, leading to important health outcomes. The next step will be to define the "key complex system" you want to bring to mind when making health-conscious decisions.
What we need to do now is think critically about what sub-system you would want to bring to mind as you make health-conscious decisions.
In doing so, we want to be careful that we don't get too focused on a particular sub-system that only partially ties into your greater health:
- for example, our world tends to focus on fat storage (primarily, adipose tissue) as a way to define each individual's state of health. While the amount of fat stored in adipose tissue plays a role in one's health, it is only one system
- as a second example, others tend to focus on cardiovascular health, leading to decisions being made based solely on concepts having to do with saturated fat and cholesterol. While saturated fat does link into cardiovascular health, this is only one part of the individual's health
Given these examples, it seems we need to go broader - to take a step higher up to a broader system that better encompasses the individual's overall state of health.
This being given, we also need to ensure that we don't go too broad such that we lose any sense of something tangible that you could bring to mind as you link your behavior to its impact on the functioning of the system.
Is there a specific system we could think about that would enable you to make decisions that support the global health of your body, while still having something tangible to think through?
Fortunately, the answer is yes, and it is an understanding of this sub-system that we will be thinking through in the next couple lessons.
A Target Sub-System
To begin making healthier decisions, it would be useful to have an understanding of one powerful sub-system that impacts the entire body in a significant way. If this were the case, then you could focus your attention on the one sub-system and its general functioning, greatly simplifying your ability to make health-conscious decisions.
Fortunately, that's exactly what I have to show you - a particularly important sub-system whose dysregulation and dysfunction underlies most cases of poor health and disease experienced in our modern world.
Before jumping into it, note that understanding (and taking corresponding action towards) this particular sub-system does not provide all the answers that each of us may need as we move through each of our own health journeys. There are other pathways through which the body becomes sick (e.g., smoking or excessive drinking; rare gene mutations).
Still, what this does is serve as a lens through which you can understand your general health, viewing it in such a way that you can make powerful decisions that lead to significant improvements in your day-to-day health while reducing your risk of the many common diseases that plague our modern world.
Plus, once this framework is understood, any individual can build upon it to better understand specific health challenges that he or she may be facing. For example, once you have taken action to improve your overall health, you can then learn to make better targeted decisions if you know you are at greater risk for a specific disease (e.g., cardiovascular disease, diabetes, etc.).
Altogether, this means that you can greatly simplify your decision-making process while you make significant steps forward towards avoiding disease. Meanwhile, you can work towards living out each day with greater energy and mental clarity, as well as an enhanced physical ability to take on your own challenges that support you in living your best life.
Also, it just so happens to tie in perfectly with the previous lesson!
Image 2: Defining a powerful sub-system that encompasses important functions that support general human health. For our purposes, we will be focusing on metabolic health, which includes various tissues and organs, including the liver, skeletal muscle, and adipose tissue.
Metabolic Health as a Framework for Understanding Most Health Challenges
This one special way I have found useful to help understand the many complex workings at play that determine an individual's state of health is through the lens of metabolic health.
To understand metabolic health, you can begin by thinking about how the body needs energy to perform any sort of function. Of course, cells throughout the body are always hard at work carrying out the innumerable complex functions required to keep each of us healthy.
Hard work. It all needs energy. And this energy needs to be controlled in a manner such that each cell receives the amount and type of energy it needs to maintain good health (homeostasis).
Now, think about what happens as the body loses its ability to manage the supply and demand of energy within each sub-system (e.g. cell, tissue, organ):
No, really, pause and think about it for yourself. Then continue.
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I think about two key pathways being activated as the body loses its system-wide ability to regulate energy:
1. As each cell, tissue, and organ loses the ability to receive energy in the proper forms and amounts, these sub-systems lose their ability to perform important functions. This leads to dysfunction, and later on to disease, as these cells, tissues, and organs fail to perform important physiological functions (e.g. the pancreas releasing insulin; the kidneys filtering toxins; the muscle tissue utilizing fats as a fuel source; the adipose tissue safely storing away fat).
2. As the body loses its regulatory control over levels of different types of energy-containing molecules, damage is done on a system-wide basis. The vasculature is the best example of this one: as blood sugar becomes dysregulated, blood sugar concentration can elevate into toxic amounts, at which point damage is done to the blood vessel walls and other biomolecules that are also in circulation. On the flip side, blood sugar may drop dangerously low, leaving different tissues and organs lacking the energy that they need to keep functioning.
See how different types of dysfunction and disease can arise out of the same underlying pathophysiology?
What arises from this state of metabolic dysfunction is all sorts of health problems, ranging from mild and annoying symptoms (e.g. brain fog or fatigue) to serious and life-threatening illness (e.g. type II diabetes or cardiovascular disease).
This, at least, is the basis of the theory: the goal is to be able to support your own body's ability to regulate energy throughout various sub-systems.
As for the practice...
In the final two lessons of this course, we will work to focus on how to put these ideas into practice by understanding the greater workings of the body's metabolism.
Before jumping into that practical application, read below to ensure that you are clear on the role that metabolic health plays in disease progression. As you do, please take care to note what is vs. what is not within the scope of this model, including how the information contained within this course should (vs. should not) be used in your own life.
A note on metabolic dysfunction at the root of modern disease
Metabolic health is a powerful lens through which we can view our general health, including how we feel on a day-to-day basis along with our risk of developing clinically relevant symptoms (those that we label as a specific disease) down the road.
It is important to understand that the purpose of this course (and more generally, the understanding of The Reprogrammed Systems Models) is not to treat disease, but instead to understand how that which is in our control (primarily our behavior) can create our state of day-to-day health while simultaneously contributing to our risk of developing a disease diagnosis. This means that, as we call upon the model we are developing here in this course (a model with Metabolic Health vs. Metabolic Dysfunction at its core), we can be thinking about how this may help reduce the risk of developing a large set of diseases while also understanding that this will not completely solve all health problems.
This all being said, the model we are developing can serve as a powerful tool to give you the best return on your time and effort making health-conscious decisions, enabling you to make changes in your lifestyle that most broadly support your day-to-day health while simultaneously reducing your risk of the most prevalent diseases in our modern world.
To further clarify what metabolic health is, it can significantly contribute to:
- how you feel each day (e.g., your energy levels, mental clarity, various pains or weakness, etc.)
- note that this is typically determined by your underlying (patho)physiology (e.g., blood pressure, blood sugar levels, inflammation, immune system, etc.)
- the underlying (patho)physiology that you may not be able to consciously experience (e.g., the formation of plaque in your vessels; your insulin sensitivity, etc.)
Now, I'd like to turn your attention to that pathological side of this as disease arises from these same states.
Again, the purpose here is not to treat any disease states, but instead to be mindful of the full pathway that begins with annoying symptoms (e.g., low energy, brain fog) and progresses forward to full-blown disease diagnoses.
The pathology arising from metabolic dysfunction
A large set of pathologic states (i.e., diseases) can arise from a state of metabolic dysfunction that, over time, damages cells, tissues, and organs that make up important sub-systems.
When discussing the pathophysiologic state of metabolic health (i.e., the poor functioning of cells, tissues, and organs and inability of these sub-systems to perform important functions), the medical community has specific terms for it.
The condition defined by the numerous disrupted mechanisms which drive modern disease is commonly called metabolic syndrome. Metabolic syndrome is defined by having a number of symptoms (usually 3, 4, or more) related to the underlying mechanisms discussed herein (e.g inflammation, hyperglycemia, dyslipidemia, excess fat accumulation, etc).
This makes for the following model:
Image 3: Metabolic health is a powerful lens for viewing general human health because, as the functioning of sub-systems supporting the body's metabolic health become impaired (that is, as a state of metabolic dysfunction arises), the numerous diseases that our modern world is so familiar with can arise.
Metabolic syndrome is the clinical name given to a set of underlying factors that routinely contribute to the progression of modern diseases. With the Reprogrammed Systems Approach, we stay away from clinical diagnoses and use "metabolic health" or "metabolic function" to explain the underlying (patho)physiology at play in this system.
A final point on metabolic (dys)function
Using this model we can clearly see that modern disease is not the linear progression of a select few underlying mechanisms (e.g., the development of cardiovascular disease is not solely a matter of the consumption of saturated fat leading to increased LDL leading to CVD).
Rather, a large number of underlying factors, themselves a part of different sub-systems, interact in a dynamic, non-linear fashion to progress towards modern disease.
These specific disease diagnoses arise when these underlying mechanisms manifest in clinically relevant symptoms in particular systems in the body:
- e.g., cardiovascular disease (CVD) arises when a combination of inflammation, hyperglycemia, dyslipidemia, etc. cause significant damage in the cardiovascular system, resulting in clinical symptoms, such as a clogged artery and heart attack
- e.g., dementia arises as chronic inflammation and elevated blood sugar levels damage neural tissue over time (as just one piece of a broad category of diseases that have many underlying mechanisms)
Keep in mind, this sub-system is significantly influenced by feedforward and feedback mechanisms, with one mechanism driving the progression of others, in turn driving the progression of others.
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A note as we wrap up here - if you find yourself confused by some of the technical aspects of what we just covered, there’s no need to worry. The purpose of building this model is not to get you to fully comprehend the inner workings of the model.
Instead, it is to help you understand the complex progression of poor health and modern disease. As long as you understand the inadequacies that go along with modeling modern disease as a simple, linear progression of a few underlying mechanisms, and as long as you understand that there is a need to model modern disease as a complex, dynamic system, then we can move forward.