Friday, 1 February 2013

The social dimension of health

Maybe I could even have title this post: the social dimension of life.

Many people seem to interpret "survival of the fittest" as relating to the fitness studio. While the fittest are simply those who survived. Whether you survive depends on lot on your tribe and only partially on your self, if you do not behave too stupidly.

Frank Forencich speaking at the Ancestral Health Symposium, 2012, explains this social part of health and a full life.

Frank Forencich is blogging at The Exuberant Animal and is a refreshing sound in the paleo world. His posts are thought provoking and well worth reading.

His own description is:
A multi-disciplinary, integrative approach to performance and health. Ideas and resources to reinvigorate your body and your organization.


If you are interested in a more social perspective on health, you may also find the blog Eatropology of Registered Dietitian Adele Hite. She does not believe in one diet that fits all, that includes the recommendations of the US Department of Agriculture.


Further reading

The Social Life of Genes at Pacific Standard Magazine by David Dobbs
A long article on the genetic basis of the relationships between loneliness, poverty, stress and health. Well worth the long read.


Daneel Olivaw said...

"Your own experiences and a healer you trust are your best guides"

And here I thought that data and the scientific method were the best guides. Huh, seems I was wrong...

Victor Venema said...

Daneel Olivaw, a more generous interpretation would be that you are also right, but that it depends on context.

Still, I have the feeling you are overestimating the power of science. Science is about solving solvable puzzles. The solvable ones are typically quite small. I would not dare to give people advice on how to life their lives based on science.

I see you are interested in climate science. Also here I am very happy when climatology is getting the climate sensitivity right, that is when climatology is making a decent prediction of how the global mean temperature responds to increasing green house gasses. Maybe we can also get continental sized averages and the latitudinal behaviour right. About smaller scale stuff, I am highly sceptical. For impact studies, we often need higher resolutions, I do not trust most of them much. (Which does not mean that we should not do impact studies, the answer is more likely right than wrong and can thus be informative, but it does not have the rigour one would expect of science.) That is not just a question of the size of the error bars, but of whether we can compute the error bars. Furthermore, for most impacts it will be important how people, groups, institutions, etc. will react, which ideas and technologies will appear or will be developed. As soon as you deal with (groups of) people, predictions become very hard.

Which leads us to the sciences of food and movement with respect to long term health and chronic decease. Almost by definition this is an observational science. Just as climatology, but in this case we have to deal with people, which is much more complicated as dead matter. Experiments would have to be very long term (decades or generations) and in this time you would have to manipulate the behaviour of the people all the time. That is nearly impossible.

Thus in praxis, nutritional science is mainly based on observational studies, which often have confounders. If you see a difference between natives and Europeans in high blood pressure, it might be that European eat more salt, but there are some other differences (to put it mildly). If the Chinese at the coast are less healthy as the inland Chinese, you could claim that it is because they eat more meat (The China study), it could also be any other aspect of their more Western lifestyle.

Even if we would understand what a good life style would be for an average person, then there are still large personal differences. Maybe science will get a handle on the average and even such individual difference once. I am sure I will not be alive any more. Thus for now, I am listen to my body. I would be very happy, if science would recommend some of the experiments people could try and maybe help with the "listening" part. The experiment, I wish science would have recommended me, is to refrain from grains for a month and then have a look how your feel and whether the possible benefits are worth it.

Not listening to your body will for many people lead to chronic decease. Science does a great job to develop medicines to reduce the symptoms. (And medicine is also very good for other acute problems.) I hope not to have pills for dessert when I retire.

Daneel Olivaw said...

I agree completely. Medicine in general is a very difficult science and it's getting harder every day since -as with any other knowledge-seeking endeavour- we first went for the low hanging fruit and know we are dealing with ever more complicated matters.
I do feel that we know a fair bit about diet and how it affects health in general and in specific populations. For the most part, we have the basics right (eat varied, lot's of fruits and vegetables, not a lot of meat, avoid abusing sugar, coffee, etc...) and we are working on the more subtle details (What's the ideal Vitamin D level? are antioxidants actually any good?[Probably not] And so on).

What I do not agree with is that gaps in our science-based knowledge is a justification for relying on pure anecdotes and subjective experience. We all know how unreliable it is.
To continue with the climate change metaphor, I don't think that the lack of scientific certainty about local impacts means that we should do what that guy there thinks we should do. If he thinks we should do something -if he has a guess- then we should subject it to scientific scrutiny.

Also, I'm highly skeptical of this kind of ideologically-based practices. If the paleodiet has benefits, this have to be demonstrated scientifically but, just as with organic farming, why should we think that a set of arbitrary rules based on the naturalistic fallacy will be the best practice (in diet, farming or anything else)?

Victor Venema said...

Sounds like you are in good health, if you are that optimistic about the state of nutritional science.

I have nothing against using subjective experience when it comes to my health. I would not base recommendations for public health on it.

Who knows, maybe it is all placebo, all subjective. You would expect the opposite in my case. I always thought I was eating a healthy diet. And eating so much fat and not eating healthy whole grains is supposed to be unhealthy. I also trust science more than some libertarian paleo-wackos. So my body should have expected my health to deteriorate if it was mainly a placebo effect.

And even if it is placebo, it is a lot better placebo effect as the one of whole grain yeast bread and low-fat margarine. My allergies and my asthma are gone, I am no longer hungry most of the time, my skin cleared up, my teeth are cleaner, my nails are stronger, etc.

I am highly sceptical of people thinking they are free of ideology. Everyone has one, the people who are not aware of one, probably have a mainstream one. You cannot think without ideology, in science it is called a paradigm or theory. You cannot start understanding the world from scratch, that is the fallacy of philosophical empiricism. You need an interplay of ideology (theory) and observation (data) to make progress.

It would be nice if science would scrutinize these ideas, see which ones hold up and make them more precise. While most of science is ignoring these ideas, because it does not fit their paradigm that biochemistry and genetics will solve all medical problems, I have to live and make choices. Listening to your body in making these choices for yourself is sound advice.

For me the paleo idea is mainly about generating hypothesis, which you can try for yourself. I am a scientist myself and am thus not that impressed by an existing set of scientific ideas. It is my job to see if I can poke holes in them. As long as the paleo hypotheses are not proven impossible to work, I see nothing against experimenting a little.

The main problem in this thinking are deceases that take a long time to develop. There you cannot rely on your personal experience. Even if this life style would make my life shorter, for which I see no proof, the increase in quality of life is worth it.

Do you know of any scientific study that proofs that one should "not a lot of meat" and avoid to abuse sugar? Eskimos eat a lot of meat (the whole animal, not just muscle meat). I am personally quite agnostic whether there is an optimal amount of animal foods in a diet. Except that the extremes (vegan and only muscle meat) are likely not healthy for most. And I seem to be able to eat a lot of sugar in the form of fruit without ill effects.