Since graduating from my pain fellowship 6 years ago I have been thinking about how to help my patients achieve pain relief and better health. In the big picture the things that make us sick are: our genes, our behavior, our environment and time. We cannot change our genes yet and even when we can do it I will not sign up for the first wave of gene therapies. We definitely cannot change time. So we are left with our behavior and our environment. From a behavior perspective I think we knew the basics for a very long time, but somehow we forgot what is truly important. In my opinion there are three levels we should be thinking about.
1. Metabolic health. I wrote a blog post about this last year. Basically, the metabolic health is closely related to our diet. My advice is to eat whole foods, lots of vegetables, avoid excessive fruit intake (especially grapes and other very sweet fruits). Stay away from sugar/fructose, fruit juices and processed foods. The goal of the food industry is to sell us stuff and they create super addictive foods. Billions of dollars are spent on creating and advertising foods that make us sick long term. The food industry is so good at getting us sick that it takes only 10-20 years to accomplish this. Just look at the children, they are getting obese and metabolically sick at very high rates. It is estimated that 19.7% of American children and adolescents (2-19 years old) are obese according to CDC. One study estimated that only 12% of the US adult population is metabolically healthy. The effort to improve metabolic health needs to be even greater for people with serious metabolic disturbances like diabetes. In addition to everything mentioned so far people with diabetes should look into a low carbohydrate diet.
2. Movement. Most of us don’t move as much as our ancestors. I am reading the book: “The practice of natural movement” by Erwan Le Corre. In Erwan’s opinion many of us are by choice zoo animals. We limit our movements and our environment so much that we are nowhere close to our ancestors in terms of movement type and frequency. Our children have the instinct of our ancestors and practice all kind of movements by crawling, jumping, climbing everything they can find. But we then restrict what children can do and we put them in chairs at desks. For many people the only movement they do is walking from one chair/couch to another. In my opinion the best is to return to a whole range of movements using as many muscles as possible. One step in that direction is yoga or tai-chi. If you have children around, try to do whatever they do. If you see physical therapists, ask them how they are going help you improve your whole body.
3. Mental health. Our minds are amazing tools but we need to use them properly for our benefit. We should give our minds as much attention as we give to our bodies. A daily practice of mind exercises like meditation can unlock deep levels of the mind. Everybody carries around a certain level of baggage from the past: e.g. traumas big and small. The good news is that we can heal the past. For significant trauma leading to PTSD and depression I think an option in the near future will be psychedelic therapy. Tim Ferris had a good podcast episode and the book “The fellowship of the river” by Joseph Tafur is a good resource. For chronic pain therapies targeting emotions (e.g EAET and PRC) are more successful than the standard cognitive behavioral therapy.
Another important area is sleep. I wrote a blog post about sleep a few years ago. In my experience if we improve metabolic health and mental health, sleep gets better. But we should not ignore sleep hygiene.
We will probably have little use of the modern medicine outside acute conditions if people master all these levels of health.