THE COMPLEXITY OF HEALTH

By Sean Kloppenburg


D uring the writing of this blog post, I have been studying for the Certified Health Education Specialist (CHES) certification. Along with these studies, and my own continuing education, I have noticed how health can be not only complicated, but confusing too. I would guess that many would agree with this conclusion. Now, this complexity is true, to some extent. However, I want to stress that this seemingly complicated world of health is actually quite simple when you grasp all the surface level jargon. For example, it is common to learn about a food.  Take coffee, for example.  One study will convince you that coffee is bad for you, while another states the benefits of it. What does "bad" even mean? And who is saying this? Think about all the brands, commercials, gyms, and grocery stores bombarding us with "health truth", which is always depicted to be so seemingly easy. All we have to do is buy the one product or service. I am sure many of you have encountered the "all-in-one exercise", or the "all-in-one method/diet/lifestyle". "All you have to do is buy this machine..." and on it goes. I find myself passionate and determined to figure out these complexities, as I imagine you do as well. It is in those moments, when one encounters someone claiming a health fact, that we must be inquisitive from our own experience. Some of the more recent claims I have heard are: gluten-free is healthier (versus what?), eggs are bad (bad in what way?), organic ice cream is healthy (does this mean all organic is healthy?), and, my personal favorite, that skinny equals healthy (I can eat whatever and not exercise because I am skinny?). We should clarify the "what" and the "why" for ourselves, and for them.

As we learned in the previous post, The Educational Value of the Study of History and Health, health is more than what we eat. It is expansive, and lies within all the aspects of wellness. The vast majority of our health beliefs are shaped by norms, personal confidence, and awareness that a health problem exists. To make our own informed decision, we need to be aware. Only you know what is best when considering all the factors of your wellness. The trick is, are you being honest with yourself? (For more information, click on the photos below).

CONSUMPTION DOES NOT EQUAL ABSORPTION

There is a large misunderstanding for the general population that consumption = exactly what your body gets. This is not true. The motto is "consumption does not equal absorption". The reality is, for example, that certain vitamins impact others for absorption, some foods inhibit other foods, and there is a myriad of other factors. When did you eat the food? Are you physically active? Were you in "fasting" or in "starvation" before the meal? One of the biggest examples of "consumption does not equal absorption" is consuming sugar. When you dump sugar (without fiber, or in the form of "complex sugars"), like an vanilla shake, into your system, the liver becomes over loaded and has no choice but to turn the excess sugar (specifically the fructose) into fat (4). The reason I mentioned above, "are you being honest with yourself", is because it is easy to hear factual health knowledge and ultimately twist it to what you want. For example, you could take this "consumption does not equal absorption" motto and go eat a whole tub of ice cream while having a soda. As a health professional - with the goal of education for empowerment - this is not what it means. Take it, use it, but don't stretch its meaning. Take the examples of this motto below:

  1. Understanding that we absorb the food that we're eating in different ways than we thought. This can be detrimental to our health, such as the differences of refined white sugar versus sugar from an apple.
  2. Understanding why whole grain is better than refined grains.  
  3. Understanding why eating approximately 30 minutes after a workout will be different than eating later in the day.
  4. Clarifying on blood glucose levels and diabetes.

This motto is meant to be used correctly, so please do.

MIXING UP THE "FATS"

There are a variety kinds of fats in the body. You may have read these terms on nutrition labels: polyunsaturated, monounsaturated, triglycerides, saturated, and unsaturated (if your not reading nutrition labels - start doing so (keep an eye out for events to go to a grocery store with an Exertion team and learn about labels)). All these terms can get kind of confusing. Lets say we take an egg, where does the egg fit into all this, and why are some people saying eggs are bad? One word, cholesterol. Cholesterol is not a fat. It is a molecule that is essential for cell structures, sex hormones, and aids in brain/nerve function/fat transportation (2). Manufactured in the liver cholesterol is transported in the blood stream to wherever the body needs (2). Cholesterol is a "fatty substance" or sometimes called a "crystalline substance". In lay terms that means it is waxy. It cannot flow with the blood (which is mainly water). An insoluble substance in water looks allot like when you poor olive oil in a pot of water, it tends to bunch together into little round dots on the surface. Since cholesterol is like that, it needs help flowing in the blood. To do this cholesterol connects with molecules called lipoproteins. The lipoproteins come in two types low-density lipoproteins (LDL) and high-density lipoproteins (HDL). This is where your general health knowledge might kick in. Have you heard of LDL as "bad cholesterol" and HDL as "good cholesterol"? This shows you how the health world changes its language to fit different health literacy levels; I am pushing you to know the difference between HDL and LDL because a higher health literacy is correlated with higher health outcomes. LDL and HDL are compiled of different molecules, including cholesterol, yet they are referred to as cholesterol because of two things. LDL has a propensity to deposit cholesterol onto the artery walls - hence the term "bad cholesterol". When LDL deposits cholesterol on the artery walls it is similar to that olive oil gripping to the side of the pot, where the water meets the metal. HDL has the propensity to take that cholesterol, and excess cholesterol in general, back to the liver to be broken down - hence the term "good cholesterol". Now if the balance is disrupted, and there is too much cholesterol floating around, it can stick to the artery walls and form plaques (check out the image above showing plaque build up). This is where the different kinds of fat come in. Some of those fats I mentioned above either raise or lower the LDL's and HDL's in your blood. Hence they are said to affect your health because they affect how much plaque build up occurs (polyunsaturated fats lower HDL and LDL, monounsaturated fats raise HDL and lower LDL).

As I mentioned above, health can be complicated, do not ever assume that only fats interact with LDL's and HDL's, for example fiber also interact with LDL's and HDL's. This is why were reading this blog, to learn, so be inquisitive. 

Combining it all together. Remember "consumption does not equal absorption"? And now you know about the chain: certain fats raise or lower > HDL and LDL which then in tern effects > your plaque build up. From here it is easy to apply the correlation that eating cholesterol (like from an egg yolk) will increase the cholesterol in the blood, leading to plaque build, and thus a variety of conditions. This is not true. Eating foods with high cholesterol can increase your serum cholesterol (the total cholesterol floating in your blood), but it is not the only source of serum cholesterol (2). The dietary intake of cholesterol effects are marginal on serum cholesterol (in most cases). Moreover, were assuming the yolk is only cholesterol. There is also omega fatty acids, and vitamins. Many of which are good for you and your heart.

Thus from here I must put major caution in the wind. This does not mean cholesterol from eggs, and other dietary sources, is an unlimited supply of golden nectar to which one can consume without thought. It means that eating eggs is not instantly bad for you. But like anything in nutrition, eating too much of it, too often, for too long will have unintended affects on your health. The motto is, "don't eat too much of anything". Now, what is too much? And for how long? Those questions are specific to each individual, and must be addressed with a Registered Dietitian. The point is, health is a balance, so be aware of what you eat.

TAKING STOCK - SO WHAT? 

From here, think about what this information could help you with. What health choices can this impact for you? For me, I always imagine swimming down a blue wales arteries (or veins) and seeing how smooth the inside would be. On the other hand mine, after many years of ingesting high amounts of sugar, saturated fats, and highly processed foods (all of which help cardiovascular disease > one of its risk factors is plaque build up) would be rough to the touch. As I swim around I would see hardening plaque in random areas, not only damaging the inner lining of the endothelium (cells that line all arteries), but also increasing their stiffness (5). The resulting pressure increase would be palpable. I would feel the tension on my body and face as I flow with the blood. When I really think about that, that is when my behavior changes, and I realize not only will I increase my health, but I could loose weight by eating foods that help counteract or stop cardiovascular disease.

If you did not notice on this site there is a survey. The survey would be best filled out by my subscribers but I also want everyone to fill them out if they can. I am very interested in the education survey, which measures where you learn about health. I am using these surveys to collect data on whom is reading and coming to my site. This will allow me to use the proper health literacy level, provide the proper health education materials, and tailor the blog and Exertion events that will help the majority of the readers. Equally important is that the information will allow me to use a "bottom-up" approach to education, where instead of me telling you how much I know, we can empower you and have this site become your site. If you have not seen or filled out the surveys, please do, it will only take five minutes or less. Click here to subscribe. Click here to do the survey.

 

Bibliography

1) American Council on Exercise: PDF: Food Label. (n.d.). Retrieved March 30, 2016, from https://www.acefitness.org/certifiednews/images/article/pdfs/FoodLabel.pdf

2) Balch, P. A., CNC. (2010). Prescription for Nutritional Healing (Fifth ed.). New York: Avery.

3) Lobez-Jimenez, F., M.D. (n.d.). Eggs: Are they good or bad for my cholesterol? Retrieved March 27, 2016, from http://www.mayoclinic.org/cholesterol/expert-answers/faq-20058468

4) "Sugar Shock: Why Experts Say It's Time to Get Serious About Taming That Sweet Tooth." ACE Fitness. Web. 04 Apr. 2016.

5) What Causes Atherosclerosis? (n.d.). Retrieved March 31, 2016, from http://www.nhlbi.nih.gov/health/health-topics/topics/atherosclerosis/causes