THE INEVITABLE: Falling Ill to Stay Healthy
Dr. Robert Barrett and Prof. Louis Hugo Francescutti have written a fascinating book on an intriguing topic. The title says it all: “HARDWIRED: How Our Instincts to Be Healthy Are Making Us Sick.” It’s surprising, isn’t it? We strive to stay healthy, yet we fall ill in the process.
Today, we live longer than any generation before us, and the chances of surviving are higher than at any point in human history. In two million years of human existence, we never understood so much about what it takes to live longer, healthier, and more fulfilling lives. Yet, despite all this wisdom, many of us feel more fatigued, stressed, and drained than ever.
The problem isn’t a lack of knowledge on how to be healthier; it’s the barriers to health posed by modern life. This raises a fundamental question: how can we overcome what prevents us from being truly healthy? Why do we feel this way, with such a poor perception of health and well-being, while living in the safest, most secure, and wealthiest era in human history? Are we justified in thinking so? Absolutely not!
Imagine this: during the Roman Empire, people lacked basic clothing, let alone shoes. During the Ottoman and Habsburg dynasties, forget about cars, trucks, and buses—there was no central heating, electric lighting, or telephone communication.
Fast forward to today, and even an average citizen has access to amenities like computers, which became common only 40 years ago. Now, we have AI at our fingertips and space tourism on the horizon.
We are living longer, healthier lives, but we’re not satisfied. We want more because we know more is within reach.
However, the real issue is that, in our pursuit of fulfilling basic biological needs and desires, our actions, even with access to all these comforts, create a dissonance that ultimately works against our well-being. Despite the exponential growth in our collective knowledge of health, we haven’t achieved the health standards we aspire to. Something is fundamentally wrong. The human body, shaped by millions of years of evolution, now displays a kind of “evolutionary mismatch” with the rapidly changing, developing modern world. This highlights the fact that our behaviors, which are intended to fulfill our basic biological needs and desires, often result in a kind of mismatch that ends up being harmful to us.
It’s time to acknowledge that in the modern world, healthy living can no longer be the exclusive domain of medicine or biology. How we perceive the world, our relationships, the choices we make, and the stressors we face—all these are at odds with the evolutionary hardware designed primarily for survival and reproduction.
If you feel it’s becoming harder to separate fact from fiction when it comes to making conscious decisions about health and life, you are not alone.
In the United States, obesity rates are soaring. Suicide and homicide incidents have doubled, and last year, 20% of all university students reportedly contemplated suicide, resembling an epidemic of depression. These facts are undeniable evidence of the worsening state of public health.
And yet, medical knowledge is growing exponentially. In 1950, it took 50 years for medical knowledge to double. By 2010, that time had decreased to less than 5 years. Today, medical knowledge doubles every two months.
While our ancestors learned life skills, dietary habits, and parenting strategies from their parents and close relatives—traditions passed down through generations—today, we are inundated with information that often prioritizes the social benefits it provides the messenger rather than delivering genuine health advice. This dynamic doesn’t just lead to fad diets and extremes aimed at gaining acceptance within an online peer group. It also breeds confusion, feelings of inferiority, and anxiety.
Our insatiable egos, driven by social status, have even learned to manufacture their own “drugs.” The desire to be liked and admired, the need for belonging, and the instinct for sexual attraction, fueled by social media, trigger our survival instincts.
The story of our children, on the other hand, is different. Concerns about how their brains are developing and why excessive screen time may do more harm than good are becoming increasingly urgent.
Reconciling our ancient instincts, which once meant life or death, with today’s world starts with understanding who we are. What motivated us in the past, and what drives us now? Does the constant influx of information from the media each day reduce our ability to think critically or distinguish fact from fiction? The decisions we make, what we consume, how we work, and how we interact with our families all offer clues about our resilience against this information overload.
The rapid pace of change in our environment demands an adaptation process, unlike anything humanity has faced before. We must now seek real knowledge about how and why our instincts sometimes lead us astray. Success in today’s world depends on our ability to filter out noise and discern meaningful signals from the cacophony of communication.
The youngest members of our society have never known a world without the omnipresence of online media at their fingertips. However, the 24/7 access to images promoting wealth, ideal body shapes, and trendy lifestyles has led to a 70% increase in depression rates among young people over the last 25 years, especially since the advent of the internet. This trend has alarmed mental health professionals.
As highlighted by a study on adolescents in the UK, protecting young people from the harms of the internet requires a dual approach. On one hand, we must be open to new medical discoveries and lifestyle recommendations. On the other, we must cultivate an immunity to misinformation and pseudoscience. This is no small task. It starts with understanding how our brains and bodies respond to this new world.
Dr. Robert Barrett and Prof. Louis Hugo Francescutti, the authors of the book, observed the connection between our health and the world we live in within this new social media era, viewing it through the perspective of public health. In their research, they uncovered a world where physical and mental health are more profoundly affected by social change than at any other time in history.
Take a moment to reflect. How have screens affected your physical and mental well-being? I mention screens because I often find myself surrounded by three screens in the evening when I’m supposedly relaxing at home—plus my wife, of course! Physical complaints like carpal tunnel syndrome, thumb arthritis, and watery eyes all started this way for me. My so-called “screen addiction,” which is viewed as a mental issue, is something I’m trying to address with digital fasting.
Throughout their book, the authors examine health and wellness in today’s world. They explain how our modern social lives, which play a pivotal role in shaping our thinking, are rooted in ancient survival mechanisms. They provide numerous examples and case studies illustrating how our prehistoric instincts—designed to keep us alive and healthy—now inadvertently harm us. Lastly, they explore how the newly formed connection between our physical health and social world influences our subconscious, shaping our decisions and behaviors in unexpected ways.
- Is the Hospital the Most Dangerous Place in the World?
Statistically, over 1% of individuals entering a hospital in the U.S. face the risk of death due to preventable errors. Shockingly, the likelihood of dying due to a hospital staff error in an American hospital is higher than the chance of dying as a soldier during the deadliest year of the Gulf War. Upon hearing this claim from the authors, I wondered what the situation might be like in our hospitals.
Preventable errors occur in hospitals worldwide, raising alarm bells for everyone involved in the healthcare system.
The issue predominantly lies in the non-technical aspects of patient care: communication, teamwork, and leadership. Addressing these issues requires systemic change, which, while slow and challenging, is by no means impossible.
In a 2012 survey conducted among American doctors, 37% responded “yes” or “it depends” to the question: “If it doesn’t harm the patient, is it acceptable to cover up a mistake or avoid disclosing it?” The same attitude applied to doctors who witnessed others’ errors.
“Avoidance and defensiveness” are default rules. A lifestyle built on “avoidance and defensiveness” begins with our daily choices. Alongside hospitals and healthcare workers accountable, we must also take precautions to avoid behaviors that could land us in the hospital in the first place.
- Why Do We Desire What’s Bad for Us?
For the past millennium, life expectancy has been gradually increasing. Barring unplanned pandemics or wars, each generation has enjoyed slightly longer lifespans than the one before. Yet, alarmingly, recent studies reveal that in certain populations, this millennia-long trend is reversing. While wealthy nations around the world are consistently living longer, mysteriously, there is a steady decline in life expectancy just in the United States. The author argues that our highly evolved present selves, generally healthier and longer-lived, are now struggling to adapt to a world where sugars, fats, and salts, once hard-earned and precious, are now abundantly and easily available everywhere. According to research-based in the U.S., the average lifespan for less-educated white Americans has dropped by four years in just one generation. This concerning trend contradicts predictions that life expectancy in developed countries would soon approach 100 years.
Case and Deaton, who won the Nobel Prize in Economic Sciences for their work on the decline in life expectancy, attribute this decline to worsening economic conditions in the U.S., exacerbated by rising drug use.
While our brains excel at regulating small but vital bodily functions, they falter when it comes to food choices. Our brain, which governs our behavioral choices throughout the day, inadvertently rewards these choices with the abundance of sugary, fatty, and salty foods that are easily accessible everywhere. Neuroscientists note that the role of dopamine, the neurotransmitter released during rewarding behaviors, is far more complex than the simple stimulus-reward cycle. A new desire is dopamine, and for instance, craving a buttery croissant stems from dopamine, as does the irresistible urge to indulge. I suggest reviewing the article I previously wrote on dopamine. It will provide a deeper understanding of the subject.
(https://muratulker.com/y/dopamin-orucu-cilehane-ve- itikaf/#:~:text=Dopamin%20hayat%C4%B1m%C4%B1zda%20iyi%20bir%20%C5%9Fey,%C3%B6d%C3%BCllendiren%20deneyimler%20i%C3%A7in%20ortak%20olgudur..)
The amount of unnecessary sugar we consume, often in liquid form, is truly astonishing. While a portion of fresh strawberries contains the equivalent of one and a half sugar cubes, a standard soda has about 16 sugar cubes. Although researchers are cautious about singling out sugar as the sole cause of rising obesity, high daily intake of added sugars remains the prime suspect, with the most likely source seen as beverages. The sugars consumed by the body are digested, and the glucose produced during this process is directed to the liver. To manage this, the liver releases insulin, and any excess glucose is stored as fat. If we do this too often or too much, we risk developing an issue related to how our body responds to insulin, exposing itself to a type of disease such as type 2 diabetes. To address balanced nutrition, I recommend following the Sabri Ülker Foundation’s website (https://www.sabriulkerfoundation.org/tr).
Since prehistoric times, our brain has evolved to ensure survival, offering us simple, almost automatic commands to either evade, escape, consume something, or act on our sexual impulses. It is our frontal cortex (PFC) near the forehead that controls this primitive part of our brain, allowing us to reason, judge, plan, and make sound decisions. this distinction is what separates us from animals. The prefrontal cortex enables us to plan, set goals, and control the urge for immediate pleasure; I call this willpower. Many of us can test this ourselves; when we see a chocolate donut or a bag of salty chips, we need to use our willpower to resist eating it.
Researchers have started to explore the idea that our willpower is not unlimited—it can deplete over time. When we spend too much energy being disciplined, our brains exhaust their willpower reserves, leaving us vulnerable to short-term emotional impulses. I’ve written an article on this topic; feel free to read it for more insights.
(https://muratulker.com/y/yapacagim-yapmayacagim-yapmak-istiyorum/).
- Raising Children Amid War, Cartoons, and Social Media
According to UNICEF, one in ten children globally grows up in a war-torn country or region. This translates to 230 million children directly affected by conflicts. Research has proven that the stress caused by war severely impacts a child’s brain, particularly its architectural development. According to UNICEF, approximately 3.7 million children were born during Syria’s civil war. It is estimated that the total number of children living under the threat of war and death will make up approximately 80% of Syria’s future adult generation. Studies indicate that 80% of these children have become more aggressive, 75% have started wetting the bed or increased its frequency, and suicidal thoughts or self-harming behaviors are widespread among them. Research estimates that a significant proportion of the four million children born amidst war are at serious risk of developing mental health disorders.
We can use these insights to understand the mental state of the fresh immigrants living among us, who will soon make up a significant portion of our nation’s youth, can’t we?
The brain of young children processes digital screens as a chaotic bombardment of moving colors and sounds. This sensory overload can overwhelm their brains, leading to a struggle to keep up with the rapid flow of information. As with other forms of toxic stress, the child’s brain enters a “fight or flight” response, leading to an increase in stress hormones in the body, much like the brain development issues observed in children who have experienced abuse.
Reducing daily screen time is a good starting point, though it’s easier said than done. For some parents, on the contrary, this screen addiction provides an opportunity to complete chores, take calls, or enjoy brief moments of peace.
Our ongoing and future challenges will revolve around reconciling the growing disparity between the rapid pace of technological change and its integration into our daily lives, and how slowly our brains and bodies can adapt to this change. Put simply, we cannot keep up with the speed of technology and fail to adapt. Our brains, by simplifying this situation as a life-or-death matter we once faced in ancient times, can make us mentally ill through changes in our physiology. Even activities once seen as mere pastimes, such as football matches, can transform into social events. What’s more, linking these pastimes to gambling is akin to adding fuel to the fire.
At California State University, Professor Dr. Larry Rosen has conducted a study with approximately 30,000 people across 22 countries, investigating how technology affects our brains. Rosen emphasizes the profound effects technology has on young brains, highlighting that the rapid pace of technological change is shortening the time spans that define generations.
It doesn’t take much imagination to grasp the impact of excessive internet use on young minds. The lack of patience and constant craving for rewards creates a cycle of pleasure that fuels dopamine release in the body. This surge of dopamine feels great for the brain, driving young individuals to seek more of it. However, living in a world filled with relentless and uninterrupted threats can lead to toxic stress. This stress, stemming from a heightened sensitivity to perceived challenges, can disrupt brain development, and impair its architecture.
Another major concern is the phenomenon of “information overload.” In this so-called “Information Age,” today’s youth seem to struggle to find a balanced way to manage the issue. It is known that screen time for children under three can negatively affect brain development. But what about college students spending countless hours navigating mobile devices and computers, often feeling anxious and overloaded? Unlike screen “time” merely measuring the duration of exposure, the anxiety and depression experienced by adults are often linked to the nature of the content they engage with online.
- The Truth About Happiness
The ultra-wealthy may enjoy very high living standards, but they can still worry, feel discontented, and even experience financial anxiety.
However, evidence indicates that the pursuit of wealth, often equated with the pursuit of happiness, is a nearly universal phenomenon spanning diverse nations and cultures, from Switzerland to Eswatini. In this case, it might be assumed that higher living standards in wealthier nations do not necessarily provide greater happiness among their citizens.
Daniel Buettner, a New York Times bestselling author, has traveled the globe to study regions where people frequently live to 100 years or older. His research identified four distant corners that defy conventional aging statistics: Sardinia (Italy), Okinawa (Japan), Nicoya (Costa Rica), and Ikaria (Greece). Despite their relatively modest lifestyles, the residents of these regions enjoy extraordinary longevity.
What Buettner and others discovered are nine identifiable commonalities among the four regions. These include engaging in regular physical activity; living with a sense of purpose; leading low-stress lives; eating smaller portions; consuming limited amounts of meat; drinking alcohol in moderation; practicing some form of spirituality; nurturing close family and kinship ties; and maintaining strong and active social networks. Among the most significant features attributed to longevity, strong community-level social networks stand out as particularly influential. In these regions, people do more than just coexist and engage in outdoor farming—they actively support and care for one another. This is especially evident among the elderly members, who are integrated into daily life, remaining physically active with farm and household tasks while finding meaning and comfort in their close connections to family and friends.
The sense of community may also play a role in reducing stress and contributing to longevity. This likely originates from the reassurance that we are not alone in the world, that others are there to support us, and that even as we grow older, we remain purposeful and valued.
It’s remarkable how I now grasp the wisdom in the Prophet’s words: “Believers are brothers, and visiting your relatives prolongs your life.” (*)
Contemporary research highlights the biological effects of stress caused by dissatisfaction or insecurity, such as shortened telomeres, decreased telomerase activity, and heightened cellular oxidation—all of which can contribute to illness. The influence of relationships on our health is undeniably profound.
- Why Do We Ignore Sleep?
When the brain demands sleep, nothing else takes priority. Its ability to “unplug” is an essential survival mechanism, although there’s a dark irony in falling asleep behind the wheel. I still vividly recall the first time it happened to me: an uncontrollable, almost sweet surrender. Whatever startled me awake, I narrowly avoided crashing into a tree, instinctively turning the wheel thanks to my familiarity with the road. Life can be thrilling and unpredictable, and it’s not hard to imagine how critical staying awake was for our ancient ancestors. The ability to remain alert for extended periods to evade predators, hunt for food, find a mate, or care for offspring undoubtedly provided an evolutionary advantage. However, this aspect of us has not fully developed. Despite our desire to stay awake indefinitely, the brain possesses a fundamental physiological adaptation that forces it to shut down.
The need for sleep isn’t complex. The longer we stay awake, the more fatigue builds up. If we try to suppress our homeostatic drive for sleep by staying awake, the brain can behave like a faltering engine, stalling momentarily when pushed to its limits. These brief moments, known as microsleeps, are one- to two-second lapses where we nod off while trying to stay awake. Alarmingly, we often don’t even realize it’s happening, as our cognitive state is too “impaired” to register the lapse.
Sleep scientists describe our natural sleep cycle as “sleep architecture,” which can be divided into five stages. Interestingly, our understanding of sleep stages is fairly recent, as sleep was once believed to involve a single phase dedicated to mental repair. Advances in diagnostic imaging have revealed far more about how our brain and body rejuvenate during sleep, as well as how factors like age and lifestyle affect this critical process. When we fall asleep, we first enter stages 1 and 2 (lighter sleep phases) before gradually transitioning into the deep sleep of stage 3. If interrupted during the first two stages, most of us can quickly bounce back into activity with minimal grogginess. Short naps of 30 minutes or less typically involve only these lighter sleep stages. In stage 3, the brain enters a period of deep sleep, known as slow-wave sleep, where its activity significantly slows down. These first three stages are part of our non-REM (non-rapid eye movement) sleep cycle. Stage 4 takes us into even deeper sleep, while stage 5, despite being a deep sleep stage, is uniquely characterized by brain waves similar to those observed when we are fully awake. Stage 5 is referred to as paradoxical sleep because, although we’re in a very deep sleep state, the brain remains highly active. During this stage, our eyes move rapidly in all directions, which is why it is called Rapid Eye Movement (REM) sleep.
Throughout a typical night’s rest, we cycle through these stages four to six times, akin to playing a song on repeat. However, not all stages last equally long as the night unfolds. In the first half of the night, we spend the majority of our time in stages 3 and 4, while REM sleep becomes more prominent in the latter half. Our age also influences how much time we spend in each stage. Newborns and infants, who tend to sleep most of the day, spend about half of their sleep time in REM. As toddlers begin walking, REM sleep decreases to about 25% of their total sleep. By the time we reach adulthood, we typically spend half of the night in stage 2, the light sleep stage. As we age, the time spent in stages 2 and 3 diminishes, contributing to poorer sleep quality. Older adults also experience much less REM sleep, which is crucial for clearing minds and improving memory and cognitive function.
Obesity, coupled with issues like palate collapse (**) and sagging uvula (***), significantly increases the risk of obstructive sleep apnea, a disorder that impacts approximately 20 million Americans (no statistics are available for Türkiye). This condition disrupts sleep by causing pauses in breathing, leading to poor sleep quality. The result is daytime drowsiness, diminished productivity, and a decline in the body’s physical and hormonal ability to burn fat, ultimately contributing to weight gain. Numerous studies have shown a clear link between sleep deprivation and obesity. For this reason, I recommend that individuals of a certain age or those struggling with obesity undergo sleep assessments and follow medical advice.
Many of us feel the pressure of missing out on a constant stream of news while we sleep, and we may think that cutting back on sleep—even by just a few minutes—will allow us to browse news feeds, stay on social media, or enjoy some downtime watching television or a movie. I’ve often felt that sleep is a waste of time. While I know this perception is inaccurate, I can’t always shake it. For many Millennials, the rise of online work opportunities has redefined the traditional nine-to-five workday. Representing roughly 40% of the American workforce, Millennials have some unique traits. On average, a Millennial now spends 18 hours a day online. For this generation, “disconnecting” and “unplugging” have become major challenges when it comes to sleep. In the U.S., about 95% of survey participants reported using digital screens within an hour before bed, and 90% of 18-to-29-year-olds sleep with their phones. Among the generation born after Millennials, currently in their teens, 97% have an electronic device in their bedroom, and surprisingly, one in five wakes up during the night to check social media.
- Are We Equipped According to Risk?
Our innate instincts grant us a mysterious ability to assess potential rewards and weigh the costs of pursuing them. While this is often a rational evaluation, more frequently, it manifests as an intuitive sense, shaped by both direct personal experiences and the lessons we’ve learned from others throughout history.
The mechanisms behind our decision-making are driven by desires that are deeply embedded in us, many of which we are not always consciously aware of. These evolved instincts, which once ensured our survival, continue to influence both our behavior and our health.
The way we indulge in showing off and presenting ourselves has likely undergone more change in the past decade than at any other point in history, primarily due to the way we interact and communicate through the internet.
- From Epidemics to Welfare: Nourishing Our Hereditary Health
One of Europe’s most horrific historical periods was the 1350s when the Black Death took the lives of 60% of Europe’s population—about 50 million people. In a way, this was an unknown turning point for human civilization, sparking a collective rebirth and renewal. The dawn of the Renaissance was thus born. The Renaissance, marking the transition from the Middle Ages to the modern era, shows how positive change can emerge not by ignoring or trying to suppress our ancient instincts, but by nurturing them. The Italian Renaissance, in all its splendor, emphasized the importance of individual happiness and satisfaction, fueling our inner impulses, nourishing our spirits, and at the same time creating a perfect aesthetic environment that provided fulfillment for our reward-seeking brains. Although the Renaissance in Italy spanned several centuries, it requires a profound understanding of how rapid social change can contribute to health, rather than hinder it, especially following one of humanity’s darkest periods of suffering and misery.
The concept of social determinants of health isn’t a new one. In 2005, the World Health Organization created a commission to investigate these factors. Today, this commission focuses on three primary goals: improving the living conditions of vulnerable groups, reducing inequality, and evaluating the impact of social determinants and interventions. While the negative effects of low socioeconomic status on health are well-recognized, the question of why affluent societies sometimes experience poorer health remains underexplored. For example, it’s a societal phenomenon we need to address and change over time, particularly considering that, despite a large and affluent portion of our population living along the Mediterranean coast, we mostly consume grains and bread instead of embracing the Mediterranean Diet.
CONCLUSION
In this book, we’ve explored how our desires and impulses are hardwired into our brains and bodies, honed over time to ensure our survival. These instincts are deeply ingrained in our lives. Yet, we also possess the ability to think, plan, and strategize. It may seem like these two aspects are at odds—either we’re driven by hedonistic desires, chasing immediate rewards and dopamine, or we’re calm, rational strategists who have gained immunity against our more basic instincts. However, the life we seek is undoubtedly the latter: it’s about mastering the art of controlling our basic desires, ultimately safeguarding our health and well-being.
References
(*) https://www.islamveihsan.com/rizkinin-cogalmasini-omrunun-uzamasini-isteyen-kimse-hadisi.html
(**) https://www.damak.gen.tr/damak-sarkmasi.html
(***) https://www.medicalpark.com.tr/kucuk-dil-uzamasi/hg-2814
Note: This open-source article does not require copyright and can be quoted by citing the author.
