Healthy New Year: The first step
We are at the beginning of a new year. A time when we begin making those ‘healthy’ resolutions. Most fizzle out within the first quarter. Largely due to what corporate executives call wrong objective-setting. The goal isn’t understood well, hence objectives are poorly defined, thereby causing a mismatch between effort and expectation and leading to disillusionment and abandonment. This article seeks to provide clarity on the goal, before proceeding to define the correct first step. After all, well begun is half done.
What is health?
The goal can be framed as follows: what does it mean to be healthy? Let’s begin by asking those that you most think of when in ill health: doctors. The healthcare — or should it be disease-care — industry would likely define health as the absence of disease. This is a good starting point, but it has its weaknesses. If you let doctors manage your health by running a battery of tests, argues Richard Smith, the editor of BMJ, you will be found deficient in something or the other.
The World Health Organization, on the other hand, has elevated health to a level that is virtually unattainable for most. Its vision of “’complete physical, psychological, and social wellbeing,’ is a state reached only at the moment of mutual orgasm, joked Peter Skrabanek,” quips Smith. Multiple daily stressors in our working lives would leave most of us unhealthy by that definition, howsoever hard we may try.
A more practical definition comes from Doug McGuff, a doctor who has played a role in popularising high-intensity physical exercise. In his best-seller Body by Science, McGuff defines fitness as the body’s ability to “handle challenges beyond the resting threshold of activity”. That is, how good you are outside of just relaxing at home — right from managing stress at work to a coronavirus in your environment. While pragmatic, it lowers fitness to a defensive act, I feel. The idea of a body and mind defending against a hostile environment. If you, like me, prefer something more aspirational, here’s Smith quoting Sigmund Freud: “the capacity to love and work”. I like this perspective of health because it captures what most of us aspire for — a good life. Imagine being 100 and still retaining that capacity to love and work! That’s my idea of what good health can truly deliver for you.
You may have noticed that none of the above perspectives parrot mass-market narratives of six-packs, size-zero waists, low-fat yogurts, immunity boosters, weight-loss diets, superfoods, intermittent fasting, and so on. If any of these items help you to enhance and retain your capacity to love and work for a lifetime, sure, go for it. But in and of themselves, the pursuit of such ‘pseudo health goals’ takes your eye off the real goal of health.
What you eat
Having defined the goal, let’s now get to the first step. Where would a human body begin work to enhance its lifetime capacity to love and work? It is a biological challenge, so let’s bring in the wisdom of biologist and geneticist Theodosius Dobzhansky. “Nothing in biology makes sense except in the light of evolution,” he observed famously. Seen from an evolutionary lens, “life is essentially the process by which living things use energy to make more living things,” writes Daniel Lieberman.
If energy be the basis of our life and existence, food is the source of that energy. It is, unambiguously, the first and crucial step to both attaining and maintaining your health goals. Nothing can be achieved without energy. As a corollary, if there is only thing you can do to improve your health, start with making optimal food choices. You are bound to improve your health. Adherence to other activities of physical exercise, sleep and more will only supplement, but can never substitute for nutrition.
So the energy that fuels life is, in turn, fueled by food and measured in calories. A calorie is understood as the amount of energy it takes to heat one gram of water by one degree Celsius. When we talk of food calories, we are almost always talking of the three prime constituents: proteins, carbohydrates and fats. These are called macro nutrients because they form the majority of what we eat in a day. A gram of each of the first two contains about 4 calories of energy, and fat contains around 9 calories. So fat, as you can see, is the most densely packed source of energy.
And that is the reason why we have a preference to store it. Our body stores fat at two sites: under the skin (subcutaneous) and around body organs (visceral). When fat stores exceed a threshold, diseases come knocking. For most of our history, human beings have faced starvation and malnutrition. We forget, but those have been our biggest hurdles to good health. Hence the need for energy-dense fat deposits that can be relied upon on a rainy day. Now that we are fortunate to be living in food-rich environments, we face a different problem: weight and obesity.
Excess body fat, as multiple studies have confirmed, is the first marker for various illnesses, including but not limited to, type 2 diabetes, high blood pressure (hypertension), heart disease, stroke, joint problems, arthritis, gallstones, kidney problems, and a slew of mental illnesses. Body fat is measured by way of weight, BMI, waist circumference, waist-to-hip ratio, and the like. A BMI (weight in kg divided by the square of height in meters) above 25 marks the onset of being overweight.
Now if excess fat is such a problem, and we are no longer in a food-scarce environment, why would our bodies not adapt accordingly and shed those fat stores easily, instead of having us freaked out just thinking of it? Simple answer: the environment changed only in the last less than a century, while physical adaptations to human beings have happened over millennia. Evolutionary biologists like Lieberman call this the ‘mismatch hypothesis’. Most chronic, non-infectious diseases that were rare earlier and affect people today are the result of “many of the body’s features…becoming maladaptive in the modern environments.”
As a result, we today have nearly 30 billion fat cells in our body “A monkey infant has about 3 percent body fat, but healthy human infants are born with about 15 percent body fat,” explains Lieberman. And it doesn’t stop there; it only goes up. “A healthy human’s percentage of body fat rises to 25 percent during childhood…” Why would a human being — of all mammals — require so much energy as fat? To support “the periods of greatest metabolic demand of the brain”. That’s right, your brain grows from infancy to adulthood, and then continues to consume a lot of energy relative to its size. Even though the brain measures only 2 per cent of our body weight, it consumes up to 20% of our total energy.
So here’s the first health issue. The goal post is clear. The first step is almost taken: good food. Now should one tinker with the composition of macro-nutrients? As in, is eating less fat the answer?
Absolutely not. Lest you forget, fat is an essential nutrient. All cells in your body take energy from fat. It is easy to confuse fat in food with fat on body, but it does not completely work that way. If you have picked up on the current fashion of ‘keto’ diets, you would know what I am saying. The theory behind keto diets is that consumption of more fats and less carbs encourages lipolysis and oxidization of fats (breakdown of fat molecules in body, and their subsequent use for energy).
How can eating more fat burn more fat? And if so, then why eat any carbs at all? Well, the human body evolved with checks and balances. It evolved to maintain a certain level of fat storage. If you consume more fat, you will surely burn more fat, but you will also store more, so the body returns your fat balance to status-quo.
What’s the way out? Think evolution again. We discussed our evolutionary adaptation and the changed environment. Where would you place your bet for quick results/changes? Yup, your food environment. Not the food environment but the choices that you are making about what you eat. What’s a single chocolate doughnut, right? Well, about 280 calories. That’s the equivalent of a full chicken breast (grilled, skinless). What can you eat more of? Therein lies the answer to the first step of your healthy journey. Food choices that don’t add to your fat balance. Think satiety, not salivation.
Disclosure and any possible conflict of interest: I am not a doctor. Nor do I hold any degree in medicine. I do not hold any positions in pharma companies or their equities. And this is not a prescription, but a lay person’s attempt at demystifying health concerns relevant to senior corporate executives. The views are my own and do not reflect anything pertaining to my employer.