The Scientific Measurement of Healthiness

Can we measure healthiness scientifically?

Note: this post was written at the beginning of my explorations of Healthicine. The book:
Introduction to Healthicine: Theories of Health, Healthiness, Illness and Aging , published in early 2014, provides a much more comprehensive, up to date view of health and healthiness - as well as a framework for measuring healthiness.

Let’s look at two hypothetical women, introduced in a recent blog about detox and cleansing.

Alice and Zizi, both in their mid-forties, have no identified medical issues. They are each relatively normal, with one notable exception. You might know someone in each profile.

Alice gets, on average 5 to 7 colds a year, over the past 10 years. When she gets a cold, she is quite seriously affected, and the cold lasts, typically, between 8 and 10 days.

Zizi gets on average, a single cold every 1 or 2 years.  Her colds typically last 3 to 5 days and she suffers only minor systems.

That’s what the health (medical) system knows about Alice and Zizi.  About their illness.  The health (medical) system never looks at their health; in fact Alice and Zizi only contact the health (medical) system when they are sick. And Zizi, because she is generally not seriously affected by her colds – has almost no contact with the health (medical) system.  Alice is well known at the clinic, if not looking for medicine; she is at the very least, looking for a doctor’s note to stay home from work.

Now, the critical question.  Who is healthier, Alice or Zizi?

I think we can agree that Zizi is the most healthy.  But we can also see that she is ignored by the (so called) ‘health system’, because the ‘health system’ is in fact a ‘medical system’, not a health system.

Our health systems are ignorant of the healthiness of Zizi.

If Alice and Zizi go to a doctor, when they do not have a cold, they might both be told they are 'perfectly healthy'.  As if health is measured using yes or no answers.  "No illness" equals perfect health. 

We don’t have a health system. There are no professionals, there is no scientific community that studies Zizi – and no-one that studies the differences between Alice and Zizi.  Our medical system pays a lot of attention to Alice, and tries to cure or prevent her colds – and it ignores Zizi. Zizi is healthy, and there is no ‘health system’ to take notice of Zizi's healthiness.

Why is it important to study Zizi?  As long as we only study illness - we have an incomplete image of health and healthiness. Our concepts of illness, treatment, cure, prevention, and health are all distorted by a view that does not understand or measure healthiness.

I believe Zizi is healthier - and the cold makes no difference. That's my opinion.  But I would like to have a scientific answer.

A scientific answer should be independent of my opinion. It would make objective measurements and decide who is healthier.  Of course there is debate, even in science, but we need a science first - before we can start a scientific debate. Today, there is no science of healthiness. 

How would we obtain an objective, independent, scientific measurement of the health of Alice and Zizi?

Is it appropriate to measure healthiness – every day?  Or can we only measure sickness every day? Maybe, when we study healthiness – we will learn that the minimum resolution of a health measurement is 3 weeks.  Or perhaps longer. That a health measurement of one day, or even 3 or 7 days is irrelevant to health status, only relevant to ‘illness status’.

Or we might find that some measurements of healthiness are immediate and effective. A visual examination of the blood cells of Alice and Zizi might consistently reveal that Zizi is healthier. While examining their colds and sickness status requires analysis over several months or years for an accurate result.

Individual illnesses are measured by a different set of symptoms, tests, and observations. But these symptoms, tests and observations do not necessarily measure healthiness. Nor does the absence of symptoms. 

I believe an objective test for healthiness must ignore the cold, which is a temporary ‘illness’.  When we have true tests for healthiness - they will detect a significant differences between the healthiness levels of Alice and Zizi, without reference to a specific incidence of a cold.

Our medical systems ignores the difference between Alice and Zizi, and has no officially recognized way to measure it.  If someone says "Zizi is healthier than Alice" - there is no proof.  Even a historical record of the frequency of their colds does not constitute proof.  It is simply historical and anecdotal.

How can we measure healthiness scientifically? We have some crude measurements - most are designed to measure populations, not individuals. BMI tells us if a population is overweight or underweight.  But we are cautioned against using it on individuals.  And if Alice and Zizi have simiar BMI scores - that does not help. Most medical tests are designed to measure illness, not to measure healthiness.

I believe we can measure healthiness scientifically.  I'm not a scientist, but I have faith in science.  If it can be measured, science will find a way. And healthiness can be measured.

If we are to measure health, we need to develop scientific measurements of various elements in each of the layers of the hierarchy of health - genetics, nutrition, cells, tissues, organs, systems, body, mind, spirit and community.

There are over 100 nutrients which are critical to optimize health.  To develop a scientific system of healthiness measurement we need to:

a) identify, for each nutrient, the optimal range
b) develop tests to determine if the person being tested is above, below or in the optimal range
c) determine which nutrients are most critical to optimal health, and which are less critical.  This cannot be done until analysis of each nutrient progresses to a point where comparisons an be made reliably.  eg. A long time in the future.

Similarly for each cell type in the body, we need tests to measure their health level. However, testing some cells, liver cells, for example, might entail serious risk.  I believe that the first tests of cell healthiness will be done by measuring the healthiness of blood cells.  We may find that testing the healthiness of blood cells is a reliable indicator for the health of many different types of cells. We can also test cells in the skin, mouth and hair - without serious risk.

Each layer in the hierarchy of health is 'greater than the sum of its parts'.  Measuring the health of your genetics does not necessarily determine the health of your nutrients.  Measuring the healthiness of your nutrients does not necessarily provide a useful measure of the health of your cells.  It might be an influencing factor, but not necessarily the complete picture.  If you are suffering from toxins, measuring nutritional health - of essential nutrients, will give an incomplete picture. Of course if you improve your health in any area - you should expect that this improvement will permeate the hierarchy to some extent.

As we move through layers in the hierarchy of health, the relationships are farther apart.  Of course there may be direct links - a specific genetic unhealthiness might cause unhealthy white blood cells.  But in general, results measured in one layer cannot be used to make assumptions about other layers in the hierarchy.

There is also the possibility that deficits in healthiness in higher layers will cause deficits in lower layers, or in all layers.  If you live in a community that consumes a less than optimal diet - your nutritional health will probably be less than optimal as a result. This may lead to other health deficits.

I believe we can measure health.  One place we could start is in the laboratory.  Maybe we should try to measure the health of lab mice?  We need to find two lab mice, name one of them Alice, and one of them Zizi - and compare their healthiness. At present, I suspect that lab mice are only used for tests of illness, not tests of healthiness. I also suspect that, like the human Alice and Zizi - if the mice are not 'sick', our current system measures them as '100 percent healthy'.  Just like we do for people.

When we learn to measure the healthiness of lab mice - we will be closer to measuring the healthiness of humans.

When we start to measure the healthiness of humans - we will take the first steps towards optimal health.

What might the world, what might our health systems look like when we can measure health?

That is an interesting question to be discussed in future blog posts.

You have a right to life, liberty and the pursuit of healthiness.  Pursuit of healthiness is impossible if we cannot measure healthiness.

Yours in health,  tracy

Tracy is the author of two book about healthicine: 

Personal Health Freedom

Alberta Views: The Urge To Purge - A Health Centred Response

Alberta Views Magazine

Re: The Urge to Purge article - November 2011

When I opened Alberta Views and saw the article Urge to Purge. I was excited that I might learn something new.  I dived in at speed.  It was only a few seconds when I spotted the name Stephen Barrett.  I knew you’d been hoodwinked.  So, I read on, but got more and more depressed and dissatisfied as the article passed thru my ummmm….

Stephen Barrett reminds me of A.A. Milne’s poem Lines and Squares:

Whenever I walk in a London street,
I’m ever so careful to watch my feet;
And I keep in the squares,
And the masses of bears,
Who wait on the corners all ready to eat
The sillies who tread on the lines of the street
Go back to their lairs,
And I say to them, “Bears,
Just look how I’m walking in all the squares!”

I can see why Deepak Chopra describes Stephen Barrett as the “self appointed vigilante for the suppression of curiosity”.  I agree with Deepak Chopra.  Stephen Barrett never steps outside of the squares.  And he thinks that anyone who does is a bear (or worse, a quack).

Enough ranting about Barrett.  What about detox? 

The article subtitle 

“Cleansing and detoxing isn’t scientific, so why do so many Albertans do it?”

Let’s deal first with the technical error, the statement that “detoxing isn’t scientific”.  I suggest you look up scientific in a dictionary.  Trees are not scientific. Drugs and treatments are not scientific.  A healthy diet is not scientific. Scientific defines a process by which things are measured against a hypothesis. ‘Things’ are not scientific, with the exception of things like scientific procedures, scientific studies,scientific measurement and the like. Note, this phrase appears again in the conclusion – it’s just as silly there. And wrong too.

I think you meant to say 

“there is no scientific evidence to support the statement that detoxing prevents illness”. 

And that is where we part company.  You are right.  And very wrong.

I run a blog called Personal Health Freedom. You can find me at www.personalhealthfreedom.com . 

My blog is about health – not about illness.  I write about the need to define and measure health. I define a hierarchy of health, so that we might learn how to study health - as opposed to studying illness.  I do take time out to define illness and the causes of illness, most of my energy is towards ‘health’. I take care to tell readers that I am not a doctor. Don't rely on my advice.  Check for yourself.

Health must be defined and measured separately from illness.  No-one bothers to measure health – our medical systems only measure illness.

Let me give a little example to clarify. Let’s talk about two hypothetical women, Alice and Zizi, both in their mid-forties.  You might know someone in each profile.

Alice gets, on average 5 to 7 colds a year, over the past 10 years. When she gets a cold, she is quite seriously affected, and the cold lasts, typically, between 8 and 10 days.

Zizi gets on average, a cold every 1 or 2 years.  Her colds typically last 3 to 5 days and she suffers only minor systems.

That’s what the medical system knows about Alice and Zizi.  About their illness.  But the medical system never looks at their health; in fact Alice and Zizi only contact the medical system when they are sick. And Zizi, because she is generally not seriously affected by her colds – has almost no contact with the medical system.  Alice is well known at the clinic, if not looking for medicine; she is at the very least, looking for a doctor’s note to stay home from work.

Now, the critical questions.  Who is healthier, Alice or Zizi?  I think we can agree that Zizi is the most healthy.  But we can also see that she is ignored by the (so called) ‘health system’, because the ‘health system’ is in fact a ‘medical system’, not a health system.

But if Alice and Zizi go to a doctor when they do not have a cold, they might both be told they are 'perfectly healthy'.  As if health was measure using yes or no answers.  "No illness" equals health. 

We don’t have a health system. There are no professionals, there is no scientific community that studies Zizi – and no-one that studies the differences between them.  Our medical system pays a lot of attention to Alice, and tries to cure or prevent her colds – but it ignores Zizi. Zizi is healthy, and there is no ‘health system’.

Now a more challenging question.   On November 12^th, 2010 – Zizi got a cold.  It was minor on November 12^th, full blown on November 13^th – and she was recovering by November 14^th. During that span of time, Alice did not have a cold.

So, on November 12^th who was healthier?  Alice or Zizi?  On November 13^th, who was healthier, Alice or Zizi?  On November 14^th, who was healthier – Alice or Zizi.

It is clear that on November 11^th – Alice was healthier, and on November 15^th, she was healthier again.    

A scientific answer should be independent of your opinion – and independent of my opinion.  

How would we obtain a scientific measurement of the health of Alice and Zizi?  Is it appropriate to measure healthiness – every day?  Or can we only measure sickness every day? Maybe, when we study healthiness – we will learn that the minimum resolution of a health measurement is 3 weeks.  Or longer. That a health measurement of one day, or even 3 days is irrelevant to health status, only relevant to ‘illness status’.

It seems clear that we need different ways to measure healthiness from illness.  Each illness is measured by a different set of symptoms, tests, and observations. But these symptoms, tests and observations do not measure healthiness.  

I believe an objective test for healthiness must ignore the cold, which is a temporary ‘illness’.  When we have a true test for healthiness - it will detect a significant difference between the healthiness levels of Alice and Zizi, without reference to the frequency or duration of colds. 

So what has this to do with detox?

Let’s go back to the scientific method question. Your quote: “why (do) detox diets never undergo scientific tests?”  You say “Then there’s the scientific method.  Detox proponents don’t seem to care for it.” 

But you, and the detox proponents and opponents, aren't understanding science. Detox proponents aren't necessarily the ones who don’t like the scientific method.  It might be the medical establishment that doesn’t like the scientific method (except when it is used for medical purposes). 

You asked Oregon naturopathic physician Dickson Thom why “detox diets never undergo scientific tests?”  he could only joke.  Why? Because he is so imbedded in the medical system he can’t see the forest (health) for the diseased trees (illnesses).  

If detox diets are about health, the scientific tests, to date, are measuring the wrong thing. 

If detox diets are about health, not about illness, then we need a scientific test to measure the health of people before, during and after the detox treatment.  We might search for a similar scientific test to use as a model.  Search away.  There are, at present, NO SCIENTIFIC STUDIES of the effect of any substance, treatment or action on HEALTH.  There are only scientific studies of the effects of substances, treatments and actions on illness.  Detox is about health, not about illness. Illness is not health.

So, let’s suppose that detox improves your health. I’m not saying it does – I’m interested in science.  But let’s suppose that a specific detox treatment improves your health, by x percent, on average. 

All tests by the ‘scientific medical system’ will not detect nor measure the improvement.  Our medical systems and our medical tests do not measure the difference between Alice and Zizi.  Because they don’t measure health.

We don’t have any independent, objective tests to measure health – so we cannot tell if health was improved or not. 

Let’s suppose the relationship is more complex.  If, as the medical scientists claim, detox kits might release toxins and thus actually harm your health status – then we need to take the measurement further.  It might be, for example that using a detox kit decreases your health for several days, or even a few weeks – but after that, your health is actually better.  Maybe this happened to you? Sort of like learning – first seem to go backwards and then rebound later.

But… Have there been any scientific tests to measure this possibility?  No.  There have been no tests of detox that measure effects on health, short term nor the long term.

So, is detox scientific?  Duh.  The people who, like Stephen Barrett, claim that ‘detoxing does not improve health’ are not scientific – because there has never been a test.  But Barrett claims that science proves detox is useless.  Where is the scientific evidence? There is some evidence that our ‘medical system’ and its ‘scientific tests’ cannot measure benefits from detox.  Is that because there are no benefits?  Or is it a deficiency in the scientific tests?  We don’t know.

What does each person who buys a detox kit decide?  I’m guessing they say something like this

   - I know it’s painful

   -  I believe my health is better after it is over

So they buy.  And use.  And if they feel healthier - that's the only measuring stick we have for health at present, they do it again, when they feel 'less healthy'. 

I make the same judgement when I go for my swim.  I know it’s painful.  Cold.  Wet. Messy.  But I believe my health is better if I do it regularly.  I know my health status does not change ‘because I went swimming once’.  I go and I swim. I suffer, and I feel better and I get healthier.

The scientific tests don’t measure this reasoning.  They measure ‘medical effects’, not health effects.

You are not the only person to make this mistake.  Many of the people you talked to in ‘health stores’ don’t understand the concept of health.  So you were told that ‘your thinking is too linear’ – when in fact Willard simply could not explain the situation in ‘medical terms’ – because it is not a medical question.  

He has not learned to think in terms of health. He may work in a 'health store', but he thinks in 'medical paradigms'. 

Arpana Taylor speaks of a necessary  ‘paradigm shift’, but cannot define the new paradigm.  Aparna might understand unconsciously that detox is about health, not about illness – but our ‘health systems’ only deal with medical issues  - and Aparna needs his own paradigm shift to understand, and then explain it to you.

Your conclusions, two:

  - detox may have its merits, but it is not scientific

  - detox diets don’t remove harmful substances from the body (Barrett is right)

Are false and misleading. 

As noted above, the statement that ‘detox is not scientific’ is not a scientific statement. If it is not false, it is nonsense.

If you meant to say “detox is not supported by scientific studies of illness”, you might be technically right. But if people take detox for their health - the statement is irrelevant. 

No-one has scientifically measured the health effects of detox.  Frankly, no one has scientifically measured the health effects of Vitamin C nor penicillin.  We have only measured their illness effects. 

The statement that “Detox diets don’t remove harmful substances from the body” is also unscientific, as is most of what Barrett says. 

There are no scientific studies concluding that detox does not remove toxic substances from the body. Proving that a detox diet does not remove a harmful substance from my body requires an exhaustive study of detox diets along with an exhaustive study of what is excreted from my body – through various orifaces, before I am on the detox diet and then again while on the detox diet and again after I complete the detox protocol. This study has not been started, and I suspect it will never be completed.

The statement that 'detox diets don't remove harmful substances from the body' is what I call a 'black swan statement'.  It is a wide generalization that can be proven wrong by a single exception. You can find a more detailed description and some examples of black swan statements in health here. 

A final comment...

You mention the possibility of a placebo effect.  But you missed a valuable alternative explanation.  The change effect.  The saying goes - a change is as good as a rest. Our diets sometimes tend to get 'stuck'.  If we do not exercise care, we might find ourselves eating the same thing, every week, every month, over and over and over again for years.  The detox diet changes this up - maybe only for a short period.  But this change might be enough to improve our health.  We don't know, because we cannot measure healthiness. 

To your health, tracy

Tracy is the author of two book about healthicine: