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A panel of experts weigh in at the Future of Mental and Behavioral Health event
There's been a lot of talk recently about the change in mindset from being a sick-care system, and only taking care of people when they have something wrong with them, to a preventive care model, where we take care of people before they get to that point.
While that's definitely a good thing, and a step in the right direction to potentially lowering the cost of care, there is also some onus that has to be on the patient to take good care of themselves, to eat right, to exercise, to form some good habits that also help prevent them from getting sick. Sadly, many people are not doing this.
Why that's the case, and what can be done to help people make healthy choices, was the topic of a panel at the The Future of Mental and Behavioral Health last week, from Vator and UCSF Health Hub.
A panel moderated Kym McNicholas, Editor-at-Large at Vator, and featuring Dr. Pankaj Vij, author of Turbocharge your metabolism; Dan Pardi, CEO at humanOS.me; and Neil Ahlsten, CEO at Abide Meditation, talked about the way food is processed and sold, getting into better habits at an earlier age, and the power of faith in getting people to take better care of themselves.
"We, as patients, know that eating healthy, working out, reduces stress. They're all critical to our well being. So, why don't we do it? Why don't we eat healthy? We know food is medicine and we know we should eat healthier, why don't we do it?," McNicholas said to kick off the conversation.
Vij was the first to answer, noting that it has to do with how the human species has evolved and what they expect to get from their food when they eat it.
"Looking around in the animal kingdom, other than animals that are kept in captivity by humans, the cats and dogs that we have in our pets, mostly they go hunt for their own food and eat whatever they can find. That's how we have evolved too. But, in our socialization, food has become this rewarding, pleasurable activity. Associated with it is all the other things that we do that are not even food, like drinking alcohol and smoking and eating sugary foods and drinking soda and buying candy and buying foods that are tainted with chemicals to give them unique, fluorescent colors that we find to be appealing. We're putting these things in our mouths that are not even edible," he said.
That means that thinking about food as medicine, and eating to nourish the body, is actually going against the social norm at this point.
"If you want to fit in with what everybody else is doing in your community and society, in your family, and in a party that you go to in your celebration, you will be the odd person if you're not ingesting all of those things that are not even edible."
McNicholas agreed, noting that even her Amish cousins are now being influenced by "all that attractive, fluorescent coloring and artificial flavoring," to which Vij brought up populations in Hawaii and the Polynesian islands, who now have high rates of type two diabetes.
"It's because they’re eating this diet that is not native to them. It's not carbs, because they were eating tons of rice and root vegetables that they would get out of the ground, it's because they're eating Cheetos and drinking giant bottles of Pepsi, thinking that this is cool and attractive and it is, it's designed to be. In essence, this is an epidemic. It's an epidemic of an addiction, not that much different from a drug addiction," he said.
Pardi agreed, saying that the modern system actually designs foods to "perfectly suit our bliss point," meaning that "we know how to construct a food that, once eaten, that behavior is reinforced and we will seek that food in the future, and that is just manipulating our physiology."
While those foods have a very powerful hold over our behavior, he said, that does not mean that we can't reject them, it's just very hard to do. The best way to prevent this, then, is to start forming good habits when people are young.
"We can start when we’re school age to learn the sorts of things that are healthy in today's world, and be successful at them because food and exercise seem like topics but they're actually categories and there are hundreds of decisions under each one of those categories."
McNicholas pointed out all the commercials and influence that makes getting people to have good habits when they're young so difficult.
"Also, the things that actually are a result of the poor choices when you're younger don't manifest, for most of us, until we're later, when we've already developed this habit and you have with my dad who's 79 years old with heart disease. And do you think he's going to make critical changes? I don't think so. A lot harder at that point," she said.
Pardi responded that becoming "highly skilled at very complex behaviors once we are already at a point where the disease process is evident and we've crossed that clinical horizon" is possible, but it's challenging and that's why starting earlier is a better idea.
"That actually speaks to one issue in the healthcare system is that we're not used to addressing issues until they arise. The currently healthy is an underserved population, and yet so much of our society is unhealthy or becomes unhealthy. So, we need to work well in advance of poor health occurring so that we have the skills to continue to prevent poor health from occurring later on."
McNicholas then turned to Ahlsten to ask him about mindfulness and meditation, and why people also don't practice stress relief, to which he said that, mostly it's because people don't know how to do it, as they haven't been practicing at it, which is why Abide has tried to adhere itself to it's users existing lifestyle and philosophy.
"We've tried very much is to say, ‘You already do this thing. You can tie up this meditation practice into your morning ritual of having coffee when you wake up or commuting or whatever that activity happens to be.' We found really interesting success even from just giving people a morning alarm that's beautiful, that takes them into a meditation experience, to say, 'Maybe the first thing you need to do when you wake up is actually reflect and meditate, rather than start looking at your phone.' That's one thing behaviorally we found we were successful."
"When you talk about just that meditation piece, that reducing anxiety piece, you believe that actually prayer and faith-based meditation, in a sense, is much more effective than general meditation," McNicholas said, to which Ahlsten responded by noting that parts of the brain light up when people are praying.
Whether or not it's scientifically true that people are actually talking to God, he said, neurologically it actually does help.
"What we’ve seen from MRIs is it lights up a different parts of the brain which are related to relationships, which are related to releasing oxytocin and building up that kind of love feeling that people have, which is a very important part of relieving stress, especially in the long haul. It's not just a short term thing but it actually builds up your capacity, and your coping mechanisms, to be more successful in future stress events," said Ahlsten.
That also helps people sleep, he noted, as the way that you fall asleep also changes how your neurology works at night.
"When people wake up in the morning, they actually feel more trusting and confident than they did when they fell asleep because they felt like God's presence was with them at night and they were protected. Now, again, whether or not you have any scientific evidence for that part is totally, who knows? But what you see in the patient in the morning is an actual feeling of personal connection and trust that allows them to be rooted."
McNicholas mentioned a story about a patient she saw who was told by 12 doctors that she needed her foot amputated, but she would pray every single day that she could keep her foot. That has helped her make lifestyle changes that might allow that to happen.
"We've been helping her and working with her on critical lifestyle changes, eating better, wrapping her foot, and doing some natural things and she's doing it every single day because she really believes that God does help those who help themselves, and she prays about it. I mean, that's her accountability on a daily basis and she's doing this because she has such strong faith, and that that is so important."
"People have different reasons to have faith in things. We all know there’s different motivators that drive people, and there’s a segment of the population for whom that's a really strong motivator. And if you can tap into that for that segment of the population, you can see much higher adherence to these things because they're like, ‘Well, this is what I'm supposed to do and I believe it's gonna work, therefore I do it.’ That just helps make them be much more successful in their experience," said Ahlsten.
Vij likened this to placebo effect, where if someone believes that whatever they're getting is real, even if it's a sugar pill that they think is pain medicine, their pain will actually decrease.
"There's no doubting the mind-body connection, for sure, and it's a continuum. We're talking about how the mind can influence the body and the body can influence the mind," he said, again bringing it back to food and what McNicholas has said about her father not knowing that the decisions he made when he would be affecting him when he was turning 80, arguing that is actually not true; that we know those behavior changes even at young ages can make a big difference.
"When someone says, ‘Hey, my kid gets really hyper when they eat too much Halloween candy, I don't want to give them too much sugar because they're gonna start bouncing off the walls,’ is it the sugar? Or is it the yellow 5 dye that’s in those fake carrots and peas that they got in their candy? So, the symptoms might be different for a four year old compared to a 79 year old but some manifestations are already there," Vij said.
Right now there's an epidemic of attention deficit disorder in children, and there are many treatment centers that are based around changing the lifestyles of those children, giving them a diet of all plant foods and unprocessed foods.
"You eliminate the soda, the caffeine, the dyes, the high fructose corn syrup from their diet, you give them the Omega-3s and, lo and behold, their symptoms disappear. So, yes, I mean, there's something to be said for having faith. When someone goes to their doctor, and I have people that come and tell me, even before they go to the pharmacy, right at the end of the 15 minute conversation, ‘Hey, I already feel better, just talking to you.’ What's that? That's another form of somebody’s faith, trust, confidence, belief in whatever power that they believe that this other human being has or they're channeling something from nature."
(Image source: thestonetable.org)
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