You already know this problem: Humans are in the midst of the worst chronic disease epidemic ever faced in our history.

  • Americans are the biggest consumer of weight loss products (80%) in the world, yet still lead the world in obesity and unhealthy lifestyle.
  • More than 70% of adults across the United States are already being diagnosed with a chronic disease and more than 75% of the nation’s healthcare cost being spent on managing and treating these conditions.
  • Nearly every single chronic condition you can think of will not successfully be treated with prescription drugs or surgery. They can only offset the symptoms. This list includes: cardiovascular disease, type 2 diabetes, infertility, hypertension, sleep apnea, high cholesterol, high blood pressure, osteoporosis, depression, anxiety, stress, and many more.
  • Heart Disease continues to kill more people than any other condition despite the fact that more drugs and surgeries are being performed to treat it than ever before
  • Cancer continues to skyrocket and we are spending billions trying to treat it.

Reality Check: We are not getting obliterated by war, famine or disease spread from one person to the next. Today, billions are suffering from biological imbalance. Unfortunately, there’s every sign that things are going to get worse before they get better.

Today is the first generation of kids in modern history that’s expected to live shorter lifespans than their parents. If current trends continue, in two decades, 95 percent of Americans would be overweight and one in three would have diabetes.

So what needs to change?

We need a new approach to medicine, one that emphasizes healthcare over disease management. What would such a new medicine look like?

It would have three characteristics.

  1. It would recognize the exposome as the primary driver of health.
  2. It would embrace an evolutionary and ancestral perspective.
  3. It would apply a functional medicine approach to care.

So let’s look at each of these in a little more detail.

The Human Exposome is the Primary Driver of Health

The exposome is a concept originally proposed by Dr. Christopher Wild in 2005, and it refers to the sum of all nongenetic exposures in an individual lifetime, starting from the moment of our conception through the moment of our death.

For decades it seemed as though genetics would hold the key to human health and disease. Unfortunately, those promises didn’t really pan out. The limitations of using genes to predict and prevent disease became apparent pretty early on (especially following the sequencing of our entire genome in 2003.

Ironically, Craig Venter, who was one of the first to sequence the human genome, was also one of the first to recognize its limitations when he said, “We simply don’t have enough genes for this idea of biological determinism to work.”

We now know that genetics accounts for less than 20 percent of human disease and that the remaining causes are environmental, which is to say, they’re related to the exposome.

The exposome encompasses the food we eat, the air we breathe, social interactions, lifestyle choices, and inherent metabolic and cellular activity.

So what does this all mean?

The bad news is that the choices our parents and even our grandparents made affect our disease risk and our health and that choices that we’ve made—perhaps before we knew as much as we know now—affect our children’s and even grandchildren’s health.

The good news is that genes are not our destiny. Genes have an influence over our health, but changes we make in real time can affect our gene expression and, not only our own health, but if we’re still procreating, our children’s health and their children’s health.

Not everybody who has genetics that predispose them to a higher risk of a particular disease actually go on to acquire that disease or die early, and the environment or the exposome is almost certainly the main factor that determined which of those people that were at higher risk got sick and which stayed well.

So while we can’t control what our parents or grandparents did or our genes, we can control these diet, lifestyle, and environmental influences.

Embracing our Ancestry is Essential for Health

For 66,000 generations, humans ate primarily meat and fish, wild fruits and vegetables, nuts and seeds, and some starchy plants. We were physically active. We didn’t sit for long periods.

We lived in sync with the natural rhythms of light and dark in direct contact with nature and in close-knit tribal and social groups. Both our ancestors and contemporary hunter–gatherers who have been studied were lean, fit, and remarkably free of chronic inflammatory disease. They were also superior to us in nearly every measure of health and fitness, from body mass index to blood pressure to insulin sensitivity to oxygen consumption to vision to bone density.

You might be thinking, “So what? Why should we care about the health of our Paleo ancestors? They all died when they were 30 years old.” It’s true that our Paleo ancestors did have shorter life spans on average, but those averages don’t consider challenges that are largely absent from modern life, including high rates of infant mortality, warfare, trauma, accidents, exposure to the elements, and a complete lack of emergency medical care.

Studies have shown that when these factors were considered, contemporary hunter–gatherers and our ancestors lived life spans that were closely equivalent to our own today, but the difference is that they reached these ages without acquiring the inflammatory diseases that characterize our old age. They didn’t have obesity. They didn’t have heart disease. No diabetes, gout, hypertension, or most cancers. In other words, if our ancestors survived the threat of early childhood and escaped the threat of trauma, they lived long and healthy lives.

So, what happened? What transformed us from a healthy, vital people largely free of chronic disease to a sick, fat, and unhealthy people?

It was a one-two punch, and agriculture was the first blow.

Scientist Jared Diamond calls agriculture “the worst mistake in human history.” Hunter– gatherers were virtually guaranteed a healthy diet because of the diversity and nutrient density of the foods they ate, but once humans settled down and started farming, there was a major shift in our diet. In short – refined carbs went up and quality fibrous vegetable, fat and protein consumption went down.

Vitamin shortages also became common. Our new diet relied heavily on a limited set of crops such as wheat, rice, and corn, and it was lower in more nutrient-dense animal products. This led to diseases such as beriberi, pellagra, rickets, and scurvy that are caused by nutrient deficiency and were rare in hunter–gatherers but became much more common in people living in agricultural societies.

We also saw an increase in tooth decay and anemia due to iron deficiency, increases in infant mortality, and decreases in average bone density. All of these diseases, again, were rarely experienced by our hunter–gatherer ancestors.

The second blow was the Industrial Revolution.

There is no doubt that agriculture led to an overall decline in human health, but the Industrial Revolution was really the knockout punch. It brought us to where we are today when white sugar, flour, and vegetable oil make up over 50 percent of the calories that the average American consumes on a daily basis. We’re more sedentary than we’ve ever been before.

We sit while we work and increasingly even sit while we play. We’re chronically sleep deprived. A third of Americans sleep fewer than six hours per night, which is up from just 2 percent in 1965. We’re working harder than ever. American men and women are working 12 to 13 hours more per week today than we were in 1968. Stress levels are off the chart for most people.

We don’t feel like we have enough time for rest and leisure, and even when we do go on vacation, many of us compulsively check our email and social media accounts.

Finally, many of us live and work in isolating and alienating social environments that are disconnected from the natural world we evolved in and from other people.

The profound mismatch between our genetic heritage and the modern environment that we live in today is responsible for the epidemic of modern disease that we’re suffering from, and it also explains why the Paleo diet and lifestyle have helped so many people.

A Functional Approach to Medicine & Optimizing Health

The third principle of achieving health is that it applies a Functional Medicine approach to care.

As I said before, conventional medicine has some amazing characteristics. It’s remarkable in terms of trauma and emergency medicine and acute care, but again, I think we can all agree it’s not very good at treating chronic disease, which is the number-one problem that we face today.

Functional Medicine is investigative. It treats symptoms by addressing the root of the problem, which leads to more profound and longer-lasting results, whereas conventional medicine tends to be more superficial, in that it masks or suppresses symptoms but doesn’t address the underlying cause, and this tends to create patients for life.

For example, if you have high blood pressure, you get on a drug to lower it, and you’re basically told to take that for the rest of your life, and the same is true for high cholesterol.

Functional Medicine tends to be more holistic. It treats the body as an interconnected whole, and we recognize that in order to treat one part, all other parts must be addressed, whereas conventional medicine is more dualistic. It views the body as a collection of separate parts. In fact, there’s a doctor for every different part of the body, and there’s often very little communication between these doctors or acknowledgement of a connection.

In functional medicine, the patient is respected, empowered, educated, and encouraged to play an active role in their healing process, whereas in conventional medicine, the patient’s opinion is often discounted or ignored, little time is spent on education, and the patient is even sometimes actively discouraged to play a strong role in their healing process.

Functional medicine is integrative. It combines the best of allopathic and alternative treatments. It doesn’t exclude drugs or surgery when they’re necessary but does tend to focus more on diet, lifestyle, supplements, and herbs as the primary interventions, whereas conventional medicine is more limited in its scope. It typically relies almost exclusively on drugs and surgery despite risks, and while it does pay some lip service to the importance of nutrition and lifestyle, physicians are undereducated on these topics and often don’t have much time to devote to them in the typical patient interaction.

Functional medicine is preventative. It’s guided by the ancient Chinese proverb, “The superb physician treats disease before it occurs,” whereas conventional medicine tends to be a little more reactive. It really aims to manage disease after it occurs and often doesn’t intervene until disease has progressed beyond a certain point of no return.

 

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