We hear the term “an apple a day” to refer to bringing one healthy food to round our diet. And truly an apple is a beneficial food, packed with fiber and vitamins in such a small structure.

I would like to open this page to comments and questions that will be answered briefly by Dr. Cirino. The attempt of this practice is to open up dialogue and intrigue to a question. The process is not intended to replace the guidance provided by your primary care physician and should not be used as such.

What is health?

The WHO defined Health in 1948 as “…a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”

I would like to propose a new way of looking at health.

You can look at Health as the outward manifestation of the many behaviors that we as humans develop to address the stressors that we face from the environment around us. Behaviors shape our movement, and dopamine guides them. Dopamine is a neurotransmitter responsible for the movement toward greater pleasure and away from more significant pain.

The body has multiple opposing neurons that keep our brains and bodies resilient after they face stressors. Think of how muscle movement of the arm requires both the bicep contraction and triceps extension. The body’s sympathetic and parasympathetic systems work to dynamically balance the system as it faces constant stressors or gravitation, temperature, and human interactions.

We interact with the environment in four main ways, referred to as the “four I’s.” These include inhalation (the act of breathing in the air), injury (burns, bites, sharp, and blunt trauma to the skin), ingestion (food, water, toxins, and microbes), and impression (the brain’s interpretative, imaginative response to assessing its environment).

The 4 I’s

1.  Impact/Injury
2. Inhalation
3. Ingestion
4. Impression/Imagination

Our brains guide our bodies to navigate through life—the brain functions with the priority of efficiency in shaping behaviors that solidify as we age. Our behaviors develop and strengthen through childhood. These behaviors provide the blueprint for how we as humans interact with our environment. They shape us through life.

Life seeks to propagate and survive, until it can no longer. Once the sperm meets the egg and forms a zygote, the body’s inner mechanisms ensure the survival of the organism through development and maturation. Even within the maternal environment, we are not free of the interactions with the environment, which affect our genetic expression.

On two ends of the spectrum are disease and health, and our behaviors sculpt these conditions. As we age, our system begins to show less flexibility to change; a more significant amount of cellular debris collects as our bodies reveal the physical signs of aging. 

Disease (Dis-ease) is a state where the body’s compensatory mechanisms and physiology are taxed, leading to a state of decompensation. It is a feedback loop that worsens without an impetus to shift out of it. Disease begins at the molecular level and represents how our bodies interact with stressors. Imagine food entering and being broken down to the smallest components. Our bodies deal with stressors through the vascular system and this is the site that generates a cascade of molecules (cytokines, chemokines, etc.) that lead to inflammation. This is named the psycho-neuro-endocrine-immune system.

The impetus to change disease requires a behavior shift. By definition, a behavior does not seek to change itself. Shifting outside of behavior creates some instability, starting from a molecular level. Dopamine levels decrease while someone faces a change “out of the comfort zone.” The brain begins to telegraph signals to the conscious state to alert it to repeat the behavior. The body may feel a state of increased discomfort, sadness, and physical signs of withdrawal.

The brain’s systems, including the “fight, flight, or freeze” response, are centered in the limbic system. Neurons interact with the sympathetic and parasympathetic nervous systems in various parts of our bodies. Thus, what is an experience in our brains is felt in our bodies as a physical process. 

Neurotransmitters such as dopamine and serotonin create the connection of movement and feeling of pleasure, respectively. The action can be away from a source of pain (towards increased satisfaction) or toward a source of greater pleasure (escaping pain). As this shift becomes successful through repetition, the signals gradually adjust to a “new normal.”

The neurons for the fight, flight, or freeze response reside in the same brain area as rewards and punishments – the limbic system (dopaminergic pathway). Dopamine is associated with movement and craving. One can move toward a challenge or threat to derive pleasure or less pain; one can escape from the same to derive less pain and more pleasure. These responses become the cornerstone of our behaviors.

The neurotransmitters Glutamate and GABA work in opposition to engage or disengage the brain from the stress response, one that triggers multiple hormones to act (adrenalin, nor-adrenalin, and cortisol). Although stress can be useful in developing new behaviors and growth, toxic stress can lead to harm. Any way that we interact with the environment (the four i’s) can lead to help or harm. We can smoke cigarettes or other drugs, eat large amounts of sugar and ultra-processed foods, drink alcohol, or inject toxins into our skin. On the other hand, we could eat a natural diet, avoid cigarettes, alcohol, and drugs, and keep physically active to promote health.

Our environment has always been integral in our health. Some zip codes of the same cities are associated with higher rates of cancer, diabetes, and obesity. Where we live can damage us through the ways we interact with it.

We can be in a harmful environment knowingly or unknowingly. Our behaviors are a blind-spot to a vision of health. Although we could not choose the environment where we developed as children (or fetuses), we can be responsible for ensuring that our environments are healthy or we can seek counsel to find ways to make it healthier.

What are your thoughts on health? I invite you to leave a comment and open this up for discussion.