You’re not going to like this, but let me tell you the truth: you have far less control over your health than you think.
It’s in our interest at Triage to have you believe that you are in
complete control of your health, as this would allow us to make claims that you will never get sick if you listen to our advice, that cancer is merely a matter of controlling your lifestyle, etc. But, that’s just not how health & disease work, and it’s certainly not how we want our clients and readers to think about it.
One of the assumptions in the health &
fitness space, particularly online, is that we determine our health through the lifestyle we choose to live. Naturally, this has some truth in it (otherwise, our business would be a waste, right?!). However, there’s a point where this belief is simply false and can actually be harmful.
If you look to the group of diseases we call “cancer”, you can begin to understand
this concept. You see, there’s no such thing as “cancer” as a single disease entity. Rather, cancer is a category and includes hundreds or thousands of specific diagnoses, depending on how you break it down. Even when someone says “lung cancer”, you probably immediately think of that as one disease, but the reality is that there are many different “lung cancers”, one of which is strongly contributed to by smoking, the others not as much.
Cancer as a category contains many diseases that have clear lifestyle risk factors, but also many that don’t. Some have strong genetic or family history contributions, some have other exposures of interest (e.g. sun, red meat, high estrogen) some are caused by micro-organisms (e.g. viruses, such as HPV, EBV), and in many cases, there remain unknowns as to what exposures are important. Therefore, when you see someone online
saying “X diet causes cancer” or “Y diet cures cancer”, you can hopefully begin to appreciate that this is unlikely to carry much weight. There may be dietary factors that contribute to a specific type of cancer, but this cannot be generalised to every type of cancer, as they are distinct diseases.
So, we have established that cancer isn’t all about lifestyle, but
Gary, what about other “lifestyle diseases” like diabetes and heart disease?!
These examples may be even more interesting, as it’s quite common for people to think that such diseases can be put down to lifestyle. This has some truth in it, but we know that both of these diseases have strong contributions from genetics and family history. In fact, type 2 diabetes risk
is estimated to be roughly 60% attributable to genetics. This doesn’t mean lifestyle is irrelevant, but rather that genes load the gun and lifestyle pulls the trigger. We also see this with heart disease, where inherited risk factors such as elevated Lp(a) has, to date, no known lifestyle change that meaningfully impacts this, leaving people at increased risk of heart disease in spite of their efforts with diet and exercise.
There are many other examples, and anyone that has worked in healthcare will begin to appreciate the complexity of disease and some of the challenges people face that make “control” very challenging (e.g. poverty, lack of education, lack of support, and more). This also applies to mental health, and despite what some of the gurus online will tell you, you’re probably not going to diet your way out of acute psychosis. The
key thing I’d like you to understand is that it’s okay to get sick. It’s okay to have a health scare. This is so important, as I’ve spoken to many who feel like they’ve failed by getting sick, or that it was all down to something they did (or didn’t do).
Health and disease is messy. You have control over a few levers, and of course, that’s what we are here to help with
at Triage. But, there are things you don’t control, and also many unknowns that neither I nor anyone can explain as to “why” you got sick. You don’t have to beat yourself up about it, and instead, taking the next step to control what you can is what’s most powerful.
If you have any further questions about this topic, you are welcome to respond to this email and I will
get back to you.