Health Matters

Connecting you to the sources of health.

Individual Choices

Can we achieve good health and longevity through our individual choices?
Can we achieve good health and longevity through our individual choices?

The simple answer seems to be "yes, of course, ultimately one's health is one's responsibility." However it turns out that we may have to look beyond our individual selves for health--to the community we live in, as well as our ancestors. New insights (which, by the way, mirror old folk wisdom) indicate that we may have to ‘broaden our lens' and change our paradigm. We will soon, thanks to the insights of science and economics, have to rebalance our thinking about the limits of individualism vis a vis the impact of the collective communal responsibility.

The field of genetics has documented that what we eat, how we live, the air we breathe affect the expression of our genes (e.g., nutrigenomics), activating and silencing our genetic expression. Now, the new field of epigenetics (‘above the genes') has indicated that how our parents, grandparents and great grandparents lived determines which genes ‘speak up' and which genes are silenced in our lives. In effect this means that what appears to be a genetically based temperament or a physical quality (‘he was always overweight, she was always sad') may not really be the result of genes, but rather gene expression, pre-determined by both our own environment and experience, and the environment and experience of our forebearers. In simple terms, the famine your great grandmother lived through may have ‘tagged' some of your genes, so that your body works extra hard to keep your weight up, leaving you overweight despite heroic efforts to be trim.

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Further, Malcolm Gladwell, in his recent book, Outliers, describes the huge effect a multigenerational community can have on health, despite very poor diet. In his book he talks about a town called Roseto, Pa. In this town, founded in 1883, lives a community of "Rosetans", all originally from Roseto, Italy. Clustered together for generations, they have developed a very strong and vibrant community of two thousand people, with 22 separate civic organizations, close long term connections, and multigenerational families. Their diet is poor, as they consume 41% of their calories from fats including lard. They do not exercise. Yet they have a death rate from all causes that is 30-35% lower than that in the U.S. (including their neighboring towns), virtually no heart attacks in those under 55, and the death rate for heart attacks in those over 65, is 1/2 that of the US average. Two physicians, John G. Bruhn and Stewart Wolf studies the town and published two books (the Roseto Story and The Power of the Clan: The influence of Human Relationships on Heart Disease). The conclusion was that health was in large measure a function of community.

Duh. Have we all been asleep? I guess we have been drinking the cool-aid of individualism. Sometimes I think that we are like giant neurons. The more connections and input a neuron has the more alive it is. Apparently, we are the same.

What are the implications of this information? First, it doesn't mean we throw the baby out with the bathwater. What we eat, drink, breath, and do does matter. That is fact. But now, we are coming to see that when analyzing problems, in this case, health, we must be able to change lenses. We must recognize that how we grow depends in large measure, on the culture we are in (just like bacteria). We must be able to assess a problem hermeneutically, from different vantage points, having a narrow focus, then changing lenses to a broader focus, and then again to an even more broad focus. Then we must learn to integrate all of that information into a cohesive whole. And finally, we must work with the problem at many levels.

Robert J. Hedaya, M.D., D.F.A.P.A., is a Clinical Professor of Psychiatry at the Georgetown University Hospital and Founder of the National Center for Whole Psychiatry.

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