If you cannot live, health becomes irrelevant

Humans are more than DNA, RNA, genes and chemicals.

The human body is indeed not just a physical engine, it is also spiritual, emotional, psychological, social – and it lives and survives in a specific environment in a uniquely individual manner.

All of this (and more) play a role in the sequence of events during which a healthy individual turns into an unhealthy one. It is therefore important to address as many of these issues as possible to understand how to reduce the number of unhealthy individuals and decrease the projected global increase in numbers of chronic disease sufferers.

To repeat a very important truth: everything about the human body and its functioning is mimicking Nature – everything – everything must be in balance. It is not about eliminating individual ingredients, foods or beverages. It is not about trying to tax people ‘thin’. Creating an imbalance through taxation and levies, destroying cultural eating habits, treating different peoples as if they are the same apparently to make a political statement, is dangerous. Contrary to apparent views by major organizations and governments, it is about ‘just enough’, ‘just in time’. Indeed – it does not just apply to the business world. It primarily applies to the human body and how it functions. Too many vitamins, (such as too many supplements) as too little vitamins, is not good enough. The same applies to minerals, micro-nutrients, glucose, fructose, enzymes, co-enzymes, hormones … as well as the human state of mind.

The human psyche plays an important role in the body. It determines the production and levels of hormones that influence

1.        sleep patterns,

2.        happiness,

3.        stress,

4.        relaxation,

5.        learning ability,

6.        brain development,

7.        synapse development and –maintenance in the brain…. Eventually, also the development and incidence of non-communicable (chronic) diseases, obesity and metabolic functioning and -disease.

Does this seem somewhat far-fetched? Not at all. As you read on, you will find that all these issues eventually play a role in what happens to each one of us – to every human organism, individually.

The question is therefore also how to turn unhealthy individuals into healthy ones and help them to maintain that status. It is in maintaining (maintenance) and logical, achievable changes (that may be different in different countries on different continents), understood and internalized by one and all, that this change from unhealthy to healthy could come about again.

There are no effective ‘shortcuts’.

The power of the human mind in health and disease

Many years ago Maslow created the hierarchy of requirements- or basic needs in life (as I am sure most of you know). This Hierarchy still applies, although some people thoughtfully added some issues based on the way our lives have changed. Let us view Maslow’s Hierarchy of basic human needs (Source: Google) and what it implies (some people would add "Wi-Fi" as the lowest level....):

According to this hierarchy (that has been presented in so many ways in so many sources), the most fundamental need is not to be healthy – it is to live, to survive, to ‘be’.

We need food and drink providing nourishment and energy to do so – not alcohol and/or tobacco. It does not matter whether the energy is ‘good’ or ‘bad’ or whether someone thinks a ‘calorie’ is not a ‘calorie’ and whether or not all kiloJoules (kJ) are equal.

Staving off starvation and hunger is more important than health … if you cannot live, health becomes irrelevant.

Rhythm and Balance

Another interesting basic need is ‘homeostasis’ which can be defined as:

“The tendency of an organism or a cell to regulate its internal conditions, usually by a system of feedback controls, so as to stabilize health and functioning, regardless of the outside changing conditions” (https://www.biology-online.org/dictionary/Homeostasis ).

In this instance “health’ means being well or whole in mind, body and soul (https://www.biology-online.org/dictionary/Health) .

To fulfill the need for homeostasis in a human being (an organism) therefore requires stability or ‘balance’ in all things. An effective spiral is created (Source: Google):

Everything that a human is or consists of, is by its very nature inter-connected.

Like a spiral, eternally evolving and revolving, one aspect of life influences another -- ever correcting, adjusting, healing (or striving to do so), until the organism stops functioning (dies).

When an issue arise to disturb the balance, the body will correct that imbalance, until it becomes overwhelmed. That is most probably when healthy individuals become unhealthy ones.

Are the issues only physical in nature?

No.

Humans are not one-dimensional. Our physical self cannot be disconnected from our phsychological self, self-image, wellbeing and more. We are indeed complicated, complex beings. Any attempt to view human life in isolation or compartmentalized, provides an incomplete image and possibly skewed interpretation of the apparent truths.

An holistic view is essential.

We are indeed ‘the sum of our parts’.

It is so easy to view nutrition, health, diet, non-communicable (chronic) diseases and more from a specific perspective – sometimes not so much human as monetary or political to address the sustainability development goals set by the United Nations and governments. It is important to understand that we cannot target certain outcomes without taking into account who and what we are as humans. We cannot agree to opinions devoid of insight, which show little or no causality (causity). We have to take the human as an organism, a complete being, into account.

Almost fifty years ago a social psychologist named Purkey pointed out that the human self- concept was influenced by all life experiences, comparing it to a spiders’ web (image source: Google), where any disturbance (for example affecting the physical self), send trembles or signals through the whole web (the whole human psyche).

With a spider, every disturbance influences the whole web – and the spider reacts to it.

We, as humans, are actually the same, and not just psychologically – in all aspects of our lives. Whenever we experience something in our lives, it is registered in our bodies and/or psyche one way or another.

Think about the spider. How intense the reaction is in a spider’s web, depends on the strength of the web, the sensitivity of the spider, the size and intensity of the disturbance….. It is the same with us, as humans. We have different personality types which makes us more or less prone to react to whatever happens in our lives – we say that some of us are more ‘thick-skinned’ versus ‘sensitive’ than others. For example, in stressful situations some people will perspire, panic, feel faint, stop functioning – while other individuals will weather the storm quietly, in control, sometimes not even registering the situation as ‘stressful’, as other people would do. Some individuals are indeed ‘stronger’ and react with fortitude to whatever comes their way – others do not.

Our bodies react to that.

Our bodies are attuned to who and what we are, how we react (physically and emotionally), our actions (activity), what we ingest, experience and/or perceive and, just like the spider in the spider’s web, it takes action. This action involves human biology, biochemistry, physiology, microbiology and more. Actually, any part of the human body and psyche is activated as required at the most macro, micro and nano level. This includes for example, microbes, hormones, enzymes, co-enzymes, different mechanisms in the body down to the smallest atom and its particles.

Our bodies are attuned to fight for life. It takes this same action when our bodies are threatened by viruses, bacteria, allergies and any other health threat or external factor, influence or injury. When we scratch our skin, we bleed, our bodies coagulate the blood in the wound on the spot – usually just at the bleeding point, nowhere else – except if we have a lack of vitamin K or platelets in the blood. When our noses detect something untoward that we breathed in, we sneeze to get rid of it. When we seem to starve, the body saves energy – dieters be warned. For every action or occurrence, there is indeed an appropriate reaction ….

Our bodies are geared to correct and even manufacture, as far as possible, everything to ensure life preservation. Unfortunately, when we are constantly putting it under strain without replenishing our bodies with whatever it requires, the body’s stores become depleted, imbalances occur and we become subject to warnings from our bodies – feeling tired, perspiring, fever, gaining weight, losing weight, chemically induced depression, and more. When we do not take appropriate action, disease (first acute, then chronic) will result.

Age and the realities of life

If most people would be asked today what has changed in their lives, do not be surprised if they answered ‘a loss of control’. Life seems to be running us, instead of the other way around.

We live in socio-economic conditions that do not encourage health, while environmental conditions actively contribute to ill-health. All of these contributing factors culminate in an unhealthy individual one way or another.

This unhealthy state can take many forms and are not the same for everyone. An unhealthy individual can display many symptoms or characteristics –each specific to that individual. Obesity, weight-loss, anorexia, bulimia, diabetes, cancer .. non-communicable (chronic) diseases.

What happens to children? Surely they cannot be subjected to the same issues that adults are?

Indeed they can and are subject to similar issues. They breathe the same air; live in the same housing as their parents, grand-parents or siblings; suffer the same economic depravations. In addition, changes in lifestyle affect our children at a younger age and it has been happening for decades. Imbalance therefore occurs at a younger age. Children are affected by home situations, staying out of the house later at night, having fewer quality meals at home, having less time to de-stress in a loving family environment, sleeping less, playing less, hiding behind electronics, reading less, being busier and less active …. They also have to excel at an earlier age, or be left behind … Pressure.

Children also learn from their parents, community, school, religion, society, electronic media (to name a few) and when the general levels of knowledge and understanding declines in a population, it is perceived in the lives of our children. Parenting has never been as important as it is right now to set the correct examples and anchor our children in a well-balanced reality. Unfortunately it is also true that no level of knowledge can assist in making our children healthier, if health realities are a lack of nutritious food, declining socio-economic circumstances, increased environmental pollution and more.

To understand how our bodies develop non-communicable diseases (irrespective of age) can be somewhat complicated and the view (as stated before) is not meant to be complete.

Where does it start?

It starts with hunger.

The need to eat and drink

Can you remember when you have been really hungry? Stomach cramps, dizziness, light-headed, faint, salivating at the mere thought of something to eat? Many people have not been really hungry for years. Others have to go without food for days.

The timing of meals, what is desired, the circumstances that prevail when we eat – all of it sets in motion a specific sequence of events on a biochemical and hormonal level in the body. Our body indeed consists of ‘clocks’ – circadian (biological) clocks that time the actions in our body. It seems to start when we start to think about food and eating (although other biological clocks may be started by other events in the body). If we do not take this into account, our bodies become desynchronized .... with metabolic disorders as result. How do we know this? From research, such as:

“The timing of three-meal schedules indicates close association with the plasma levels of insulin and preceding food availability. Desynchronization between the central and peripheral clocks by altered timing of food intake and diet composition can lead to uncoupling of peripheral clocks from the central pacemaker and to the development of metabolic disorders. Metabolic dysfunction is associated with circadian disturbances at both central and peripheral levels and, eventual disruption of circadian clock functioning can lead to obesity. While CLOCK expression levels are increased with high fat diet-induced obesity, peroxisome proliferator-activated receptor (PPAR) alpha increases the transcriptional level of brain and muscle ARNT-like 1 (BMAL1) in obese subjects. Consequently, disruption of clock genes results in dyslipidemia, insulin resistance and obesity. Modifying the time of feeding alone can greatly affect body weight. Changes in the circadian clock are associated with temporal alterations in feeding behavior and increased weight gain. Thus, shift work is associated with increased risk for obesity, diabetes and cardio-vascular diseases as a result of unusual eating time and disruption of circadian rhythm.” (https://www.ncbi.nlm.nih.gov/pubmed/29358041 )

Selection and choice … How do we decide what to eat or drink?

When we become dehydrated, we become thirsty.

When we need energy replenishment, we get hungry.

When we need salt, we start to look for something savory.

If we stay thirsty after drinking water repeatedly, we start to search for something that will keep our mouth and lips moist (something that attracts and binds water, providing a moist coating for the mouth – such as a sugar-containing drink).

When it is cold the beverage will be either warmer and/or thicker.

When it is hot, the drink will probably be more liquid containing a combination of acidity and sweetness to encourage salivation that registers in the brain as satisfaction and moistness associated with hydration.

Many of our decisions, selections and choices are therefore guided by the body’s requirements at a specific time. Unfortunately, it only works when we do not overindulge or ‘override the programming’. Then the messages get scrambled – it is time for us to eat, yet we are not hungry. We need to keep our hand busy so we grab a glass of liquid, yet we are not thirsty. We take alcohol even if we do not like it, because a social occasion demands it, not because our bodies require it. We eat cake to reward ourselves when we are lonely, yet we do not need the energy….

Automatic, autonomic responses are overridden and our decisions, selections and choices are not a reflection of what our bodies require.

Another influence on food choice and selection are well-known to all of us. We are pressured for time, we need to buy food for ourselves and or the family, we grab what we need --- sometimes stopping to read the label, having no time to study it (with or without different colors to warn us we are killing ourselves by eating and our need for convenience)…we may understand our options or not, we may understand the labels, or not; we may be able to buy ‘real’ beetroot per bunch, potatoes by the pocket, a freshly slaughtered chicken (unlikely)…or not. In the metropolitan areas of the world, convenience is everything. When something is needed, it is needed now … ready to eat, ready to serve, ready to heat. Is the Food Industry really supposed to tell you that you are not allowed to spare yourself the time if you have the money to spend?

Can you find out what you are buying and consuming?

Of course – all packaged foods in a retail outlet must be labeled – it is law. When you buy from a quick service restaurant or a sit-down restaurant? No. Is it not therefore peculiar that foods in retail stores are singled out as the culprits when it comes to speculation about what is nutritious and what is unhealthy? In a retail outlet the label tells all.

Any packaged food or beverage product requires a label that adheres to regulations that differs between countries of origin and –sale.

It is not the purpose of this article to dwell on the logic of some of these regulations. Suffice it to say that informed, literate consumers rely more on statements on the label than ever before. Unfortunately some label requirements now border on the ludicrous. It is not aided by the fact that it is not inclusive of all foods consumed. In the mind of the consumer, quick service offerings (without restrictive labels) will seem ‘healthier’ than packaged foods in supermarkets when the opposite will most probably be true. This discussion is inherent to the choices that individuals make on their way when moving from health to unhealthy (https://beta.theglobeandmail.com/news/national/food-label-health-canada-lobbying-sugar-salt-fat/article36889367/?ref=https://www.theglobeandmail.com& )

Deciding what to eat or drink -- Attitude, desire, preference, habit, trust, availability and culture

Obesity and its accompanying diseases can only be addressed successfully to ensure a healthier population if the habits, beliefs, attitudes, choices and preferences of individuals, groups, cultures and religions are addressed. This also entails that each individual should have at least

1.        access to healthy, affordable and available food and beverages,

2.        access to clean water,

3.        access to affordable healthcare that displays a high level of competence, diagnostics, and a profession filled by knowledgeable individuals that embrace continuous learning throughout their professional life, researchers that are responsible, knowledgeable, not populist and most certainly ethical and honest, to name a few requirements.

When individual realities, ingrained habits and culture are not taken into account, no effort to change the outcome of individual health realities will ever be changed sustainably. Many psychologists will agree that it is indeed extremely difficult for individuals and groups to change the way they think, what they believe, what they have been taught and their habits. Does this mean we should no do so? No. We should just think twice about achieving an acceptable and successful outcome.

Sustainable change in food attitudes and interaction, requires a detailed strategy (‘road-map’), which identifies as many aspects that influence individuals and groups as possible, with set objectives, measuring instruments, targets, dates and ways to monitor and compare progress scientifically and correctly, as well as a way to address non-compliance that is not based on penalties.

Penalties are not successful in ensuring a change in attitude. It may actually have the opposite effect (especially when the action on which it is based is just one of many that is touted as a cause for non-communicable or chronic diseases which includes everything from diabetes, cancer, dementia, diseases of the brain, liver infection – actually any disease which afflicts any and every part of the body). When some followers of religious leaders actually allow those prophets or pastors to spray them with insecticide or make them eat grass to ensure that their ‘sins are forgiven’ (as happened in South Africa – a pastor was sentenced in court for this), the seriousness of trust, habits, culture and more is clear.

Satisfaction and Liking

When consumers are not satisfied with a food product , or do not ‘like’ it, it is unlikely that they will continue to purchase that product. It is well known in marketing that consumers will stop to consume a product when the formulation is changed to provide a product that may differ in an almost insignificant manner. Usually, the company is made aware of consumer dissatisfaction and the original product is returned to retail or sold adjacent to the less desired product to determine whether consumers will not get used to the changed product (sometimes because the new formulation is actually ‘better for them’). What consumer say and what they prefer and will purchase is not necessarily the same thing. In a study to determine the effect of fat content, sweetness and seasoning (salt) in food, it was once again indicated that salt and sugar influenced ‘liking’ of a food product more than fat. The perception of ‘fat’ was less important than the perception of sweetness and seasoning  (https://www.sciencedirect.com/science/article/abs/pii/S0950329317302276 ).

What does this mean?

Simply that consumers may indicate how health conscious they are when they complete a survey, only to reject food that is not to their liking, even if it is healthier. A simple example is that of UHT liquid custard which does not contain salt. It is not uncommon for consumers to add a little salt when they decant the product to make it taste more ‘ home-made’. Anyone making home-made custard will also probably add salt – despite the fact that the food industry had to reduce salt content in many foods to a level where preservatives would have to be added to ensure the safety of the product. Since fat (adding creaminess, smoothness or mouthfeel to a product) adds more kJ or calories to the diet than carbohydrates, it is important to understand when it is a driver of preference, acceptability and liking, and when the drivers are sweetness and/or saltiness (increasing the flow of saliva in the mouth – which is actually very important for adequate digestion and events in the body associated with digestion). Many taste interactions exist that influence this delicate balance that can make the difference between consumers finding a product acceptable or not.

Hidden hunger and diet food

What is hidden hunger and what is its link to cravings and ‘food addiction’?

It is “a state of deficiency in humans of essential vitamins and minerals (referred to collectively as micronutrients) that occurs largely without signs and symptoms of micronutrient deficiency diseases. There is a long history of discovery of essential vitamins and minerals, and considerable success has been made in the prevention and treatment of related classic deficiency disorders (e.g. rickets, scurvy, and anaemia). Only more recently has it been appreciated that an inadequate intake of micronutrients may have health consequences even without overt signs of disease.” (https://www.karger.com/Article/Pdf/442378). It is therefore not about removing anything from the diet, rather adding to it to ensure that nutrient balance is restored to prevent genes being activated that cause cravings (increased appetite). Until those genes are ‘switched off’, some individuals will continue to eat, never satisfied or satiated, thus presenting symptoms of addiction (uncontrolled appetite).

What about low-energy dense food (‘diet’ food) – can it control calories and hunger?

According to the CDC in the United Stated it can be done, yet not by the usually suggested ways. “Americans have used many dietary strategies to consume fewer calories including limiting portion sizes, food groups, or certain macronutrients such as carbohydrates or fats. While these strategies can help moderate calorie intake, particularly during the short-term, they do have limitations. These approaches may compromise diet quality or cause feelings of hunger and dissatisfaction, which can limit their acceptability, sustainability, and long-term effectiveness. […]”   (https://www.cdc.gov/nccdphp/dnpa/nutrition/pdf/r2p_energy_density.pdf ). Once again the problem is not in developed countries; it is about the affordability and availability of lower energy dense foods especially in the metropolitan areas of developing countries.

What about very low energy diet products to ‘curb’ obesity?

It may be possible that a person can lose weight, yet become malnourished in the process.

Research from Australia made this statement: “Very low energy diets (VLED) are efficacious in inducing rapid weight loss but may not contain adequate macronutrients or micronutrients for individuals with varying nutritional requirements. Adequate protein intake during weight loss appears particularly important to help preserve fat free mass and control appetite, and low energy and carbohydrate content also contributes to appetite control. [Although] very low energy diets (VLED) are efficacious in inducing rapid weight loss [it] may not contain adequate macronutrients or micronutrients for individuals with varying nutritional requirements. Adequate protein intake during weight loss appears particularly important to help preserve fat free mass and control appetite, and low energy and carbohydrate content also contributes to appetite control” (https://www.mdpi.com/2227-9032/4/3/71/xml ). Unfortunately protein-rich foods are also more expensive and unaffordable, especially in communities with high levels of unemployment.

Remember what was stated in a previous article about the cornerstones of life, the brain and health? It is indeed ... Protein, followed by essential nutrients such as certain fatty acids, vitamins, minerals, micro-nutrients…. it is possible to become lean, only to suffer from non-communicable (chronic) diseases later in life -- even decades later. Some individuals will now suggest that the nutritional content of diet foods be optimized (processed and adjusted despite the fact that the food industry has been lambasted about preservation and processing that is much less ‘manufactured’ than this). Once again the level of refinement and processing make such adaptations expensive and mostly unaffordable, while it is unnecessary if socio-economic conditions and levels of knowledge, insight and affordability is addressed at ground level (as it should be). 

Resorting to excess in anything (even dieting) will have consequences. It is only when health and the cause of disease (and not food) becomes the most important part of the NCD / chronic diseases conversation with a 360° view and holistic approach, that humanity can hope to address this issue. Blaming sugar, products, foods, fats, meat, ingredients – and then taxing them again and again, will not assist.

When a balanced diet is sacrificed for whatever reason, individual nutritional status is in danger, not because of the ingredient or product that is targeted as undesirable, but also due to the message it conveys, namely that it is acceptable, desirable, important (and even expected) for ‘healthy’ individuals to ‘remove’ anything that is deemed undesirable by anyone (or themselves) from their diet and probably from the family diet. This skewed perception perpetuated by professionals that should know better, will have consequences with regard to malnutrition that cannot be imagined. And teenagers? They learn not to accept their bodies, they get depressed and even worse.... as research in the UK seems to suggest. Suicide in the teenage group has been steadily increasing. It is inexcusable.

Healthy eating, obesity and non-communicable (chronic) diseases are not just a matter of tax and health – it can only be addressed correctly when the nature of the human organism and how he/she interprets information, internalizes the information and act on it is front of mind. A ‘one-size-fits-all” solution can never succeed since this part of human nature is not linear as some nutritionists, physicians and politicians apparently expect it to be.

More in the next article – there are other 'role-players' in our bodies that are very important to address obesity and health.

Source list available on request.

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