Friday, July 26, 2013

The Power of a Four-Way Wrench and Why Embracing Strangers is Good For Your Health

I left Local Bar + Kitchen after some chow with Evan Handyside, a good friend of mine and contributor to this very blog. Our schedules rarely align, but, when they do, our meetings always turn into several-hour ordeals. My work schedule makes it difficult to meet up with friends, especially when your friends are entrepreneurs that work impossibly long hours as well (just ask Evan). One of my priorities over the past few years has been to invest as much time into my social network as possible. The members of my network reciprocate, and we benefit mutually.

As you’re probably aware, members of the communities with the highest concentration of centenarians around the world have extensive social networks, and they invest a great deal of their daily life to maintaining and creating interpersonal relationships (check out the work of Dan Buettner if this is the first time you’re hearing this). Evan and I benefited mutually from the 2-hour merry-making session as those people in the blue zones benefit from a life that focuses on relationships. But this meeting isn’t really what I want to focus on here. Read on.

I was driving home from the bar, and I hit what seemed like a half-curb that somebody must have put there to trip me up (couldn’t have been my fault, right?), and I heard a loud hissing sound followed by a clunking noise: flat tire. A few moments later, I was on my hands and knees fussing with a stiff jack trying to get my car’s rear end off the pavement to change my stinkin’ tire. Then it started to rain. Then it started to pour.

Rushing through the job, clothes soaked throughout, two guys called to me from the rain holding umbrellas. “We heard you hit that metal grate at the corner, and we knew you must have gone flat...Seen it a hundred times. Do you need any help?” They offered me a 4-way wrench, which expedited the process. One of the guys, Dave, helped me get the flat off of the studs, and Sid, his brother, helped me replace the lugs. While the three of us fumbled in the dark, a set of headlights suddenly illuminated the scene: another good samaritan trying to help out in whatever way possible.

“Good thing this happened in Pittsburgh, eh?” said Sid. He was referring to the community fostered by Pittsburghers. The city is known for this: We look out for one another. In the animal kingdom, organisms more commonly than not operate in packs, flocks, or cultures and we interact with them in an ecosystem whereby each member prescribing to the rules of this ecosystem benefit mutually. So it’s no surprise to learn from current research on the civilizations whose individuals live, on average, longer than the rest of the human populace that our health and general well-being might benefit from dedicating a chunk of our day to have a good laugh with friends.

Indeed, a metanalysis performed by Julianne Holt-Lunstad and her team at Brigham Young University in Utah showed that social networks have as profound an effect on mortality risk as many of the conventional risk factors (smoking, alcohol consumption, sedentarism, etc.).

In her summary, she states:

“Although further research is needed to determine exactly how social relationships can be used to reduce mortality risk, physicians, health professionals, educators, and the media should now acknowledge that social relationships influence the health outcomes of adults and should take social relationships as seriously as other risk factors that affect mortality, the researchers conclude.”

This isn’t to say that you are on a path for total destruction if you can’t spend two hours with a good friend(s) every night, but it certainly does suggest that your health and longevity would benefit from dinner with your spouse or drinks with an old friend.

Nerdy research aside, we know that spending quality time with the ones we love makes us happy. Those evenings where we spend a few extra moments soaking in the positive vibes of some Dave Matthews and laughter with our pals leave us longing for more. They leave us wishing we could “do that more often”. Evolutionary theory suggests that these feelings are a natural part of our human make-up; we benefit from social interaction. Indeed, our prehistoric ancestors largely depended on strong relationships within a close-knit social network to survive to an age at which they could reproduce.

My fellow Pittsburghers didn’t think twice when they heard my tire blow. Their gut told them to offer me help. Likewise, the elderly man that sat for twenty minutes with his headlights focused on our work site didn’t blink an eye. These are busy people with many of the same responsibilities that you and I share, yet they invested a small part of their day to support a member of their human network. For them, “us” is greater than “me”. I imagine that they wouldn’t bat an eye at an offer to have dinner with friends, regardless of how busy and important they perceive their lives.

So, following their example, would it kill you to call your mother or best friend once in awhile?

Nathan Riley is a 2014 MD candidate at Temple University School of Medicine; He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence. You call follow him on Twitter @BeyondtheMD. He can be reached at

For information check out the following links:
Dan Buettner’s TED Talk: How to Live to Be 100+
The Blue Zones, by Dan Buettner
The Longevity Project, by Howard Friedman and Leslie Martin

Welcome Note

Greetings! Welcome to the S&B Journal.

You've made it this far, so we must have had a positive impression on you. The purpose of the S&B Journal is to provide you with some reading material to complement your lifestyle transformation and fuel your role as an active player in the paradigm shift that we are beginning to see in this country's attitude about health. Welcome to the family. I'll be your tour guide.

My background is in medicine. I'm going to be graduating with an MD in about ten months, which gives me the advantage of nearly ten years working in the biological sciences and practicing clinical medicine. I approximate that I - along with the other dozen or so thousands of medical students that will graduate with me - have answered around 22,000 multiple choice questions about disease, the treatment of disease, and the prevention of disease. We are extremely educated, and we are determined to use this education to improve the health of our world.

But the fact remains that the majority of things that are killing us - diabetes, heart disease, and obesity - are largely preventable. There are a lot of factors at play: pollution, consumerism, electronics, packaged foods, the food system, water contaminants, lack of vacation, yada yada yada. Every day, the media seems to have some new break through treatment for that which ails us. If I had an answer to your health, I would be rich, because this is the billion dollar question: how can I live a healthy life?

Contemporary American living isn't ideal. We can all agree on this. We work too much, worry about minutiae, and are perpetually moving forward. On the other hand, those people around the world living longer than the rest have a very different lifestyle. And they're not only living longer. They're thriving. At age 90, they're doing things that most of the world struggles to do at age 40. I'm not comfortable with this. I train thirty year olds at Crossfit Pittsburgh who, on their first day, struggle to squat to the ground, instead preferring to hinge at the hip. What is going on here? We live in a culture that's the breathing definition of abundance, technology, luxury, and scientific genius, so why are we still so sick?

You've been told by your doctor a dozen times to make changes, but there is obviously something preventing you from making those changes. When a doctor recommends that a patient lose weight, the patient nods his or her head, goes home, then returns six months later worse than when they started. We react to their illness with medication, as if high blood pressure is a beta blocker deficiency or high cholesterol is a statin deficiency. Physicians are intelligent people, but our health care system is not preparing us to save the world. There's only so much that we are prepared to do, and the state of the nation's health is way out of our league. We need a paradigm shift, and that's where health coaching comes in.

As you have likely figured out, our approach at Sweat and Butter is a little bit unorthodox. We focus on five primary areas for improvement: food, stress, sleep, relationships, and movement. The only way to do this is to take baby steps. Your transformation will go a little bit like this graph:

When you really start working on forming healthy habits around our five big categories, you have to persist through some growing pains from the onset before you see any major changes. This is different from what you might be accustomed to. Our health care system reacts to your medical problems with quick fixes, and you have become conditioned to requesting those quick fixes. A lifetime of bad habits is only going to be transformed with patience and perseverance. On the plus side, you will reap the benefits of true wellness and longevity. This is different from what you get through a quick fix. The latter might provide you relief in the moment for some isolated symptom, but you quickly need another treatment as the effects of a quick fix are short-lived.

This program will work for you. We know this because we practice it. Our lifelong project is optimal health. We are productive, happy, energized, and pain-free because we have spent the greater part of our lives taking the aforementioned baby steps and fine-tuning our lives because we want to be optimally healthy. We are constantly revising our strategy because that's required in order to find what works for us as individuals. This project can be yours, too.

The first step is to identify bad habits. Often times it's less important to identify what you aren't doing so much as identifying why you aren't doing those things. Going back to your last doctor's visit.  Did you heed their advice? If not, why? At Sweat and Butter, we ask the "why?", then we answer the "how?". For example, the educated, affluent members of our society have all the means to locally-sourced, organic produce, so why aren't they all buying it? These are the questions that we must ask ourselves on a daily basis. When we identify a bad habit, it's critical to determine the underlying reason or past experience that has paralyzed our healthy decision-making capacity and to furthermore implement healthy change in those moments when we do find the resolve required to change our lifestyle. This is heavy stuff.

Working with our coaches is equivalent to being grabbed by shoulders and pulled out of the open bay door of a plane. You've got your parachute in place. The person strapped to you has performed this jump a thousand times, and they can assure you that you'll land safely on the ground the below. You know that it will be terrifying and uncomfortable as soon as you sign the four-page long liability form. You'll probably get irritated by our persistence, and you'll curse us the whole way through. But in the end you'll land safely.

Now this next paragraph is for those of you slouched in the back of the room playing on your phones. You're thinking: "Baloney! Look at me. I feel great! I don't need this garbage. Ain't nobody got time for this!" Even if you don't feel sick now, chances are you could be performing a lot better.  Consider the sensation of slipping on a brand new pair of running shoes. You insisted that your old ones were just fiiiiine. But then you slip on a new pair, and your next run feels amazing because of it. Our approach to lifestyle modification is a little bit like that.

As a health coaching company, this process is a fundamental part of our inner dialogue: How can I break bad habits and develop healthier habits to replace them?

We want to take you through this process, too.  This blog will regularly be updated with updated research in the field of medicine, motivational pieces, and insights from experts in the five main lifestyle categories that we mentioned before: food, stress, sleep, relationships, and movement. Think of the S&B journal as the fuel feeding your hunger for change.

We've got some work to do. Let's get started!

Nathan Riley is a 2014 MD candidate at Temple University School of Medicine; He writes about food, movement, sleep, relationships, and stress in order to bridge the gap between his patients and evolutionary theory and clinical evidence.  You call follow him on Twitter @BeyondtheMD.  He can be reached at

Follow me on Twitter @BeyondtheMD