It’s Time to Redefine “Perfectly Healthy”
By Joy Stephenson-Laws, Managing Partner
As a society and as individuals, we often strive to have the “perfect” everything. The perfect mate, the perfect body, the perfect job, the perfect house or even the perfect nose. We also often believe that once we achieve the “perfect” fill-in-the-blank that our lives will be better, and we will be happier and healthier as a result.
While psychologists and anthropologists may debate whether this drive is nature or nurture, one thing that is unequivocally certain is that the definition of “perfection” is quite ephemeral and constantly changing. This is especially true when it comes to our bodies.
Consider, for example, that at one point having a “rubenesque” (so more voluptuous) figure was the ideal for women. Only a few decades later, being almost stick-thin was considered the ultimate in feminine attractiveness. Today, that “perfection” now leans toward the traditional “hourglass” figure.
Men are also not immune to passing ideals of “perfection.” At one point, weight on a man was equated with status. Later on, the “perfect” male body looked more like a Greek statue. Today, having a “dad bod” is what some men go after.
And when it comes to health, the concept of being “perfectly healthy” has also evolved and changed over time. As our understanding of human physiology, and especially microbiology and genetics, has advanced, so too has our definition of what it means to be healthy. On one hand, it has become much more inclusive and holistic to lump together physical health, mental health, social health and even financial health. On the other hand, we are still prone to letting our eyes be the judge as to whether someone “looks healthy.”
Back in 1948, the World Health Organization (WHO) defined “healthy” as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. This definition was updated some 40 years later, when the WHO added that health is a “resource for everyday life” rather than being an end in itself. And, a little more than a decade ago, the respected periodical The Lancet published a new definition posited by some researchers that health is the “ability of a body to adapt to new threats and infirmities.” How relevant this is right now with the coronavirus pandemic!
While all of the above are workable definitions that give healthcare providers, and the communities they serve, some guideposts for defining “healthy,” they unfortunately are rooted in an obsolete understanding of “perfect health.” This understanding permeates every aspect of healthcare and, in fact, is the foundation of how most providers approach patient care. Unfortunately, it has resulted in most healthcare being focused on the absence of symptoms.
Many people consider themselves healthy if they do not have symptoms of a disease, and healthcare is usually focused on providing acute care for diseases once they present rather than on preventing these diseases in the first place.
But, as with many things in life, the fact this has been the norm for centuries does not necessarily mean that it is the best approach. In fact, this approach unnecessarily – as well as unintentionally and unwittingly – can end up making it harder for healthcare professionals to address underlying health issues before they become problems. Often, a potential health issue is not recognized – or addressed – until a patient is already in crisis.
A tragic recent example brings to focus the urgent need to redefine “perfectly healthy.” In April, a 16-year-old in Indianapolis succumbed to complications from Covid-19. His family described him as “perfectly healthy” before he fell ill and suffered a cascade of medical challenges ranging from previously undiagnosed Type 1 diabetes to Covid-19-related issues with his brain, heart, lungs and kidneys. He had so much trouble breathing that he eventually was placed on a ventilator. He later died from heart failure.
What is important to consider here is that reports say he had no underlying medical conditions and was described as “resilient.” He also enjoyed basketball and bowling and was quite accomplished at both. It is understandable that some would describe him as “perfectly healthy.”Don't judge a book by its cover.
Unfortunately, pictures of the young man give the impression that he also was overweight, a condition that can be the precursor to a wide variety of diseases such as diabetes, cardiovascular disease, hypertension and respiratory problems. So, while he may have seemed or looked to be perfectly healthy, the reality is that he most likely was on his way to developing obesity-related diseases at some point had he survived his bout with Covid-19.
Another area of healthcare where the illusion of being “perfectly healthy” occurs is the way many doctors and patients interpret blood panels. For example, a person may have very unhealthy dietary habits, be obese, not exercise, smoke and/or abuse prescription medications or even street drugs and still have a blood panel whose components – for example, cholesterol, glucose, creatinine, blood counts, and liver enzymes – all fall within the generally accepted reference ranges. Many times, upon reading such a panel, both the provider and patient will assume that all is well since the blood work indicates that the patient is “perfectly healthy.” This approach can create a false sense of security which could lead to even more less-than-healthy behaviors and lifestyle choices. At the very least, this type of panel will be of little motivation to a patient to adopt a healthier lifestyle.
For example, a person with a cholesterol of 195 (the maximum should be around 200) or a hemoglobin a1c of 5.6 (maximum should be around 5.7) may reach for a donut or French fries thinking, “My blood work is fine so I can eat this. I am healthy!” But nothing could be further from the truth.
What all this suggests is that healthcare providers – doctors, nurses, medical groups, longer term care facilities and hospitals – may need to take another look at how they are defining “perfectly healthy” if they hope to truly protect their patients’ and communities’ health. This literally will require unlearning how they have been trained and educated about what being healthy is and isn’t.
If the healthcare community continues to focus on symptoms, then it will continue to define being healthy as a lack of symptoms and will continue to define prevention as looking for the earliest signs of disease symptoms. This approach makes communities constantly vulnerable to pathogens and chronic diseases linked to preventable physical conditions such as obesity. This is because even though people’s bodies may be compromised, they may not be “sick.” If this paradigm shift doesn’t happen, community health will constantly be behind the proverbial 8-ball.
This is not to say that providers should abandon providing the best possible acute care, but rather that they should not wait to treat or help patients until a health threat or situation reaches a crisis point. And in addition to ongoing preventative diagnostic tests, such as a mammography or colonoscopy, needed to identify symptoms of possible diseases at the earliest possible moment, healthcare providers should also redefine “perfectly healthy” to include the following, which are critical elements for protecting health:
- Immune system status – According to the National Institutes of Health, (NIH), without an immune system, people would have no way to fight off harmful pathogens that enter their bodies from the outside or harmful changes that occur inside their bodies. It quite literally is the first line of defense for protecting health and should be front-and-center in the understanding of “perfectly healthy.” Medical professionals rarely focus on identifying the status of a person’s immune system early so steps can be taken to improve their health before symptoms occur.
- Nutritional balance - Roughly 80 percent of people in the United States have some form of nutritional imbalance, and research continues to support the claim that diseases linked to unhealthful diet and lifestyle choices, such as diabetes and cancer, are the leading causes of death in the United States. Unfortunately, nutritional analysis is often overlooked when looking at health.
- Gut health - A healthy gut has enormous importance for overall health, energy levels, fighting off diseases, properly absorbing healthy nutrients and eliminating bad bacteria. It is the single area with the most interaction with agents from the environment. Gut health is easy to maintain through diet and, if necessary, taking probiotic and prebiotic supplements.
- Body composition profile – The proportion of fat, water and muscle in any given body is a much better predictor of health than just body weight alone. Because of this, someone with an “ideal” body may actually be quite unhealthy and even malnourished. But a doctor or other healthcare provider would never know by just looking at the person and their weight.
- Fat distribution – Where fat accumulates and is stored on the body may be an indication of both overall health as well as the potential risk for developing conditions/diseases such as metabolic syndrome, insulin resistance and diabetes. If body fat is evenly distributed (creating a “pear” shape) there is a good possibility that the person has what is known as “metabolically healthy obesity,” which does not present an immediate health risk. Fat that accumulates mostly around the belly (creating an “apple” shape) may present a higher health risk.
By incorporating even just these five elements into a new definition of “perfectly healthy,” the healthcare community can make enormous strides in protecting community health. It’s time to do so.
Finally, focus on consistency with practicing healthy lifestyle habits. None of us, of course, are in fact perfect. But we can certainly be proactive.
Enjoy your healthy life!
The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.