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What is good health?

Our society has an interesting way of thinking about the health of our bodies.

When we talk about health, we often think and speak in terms that don’t actually define the concept, but instead, define it by what it is not: good health is simply the absence of negative symptoms. That is, good health is the absence of poor health.

I know this because a google search for “health definition” takes me to this:

noun

the state of being free from illness or injury.

I also know this because it is plastered all over our society and engrained in all of our healthcare systems.

For example, I walked into one of those corner pharmacies the other day and, covering the doors was different variations of “supporting your health.”

How does this pharmacy support one’s health? By providing pharmaceuticals and simple medical products to help manage the symptoms of poor health.

How does it not support one’s health? By having aisles lined with industrially processed foods that are the very drivers of poor health and modern disease.

The point here is not to knock on a particular business, but instead to acknowledge that there is a serious problem when our idea of supporting health is by helping to manage the negative symptoms of poor health. (*see notes)

The problem is that our understanding of a concept leads us to take specific actions.

If our understanding of good health is simply the absence of poor health, then if we want to become healthier, we will take action by focusing on the symptoms of poor health and making choices to mitigate those.

For example, if we keep getting headaches, becoming “healthy” again could involve taking pain relief medication.

Or, as a more severe case, if we become diabetic, then becoming “healthy” would involve taking insulin to manage blood sugar.

The problem is not that medication and other treatments exist to alleviate symptoms. That’s not a problem – it’s a blessing to be able to manage symptoms of poor health.

Rather, the problem is what we are ignoring completely as we go about our lives focused on mitigating symptoms.

So, what are we ignoring?

The actual idea of “health.”

Let’s clear this up now.

What is health, really?

Let’s try a different definition from the world’s leader of health. The World Health Organization gives us this definition:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

This definition is an improvement. Here we see that health, itself, is a physical state. Being healthy is a state of well-being.

This is more useful than the idea of health being the absence of poor health. It is useful because, as we take action towards being a healthier individual, we can aim for states of well-being.

In other words, we can think about what makes us feel good and then take action to get us there:

  • I know that when I sleep for 8 hours, I feel good the next day
  • I know that when I avoid cereal for breakfast, I feel good all morning
  • I know that on days I wake up and go run, I feel good all day long

With this definition of health being roughly equal to “well-being” we can begin to take action that leads us in  a healthier direction.

But there’s still a problem.

What happens when our healthy decisions aren’t directly tangible – that is, what happens when we no longer understand what specific action will make us feel good?

For example, what if an individual wanted to lose 20 pounds because he knew that extra weight is holding him back?

While weight loss is something that can happen within weeks, it isn’t something that we can feel immediately, so it would be difficult to know if a specific action were the “healthy decision” if we were to go off of this well-being definition, alone.

Or, what happens if we want to take action to create healthy vasculature so that our arteries stay open and provide our bodies with good blood flow? We have no idea whether our actions are leading to healthier arteries or whether they are leading to their occlusion.

We need to know exactly what it means in these cases to take the healthy course of action.

Unfortunately, there isn’t a simple answer that I can give to answer all of these questions completely and accurately.

Still, I’m here to tell you, there is a simple way that we can think about health that will help guide our decision-making abilities. Once we have this general idea of what “health” really means, then we can go about our lives making decisions that are better aligned with this clear definition.

To understand this concept, we need to dig into some technical physiology. After all, we are biological beings, so let’s now take some time to understand how our bodies work as biological systems.

Your body as a biological system

You, as a human being, are a biological system. In other words, you arise from the complex sub-systems that interact to produce the complete system that is a human body.

We can define these sub-systems on multiple levels. We could speak to each individual cell in your body (all the trillions of them) as individual sub-systems. We could speak to the tissues that these cells make up as sub-systems. We could also speak to organs or organ networks as sub-systems.

All-in-all, I’ll paint the picture of the human body in this way: you, as a complex system, are made up of a complex interaction of sub-systems, composed of individual cells, various tissues, and organs, all connected through different types of networks, including:

  1. Circulatory system that transports information (e.g. chemical messengers like hormones) and nutrients (e.g. oxygen, water, and energy)
  2. Nervous system that communicates information electronically

To appreciate how any system with such immense complexity can survive for decades, you have to understand a few basic principles of biology.

First, biological systems are dynamic.

Dynamic: no one factor is usually kept at a constant level in a biological system. Each factor is generally fluctuating around an average value (the mean).  This occurs because biological systems are networks of dynamic processes – something is always happening that causes any particular factor to elevate or decline.

However, if a system is to continue existing as a system, it is essential that none of these factors ever veer too far off course. In other words, we have to accept that these factors are always going to be changing, and yet also ensure that they never change too much.

Figure 1: In a dynamic system, each factor is never kept constant but instead fluctuates over time. If the system is to continue functioning as a system, it is essential that the factors that make up that system never change too much.

Second, a biological system is complex.

Complex: multiple factors are always at play within any sub-system, and these factors operate through various networks. This means that it is difficult (and sometimes even impossible) to trace a pathway through the entire system, especially in regard to how a change in one factor impacts the change in another. This challenge arises from the fact that any one factor is always impacting a multitude of others, which in turn impacts a multitude of others, and so on.

Figure 2: Within any biological sub-system, numerous factors are at play as a network. It is difficult to measure how one specific factor (input) would impact precise factors within the system while tracing that particular pathway through the entire system. Instead, it is more feasible to consider how one input impacts an entire sub-system, and then measure a specific output of that entire sub-system.

Third and finally, the complex, dynamic system does not operate simply within the confines of its own boundaries. That is, a biological system is not closed to the outside.

This means the system is an open system, in which it continuously takes in information and resources from the environment while also expelling waste and information.

Applying this all to the human body:

The system that is the human body exists as a complex network of factors maintaining a dynamic state of equilibrium. The system exists as multiple factors that are constantly interacting with themselves (internal) and with the environment (external) such that over time equilibrium of the system (and each individual factor) is achieved. 

This dynamic state of equilibrium is termed homeostasis.

Figure 3: A biological system, such as the human body, is able to maintain good functioning over long periods of time by taking in resources and information, using these inputs to make necessary internal changes, and expelling waste.
Figure 4: Homeostasis is a state of dynamic equilibrium in which the factors within a biological system fluctuate within a controlled window of normal functioning. Upper and Lower Sustainable Limits mark a sustainable operating window. That is, when the particular factor stays within this window, the system can continue to operate indefinitely. If the factor leaves the healthy operating window (drops too low or elevates too high), then the system is at risk of failing.

For example, “normal”** blood sugar concentration fluctuates between ~70-120 mg/dL. Following a meal, blood sugar concentration can rise up above 100 mg/dL, resulting in the release of insulin from the pancreas

Insulin tells cells throughout the body to take up glucose, thus lowering blood sugar back down.

In the hours following a meal, blood sugar concentration drops down towards 70 mg/dL, resulting in the release of glucagon from the pancreas

Glucagon tells cells throughout the body to release glucose, thus increasing blood sugar.

Figure 5: Blood sugar homeostasis. Blood sugar is able to stay within a range of about 70-120 mg/dL because of the release of two hormones, insulin and glucagon.

Note that as long as each factor stays within a set of limits (what I will call sustainable limits), the system is able to continue operating indefinitely. Things will be moving around in the system, work will be done to maintain homeostasis, but overall, the system is never threatened.

Often times, though, an external factor comes into play to significantly impact this equilibrium.

We can label this significant factor a force that causes a significant change, labelled as a stress.

Figure 6: When an external factor impacts the system, any particular factor may be forced out of the sustainable operating window. However, because biological systems have been designed to endure, the system is generally good at fixing itself once the external stressor is removed.

When external factors impact the system, any particular factor may be forced out of the sustainable operating window.

If the stress is moderate, then the particular factor may rise above or drop below the sustainable operating window. If this is the case, then the system isn’t in immediate danger; chances are it will return back down to “normal” once the stress is removed and the system will return to existing within a healthy window of operation.

However, if something doesn’t happen to change the workings of the system, then the system is at risk of the same type of stress coming back again, maybe even stronger. And, if it does, then there may be an immediate and catastrophic threat to the system.

Figure 7: When an external factor impacts the system, any particular factor may be forced out of the sustainable operating window. When this occurs, that factor will return to normal once the stress is removed. However, if the stress is too strong, then the factor will be forced to a limit that is catastrophic for that factor, and ultimately, may result in significant damage to the system, as a whole.

What this means is, if any system wants to continue functioning, it needs to be able to change itself so that when it encounters a similar challenge in the future, it is better equipped to survive.

Fortunately, biological systems have this particular ability to change – to adapt – so that they are better able to face similar challenges in the future. That is, an inherent property of biological systems is that they can improve to be more capable of surviving among their environments.

As a system adapts to this higher load, it becomes capable of maintaining a better balance in the future as that same higher load presents itself again.

Figure 8: Same stressors, but now the system has adapted such that the impact on the internal state remains within sustainable limits.

Okay, that’s enough of the technical lessons for one day. Let’s get back to the important question of what is health?

That is, when we think about what it means to make a healthy decision, or when we think about having a healthy body, what exactly is this concept?

Here’s my short answer: health can be thought of, simply, as homeostasis.

Remember, as long as the systems supporting your body can maintain homeostasis, they can go on to function indefinitely.

It is only when the factors within these sub-systems are perturbed such that they leave the sustainable operating window that the system is threatened or irreparable damage occurs.

It’s okay to stress the body to a certain degree, because, here’s the thing about the health of the human body:

The human body has been designed with systems in place such that it can take care of itself. It understands what needs to happen as it takes in information and substances from the environment.

Moreover, we don’t have to micromanage*** what goes into the body because the body does most of the work for us.

It takes in resources, moves these resources around to where they are needed or where they can be stored for later use. Then, it takes the waste from the processes that use these resources and, along with any excess of the resources, expels them from the body.

It’s worth repeating that the human body has been well-designed to perform these tasks. Now, this design isn’t perfect (were we to sit back and think about how to optimally design some of these systems, we could definitely make some improvements). Still though, we have to acknowledge that the body does a fantastic job taking care of itself, all on its own (that is, without any conscious effort on our part).

How do we know this?

Because human bodies have been surviving for 150,000+ thousand years. Our species spent thousands and thousands of years doing very well (that is, moving out of a small area in sub-saharan africa, conquering the globe, building societies, creating art and culture).

And, it did so without the absurd rates of poor health and modern disease that we experience today.

This tells me two things:

  1. The human body does not need our meddling to be able to function properly.
    • What I mean is, even though we think we need to control everything we are doing to our bodies to produce precise results (counting calories, measuring macros, refining exercise routines), the body really does most of the work and calculations itself.
  2. The human body can only do its job if given the proper resources and if it is never stressed too much.
    • The first point being said, it can only do its job if it is given the resources it needs to do so (nutrient-dense food, water, oxygen, and minerals) and it is not significantly or regularly over-burdened (with food it does not recognize, with too much exercise, with other environmental stressors).

Remember, if each sub-system receives the resources it needs to function, it will be able to continue operating indefinitely. And, if that sub-system is moderately stressed, it will adapt to be able to better manage that stress in the future.

If, however, that sub-system is stressed too much, then damage occurs and that system loses its ability to function.

If that stress comes on too often, then that damage will accrue over time and the sub-system will be on the decline.

This accrual of damages over time is what drives the progression of poor health and modern disease.

But, if we were instead to make decisions that never (or more realistically, rarely) significantly stress the systems supporting the body, then we should be able to make it through life with well-functioning bodies.

And, if we are to regularly stress the systems supporting the body just enough, then the body should be able to continuously adapt – to improve, to become even better at managing the stresses of this world.

That is, if we are able to understand how our decisions impact our internal state of homeostasis, we should be able to maintain a state of good health for years and years to come.

Notes

*And, if I may add, the problem is even more serious if we consider how the business is simultaneously promoting the progression of poor health with everything else that is sold inside (all those industrial not-so-foods I urge you all to avoid).

** If you look up “healthy” blood sugar levels on Google or in most text books, you’ll see this range. However, there is a fair argument to the point that we should tighten up this window and take action that keeps blood sugar even more stable. This is an interesting topic, one we will absolutely circle back to at another time.

*** Micromanaging the inputs into the human body – what I mean is, we live in a healthy-decisions paradigm in which we are told that we have to do all of the calculations for the body. Whether it’s counting calories, measuring macros, getting our LDL cholesterol in a tight range, or any other action that finely tunes what we do to our bodies. My point is not that we can’t achieve specific results with these methods (sometimes we can and sometimes we can’t), but instead that we don’t have to. And, even more, if we do try to micromanage, this often isn’t what is in the best interest of the health of the body, overall.

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