So the amount of money that we spend on health care every year is almost inconceivable. We spend about $316 billion on cardiovascular related costs, and then another 327 billion on costs associated with diabetes. Last year, we spent over $11,000 per person on health care. And now the irony of this is, is that most of that money is actually going to sick care, not to things that help us with healthy behaviors or for wellness. So what are we buying with all of that money? Is it good health? Is it maybe a long life expectancy? Do we actually have more vitality and resilience and endurance than citizens of other countries that spend significantly less than we do on health care every year? Unfortunately, no, actually, not only No, but hell no. Now growing up, I actually didn't want to be a doctor. I wanted to care for the physical and the mental and the emotional and the spiritual health of my community, while living my life ensconced in that web of relationships that makes up a tribe. Now, you may not be surprised that shaman was not a career path that was listed in my high school guidance counselor's college catalogs. So I decided to choose medicine instead. And I thought that becoming a family doc would be the most modern path to serving my community as a healer. Now, it might surprise you to know that only about 20% of the health outcomes here in the United States are directly related to the clinical care that we receive. So that's like the quality of the doctors and the medical facilities we can access. The remaining 80% is directly related to our own health behaviors, socio economic factors, and the impact of our physical environment. So the chronic disease epidemic that has really emerged over the last 50 years, including cardiovascular disease, diabetes, cancer, dementia, these things can really be attributed to the cumulative effect of our lifestyle choices that we make every day. For the most part, these diseases happen by choice, not by chance. And unfortunately, all those pills and procedures that we use to try to combat them, it might slow down this impending train wreck of disability and disease, but it rarely is able to bring us back to a state of resilience and well being. But what if we could change the game? What if we could create a new paradigm, something that actually brings us both along healthspan and a long lifespan? Well, I studied hard in medical school, and I learned many things. And that brilliant clinicians, I devoured cutting edge research studies, I experienced the joy of delivering babies.lifestyle import meaning
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lifestyle 127 And I also found that peace and solace are possible, even for those that are dying, if someone has time to sit and breathe, and just be there for the experience with them. So I found a quote during medical school that I felt distill this essence of being a healer. And it said, to cure sometimes to relieve often, but to comfort always. And so I chose that as my creed. And I absorbed everything that I could from the late 20th century Western medical paradigm, I memorize things about pharmacology and physiology and pathology, microbiology, I learned all these evidence based guidelines for treating hypertension and heart disease and high cholesterol and diabetes. I eventually became a practicing physician, with my own panel of wonderful patients, forced by the system to spend 15 minutes or less with each of them, but still finding my purpose in trying to live that creed. cure. Sometimes, we leave often, but comfort always.lifestyle
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lifestyle design But unfortunately, I began to see that the medical paradigm that I had been trained in and practiced, was not working. I cared for many children who struggled with obesity and had very poor cardiovascular fitness, so much so that they could not even run one lap around the gym without getting out of breath. And I could see that they were already well on their way to a lifetime of chronic disease. Just because of the lifestyle choices and social norms that were surrounding them. So coming to see me once a year for their well child check and being told, drink less sweetened beverages,participate in active play for 60 minutes a day. Oh, this was completely ineffective, me, especially compared to the tsunami of competing messages that they were exposed to every day in our society, asking them and urging them to eat more sugary, sweet, salty foods, to exercise less, and to consume as much digital entertainment as possible. I kind of felt like I was trying to prevent an avalanche from like burying them by flicking cotton balls at it, which is basically an exercise in futility.
And how about their parents? Well, following evidence based guidelines on how to treat my patients hypertension and diabetes and heart disease did not reverse these problems. I frequently found that I needed to either increase their medications, or maybe even add additional new pills to try to combat this stubbornly rising blood pressure and blood sugar and chest pain. The pills and procedures that I had been taught where the gold standard for maintaining and improving health had failed. So I became discontented. Actually, in the medical vernacular, I reached my peak point. So I felt like there had to be a better way to nurture your well being and reverse disease. And being a science geek, I decided to take a deep dive into the medical literature, and hope that I could find some answers there. So one of the most inspiring and impactful studies that I have ever read was done back in 2009. And evaluated for simple lifestyle.does a person have a BMI less than 30, which means they're not classified as obese? Do? Do they smoke? Three, do they participate in at least three and a half hours a week of physical activity. So that's like 30 minutes a day. And This is just getting your body moving enough to get your heart rate up into that light to moderate activity zone. And then four, do they eat a predominantly diet that has fruits, vegetables, and whole grains with low red meat consumption. So I'm not talking about a vegan diet here are not even a vegetarian diet, but an unprocessed predominantly plant diet. And what they found was shocking. So for the people that actually could follow all four of those lifestyle factors, they were rewarded with a decrease of risk of disease, any chronic disease by 80%. And we're talking about anything heart disease, cancer, diabetes, stroke, all of that decreased risk 80%. I mean, for me, as a doctor, that is mind blowing, if we had something like a pill that had that type of efficacy, I'd be prescribing it for all of you guys, by the time you were 30. We have nothing in our pharmaceutical, or in our surgical armamentarium. That comes close to decreasing the risk of chronic disease by 80%. So for me, this was like finding out that there is a longevity jackpot out there with all of our names on it. I mean, this is great news.
So I quickly looked up, how many Americans can actually hit all four of those lifestyle factors. And I found you guys ready for it? 2.7%.
Yes.
So we have documented evidence of therapeutic lifestyle behaviors that can change the trajectory of the chronic disease epidemic in our society. And less than 3% of Americans are benefiting from those habits. inconceivable, right.
I mean, but why?
Why is that? Well, if we know that lifestyle choices have such a dramatic impact on our health outcomes, why do we have such a dismally low percentage of people actively engaged in those health
habits? Well,
it turns out that lifestyle choices are contagious, in a very similar way to a virus. So we are likely to pursue the same types of habits and activities that those who are around us are also engaged in. So for example, if you hang out with people that like to go for hikes on the weekend, and maybe they share plant based potlucks, you are likely to be doing those sort of activities to conversely, if you hang out with people that are spending a whole lot of time in front of screens, and they're having a lot of sort of junky convenience food and sugary snacks, and maybe not prioritizing sleep, you are less likely to be focused on exercise healthy food and sleep in your life as
well.
This is the power of social nudges, which means that most people in a group will follow along with what the rest If the group is doing and if you combine that with a predominant choice architecture of our environment, you have a one two punch that really affects the choices that are made. So choice architecture actually is more about what is the default option in any particular situation. And it can have a huge impact on the outcome of that situation. So, for example, there were theater goers in a Chicago movie theater that were all given free buckets of stale popcorn. Those that were given large buckets of stale popcorn, actually ate 50% more popcorn than those who were given medium buckets, even though both groups said it did not taste good.
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