Pop Quiz: What Does "Healthy" Mean?
Have you ever noticed how often we’re told what we need to do, eat, drink, avoid, increase, decrease, or look like to be “healthy?” As if everything we’re already doing can’t possibly be healthy already…
From my experience working with clients, when I ask what they can do differently, they often reply with a simple response like, “be healthier,” but what does that even mean?? When I ask them to elaborate, EVERY person provides a different definition. So, if we don’t have a universal understanding of what health really is, how are we supposed to know how to or when we’ve achieved it?
What is health?
When you think about health the need to see a doctor might come to your mind. This isn’t surprising! According to the CDC, there are about 833 million physician office visits each year. If going to the doctor determines if you’re healthy or not, then they must know how health is defined. Well, you might be surprised to hear that traditional medicine is actually disease-focused. What this means: medical research and practice surrounds the premise that health is the absence of disease. That’s not quite the definition I was expecting…
Definition #1
In the fields of medicine and pharmaceuticals the end result of disease is death, so they work to understand and prevent the processes that lead there by keeping you healthy or “disease-free”. They do this by trying to control the known risk factors of each disease.
Let’s back up: what’s the definition of a disease? The Oxford Dictionary defines it [disease] as a “disorder of structure or function in an organism that produces specific symptoms and is not the result of physical injury”, the word disease is actually derived from a French word meaning “lack of ease”, or ‘dis-ease.’
Definition #2
Not all of the healthcare field supports this definition of health. In 1948, the World Health Organization preferred a more humanistic definition. They consider the following principles of health as being key to happiness, harmonious relations, and security of all people, “health is a state of complete physical, mental, and social well-being, not simply the absence of disease”. Thereafter, in 1986, they clarified it further stating it [health] isn’t an objective thing but a positive concept with physical capacities. Your physical health describes a state where the body is functioning at optimal performance and your lifestyle supports a low risk for developing disease.
This “lifestyle” is influenced by many factors. It can be physical health — achieved via fitness — where you work to develop cardiovascular endurance and develop strength and flexibility. Some other examples of promoting physical well-being are minimizing workplace hazards, practicing safe sex, good hygiene, and avoiding drugs/alcohol. Another pillar prioritized by the WHO is our mental health, which encompasses emotional, social, psychological well-being. Promoted by finding the ability to enjoy life, achieve balance, adapt to adversity, all while feeling safe and secure. Finally, one of the understated determinants of health is the impact of our environment. Which includes where you live and the state of the physical environment (pathogens, toxins, etc), the state of the government, your genetics, family income, access to healthcare, ability to manage stress, level of education, and relationships with friends or family.
These are two drastically different definitions and there’s likely so many more out there. Isn’t it so puzzling that a word used so frequently, across the scientific disciplines can be so difficult to define!?
Impact of wellness
Let’s add another layer to this puzzle. What about wellness? What is that? One definition of wellness surrounds the idea of preserving health — where you strive for an optimal state of well-being by working to maximize your potential. According to McKinley Wellness Center, it [wellness] is “a lifelong process of moving towards enhancing your physical, intellectual, emotional, social, spiritual, and environmental well-being.” We work towards promoting wellness through our daily lifestyle choices. These choices and behaviors act like maximizers to support our body and work to preserve our health in the process. Things such as eating a balanced and nutritious diet, managing stress, getting regular exercise or movement are basic wellness activities you’re likely aware of. Some lesser known wellness activities are: engaging in things that give us purpose and connection, having a positive outlook on life and being appreciative for what you have, identifying a set of personal values and aligning your choices by them, and taking the appropriate steps to screen for diseases that could be a risk for your health.
It seems that if we combine the medical definition of health, the WHO definition of health, and the definition of wellness we can see how all these concepts melt together. If health and disease are on a spectrum, we strive to exist on one end more than the other. Where we fall on that scale is the tricky part. I don’t think someone (even physicians) can truly tell you where you fall, because only you know the true impact of all the aspects of your well-being. A doctor can tell you your objective (scientific) risk for disease, but that doesn’t necessarily make you unhealthy. The WHO’s definition of health is multifactorial — not simply the presence or absence of disease. You are the master of your body! Only you can determine what the state of your physical, mental, and social well-being is. You can’t let disease-indicators drive your belief on the state of your health.
The role of our diet
So we talked about “healthy” in general terms, but what about when the term is used to describe your diet? Similar to the ambiguous nature of physical health, what exactly is healthy eating?
Let’s first look a basic definition of food: a provision of nutrients, of which our body uses a fuel and information. That goes for all foods, whole and processed alike. They all are broken down in our body and provide different things based on what they’re composed of. We’re told to eat “healthy foods,” but what exactly makes something healthy or not? Who decides that?
What are the guidelines?
The government’s dietary guidelines tell us that a “healthful eating pattern” includes a variety of vegetables, fruits (particularly whole), grains (mostly whole), low-fat dairy/soy beverages, a variety of protein foods (meats and plant based) and oils. They also state to limit intakes of added sugars, saturated fats, sodium, and alcohol. Now, we could hash out some of the specifics of their recommendations, but the bigger picture here is that this describes a diet that could be applied to a variety of people from various backgrounds.
According to the FDA, who is in charge of food labeling, a food can be marketed to you as “healthy” in the grocery store if its nutrient contents fall within their established limits of total fats, saturated fats, sodium, and cholesterol. As well as containing certain vitamins, minerals, or fiber. Sadly, these limits aren’t up-to-date with scientific research (for example, they leave out the important aspect of added sugar).
For example, just because something has saturated fat doesn’t inherently make it bad. It’s not that simple! Food labeling, exhibit A: a phrase you may have heard before, to eat more “healthy fats,” like those in avocados. Ahhh there it is again… “healthy” used as a describing word!? If you compare the amount of saturated fat to the FDA food labeling limits, we likely wouldn’t be able to physically “label” avocados as healthy. But we know that the omega 3 fatty acids in avocados are VERY beneficial for our bodies! Now we’re back to square one in our fight against confusion… in the food and health industries, the term “healthy” is used in a few different contexts. It’s easy to see how this can get confusing!
I wish all people could tell me that a whole apple is better for you than an apple cereal bar, but sadly this isn’t always the case. Mostly because of the added confusion due to the word “healthy” plastered all over our packaged foods. As well as the wide variety of misinformation that makes the public think that the sugars in fruit are unhealthy (utter nonsense!). In food labeling, to describe a food or diet as being “healthy” usually means either it removes or limits solitary nutrients from our diet, or it adds important nutrients to our diet. You might see similar rules apply when reading recipe blogs and food magazines. They may title a recipe, “Healthy Brownies” because they use honey instead of white sugar and black beans as a base instead of flour. Do these “Healthy Brownies” likely have more nutrients than traditional brownies? Yes probably, but at the end of the day they’re still brownies. You should still be mindful before eating an entire pan! These types of labels just create confusion. Don’t be mislead by claims that you need to eat a certain product because someone else labeled it the “healthier” version.
My tips to fight confusion
I love that people are starting to recognize the power of nutritious food over foods devoid of nutrients., but don’t get distracted by hype or food fads, prioritize what feels good in your body, and take the necessary steps to maximize your health. Achieving health may be more about adding the “positive” (whole-fruits, vegetables, and grains, quality meats, etc.) than limiting the negative. So when you’re asking yourself what you should eat, try to ADD foods to your diet that are nutritious and make you feel good. Like Michael Pollan says, “eat food, not too much, mostly plants.” Keep it simple friends.
Putting it together
So now we have a better idea of how health is defined, what wellness is, and how '“healthy” is construed in the food industry. A general rule of thumb moving forward is to take everything you see or hear online regarding health & wellness, especially from social media, with a grain of salt. Take a look at the source of the information, and ask yourself a couple questions: “is it likely that this one food/trend/etc is a cure all?”, “Is it possible that these complicated disease states and metabolic processes of our bodies can be impacted by one food/trend/etc?” — think about what your answer to those questions might be the next time new trend strikes in the media.
Hopefully this makes you realize that every health journey is unique. Your road to physical, mental, and social well-being is likely going to look very different, even if compared to your friends or loved ones. So remember, when someone tries to tell you what you need to do, eat, or look like to be “healthy” — you’re the only judge! It turns out “healthy” and “happy” are in the same boat… more subjective than measurable or comparable.
References:
What is health? Microbial Biotechnology 2013; https://www.researchgate.net/publication/236641587_What_is_health
What is good health? Medical News Today 2019; https://www.medicalnewstoday.com/articles/150999
Wellness — Understanding wellness; https://mckinley.illinois.edu/health-education/wellness
WHO Constitution/Values; https://www.who.int/about/who-we-are/constitution
Ambulatory Care Use and Physician office visits. Center for Disease Control and Prevention 2017; https://www.cdc.gov/nchs/fastats/physician-visits.htm