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The Next Prescription -- Primal Stress

The moral of this story lies in the perverse idea that the masters of disease have the prescription for health. Doctors have no real conception of health beyond the absence of illness. No one would go to an auto body shop for advice on how to keep a car in good running condition.
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"We can't solve problems by using the same kind of thinking we used when we created them."
--Albert Einstein

We have passed a tipping point. The armamentarium of medications and procedures for preventing and treating diseases caused by the way we live, are failing.

About half of American adults have one or more preventable, diet or activity-related chronic diseases. These include cardiovascular disease, type 2 diabetes, cancer and obesity. This epidemic threatens both our physical and fiscal health. The direct medical cost of obesity alone now totals $190 billion annually in the U.S. For the first time, life expectancy may be significantly decreased for a generation of American children.

The common thread linking these diseases of lifestyle is a chronic low-grade systemic inflammation. The most common contemporary causes of such inflammation are Western diet, inactivity, stress and excess fat tissue. These conditions disrupt the body's equilibrium. In an attempt to regain balance, the body mobilizes its defenses and mounts an inflammatory response.

Millions of years of evolutionary pressure created this sophisticated stress response system. It has been essential for our survival. Its present malfunction is now the greatest challenge to our survival as a healthy animal.

How did our best defense become our downfall?

Why would the very capacity for fight or flight, healing after trauma and the destruction of infection, become the cause of most contemporary disease?

The answer lies in a disparity of two time lines. One tracks evolutionary change, the other environmental change. Our genome is the crowning achievement of adaptation to a life that no longer exists. In surviving as hunter-gatherers, populating the earth as agriculturalists and building the modern world as industrialists, we have created an environment that is alien to our biology. We might as well be on another planet.

Of all the many changes brought about by this manmade environmental transformation over the millennia, one plays a leading role in turning defense into defeat. Stress. But not in the way you might think.

The problem is not excess stress. In fact we are under-stressed. The absence of formative ancient stressors has disrupted the remarkably resilient biological regulation that allowed us to survive as a species. The result: an epidemic of chronic diseases.

The ironic task of contemporary society is to recreate the ancestral stressors we so successfully eliminated. This alone will allow our exquisitely tuned biology to return to its evolutionary preferred setting. This is home. This is health.

So what would this look like?

The formula is familiar. Sophisticated scientific research has yielded unsophisticated recommendations. Move more, eat real food, fast regularly, sleep, go outside, spend time with friends, help others and do something to metabolize stress such as meditation, yoga, tai chi or diaphragmatic breathing.

Perhaps it is the very simplicity of these actions that makes them easy to dismiss. We have been conditioned to perceive medication as a more powerful intervention than the remarkable effects of a good night's sleep. Ubiquitous social forces conspire against us in the form of fast food, escalators, automobile culture, the passivity of television and the insanity of things like electric can openers, to name a few.

The moral of this story lies in the perverse idea that the masters of disease have the prescription for health. Doctors have no real conception of health beyond the absence of illness. No one would go to an auto body shop for advice on how to keep a car in good running condition.

The current epidemic of chronic disease is not caused by a medical problem. It is caused by a cultural condition. Our health crisis is the product of our ingenuity in eliminating the stressors that made us strong. A similar level of ingenuity is needed to reincorporate these essential physical challenges. If not, we are destined to a parade of inadequate medicines that will never provide what millions of years have designed us for.