Behavior Change - Rocket Powered Healing
It’s time to move away from the old “ diagnose and adiós” mentality.
Providing information alone or education is not a good recipe to change a behavioral or a pattern. Changing a person’s mind with information is tough whereas changing someone’s behavior with information is a true test.
We live in a fast-paced demanding world. It’s not unusual for us to create habits and even routines that help with the decision fatigue and a constant barrage of responsibilities. Some of these habits are by design and others just a default pattern. In some ways we are in “self preservation” mode.
Let me ask you – How many minutes per year do you spend on “habit change,” or “decision making.” It’s not really something we ponder, but maybe we should. Why? I’d argue that if we don’t we are more likely to go on cruise control and allow subconscious programming to guide our current behaviors. That inner pilot light that’s helping us close the gap on our goals, assess our progress, and change our behaviors grows silent.
So what do we have to do to enhance that inner voice and position ourselves to choose better behaviors? Dan Ariely, is a psychologist that uses a rocket analogy. It’s simple yet profound. Dan’s point is that we must change our environment in a way that reduces friction to make a desired behavior more attainable. Just as a rocket is designed with aerodynamics in mind people can minimize different types of resistance. Once friction has been reduced the rocket needs as much fuel as possible. Fuel in behavioral change is the motivation/energy or incentivizing factors.
How do we apply this analogy to actually making better choices. Providing information alone or education is not a good recipe to change a behavioral or a pattern. Changing a person’s mind with information is tough whereas changing someone’s behavior with information is a true test.
Instead we need to take it a step further and reduce friction by changing our internal environment and external environment. If that's true we already have a leg up on the rocket because we have more control over our external environment. Last I checked gravity does not fluctuate therefore it's a constant variable for the rocket scientists to overcome.
However, we have control over the people we choose to be with, the food that we eat, the relationships we foster, our attitudes, the dreams we pursue, and how we respond to our circumstances. And because our behaviors are often irrational it’s imperative we attempt to harness health related irrationality.
Similar to the mind our physical body responds to friction and fuel (here fuel is food, sleep, stress, social determinants, and mental attitudes).
Let’s look at 3 conditions people struggle with and then engineer ways to reduce the friction and fuel a sustained change.
LEAKY GUT
What creates friction?
Processed foods
Industrial seed oils
Multiple courses of antibiotics
Extended use of Antacids, histamine blockers and PPI’s
Unknown food intolerances
Bacterial overgrowth
Overtraining
Lack of sleep
How to reduce friction?
Create weekly meal plans
Allocate time to create a recipe list
Limit eating out
Test your gut
Look to natural remedies
Try an elimination diet
Intermittent fasting
Utilize a prebiotics and probiotic
Fatty Liver
What creates friction?
Overeating Leaky gut
Food intolerance
Poor bile production
Poor food choice
Endotoxins from GI tract
Alcohol in excess
Nutrient deficiencies
High blood sugar Medications
Bad Oils (seeds oils)
How to reduce friction?
Portion control
Eat for gut health
Liver support
Eat protein fats and some carbs
Liver blood work
Use time-restricted eating Intermittent fasting
Check thyroid health
Blood sugar and cholesterol problems
What creates friction?
Processed food consumption
Calorie surplus and high carb diet
Excess body weight
Insulin resistance
Elevated inflammatory markers
Genetic predisposition
Lack of activity
Emotional eating
Nutrient deficiencies
How to reduce friction?
Increase insulin sensitivity
Liver support
Eat protein fats and some carbs (Nutritional balance)
Use time-restricted eating
Check blood glucose with a glucometer after food (1hr & 2hr)
Check thyroid health
Get adequate sleep
What fuels these examples of friction?
Eating out (especially fast food)
Lack basic cooking skills
Poor time management
Not enough social connection
Poor sleep hygiene
Inability to cope with stress
Inadequate amount of downtime
Fuel to minimize friction?
An unhealthy gut creates problems elsewhere in the body
Gut problems may weaken your immune tolerance (autoimmune)
Gut problems may shift hormonal balance (i.e. PCOS, Cancer)
A dysfunctional gut suppresses our detox pathways
Leaky gut may interfere with your metabolism
What fuels these example of friction?
Disconnection from food choice and disease
Hyper-palatable foods (i.e. potato chips, pizza)
Ignoring constipation
Alcohol addiction
Not enough social connection
Lack of plants and animal products
Pill for every ill mentality
Oblivious to your lipid levels
Fuel to minimize friction?
We tend underestimate our dietary calories
Comprised liver leads to inflammation in the joints as well as the brain
Inflammation is linked to poor liver function
Liver health is directly connected to disease risk
A dysfunctional liver impairs our detox pathways
Liver can be compromised by 90% without a warning signs
What fuels these examples of friction?
Hyper-palatable foods (i.e. potato chips, pizza)
Giving in to cravings
Disregarding weight gain
Sugary drinks
Excessive snacking
Limited information from your doctor
Relying on basic lipid panels and subpar labs from a annual physical
Fuel to minimize friction?
Diseases associated with insulin resistance includes obesity, cardiovascular disease, nonalcoholic fatty liver disease, metabolic syndrome, and polycystic ovary syndrome(PCOS)
Gradual increase of physical activity and energy expenditure
Liver can be compromised by 90% without a warning signs
A dysfunctional liver impairs our detox pathways.
Sleep is necessary appropriate metabolic function
You may have noticed some of the overlap and redundancies, but that’s because there is an interplay going on in all these conditions. What’s going on in the gut directly affects the liver and both organs affect the cardiovascular system all the way down to each individual cell.
Leaky gut, fatty liver and blood sugar/cholesterol problems put a tremendous burden on the healthcare system and can subtract years of good health from just about anyone. Don’t fret because lifestyle modification should be the primary focus for treating any of these conditions.
The body is interconnected, complex, but also self healing. For example the The Diabetes Prevention Program and its Outcomes Study (DPP & DPPOS) demonstrated A 7% weight loss reduced the onset of type 2 diabetes (T2DM) by 58%. The best treatment for non-alcoholic fatty liver is weight reduction and correcting leaky gut and restoring immune tolerance can be done through shifts in diet, diagnostic testing, and targeted supplement protocols.
Given the importance of patient participation in healthcare decisions you deserve sufficient time and treatment solutions that require some self-management other than guzzling down a pill. It’s time to move away from the old “ diagnose and adiós” mentality. Never underestimate the changes you can make by learning about your health and assessing your habits. This exciting shift puts you in the driver’s seat of your life.
I’ll leave you with this, we don’t always do what’s in our own best long-term interest. With that in mind what will you do differently? Can you identify areas of friction and find your source of fuel?
Emptying the Dishwasher. Exposing a Lost Art.
So where does emptying the dishwasher come in? I have caught myself thinking about this a handful of times while emptying my own dishwasher.
When, how often and how we move has a profound impact on our health. The frequency and duration of movement affects our metabolism and how much fat we burn. It’s literally silencing hundreds of genes and activating others. Motion through the spine in tandem with a healthy cardiovascular system ensures that cerebral spinal fluid (CSF) moves through the ventricles in your brain and supplies the spinal cord with nutrients while removing waste.
Motion promotes joint and muscle health, which in return may keep pain at bay. Moving activates stabilizer muscles and helps balance overall muscle tone. Paying attention to our body mechanics promotes brain plasticity and strengthens new movement/motor circuits.
Movement can be used to help us regulate emotional states. It can help us regulate the autonomic nervous system (flight or flight vs rest and digest). The large majority of Americans are bombarded with stress and experience a hyperactive sympathetic response - exercise and motion is a great way to put the adrenaline and cortisol to good use.
So where does emptying the dishwasher come in? I have caught myself thinking about this a handful of times while emptying my own dishwasher. I’ve experienced that my own conditioned movements inadvertently put me in a less than ideal posture. We create “default neural networks” which means that the brain gets good at using certain pathways. This is especially true with our movement patterns.
A task as mundane as emptying the dishwasher seems like it would serve very little value. However, like most of our daily movements they have become automatic or predetermined if you will. Whenever we move we are either “ gaining ground or loosing it.” In other words, we are training healthy engaged movement patterns or causing harm.
I’ll be the first to admit that unloading the dishwasher is not Thai Chi or yoga for matter. These forms of exercise require precise “conscious movement.” However, I would encourage you to take a more mindful approach next time you fill or empty the dishwasher. Go through the whole process with awareness. This way you will witness how the whole body works together while gaining a better sense of structure and posture. From start to finish you will bend, flex, reach, push, pull, lift, rotate, look up, look down and hopefully get a few breaths in.
Think about a few things:
Are you bending your knees and hinging at the hips or straining your low back?
Is your weight evenly distributed or do you dump weight into one leg and or even a specific spot on the sole of your foot?
Are your upper trap muscles and neck tight with your head jutting out over your chest?
Is your upper body squared off or are you cockeyed?
When you reach to put away dishes is your core limp or activated. Does your arm elevate or does your whole shoulder move with it?
Are you tuned in to what muscles are activated? Do you know what your posture looks like as you transition between sorting the cutlery and sliding the racks back into place?
Are you moving in a conscious matter or allowing for poor body mechanics due to muscle imbalances, prolonged static postural stress, lack of movement variety and overall sedentary lifestyle.
Are you familiar with the statement “where the mind goes the body follows?” This simple concept of body awareness and our power to create and change is an active process. Today it’s not part of our normal routine to set aside some energy to restore healthy movement patterns. At any moment we are presented with an opportunity to cultivate more engagement and check-in with how we move.
A little bit of extra effort and examination on how we move may be the very thing that negates the need to pop some ibuprofen, saves you a trip to your ortho, keeps you in the gym, or even allows you to hold your grandchild without aches and pains. I’d gently implore you to pay a little more attention.
Putting Your House in Order: Food Reigns Supreme
Is eating gluten/lectins, grains and legumes problematic? Let’s focus on the elephant in the room: diet. It’s time for a gut check; by definition a gut check is an honest reflective appraisal of one’s true feelings regarding a matter of concern.
Wouldn’t it be nice if managing one’s health was like maintaining a clean home? Make the bed, empty the dishwasher, swiffer the floors, cleanse the sinks and tubs, tidy the countertops, use some floor mats and don't forget your annual window washing. Only green cleaners, right? Barring any catastrophic natural disasters, a two-minute shower while your four year-old is unsupervised, or an ant infestation (anyone else in OC relate to this?) the formula is rather simple.
On the other hand, obtaining a clean bill of health from your doctor can feel complex and downright overwhelming. Perhaps you are not feeling well, but your doctor(s) can’t seem to find anything wrong. You might be wondering if you have taken the right tests and had a thorough work-up. Conversely, maybe you are pre-diabetic, struggling with hypothyroid, joint pain, skin rashes, bouts of anxiety and depression, and migraines. You have been prescribed a host of medications and you’re expected to remain on those meds into perpetuity. You may be searching for a sustainable solution, one with fewer side effects, and one that allows your body to heal from the inside out. By and large, we underestimate the potential of food, sleep, and stress management.
Setting yourself up for a life free of disease and vigor in today’s society may feel like a pipe dream for a growing majority. I’d argue that there are a handful of reasons this is such a common dilemma.
Mismatch between diet and activity levels.
Change is hard, reinforced patterns are easy
The “attention economy” does not provide valuable education
Repetitive insults to the gut, immune system and metabolism go unchecked
A one size fits all healthcare approach
Conventional medicine is designed for disease management and not prevention
Most medical paradigms do not “aim at the origin” and/or discount the body’s interconnectedness
Lifestyle interventions are time-intensive and difficult to align with insurance- based care
Diagnostic testing is looking downstream
Poor diagnosis and treatment plans do not educate or empower the patient
Let’s focus on the elephant in the room: diet. It’s time for a gut check; by definition a gut check is an honest reflective appraisal of one’s true feelings regarding a matter of concern. How and what we eat is either optimizing our health or initiating new underlying pathology and eventually disease. For example, patients struggling with supporting thyroid function may need to address gut function to fully combat symptoms of hypothyroidism.
Risk factors for developing Digestive Pathology.
Chronic Stress
Sleep Deprivation
Physical inactivity
Hypothyroidism
HPA Axis dysfunction
Excess Alcohol
Environmental toxins.
Family History
Cesarean Birth
Formula fed
Standard American diet
Food poisoning
Antibiotics
Medications
The evolving role of diet has altered the way we understand disease. In fact, digestive health has a wide array of implications. Intuitively, this should not be a surprise. The gut is one of our main interfaces with our external environment, it houses trillions of bacteria, has its own nervous system and gut-associated lymphoid tissue (GALT).
The digestive system is both resilient and dynamic. This is a double-edged sword because it is really good at masking the effects of a poor diet. What happens in the gut is so powerful that it has long-distance effects on the brain, skin, skeleton, muscles, metabolism, cardiovascular system, endocrine system, and immune system. It’s not like the “what happens in Vegas stays in Vegas.” Take a look at figure 3. These examples of reactivity may be the result of something called molecular mimicry. Due to the similarity in molecular structure with food we eat and our own tissue, the immune system can be fooled into attacking look-a-like molecules that make up our own tissue leading to autoimmune disease.
Educational resource from Cyrex Laboratories.
Below is my own list of the top 10 effects of a poor diet:
6 Joint pains
7 Neurodegenerative syndromes
8 IBS and GERD
9 Dermatitis and eczema
10 Constipation
1 Diabetes
2 Obesity
3 Cardiovascular disease
4 Autoimmune disorders
5 Anxiety and Depression
So how do we detect, avoid these problems and remedy our diet. Some patients have symptoms like gas, bloating, constipation, abdominal pain and cramps, skin rashes, diarrheas, excess gas, brain fog, heartburn, excessive hunger, and other complaints. However, there are patients that do not have symptoms or have symptoms that seem unrelated. For example of those diagnosed with Celiac Disease, autoimmunity to gluten, only 50% have GI symptoms.
With advances in research we have a better understanding about gut pathologies such as intestinal permeability aka “leaky gut,” food intolerances (tend to be undiagnosed), celiac disease and non-celiac gluten sensitivity, hypochlorydia, gut dysbiosis, small intestinal bacterial overgrowth (SIBO) and infections.
A functional medicine approach is a great way for patients to understand what is at the root of their health challenges. What that looks like for most patients is an extensive history, some form of altered diet (in some case removing gluten, wheat and dairy) and tests or screens for:
Wheat/Gluten reactivity
gluten-associated cross-reactivity
pathogen screens
intestinal permeability
SIBO
and other tests depending on a working diagnosis.
Treatment protocols are designed for each patient and tend to employ a mixture of dietary restriction, antimicrobials, pro/prebiotics, and other temporary supplementation meant to heal the gut
Researchers and clinicians continue to unravel the different mechanisms behind health pathology. There is some controversy regarding food intolerances, dysbiosis, leaky gut, autoimmunity, and hormone dysfunction. However, novel screening tools and continued research help shed light on how to treat the source of the problem and return your overall health.
If you have questions please email them to nick@spineandjointoc.com
Are you the CEO of Your Health and how does Chiropractic care fit
If you have suffered an injury we can look at it on three levels.
Running a results-driven chiropractic office is less about gadgets and more about providing potent corrective care. It’s more about clinical diagnosis and less concerned with e-stim, massage guns, and pulsed compression sleeves for leg recovery. Through my lens we deal with people and their multi-dimensional struggles.
If you have suffered an injury we can look at it on three levels. The external level, which equates to the pain, soreness, and the physical extension of the issue. The second part is the internal component. How has this injury manifested from an emotional standpoint? Are you scared, frustrated, anxious, or even apathetic? Lastly philosophically speaking what does it mean to you? Are you dumbfounded that this has happened to you? Do you think you deserve to be aligned and healthy? Are you in a position to look after yourself?
Patients often look to their D.C.s as a primary source of healthcare when helping their children with sports-related injuries. Equally pertinent, are the high number of patients that look to chiropractic treatments after all other avenues have proved ineffective. It’s why taking a thorough history on every new patient and performing an in-depth evaluation is a critical component for any clinician working on neuromuscular issues.
Patient’s present across a spectrum from simple injuries to complex polygenic illness.
At a time where:
2/3 of American adults are overweight,
7/10 Americans take at least one prescription drug,
45 % of the population have at least 1 chronic disease
35 % of Americans are inactive (no regular physical activity),
44% admit to feelings of increased stress over the last 5 years
4/5 Americans are undiagnosed pre-diabetic or diabetic (insulin resistant)
The large majority has no idea how to tailor eating to optimize their health
The bodies natural ability to function and heal is being suppressed. Chiropractic is grounded in this idea of lifestyle based medicine. As a clinician it’s my goal to help boost a patient’s wherewithal to look after themselves. In addition to adjusting the joints we act as guides providing accountability when it comes to exercise, reexamining a patient’s eating habits, or informing them on the efficacy of cryotherapy, use of CBD, or other relevant research
Speaking of research, here are two interesting summaries on new literature that provide additional insights into the nervous system
SCIATICA
- More than 5 million cases of sciatica are seen annually in the US
- Animal studies have uncovered activation of the immune system linking it to neuro-inflammation beyond the brain
- A combination of diagnostic imaging (MR and PET) in a human study shows increased inflammation in the brain, spinal cord, and nerve roots that correspond with the effected leg.
- One of the first human studies to demonstrate evidence of an inflammatory process happening at the nerve root.
(Journal reference #1)
LEG EXERCISE
- Groundbreaking research shows that neurological health depends as much on signals sent by the body's large, leg muscles to the brain as it does on signals from the brain to the muscle. The brain is receiving direct input from the muscles throughout the body.
- In animal studies, it was demonstrated that limiting the physical activity, specifically the hind legs, led to a 70% decrease in neural stem cells compared to a control group in mice.
- Cutting back on exercise makes it difficult for the body to produce new nerve cells -- some of the very building blocks that allow us to handle stress and adapt to challenge in our lives.
Quote from Lead researcher
"It is no accident that we are meant to be active: to walk, run, crouch to sit, and use our leg muscles to lift things," says Adami. "Neurological health is not a one-way street with the brain telling the muscles 'lift,' 'walk,' and so on." -Dr. Raffaella Adami
(Journal Reference # 2)
REFERENCES
1. Daniel S. Albrecht, Shihab U. Ahmed, Norman W. Kettner, Ronald J.H. Borra, Julien Cohen-Adad, Hao Deng, Timothy T. Houle, Arissa Opalacz, Sarah A. Roth, Marcos F. Vidal Melo, Lucy Chen, Jianren Mao, Jacob M. Hooker, Marco L. Loggia, Yi Zhang. Neuroinflammation of the spinal cord and nerve roots in chronic radicular pain patients. PAIN, 2018; 159 (5): 968 DOI: 10.1097/j.pain.0000000000001171
2. Raffaella Adami, Jessica Pagano, Michela Colombo, Natalia Platonova, Deborah Recchia, Raffaella Chiaramonte, Roberto Bottinelli, Monica Canepari, Daniele Bottai. Reduction of Movement in Neurological Diseases: Effects on Neural Stem Cells Characteristics. Frontiers in Neuroscience, 2018; 12 DOI: 10.3389/fnins.2018.00336
Long term activation of stress disrupts all of the body's processes
The impact of stress hormones on basic physiology...
This video is Part 3 of a discussion on stress reduction. If you want additional context please follow us on Instagram @spineandjointoc.
Below I provide a summary that highlights the types of dysfunction one may experience due to overexposure to stress. If you watched the clip, I corrected a slip of the tongue. I replaced sleep deprived with sleep de-fried and I own that folly. Now for the comparison.