Regularity in Diet & Lifestyle

The oldest text in the canon of Chinese Medical Theory is the Huang Di Nei Jing, or the Yellow Emperor’s Classic of Internal Medicine, which is set up as a series of questions posed by Huang Di, the emperor, to his wise ministers Qi Bo, Lei Gong, and others. The first question asked concerns lifestyle:

I’ve heard that in the days of old everyone lived one hundred years without showing the usual signs of aging. In our time, however, people age prematurely, living only fifty years. Is this due to a change in the environment, or is it because people have lost the correct way of life?

Qi Bo’s answer is essentially that yes indeed, people have lost the correct way of life:

In the past, people practiced the Tao, the Way of Life. They understood the principle of balance, of yin and yang, as represented by the transformation of the energies of the universe. Thus they formulated practices such as Dao-in, an exercise combining stretching, massaging, and breathing to promote energy flow, and meditation to help maintain and harmonize themselves with the universe. They ate a balanced diet at regular times, arose and retired at regular hours, avoided overstressing their bodies and minds, and refrained from overindulgence of all kinds. They maintained well-being of body and mind; thus, it is not surprising that they lived over one hundred years.

These days, people have changed their way of life…”

The first part of Qi Bo’s answer is abstract: following the Tao, understanding balance, yin and yang, transformation of energies of the universe. The second part gives two examples of practices they had, exercise and meditation. The third part, however, is what gets to me because of its simplicity and continued relevance: habitually waking, eating, and sleeping in accordance with a regular schedule is central and essential to good health. The Huang Di Nei Jing is well over 2000 years old, and yet I heard very similar simple advice from Dr. David Agus, Jon Stewart’s guest on the most recent episode of the Daily Show (Feb. 2, 2012):

We want to do things very quickly and very easily in our country. Pills are a great way to do it. Forget about food, I’m just going to take that pill and be healthy. It’s empowering to spend twenty bucks on vitamins. We have to change that culture. Real food, regular schedule. Get a load of this: you eat your lunch today at noon, and tomorrow at two o clock, for two hours your stress hormones goes up. That’s a lot of stress on the body. You don’t think as well, you don’t function as well. Over time you gain weight, because your body shuts down metabolism to save energy. Something’s wrong. Regular schedule makes a big difference.

Although Dr. Agus’ book, The End of Illness, is advertised as being full of revolutionary new ideas, in this case he is echoing advice that has been recognized for millennia. It’s remarkable that the problem doesn’t seem to have changed much since the time of the Nei Jing. We seem convinced that our bodies work better on a regular schedule and a natural rhythm, yet it remains difficult to stick to one simply because long-term health is not an immediate and motivating priority. Qi Bo says of “people these days”, that,

Seeking emotional excitement and momentary pleasures, people disregard the natural rhythm and order of the universe. They fail to regulate their lifestyle and diet, and sleep improperly. So it is not surprising that they look old at fifty and die soon after.

In other words, it requires taking the long view and having self-discipline to stick to a regular schedule. It seems like too much effort to think about. As Jon Stewart reacted to Dr. Agus’ advice, “I’m never eating lunch again. That’s the right message to take from this, right?”
It says something about the current medical climate that with such platitudes as  “its better to prevent disease than having to treat it afterwards,” “we should eat and sleep on a regular schedule” and “being sedentary is terrible for your health,” Dr. Agus’ book can advertise itself as totally revolutionary, giving us a whole new way to think about health.

Sapolsky’s “Why Zebras Don’t Get Ulcers”

Recently the student intern that I’ve started seeing for acupuncture treatments recommended a book by Robert Sapolsky called Why Zebras Don’t Get Ulcers. I haven’t actually acquired this book and would probably not have time to read it, but I checked it out online and found this video. The basic answer to the title question is that zebras stress out mainly in response to real physiological emergencies only (i.e., being chased by a lion), which helps them in trying to escape and then fades once the crisis is over. Humans, by contrast, in particular those in modernized societies, react with the same stress response to day to day life without the same catharsis to relieve it. This build-up of stress becomes a chronic condition that hugely impacts our health.

“After a while, the stress response is more damaging than the stressor itself because the stressor is some psychological nonsense that you’re falling for. No zebra on earth running for its life would understand why fear of speaking in public would cause you to secrete the same hormone that it’s doing at that point to save its life.” – Sapolsky

Last year I worked for a while as a door to door canvasser for a window company, and believe it or not, I ended up having some pretty awesome conversations with strangers on their front door steps (admittedly, this was the exception, not the rule). Possibly the best conversation I had was with a psychologist in a city about an hour south of here, who talked with me at least fifteen minutes about science, medicine, and philosophy after we were through discussing windows. I remember now that one of the thinkers she recommended to me was the same Sapolsky who wrote this Zebras book. In that context he was recommended to me as someone who did a lot of interesting work on the neuroscience of primates. Turns out he spends quite a bit of time studying baboons in East Africa, and this is part of what gave him the perspective to write a book about human stress. The baboons he studies have a lot of free time to torture each other, so, to quote the video I posted, they are “not being stressed by lions chasing them all the time, they’re being stressed by each other. They’re being stressed by social and psychological tumult invented by their own species.” And therefore? “They’re a perfect model for Westernized stress-related disease.” This short video is worth checking out, and a more in-depth article can be found here.

What I particularly like about Sapolsky’s perspective is that he understands humans in our context as primates and as mammals and recognizes more clearly what we do and don’t have in common with other species, a topic I’ve very briefly mentioned before in the context of veterinary acupuncture. For those more interested in the subject of humans as animals (and in what ways we can continue to think of ourselves as special among animals, as seems to be so important for us), there’s another great talk by Sapolsky at Stanford that can be found here that is highly recommended.

The Rise of China

The English economist Martin Jacques delivered a talk last fall that was partially meant as a wake-up call to the Western world. Over the next few decades, he argued, China will become the predominant country in the world. For the West, this increase in China’s influence will mean that the world will become increasingly foreign and strange because it will be shaped by cultural and historical forces we do not understand. We have had no need to understand them; for the last 200 years, the Western world has essentially dominated the globe. We have so far arrogantly seen China as a “little West” – in Western terms, but not quite as far along – and assumed that they are similar to us in ways that they are not. Given what the future is likely to hold, this understanding will no longer suffice, and Jacques’ talk is an attempt to get us to begin to recognize what he calls “the difference that is China.” He gives us three “building blocks” – three common points of misconception – to do so. First, China is better described as a “civilization-state” than a modern nation state and is much more diverse, pluralistic, and decentralized than we recognize. Second, they have an ethnocentric conception of race – over 90% share a Han identity that holds the country together (this point is unfortunately not much developed). Third, the Chinese State is regarded very differently by the Chinese than Westerners regard their governments – as the intimate and ubiquitous patriarch of the family rather than an intrusive necessary evil that must be kept in check – in part because of its significance as representative of Chinese civilization, how little its authority has been challenged over the last 1000 years, and its extraordinary accomplishments in state infrastructure, such as the Great Wall and Grand Canal.

It will be interesting to see how the West, America in particular, will react to the rise of China’s global power. There does seem to be a growing fear or apprehension about it, ranging from the stir that the Tiger Mom memoir caused to jokes on the Daily Show. I’m particularly curious how this larger economic and political shift will affect the reception of Chinese Medicine here. Hopefully the need to learn more about Chinese culture (and other cultures generally) will lead to more openness and acceptance of foreign ideas in place of ignorance and fear of them.

For those interested in delving deeper into the topic, you can find criticisms of Jacques’ book and ideas here and watch another TED talk for a different perspective.

Marco Gagnon’s Tai Chi Chuan

Although I didn’t know his name, for a long time, when I came across his videos, I recognized Marco Gagnon as Master Yang Jun’s assistant in his instructional video for the long form. He was the amused-looking goatee’d bald guy would walk onto the screen to get thrown about a bit then wordlessly disappear whenever Master Yang Jun would say something like “How you imagine with opponent…” Turns out Marco is from Quebec, Canada, and runs a tai chi center there. I enjoy the videography, and his form is excellent as well. It’s rare to see high-quality videos of well-performed tai chi, especially ones that aren’t set to corny music in hokey settings, so I was pleased to come across these ones.

This first one is an urban performance of the 49-form demonstration form. The motions are all motions I teach, but the form is shortened and arranged in a different order.

The second video seems to be a promotion for Marco’s Tai Chi Center, but I like the human interaction it shows, particularly the impressive push hands towards the end.

Tai Chi Sword Update

Though a while ago I posted a video of what the tai chi sword form that I’d be learning would probably look like, thanks to my instructor, I now have two videos of the exact form, which is going to be really helpful for learning it. The first is by Master Yang Jun of the Yang family, and it is the Yang Family Style 67 Sword Form, meaning there are 67 movements (the previous video was of the 32 form).

The second is an apparently less perfect version (in rhythm, momentum, and body swing), but it still looks very good to me. I hope to get there someday.

I really enjoy the sword form so far. Though it is based on similar principles as the long form (or empty hand form) it definitely adds a new element to have a weapon to control. I also feel lucky to have found a hobby that allows me to wield an awesome looking sword toy with a semi-serious look on my face. : )

Shiiiing!

Needle and Placebo Effect

One of the many challenges of validating acupuncture from a research standpoint when comparing it to “placebo” acupuncture is that the placebo effect associated with needling is extremely strong. Is acupuncture no good because it is not significantly better than a placebo? Or is the placebo in this case so strong that it works almost as well as real acupuncture?

In this video a magician shows us that a trick that we know to be fake can still cause a visceral reaction in us if it involves a big needle. Definitely not for the squeamish.

The general impression I’ve come away with from hearing about research trials on acupuncture and placebo effect is that, while acupuncture hasn’t been shown to be significantly stronger than its placebo effect, it has been consistently shown to be more effective than conventional treatments for certain conditions, and this latter aspect has been played down by its detractors. The research shows that acupuncture works, but so does placebo acupuncture. In some cases this is because of a poor design of “sham” acupuncture, for instance, superficial needling (which is pretty much Japanese-style acupuncture, not fake acupuncture), but in others it seems the sham acupuncture is more legitimately illegitimate: I’ve heard of researchers using a prick-then-away of a toothpick to deceive subjects into thinking they’ve had a needle inserted (these obviously aren’t patients who have experienced acupuncture before). What is needed now are studies with larger sample sizes to be able to differentiate the effects of acupuncture from its strong placebo. I am not personally inclined to believe that Chinese medicine is well-represented or understood in these randomized controlled trials or needs them for its legitimization, but it would still be interesting science. There is most likely to be a strong therapeutic effect associated with entering a clinical setting setting, lying down in a medical room, and knowing that you are there to get help and take care of your illness. It gives you a chance to let yourself free from other responsibilities and stress and to focus instead on how you feel and how you can begin to get better. It probably also helps just to have someone listen to and respond to your description of your ailments, even without treatment. How much does this atmospheric effect and the patient/practitioner relationship play a role in the treatment? They are certainly important, but then again, I’m sure acupuncturists would like to think that they don’t consist of the entirety of the efficacy of the treatment. Would the research reflect that, or not?

This video had nothing explicitly to do with acupuncture, but it was a fun one. Enjoy.

Tai Chi Cat

Last night when I practiced the tai chi form in my driveway, I noticed that the neighbor’s cat was watching me from inside their living room window. It watched me for practically the entire form. Naturally the form doesn’t mean the same to a cat as to a human (especially another human who knows the form) but it made me wonder if at least it considered it to be an odd thing for a person to be doing.

The owner of the movement studio at which my classes take place has a dog, who sometimes comes in just before class, to be asked (inevitably) if he is going to take the tai chi class, too.

Some ambitious souls are driven enough to make it through both veterinary and acupuncture schools to be acupuncturists for animals other than humans, something I know little about but admire as a concept. Though it might seem like a bourgeois luxury to take one’s pet to an acupuncturist (though if it is effective and reasonably priced health care for a fellow creature, I don’t see what’s wrong with it), from a practitioner’s point of view it would create such a broad perspective to be able to apply and adapt the principles of the medicine across different species, utilizing an knowledge not just of human physiology but animal physiology in general.

Picture taken from http://www.acaciaanimalcare.com/testimonials.html

That cat was likely just being a cat, looking out the window for cat-like reasons. But although animal intelligence is so different from ours, I think we overemphasize our differences with and ignore our similarities to animals of other species, choosing to interpret their behavior as need-based and mechanical rather than intelligent or emotional. Much of what characterizes our lives is characteristic of life in general, not of humans specifically. Even creatures like houseflies, for instance, begin young, go through adolescence, mature, age, and die. From a biological perspective so much genetic material is uniform across all kinds of lives and basic biological mechanisms are preserved. We identify ourselves by our career, our gender, our race, and our being a member of the human species…why not extend it one step further as, for instance, being mammals, with a conscious affinity for all others who birth and nurse their young?

It’s also really cool to learn, by the way, that the points that I am learning and finding on humans can be to some extent generalized to other mammals.