Assessing Function and Preventing Diseas

We’ve now seen how balancing your health and fitness can lead to greater human performance, and provide for more energy for all aspects of your life. But more often than not, some piece of this eqution gets out of balance. The result is some type of bodily dysfunction that, over time, can become some named disease. We’re all too familiar with the common diseases, such as heart disease, cancer and stroke. But how do these diseases begin? The truth is most diseases don’t just happen overnight. They have their beginnings as some relatively minor functional problem due to some imbalance of health and fitness. Reducing these problems in their earliest stages, which is relatively easy to do and a key focus of this book, is the best way to avoid disease. These seemingly innocent functional problems, often erroneously associated with aging, are termed functional illnesses.

Functional Illness

There are often no particular names for various early stages of disease development. There are simply signs and symptoms, and previous to that you may get no clues that a problem is arising. These signs and symptoms, as subtle as they may be, are known as functional problems, or functional illness. They are sometimes referred to as pre-disease, preclinical or, in the case of cancer, pre-malignant. Functional illness is that gray area between optimal health and disease. Many people have some signs and symptoms of functional illness, such as fatigue, headaches, indigestion, back pain, allergies and dozens of other complaints. Not only can functional illness be the early stage of disease, it can also interfere with present quality of life.

It’s not normal to have these problems; it’s a sign that something is wrong. The shelves of grocery stores and pharmacies are loaded with products made to medicate and mask these minor illnesses. But covering the problem does not make it go away, and worse yet, it turns off the body’s attempt to tell you there’s something wrong. These types of signs and symptoms aren’t really addressed by mainstream medicine, which usually deals only with disease, the after-effect of functional illness.

Case History

John went to the company doctor for his annual physical examination. Many tests were performed — a very complete evaluation. The next week when John returned for the results, the doctor said, “Good news, everything looks great, there’s nothing wrong.” True, everything from blood pressure to cholesterol, clear lungs to strong heart was great news, but John was now more confused. He asked, “Then why do I have these headaches, and why is my energy so low? And why does my stomach always hurt after eating?” The doctor had no answer other than to say that he had ruled out disease. In ruling out disease, John’s doctor performed a vital service. But it was only the first step in evaluating John’s fitness and health. Though John didn’t have any disease, he had symptoms that made him uncomfortable and were interfering with his quality of life.

What’s more, these symptoms could be pointing to bigger problems down the road. This is a common example of functional illness.

Such functional illness — or dysfunction — is often the precursor to disease. By assessing your level of function you can find and correct many problems before they become diseases. As a clinician, a significant part of my initial examination of a patient was listening to his or her problems. I heard the main complaints of “I’m tired all day” or “my back hurts,” but I more closely tuned in to other details such as waking in the middle of the night and being unable to get back to sleep, or exactly at what time of day the back felt worse, and when it was OK. Most of what I needed to know came from the patient telling me things of which he or she was not fully aware. These kinds of clues, the subtle and the obvious ones, and what they mean, are functional problems discussed throughout this book.

One way to know if you have a functional illness is through selfassessment. When we start listening to ourselves we will begin to get many clues. Once we have collected these clues, sorting them out becomes another art form. The most important distinction to make is the difference between primary and secondary problems. This is associated with what I call the domino effect.

The body tends to accumulate problems, often beginning with one small, seemingly minor imbalance. This problem causes another subtle imbalance, which triggers another, then several more. In the end, you get a symptom. It’s like lining up a series of dominoes. All you need to do is knock down the first one and many others will fall too. What caused the last one to fall? Obviously it wasn’t the one before it, or the one before that, but the first one. The body works the same way. The initial problem is often unnoticed. It’s not until some of the later “dominoes” fall that more obvious clues and symptoms appear. In the end, you get a headache, fatigue or depression — or even disease. When you try to treat the last domino — treat just the end-result symptom — the cause of the problem isn’t addressed. The first domino is the cause, or primary problem, and is often asymptomatic, meaning that you don’t notice it. The next dominoes are the main complaint, or secondary problem, which produces the symptom but is merely the result of the first domino. The final domino is disease itself. Being able to differentiate between primary and secondary problems is important for all of us, including health-care professionals. The classic example is treating a diseased organ. A heart-bypass operation or removing a cancerous growth satisfies the end result. But what about the cause of the problem? If it’s not found, how long will it take before another major problem arises, if it hasn’t already?

As you become more intuitive about your health, you will begin to understand the signs and symptoms your body is providing in its desire to get your attention and your help. Once you develop your instincts, you’ll be able to take responsibility to care for your own health. For those who can’t or won’t assess for functional illness and take appropriate actions to correct problems, there’s always disease.

Disease

We can define disease quite simply as a gross imbalance of normal body function. Disease is the end result of dysfunction, usually expressed by signs and symptoms, of something in the body that has gone wrong. Heart disease, for example, begins many years or decades before the first sign of its presence appears (the most com- mon one, unfortunately, being death). For almost all diseases there’s a buildup of imbalances, and this eventually causes the end-result diagnosable disease.

Perhaps the most important question you should ask yourself is:

Are there indications of these diseases earlier, in the pre-disease state? The answer is most definitely, yes! Your body usually tells you when something is going out of balance. In the case of heart disease, for example, abnormal blood cholesterol ratios or chronic inflammation, as discussed in later chapters, could be indications you are at risk. Both can be assessed through simple blood tests. These signs of dysfunction may exist years before the disease. What about even before your cholesterol goes askew? It’s well known that men who develop even moderate amounts of abdominal fat are at much higher risk for a heart attack. And, symptoms like sleepiness and intestinal bloating after meals begin long before the fat begins showing up on the abdomen. Even early clues such as being overfat in childhood, and even birth weight, may be predictive.

Diet and Genes

The maturing field of genetics is showing us what many clinicians have suspected for years — foods can immediately influence the genetic blueprint. This information helps us better understand that genes are under our control and not something we must obey.

Consider identical twins, both individuals are given the same genes. In mid-life, one twin develops cancer, and the other lives a long healthy life without cancer. A specific gene instructed one twin to develop cancer, but in the other the same gene did not initiate the disease. One possibility is that the healthy twin had a diet that turned off the cancer gene — the same gene that instructed the other person to get sick. For many years, scientists have recognized other environ- mental factors, such as chemical toxins (tobacco for example), can contribute to cancer through their actions on genes. The notion that food has a specific influence on gene expression is relatively new.

From the moment of conception, the genes our parents give us provide continuous molecular instructions to cells and tissues, and ultimately the heart, lungs, brain, muscles and the rest of the body. In doing so, your health is regulated by what would seem to be a predetermined set of plans. However, genes, along with their diverse set of detailed instructions, are significantly influenced by the very foods you eat, and at each meal. In fact, the whole process of aging — how well we age and how long we live — is controlled throughout our lives through the impact on genes by nutrition. The foods we eat can actually turn on, or turn off specific genes, and with it, detailed instructions regarding specific diseases. The bottom line: A good diet turns off genes that cause disease, and a bad diet turns on disease-causing genes. While we all have genes for diseases, they act like a light switch — they can be turned on, or turned off. The diet is like a finger controlling the switch. So what you eat — the quality and quantity of food at each meal — can dictate whether you turn on a particular genetic switch for diabetes, for example. The same is true for virtually all the problems that reduce quality of life, and for the diseases that kill us. This also includes being overweight whether your parents were overfat or not isn’t the issue but rather how and what you eat.

Many people use “genetics” as an excuse for their health problems — "my parents had this problem," "my grandfather had that problem." This attempt to justify ill health is no longer valid. Unfortunately, this defense is propagated throughout our culture, with the media partly to blame. Headlines touting “research shows addiction is genetic” or “obesity gene discovered” is a distortion of the truth promoted to sell newspapers and magazines. Let’s look at the facts. We may be predisposed to addiction or obesity, predisposed to diabetes, heart disease, cancer or many other problems, but if we become addicted, fat, diabetic etc., we are to blame, not our genes.

Gene Exceptions

A handful of true genetic disorders are the exception to this rule, and are rare. These include damage or other unwanted changes to genetic materials that occur soon after fertilization (some of these changes may even be part of the “natural selection” process humans continue to experience). After fertilization when mom and dad’s cells share their genetic materials and begin to divide, changes in the genetic code no longer occur. At this point, the information in the genes no longer changes. From that point on it’s the diet that controls the genetic switches. Conditions not considered to have a strong dietary or other environmental influence on genes include Rh incompatibility, sickle cell anemia and hemophilia. In addition, genetic injury can occur anytime throughout life, such as with radiation damage. Even though so-called genetic diseases may exist in an individual, whether that disease is genetically expressed — and whether it is severe or mild, or not evident at all — may be mostly influenced by diet, and other environmental factors such as toxic exposures.

Foods that can dramatically affect our genes include high glycemic carbohydrates, especially processed starches and other grains, and sugar — bread, bagels, cereals, muffins, potatoes, and sugar and sugar-containing products including all popular soft drinks. In addition to the poor nutritional value of these foods, they release specific hormones, such as insulin, that adversely affect the body’s metabolism. These foods also trigger genetic switches, turning on diseases such as diabetes, cancer, Alzheimer's disease, heart dis- ease and many others. A low-glycemic meal, one without refined flours and sugars, can switch off the genes for these diseases. A recent study published in the American Journal of Clinical Nutrition (May 2007) demonstrated how a high-glycemic meal switches on the genes that increase stress and inflammation (conditions that pave the way for most chronic disease) while turning off the genes that promote health.

Currently, billions of dollars are being spent in hopes of developing new drugs that will “switch” our genes in a certain direction. However, we already have the power to control our genetics in a natural way with diet. And, we have the ability to control future gener- ations as well. Consider, for example, a couple starting a family — if one or both parents switch off healthy genes or turn on unhealthy genes the children can be even more vulnerable to disease.

Assessing for these signs in order to prevent disease is an important aspect of maintaining your fitness, health and human performance. We’ll discuss more specifics about assessing for functional problems and avoiding disease throughout life’s journey, which I call the human race.