We should face facts. We are slightly fat, furless, bipedal primates who crave sugar, salt, fat and starch - and try to make ourselves as comfortable as we can by conserving energy.
It's not a character flaw; it was the best way to survive on earth 10,000 years ago.
"The Story of the Human Body: Evolution, Health, and Disease," a new book by Harvard professor Daniel Lieberman, exhaustively traces the roots of our species back to pre-human times. While not as strong or agile as chimpanzees, early humans distinguished themselves with bigger brains and, most importantly, the ability to run and hunt down game through endurance. In fact, no other animal can run in the mid-day heat like humans. Successful hunts required communication and teamwork. All this led to hunter-gatherer Neolithic culture.
The hunter-gatherers had a much healthier life than has been commonly supposed. Until the past few generations, few humans have been as tall or have lived as long as they did. It is estimated they spent about six hours a day finding food, and the rest of the day socializing and resting. Because of their high levels of activity and broad diet, they had very low rates of diabetes, heart disease or cancer.
Furthermore, Lieberman supposes they also did not suffer much from anxiety, depression, ADHD or other mental illnesses due to less social stress and "stuff" to worry about - no retirement to plan for, no college applications, no grades, no taxes, etc.
Some time after the glaciers retreated, weather patterns stabilized and allowed our ancestors to grow crops to supplement their diet. Over time, farming allowed for higher fertility rates, since milk and cereal were available to wean children.
What was a success for our species was calamity for individuals. Diets became far less varied. Times of plenty occurred, but overreliance on crops allowed for famines.
What's worse, the domestication of wild animals led to diseases that jump from animals to people - influenza, leprosy, smallpox and diphtheria. Crowded conditions led to unsanitary conditions, water-borne diseases and hordes of mice, rats and insects.
Slowly, medicine and science beat back these diseases with proper sanitation, public health, immunizations, soap, antibiotics and modern medicine. But now we have become too accustomed to bending nature to our will. We have developed environments that may be too clean, so our immune systems are unoccupied, go haywire and turn on us - allergies, multiple sclerosis, auto-immune diseases, Crohn's.
We have machines that transport us (elevators, cars), entertain us (smartphones, TVs, computers) and do our chores (washing machines, water pumps, furnaces) so that we can get by without ever having to break a sweat or raise our heart rate.
Calories have never been cheaper. Ironically, we pay more for unprocessed foods. We burn out our pancreases trying to keep up with the sugar and carb loads we ingest. The spikes and crashes only make us hungrier and crave more sugar. Lack of exercise leads to less dense bones in early life, so later we suffer from broken hips and osteoporosis.
Modern medicine was born in the day of infectious disease, and we still have that transactional model. If you get sick, you see the doctor, get a pill and then expect to get better with very little, if any, lifestyle modification.
We get caught in this loop where we reinforce low expectations, easy fixes and abdication of responsibility. But this sort of medicine cannot deal with the epidemic of obesity, high blood pressure, stroke, cognitive decline, infirmity and disability caused by the modern post-Industrial American lifestyle. We don't have the money, workforce or physical resources to deal with it.
So what is the answer? While few of us would choose to become hunter-gatherers, we can treat our bodies to what they crave - physical exertion, healthy diet and freedom from toxins. As for health-care professionals, we need to model healthy behaviors and teach them. We need to set the bar higher for patients and tell them that good health is not easy to achieve. It is a daily struggle.
We need to stop equating comfort with good health. We were made to be bruised and sore, scraped and bloodied, dirty and sweaty. No more three-hour-long meetings sitting down. Get up. Walk. We should not consign our patients and our community to this fate - so we need to be the change we want to see.
