Introduction to Health and Wellness

These terms are often loosely used when referring to similar things, but technically speaking, they are not interchangeable. Health is more of a medical concept that can be defined as being free of physical and mental illnesses and injuries, whether acute or chronic. Being completely healthy is an ideal state that few adults can actually achieve, yet it is still a worthwhile goal. The alternative is to invite infirmities until reaching an early demise.

Wellness is a broader and less well defined concept that encompasses the integration of physical, mental, emotional, social, and spiritual dimensions of a harmonious and deeply fulfilling life. It requires optimal physical health and functioning, along with a high level of mental health, emotional well-being, and a sense of contentment.

The foundation of wellness is good health. Obviously, wellness cannot be achieved when one is unhealthy. However, simply being healthy is not enough to experience wellness. You would also need to optimize all the other areas of your life in order to sustain a state of wellness. That includes areas such as personal growth, intimate relationships, social connections, and the kind of spirituality that connects us to the natural world.

We can have good health, and we can also be well, although these are relative terms representing a continuum along which we can make progress. Being healthy focuses more on our outward physical, mental, and social functioning, while wellness can be thought of as an inner state of being.

Good health enables us to effectively deal with our physical, mental, and interpersonal challenges, while a high level of wellness might be experienced as a greater sense of vitality, fulfillment, and well-being. Wellness is a purely subjective experience, whereas good health can be objectively validated and measured.

The two concepts are not mutually exclusive, nor are they fully inclusive. You can be healthy, yet be unable to personally experience wellness. On the other hand, you can feel well, but still not be objectively healthy. However, if you concentrate on increasing your level of wellness, it could help you achieve better health, although the converse is not necessarily true.

Healthcare

Your healthcare provider should be both qualified and competent in diagnosing and treating your kind of problem. It pays to shop around. Go to the internet to research a physician's education, training, professional memberships, and complaints received by any state medical board. My own strategy includes asking other physicians what specialists they would go to if they or a family member became ill. I can assure you that medical doctors tend to be a lot more picky about their healthcare providers than the general public.

I wouldn't be too concerned about their personality, but I'd definitely want them to be smart, well-trained in their specialty, and willing to put forth their best efforts on my behalf. In addition to having a list of trusted specialists, I recommend that you have a primary care medical doctor (Family Medicine or Internal Medicine specialist) who can quickly see you and deal with most problems. Your primary care provider can coordinate specialist care and keep all of your medical records in one place, including your Advance Medical Directive.

It should be obvious that we need to do whatever we can to deal with small medical problems before they become bigger. You've heard the old saying that "an ounce of prevention is worth a pound of cure." Well, it's true! Surgeons can offer many examples of "a stitch in time...." Although it may seem like a no-brainer, I suggest that you try to avoid letting a problem continue until you need to be hospitalized. Hospitalization carries the very real risk of acquiring infections that are resistant to multiple drugs. In most cases, your attending won't be your primary care provider. Shift-work by hospital specialists has replaced the image of the family doctor at the patient's bedside. Perhaps the best strategy in dealing with today's managed care system (which is run by accountants) is to make sure that your electronic medical records are up to date.

If you think I'm being overly cautious in my recommendations, let me acquaint you with some statistics: Prior to the COVID-19 pandemic, one out of ten hospital deaths was due to a major diagnostic error. After dying in the intensive care unit, twenty percent of the patients who had autopsies were found to have been wrongly diagnosed. One out of seven hospitalized Medicare patients experienced an error that caused serious harm. It has been estimated that one out of four hospital beds contain someone whose stay has been prolonged as a result of errors. Medical errors, based on some estimates, were the third leading cause of death in the United States, significantly higher than in other developed countries. Am I making a good case for preventive medicine?

America's Healthcare Crisis

America is facing a healthcare crisis. We have a full-on epidemic of type 2 (insulin-resistant) diabetes mellitus, a leading cause of death and disability. The numbers of people afflicted are overwhelming our healthcare system. No longer considered a disease of adults, increasing numbers of children are developing type 2 diabetes, primarily as a result of their sugar-laden diets. Coincident with the rise of childhood obesity and diabetes is a dramatic increase in psychiatric illnesses in children, including attention-deficit/hyperactivity disorder, autism, depression and bipolar disorder.

In addition to the industrial pollutants and contaminants that have made their way into our air, food and water, we are exposed to pesticide and herbicide residues, rancid oils, hormones, food additives, dyes, preservatives, and synthetic foods such as hydrogenated oils and high-fructose corn syrup. What information we have about the long-term effects of some of these substances, especially upon the developing brains and bodies of our children, is cause for great concern.

My advice to parents: Don't allow your children to determine what foods you buy. Read the ingredients labels on all processed and packaged items very carefully, and refuse to purchase any products that contian things that aren't healthy. Do your best to eliminate the biggest sources of sugar and other sweeteners, as well as saturated fats. Packaged snacks and treats may be delicious, but they aren't healthy. If you don't want to perpetuate your children's addiction to sweets, avoid all soft drinks and fruit juices. Of course that significantly narrows down your shopping choices, but it's better to be healthy, than sorry.

A Quiet Epidemic

As far as epidemics go, type 2 diabetes has failed to provoke sufficient fear in the public mind, the way that COVID-19 did, and cancer still does, even though a third of all heart attack patients have diabetes, and another quarter of them have abnormally elevated blood sugar levels. Public health efforts have been relatively lacking, despite the fact that so many Americans already have diabetes and many million more are pre-diabetic, creating a public health nightmare and an economic disaster. Yet, the number of diagnosed cases of diabetes continues to increase.

Early Detection

The best tool for early detection of diabetes is the hemoglobin A1c blood test (also called glycated or glycosylated hemoglobin), which gives a weighted average of blood glucose levels over the previous 2-3 months. If you think you could be at risk because of family history, being overweight or having poor eating habits, please get your HbA1c checked. Even in the absence of diagnosed diabetes, a chronic mild elevation of blood sugar is associated with an increased cardiovascular mortality rate. HbA1c greater than 5 percent deserves intervention.

Preventive Measures

Without a doubt, the best defenses against type 2 diabetes are a healthy diet and regular exercise. Although this disease has a genetic component, many studies have shown that diet and exercise can help prevent it. Although good advice in general, and especially when it comes to preventing type 2 diabetes, proper nuturition means avoiding simple carbohydrates and sweeteners that contain fructose (sugar, honey, maple syrup, etc.), reducing overall calories, and increasing dietary fiber.

Avoiding Fructose Poisoning

Unlike acute poisoning, where a single exposure to a sufficient quantity of a toxic substance produces symptoms shortly thereafter, chronic poisons act over a longer period of time and produce their harmful effects only after someone is continuously or repeatedly exposed. As a result, a person either gradually becomes more ill over time (as with heavy-metal poisoning), or develops their illness rapidly, after a long latent period during which they appeared to be healthy (such as the case with tobacco-induced cancers).

Fructose, the sweetest of all sugars, makes up half of table sugar. In sufficient doses, it is also a chronic poison. Fructose is now linked to the current epidemics of obesity and type 2 diabetes. The number of diagnosed cases of diabetes has steadily increased, putting a strain on the U.S. healthcare system. Fructose has created a public health crisis, with huge budgets deficits that will be passed on to taxpayers.

Enormous amounts of fructose have made its way into our industrialized food supply, with a huge increase in per capita consumption. Fructose has been implicated in a number of chronic illnesses, including heart disease and cancer. The single most important thing you can do to prevent these diseases is to eliminate all processed or refined sources of fructose from your diet.

Unfortunately, eliminating fructose is very difficult to do because, in one form or another, it is found in almost all packaged foods. That's what makes their taste appealing. Cane sugar and beet sugar, honey, maple syrup, molasses, agave nectar and high-fructose corn syrup contain a high percentage of fructose. Concentrated grape juice and apple juice, frequently used as sweeteners, also have a very high fructose content. To put it plainly, sugar is toxic. Over the long run, it can prove very dangerous to your health.

Why isn't this information public knowledge? Consider the fact that the sugar and corn industries spend lots of money on lobbyists, and food corporations are able to make unlimited campaign contributions to the politicians who wield influence over the Department of Health and the Food and Drug Administration. Because tobacco takes 20 to 40 years to cause lung cancer, it is unlikely that it would have been widely recognized as a cause, had it not been for the fact that a previously rare cancer increased in parallel with the increased use of cigarettes. It is also unlikely that the government would have taken any action had there not been an outcry by an informed public.

Physicians first became suspicious about a link between tobacco and lung cancer in 1929. The first case-controlled study was published in the Journal of the American Medical Association in 1939. In 1950, four separate papers appeared in prestigious American medical journals, demonstrating a high statistical correlation between smoking and lung cancer. Of course, the duplicitous tobacco industry challenged the studies, and did everything it could to prevent the public from learning the truth about the health risks of cigarettes. The tobacco lobby insisted that a causal link had not been established, dismissed the evidence as flawed and circumstantial, and insisted upon "further studies" financed by them, while buying time to shift their distribution efforts overseas to third-world countries. The government bowed to the well-financed tobacco lobby and did nothing for years. The first Surgeon General's warning on cigarette packages didn't come until 1966.

As was the case with tobacco, there is a similar relationship between fructose consumption and the increased prevalence of diabetes. The biochemistry of fructose metabolism shows exactly how it causes disease, but it will take more than scientists and physicians to create pressure for change. We, the people, must refuse to be poisoned for profit. Don't wait for the Surgeon General to require warnings on packaged foods. Millions of people will die from heart disease and the complications of diabetes before the government does anything to protect the public from this insidious and profitable poison.

Unfortunately, if we didn't have a biological predisposition for a sweet tooth, it would be a whole lot easier to "just say no" to sugar. In prehistoric days, our ancestors needed calories from fruits and fats for their survival. Calories are now abundantly available, while our appetite for sweets and fats remains unchanged. This creates a perfect opportunity for exploitation by the food industry. Sugar, salt and fat make food taste good. No restaurant is going to serve meals that taste bland, and no food company is going to make products that don't appeal to consumers' taste buds. The defense against this commercial onslaught is to limit dining out, do the bulk of your shopping on the perimeter of the grocery store, and carefully read all package labels.

The safest way to ingest fructose is by eating fresh, whole fruits, just as our ancestors had done. Fresh fruits, because of their moisture content, are more filling, limiting their consumption. The fiber content of whole fruits slows down fructose absorption enough for the liver to metabolically detoxify the fructose molecules. Fruit juices, on the other hand, contain little or no fiber, so their fructose load is rapidly absorbed. Consequently, it is prudent to avoid drinking fruit juice and eating dried fruits.

When fructose loads exceeds the liver's detoxification capacity, it results in the glycation of proteins. Glycated proteins are toxic metabolic by-products that appear to play a role in the aging process and the development of atherosclerosis. These toxic by-products of fructose metabolism have a wide range of deleterious effects, including the metabolic syndrome (central obesity, high levels of "bad" cholesterol, insulin resistance, and type 2 diabetes), as well as directly promoting the development of gout, hypertension, kidney disease, and the formation of plaques in the arteries that cause heart disease and strokes.

Because fructose has a much lower glycemic index than sucrose, it has sometimes been recommended as a sugar substitute for diabetics. This is a huge mistake, but nutrition bureaucracies have been slow to admit their errors and change their policies. In addition to promoting insulin resistance and the production of atherogenic lipoproteins, fructose chelates circulating minerals, which can result in deficiencies of micronutrients such as copper, chromium and zinc and cause immune system impairment. Chronically overloading the liver with fructose can also cause steatohepatitis; NAFLD is similar to alcoholic fatty liver disease. Fructose has also been implicated in the development of pancreatic cancer, one of the most deadly types, as well as in the proliferation of other cancers.

Dr. Robert H. Lustig, Professor of Pediatric Endocrinology at the UCSF Medical School, is alarmed by the tremendous increase in obesity and type 2 diabetes that he sees in infants and young children. He has made a persuasive case for labeling fructose as a toxin that's at least as harmful to the body as ethanol, but without the buzz.

Don't be fooled into thinking you are safe when you see package labels that proudly proclaim, "No High-Fructose Corn Syrup." You will often find that these foods contain enough fructose from other sources, such as cane sugar, molasses, honey, and grape or apple juice, to be just as bad for your health. The bottom line here: Stop eating sugar! Don't pass the sugar; pass on this warning about the sweetest of poisons called fructose.

You may experience an emotional void when you suddenly stop eating for pleasure, but that's really the best way to do it. Just be prepared to find a more healthy source of pleasure to take the place of sweets. Shift your perspective, and think of eating as if you are putting some gasoline in your vehicle. You do it, not for enjoyment, but so you can keep going. Simply choose the right octane for your engine. Hang in there, and your craving for sweets will diminish after a few weeks. Then, you will become aware of the more subtle flavors in your meals, and find new joy in eating wholesome, unadulterated foods. Think of this as doing an experiment, and give it a try. Not eating sweet poisons could save your life!

Weight Control

People who are obese, as well as those with excessive abdominal fat deposits, have a far greater risk of developing metabolic syndrome, type 2 diabetes, and coronary artery disease, than those who are relatively slender. The weight loss produced by a combination of exercise and a calorie-restricted, low-fructose diet effectively contributes to diabetes prevention and treatment. Those at risk for developing metabolic syndrome require a diet with 55-60% of their total daily calories from low-glycemic carbohydrates, 20-25% from protein, and 15-25% from unsaturated fats.

The World Health Organization (WHO) recommends limiting intake of the added sugars found in processed foods and drinks to no more than 10 percent of one's total daily calories, in order to stem the world-wide rise in obesity and type 2 diabetes. The WHO recommendation is far stricter than anything proposed in the U.S. According to the U.S. Department of Agriculture, what also has changed beside the quantity of sugars in the American diet is the type of sweeteners consumed, which some studies suggest interfere with appetite control, leading to weight gain. If you can't avoid processed and packaged foods altogether, at least read their labels carefully and reject heavily sweetened items.

Taking Charge of Your Health

In a scathing indictment of America's health system, Cornell University professor of nutritional biochemistry T. Colin Campbell wrote in The China Study, "Unfortunately, misinformation and ingrained habits are wreaking havoc with our health. Our institutions and information providers are failing us. Americans are being cheated out of information that could save their lives. Food as a key to health represents a powerful challenge to conventional medicine, which is fundamentally built on drugs and surgery. So why is our government ignoring the abundant scientific research supporting a dietary approach...? I have come to the conclusion that when it comes to health, government is not for the people; it is for the food industry and the pharmaceutical industry, at the expense of the people." The U.S. healthcare system, the most expensive in the world, ranks far behind that of many other nations in terms of health care quality.

Since we cannot depend upon the healthcare industry or our government agencies to protect our health, staying as healthy as possible, especially when living in an increasingly toxic and stressful environment, has to become a matter of our personal responsibility. Armed with relevant information, preventive medicine can be practiced by anyone who has the courage and determination to implement positive changes in their eating habits, physical activities, rest and sleep patterns, and the ways in which they manage stress and their relationships with people and the environment. Even small changes in the way that we live, if they can improve our nutrition, increase our exercise level, reduce our exposure to hazardous substances, and enable us to take charge of our state of mind, will pay huge dividends in terms of a longer, healthier and happier life. Power to the people!