Pillar 4 Nutrition

This is post 4 of 6 focused on exploring my 'six pillars of health'. 

Coming at longevity medicine without a mental model leads me to fall down a dizzying rabbit hole of options which are overwhelming and exhausting. Thus, I created a six pillar model of health that allows me to sort, triage, and critically assess all the information I obtain in my never ending journey to optimize health. 

My six pillars are Life Philosophy, Sleep, Exercise, Nutrition, Social, and Sex. Is there something sacred about these 6 pillars? No, these pillars were not divine revelation delivered to me on tablets of stone. However, I have found that designing specific and actionable interventions to improve health works well in the 6 pillar paradigm. It’s broad enough to cover the most important bases but not so broad as to be directionless and unhelpful; they are useful guide-rails that are not overly ridged. 

With that being said, let's take a look at our fourth pillar, 'Nutrition'.

Nutrition is a daunting pillar because it can take an almost unlimited number of forms, the science behind it is messy, the sheer complexity of the biochemical pathways in the human body that nutrition is supposed to support is bewilderingly complicated, and there is the added social layer of cult like tribalistic thinking that often prevents individuals from approaching the entire complicated question rationally.

So how do I approach it?

I keep it very very simple.

First let's start with my definition. I define my nutrition pillar as 'everything going into your body'. This of course includes the first thing every one usually thinks of which is food. But I also group all drugs, supplements, creams, inhalants, and infusions into this pillar. Anything that goes into your body and affects your metabolism is considered part of this category. Simple.

Next, similar to my approach to the 'Life Philosophy' health pillar, my approach to your nutrition health pillar starts with curiosity and agnosticism.  Which specific form your nutritional routine ultimately takes I am agnostic to. That doesn’t mean I don’t care about it. It means that the specifics and the nuances of what is going in aren't terribly important to me. What does matter to me is that your nutrition is helping you hit specific metrics and providing key structural components that I feel are vital to your health. Simple.

Now on to the elephants in the room, what’s the right diet for you? I’m not sure yet, let’s find out together, and let’s be objective and outcome focused about it. As you can see, I take a different approach than most with this question. I look at our output and then work backwards to get a sense of what we need to change with our input. In the end I am less concerned about what is going into your body, than what it is doing for your body. Want to be vegan, great, want to be a carnivore, great, want to only eat orange things that don’t cast shadows, great. Let’s see what that diet of yours is doing to your glucose and insulin levels, where it pushes your inflammatory markers, and how it is affecting your gut lining. Let’s see how that diet is affecting the levels of chemicals that are the causative agents of disease and what it’s doing to your cognition and performance. Let’s look at how you feel and how you sleep. Let’s look at your body composition to make sure you are maintaining or gaining lean mass and losing visceral fat. Let’s make sure your diet is allowing you to engage in meaningful social events and is aligned with how you see your place in the universe. If these outcome measures are going the right direction then you are on the right diet, if they are not going the right direction, let’s change it up and get on the right path. Simple.

To this end, I created a checklist to systematically go through the important outcome metrics of a diet in my patients. When you see the checklist, you will notice that the metrics are based almost entirely on how your body is reacting to the fuel you are putting in as opposed to being focused on the specific foods you are putting in your body. After-all, it’s the ‘results’ we are looking for when it comes to maximizing your health span and longevity. I believe this framework gives direction and guardrails while also providing flexibility and gives you a lot of choice in the matter.

The more points you are getting on this checklist, the better the diet is for you overall.

Simple.

When I take this agnostic, outcome bases, metric driven approach, the messy and complicated area of nutrition becomes quite simple.

Simple is good, simple is approachable, simple is digestible, simple is actionable, and simple gets results.