Moderation Versus Optimization
As part of patient care, I have conversations about the introduction of processed grains to our diets about 10,000 years ago and all the detrimental effects that came with it; tooth decay, gum disease, stunted growth, etc. I also discuss the introduction of industrially processed seed oils like corn, canola, and soy and their connection to heart disease, diabetes, obesity, inflammation, and more. A frequent response I hear is the phrase, "everything in moderation." I am unsure what they mean, and I wonder if they do either. I think many who utter it feel guilty for eating those things, but they should not. Nobody told them the truth, and the truth can be hard to hear.
The Obvious
Let's get the easy stuff out of the way first. Is there a moderate amount of fentanyl, cyanide, tooth decay, gum disease, or cancer? I think the answer is no.
The Not So Obvious
Is there a moderate amount of exercise, oxygen, water, or kale? There could be. But what if you have a coronary blockage and exercise? Could it result in death? What if you have ulcerative colitis and fiber acts as an irritant for you? Then there are better dietary choices than kale for you. Sometimes there is no moderate, and people find it difficult to determine what it is, even if there is one. I will guide you later in this post to help you figure out what you should be doing.
The Optimum
The recommended daily allowances for most nutrients are the minimum needed to avoid deficiency diseases. Is lacking malnutrition moderate? Is having a bit more than the RDA moderate, even though you may benefit from more? Is it OK with you if your state of health is moderate? Not for me. I want to optimize.
Luckily, our genes are primed through thousands of years of survival to help us achieve optimal health. Things like needing eight hours of sleep and breathing to 100% saturate our hemoglobin with oxygen are essentially etched in stone. If they are not optimal, there will be health consequences.
How Do We Optimize?
For the most part, we all have good genetics. Our genes expect specific environments. We need to harmonize with our environments to optimize our health. Simply put, our genes expect a certain amount of sun, movement, sleep, oxygen, etc. The amounts can vary depending on factors like the time of year or age. However, how we look, feel, and execute tasks will inform us of our success at optimization.
I have simplified the parameters of health optimization. Here they are:
Oxygen: This one is easy. Oxygen is absolutely needed for life. We can go about 6 minutes without it. Many people, including children, are chronically short of oxygen due to obstructive sleep apnea. The complications are many, but here are the main ones: fatigue, high blood pressure and heart problems, obesity, blood lipid problems, liver problems, and diabetes. Normally, we don't need to worry about the oxygen we need, but we need to be aware of the symptoms of not enough, which are: snoring, waking up gasping, insomnia, sleepiness during the day, short attention span, and irritability.
Getting eight hours of sleep: Sleep is way more important than most people suspect. Most of my patients don't sleep enough and usually qualify it by saying that's all they really need as if they are superhuman. I promise you that none of us are superhuman. It is well established that we need seven to eight hours each NIGHT. We are not nocturnal beings. According to a recent report from Gallup, the average American gets about 6.8 hours of sleep each night. 40 percent of us are sleeping 6 hours or less! The risks of improper sleep are similar to sleep apnea. Please read this post about proper sleep hygiene to maximize your sleep. Make it a priority!
Handling stress: We all have stress. There is little we can do about some of it. Stress components can be remembered with the mnemonic NUTS:
The novelty of the event
The unpredictability of the event
The perceived threat to us
Sense of loss of control
What we can do about it is change how we deal with it. There are so many stress management techniques to choose from. Here are a few: meditation, yoga, Tai Chi, massage, journaling, volunteering, mindfulness, and religion. In addition, there are more than a few good apps like Headspace, Calm, and Insight Timer. YouTube is great as well-search for guided meditation, yoga, and deep breathing exercises. Just search for videos and relax! Please read my post on stress here.
Getting enough nutrition from eating nutrient-dense foods: So many diets work; it is up to you to find out what works for you. Ps, I am including water as a nutritional element for the sake of this article-simply drink when you are thirsty. For a good starting point, I recommend this post.
Moving/avoiding sedentary living: Be active most of the day. Walking is the best thing you can do. This video on walking says it all. I recommend about three weight training sessions (bodyweight is fine) per week. Cardio is easy to mix in, do just what is necessary. Resting less or supersets is a big way to add cardio without adding time when lifting. Finally, intense bursts of activity a few times per week are ideal.
Having social connectivity: We need a small number of people with whom we can relate well. Strong relationships contribute to a long, healthy, and happy life. On the other hand, being alone is similar to the risk factors for smoking and obesity. Research has shown that people live longer, have lower stress, and are healthier when they have reliable friends. Research also shows that toxic relationships heighten stress, decrease health, and shorten lives. Julianne Holt-Lunstad famously concluded in 2010 that those with good social relationships have a 50% greater likelihood of survival than those with poor or insufficient social connections. 1
Getting non-burning sun: Less pigmentation means less protection from harmful UV. The trick is getting enough exposure to boost vitamin D, but not burn. Too little sun is just as bad as too much sun. This talk by Dr. Ruscio from AHS 2018 Boulder explains it all. If you get the proper sun, you will have stronger bones, better sleep, an improved mood, and a healthier immune system.
Conclusion
Ultimately, we make the choice every day. Do we binge-watch one more show or go to bed on time? Do we eat the free bagels in the workplace break room, wait for lunch, and eat a nutrient-dense meal? Whether you choose moderation or optimization, health problems will occur. Sometimes people feel poorly and need to optimize something in their life, like diet, sleep, or activity, and benefit from the change. Sometimes the people who try as hard as possible to learn and optimize their life get sick. That should not be an argument against optimization. I would rather sleep eight hours each night, eat a nutrient-dense diet, get some sun, enjoy socializing, exercise (not too much), minimize how I react to stress and ensure I am getting enough oxygen, and take my chances.