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RHR: How Evolution Has Shaped Our Behaviors, with Dr. Robert Barrett and Dr. Louis Francescutti


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Between chronic disease, depression, loneliness, opioids, COVID-19, and more, we are at a crossroad of multiple health epidemics—the majority of which stem from the mismatch of our current environment and our biology. In this episode of Revolution Health Radio, I talk with co-authors: Dr. Robert Barrett, a PhD from the world of social science, and Dr. Louis Francescutti, an MD from the world of medicine, about the influence of evolution and how it affects all aspects of our behavior. In their recent book Hardwired: How Our Instincts to Be Healthy Are Making Us Sick, the authors illustrate how our social lives, and community, are more of a determinant of health outcome[s] than at any other time in human history.

Revolution Health Radio podcast, Chris Kresser

In this episode, we discuss:

  • Barrett and Dr. Francescutti’s backgrounds—how they got into this work
  • How our biology is positively and negatively affected by our environment
  • The recent decline of life expectancy in the United States
  • How social media contributes to the epidemic of depression and loneliness
  • Finding meaning and purpose in your life
  • Risk tolerance and COVID-19
  • Humans are hardwired: information is not enough to change behaviors
  • Protecting the health of children

Show notes:

Hey, everyone, Chris Kresser here. Welcome to another episode of Revolution Health Radio. This week, I’m really excited to welcome Dr. Robert Barrett and Dr. Louis Francescutti as my guests.

Dr. Barrett has spent much of his life studying behavior, group dynamics, and organizational culture. His primary focus is on why we do the things we do and how individuals and teams can reach top performance. Dr. Francescutti is an emergency and preventive medicine physician, a university professor, and an international speaker. He trained in preventive medicine at Johns Hopkins University in Baltimore and is past president of the Canadian Medical Association and past president of the Royal College of Physicians and Surgeons of Canada.

And what we’re going to be talking about today is their recent book Hardwired: How Our Instincts to Be Healthy Are Making Us Sick. This is obviously a very interesting topic for me, as someone who has paid a lot of attention to the influence of evolution on all aspects of our behavior, from how we eat to how we sleep, to how we exercise or don’t, how we interact with digital devices that are becoming an increasingly large part of our lives. So I’ve been looking forward to this interview; I really enjoyed it, and I hope you will, too. Let’s dive in.

Chris Kresser:  Dr. Barrett and Dr. Francescutti, it’s such a pleasure to have you on the show. Welcome.

Robert Barrett:  Thanks for having us on.

Louis Francescutti:  Thanks for having us.

Chris Kresser:  So, I got [a] copy of your book, I think from your publicist. I get lots of books all the time, as you can imagine, in the mail. A lot of them, frankly, don’t get read and end up in the recycling bin because I’m not interested. But when I see a book that’s called Hardwired: How Our Instincts to Be Healthy Are Making Us Sick, that got my attention right away because this, of course, is an area of interest of mine. How evolution has shaped our behavior and continues to shape our behavior and the impacts of that, both positive and negative. So how did you arrive at the idea of hardwired instincts? You both come from different backgrounds. So I’m curious how you arrived at this concept and then how you teamed up and decided to write this book.

Dr. Barrett and Dr. Francescutti’s Backgrounds—How they Got into This Work

Robert Barrett:  I can start off with that one. Well, coming from different backgrounds, so we see that as a pretty distinct opportunity and advantage in putting these ideas together. I’ll start with the second question, which is how did we start working together. We’re both basically asking the same question: why do we do the things that we do? Louis is an ER doc and professor. As an ER doc, of course, he sees things from a pretty serious side when we talk about why we do the silly things that we do.

For me, as a social scientist, at looking at society and conflict and decision-making, and judgment and all that, and putting it together, we found that there was a gap that was happening with respect to understanding our health with looking at how society is changing very, very quickly, and how our deteriorating health situation, which is manifesting in various fronts, how those two things play together. And we looked at it from the point of view that our society around us, our modern world, is changing at such a rapid pace that it seems to be outpacing some of our ability to stay in front of it in terms of our survival drive. So these things are always active, and they never stop, of course. But we are now in this world of plenty, and it’s almost in an overload situation. And that’s having some serious consequences with respect to our health.

So the underlying question then is that these are our instincts that are evolved to help us survive and help us stay healthy. But in our current rapidly changing world, what is actually happening is the opposite.

Louis Francescutti:  Yeah, Chris, just to simplify it for your listeners, Rob and I believe that humans are running on outdated software. The software that’s kept us alive for millions of years is done working in the current environment.

Chris Kresser:  It was designed for different hardware and circumstances, right?

Louis Francescutti:  Exactly. And that’s why in the States, especially, I think the tribalism that you’re seeing right now—I know it’s a brutal word to use, but it’s all driven by social media. And social media is not the way our brain is designed to work. And the people that have figured out how to use social media to reward the brain with dopamine, I’ve got them hooked. And you can listen to people that have almost been, I don’t want to say brainwashed, but they’ve kind of been brainwashed and given a little patch to update their outdated software.

And some of us, the halves of society, have been able to figure out how to create our own patches. But COVID[-19] has shown us that there’s a whole different response out there if you know how to survive in the 21st century versus not surviving.

Chris Kresser:  Right. So I want to talk, of course, about the health implications of this, which you cover in your book. But as I was learning a little bit more about you, Louis, I came across an interview that you did way back in 2014. It’s not way back, [but] it does seem like a different era, about cell phone-free driving. And that seems to be a really interesting example of the conflict between what our brains were designed for and the evolutionary patterns that would have kept protected survival and natural fitness in an ancestral environment. And then the impact that those tendencies have when we’re subjected to, let’s say, a smartphone beeping and flashing while we’re driving a heavy metal vehicle.

So maybe we could start there and talk a little bit about that as a doorway to understanding this mismatch between our genes and biology and our current environment.

We are at a crossroad of multiple health epidemics, the majority of which stem from the mismatch of our current environment and our biology. In this episode of RHR, I talk with Dr. Barrett and Dr. Francescutti about the influence of evolution and how it affects all aspects of our behavior. #ancestralhealth #chriskresser #revolutionhealthradio

How Our Biology Is Positively and Negatively Affected By Our Environment

Louis Francescutti:  Yeah, Chris, that’s a perfect example. And we were ahead of the curve, like we were warning people that this was dangerous before the evidence showed us that it was dangerous. And simply because it’s not whether you’re hand-held or hands-free that’s distracting; it’s the conversation that’s the distraction. Because, as you mentioned, for millions of years, through storytelling, we’ve been able to share where the food, the water, the fire, the shelter, the mates, the enemies were, and storytelling allowed us to put a real premium to it.

So when you hear another person’s voice, 60 percent of your brain, and this has been shown with [positron emission tomography] (PET) scans, is activated. And so your attention is to the conversation. And a passenger will adjust their conversation through what’s known as conversation stalling if they see that you’re driving fast, merging, you don’t have good vision, [or] the weather’s bad. But if we were to try and do this interview now and I’m driving, I’m so focused on trying to give you a good interview [that] I’ll be in a state of inattention blindness where I’ll run over a kid. And when the police officer says, “Didn’t you see the kid?” I will honestly say “No, I didn’t,” because I was in a state of inattention blindness. And that’s hardwired. We’re hardwired to be social creatures and to listen to other voices.

Chris Kresser:  And we’re also hardwired to be distractible, right? Because if we, in a different context, if we’re let’s say sitting in a prairie or a savanna, and then off in our peripheral vision, we see some movement, that could be a predator that might be stalking us and ready to kill us. So maybe our ancestors who were hyper-focused on whatever they were doing in that savanna didn’t survive to pass on their genes, while our ancestors who were distractible by that movement in the peripheral field did survive and passed on their genes.

So I wonder how that also impacts our lives in a world where you cannot escape the distractions, and they just seem to be multiplying every year.

Robert Barrett:  Yeah, I can step in there. We see that manifesting in several different ways. The distraction point, one aspect of that is, as Louis had mentioned, that we get this brain reward. Our reward system lights up with dopamine and oxytocin. We know there [are] studies that tell us what percentages increase when your phone vibrates in your pocket, or you get it a Like on social media. These are very, very real.

And then some of the demographic sectors that are most affected by this, say the adolescents and young adults, who are most predisposed to their social peer group. That is, they make their decisions based on what their peers think of them. They are hyper-focused on this. And it’s also a stage, from an evolutionary standpoint, that we would have been going out to seek mates and we would have been taking risks to go and maybe leave our village to go seek a mate. So this is also part of this hardwiring that’s built-in, and we’re always socially comparing ourselves to others. We see that, of course, in social media. There is this underlying social ascendancy that is always there that creeps into all the posts where people are comparing themselves to everyone else. And that creates a lot of anxiety, as well.

So you have all this dopamine and oxytocin, which is you say, “Hey, well, that’s pretty good.” Your brain feeds off of this, and that’s what we’re evolved to do. But [on] the flip side of it, you have the anxiety and the depression and everything else that comes with the fact that we are glued to these devices. And it creates almost a fight or flight in us that we can’t escape from.

Chris Kresser:  I think it’s, the reason I like talking about this topic and having this conversation, and I always like to pause and point this out, is that there’s such a, in my experience as a clinician, over a decade treating patients with chronic disease, there’s such guilt, and shame and self-blame are very common. And explaining to people the evolutionary roots of their behaviors, it’s not meant to absolve them of responsibility, technically meaning the ability to respond appropriately in that situation. But to maybe take a little bit of the individual burden off. Like the idea that there’s something wrong with them and they’re weak or lack willpower, or it’s some individual failing rather than they’re actually acting out their biological programming in exactly the way that they were designed to do.

Robert Barrett:  That’s right, and we talk about the idea of resilience. It’s a very popular word, and I’m not discounting it. But there is something to be said for the idea that we are constantly saying, hey, you just have to be more resilient. You just have to push harder against all of those, all the dopamine and all the biological urges you have. There has to be a smarter way of doing this than just saying you need to be stronger and push back all the bad stuff and take in all the good stuff. And understanding, as you say, understanding the mechanisms that are driving that behavior is a great first step, to being able to understand it.

The Recent Decline of Life Expectancy in the United States

Chris Kresser:  Let’s talk a little bit more about some of those mechanisms and how they’re affecting our health. A couple of years ago, we started seeing studies coming out suggesting that for the first time in modern recorded history that we’re aware of other than short periods like the 1918 pandemic and the war periods, life expectancy, which had pretty much been on a linear increase, has actually declined. And I know there’s some debate about how much this has happened and what the causes of that might be. But I’d love to hear your take on this. What’s actually going on here? I know it’s more pronounced in certain demographics or parts of the population than others, and how does this relate to the hardwired hypothesis?

Robert Barrett:  I can start out, and then Louis can polish it off. So, in the book, we talk about certain sectors of the population [that] are experiencing a decline in lifespan. As you say, this is extremely unusual. What we saw was that among many industrialized countries, there was a dip in lifespan. But while most [countries] have recovered, the [United States [has] been particularly hard hit. And in some sectors of the population, we haven’t really seen a full recovery from this loss of lifespan.

And the sectors that have been [hit] particularly hard are those who are less educated, they are less wealthy, and they’re also ones that, where we are seeing particularly strong evidence of lower lifespans are in the midlife category. And these have to do with behaviors. It’s really interesting that opioids, prescription drug medications, and alcoholism, and smoking, if you can believe it’s still there, that these are actually affecting midlife mortality. And they’re coined as deaths of despair. So they have a psychological element to them. And Louis sees a lot of this firsthand in the ER, as well. And maybe I’ll let him round out the answer on this.

Louis Francescutti:  Yeah, Chris, I think it’s going to get worse before it gets better. We’re not over this opioid crisis, and that’s driving a lot of this. And also, as you know, unfortunately, when kids die in motor vehicle collisions, then they do autopsies and they look at the coronary arteries, there’s plaque. There is plaque like they’ve never seen before. And so we’re raising a generation of kids that are not quite as healthy as they used to be in the past. And then the World Health Organization was right on when they predicted that by 2020, depression would surpass a lot of other chronic illnesses.

And when we see the burden of mental illness among our young people, the rise in suicide rates, [the] latest [Centers for Disease Control and Prevention] (CDC) numbers I saw show a slight decline. But as a university professor just the other night, my class was talking about suicides among university students. And the last thing is, there’s a reason why the UK created a ministry of loneliness because loneliness is worse for your health than smoking.

Chris Kresser:  Yes.

Louis Francescutti:  I never thought I’d say that, but being lonely on a day-to-day basis is actually worse for your health than smoking. So there’s a lot of room for improvement. And thank goodness for guys like yourself and others that are out there, that understand we’ve got to approach this very differently. It’s not as if we have to spend more money, especially in the States.

Chris Kresser:  Right.

Louis Francescutti:  I mean, you guys spend more than enough money.

Chris Kresser:  Yeah, we spend $3 trillion a year. It’s a question of how that money is being deployed. Right?

Louis Francescutti:  That’s right. And so all these things combined made us say we’ve got to share this information with others. So Rob and I used to do talks together on safety for industry, and people would always say, “Well, you guys have got such great ideas. Why don’t you write a book?” And so, that’s where the genesis of the book came from.

How Social Media Contributes to the Epidemic of Depression and Loneliness

Chris Kresser:  Here we are. Yeah. Let’s dive a little deeper into depression and particularly, for adults as well, but also adolescents and teens. We’ve touched on it briefly, the impact that social media may have. I’d like to hear both of your take[s] on why you think depression is rising, and how that relates to the hardwired concept. And then the role that social media plays there.

Robert Barrett:  Okay.

Louis Francescutti:  Rob, you want to talk about Roseto?

Robert Barrett:  Yeah, sure. So, first of all, we all instinctively feel that the world is shifting beneath our feet. And it’s not just COVID[-19]. This predates COVID[-19]. The way that we communicate, the way that we interact, is getting faster. There’s more expected of us. And a lot of that happens on social media. So we see that social media, as we talked about, has this strong social comparison element to it. And if you think about rungs on a ladder, if you’re not on the top rung or you don’t perceive yourself to be on the top rung, then you’re somewhere less than where you think you should be. And for a lot of us, that’s not satisfying. And it tends to create anxiety and an expectation that we should do better compared to our peers. And everybody on social media is putting their best foot forward and we’re constantly comparing ourselves. And that causes, in itself, a lot of anxiety.

Now, we’re on a lot of that social media; we’re on our phones all the time. And Louis mentioned Roseto, and that is a community that was studied in depth that was in Pennsylvania, where they had a near absence of coronary heart disease. And it was a total anomaly trying to figure out why this was the case. And it was a community of Italian immigrants that had really hard jobs working in a mining sector. They lived hard, they worked hard, [and] their diets weren’t especially great. They drank copious amounts of wine, the whole bit, and yet they had this great cardiac profile. And, after much study, the conclusion was that it was the sense of community that really helped alleviate that stress level, that anxiety, and potentially depression. And I think we all inherently understand that.

If our community, and this may go back as well to our evolutionary history, if we sense that our community has our back, that we are able to rely on them when times are tough, it feels good, it feels good to us, and it lowers our stress levels. If we’re feeling that we’re out there in the wind all by ourselves, and we’re worrying about tomorrow every day, that’s anxiety-inducing. So that was the case with Roseto. They had this sense of strong community, they looked after each other, and it lowered their stress and anxiety. The opposite is happening on social media. Now the book is much more than social media. But that is one of, obviously, the leading ways that we see that our world is rapidly changing around us.

Chris Kresser:  Right. So, Louis, you mentioned loneliness, and I’m familiar. I actually covered perhaps the study you were referring to, in my first book. It’s more dangerous than smoking 15 cigarettes a day, having [a] high [body mass index] (BMI), a whole bunch of other risk factors that we would typically think would be much more serious. And there’s just been more and more research pointing in that direction since then, and I think the average American now has less than one confidant or person that they can feel like they can confide in.

I’m curious what you guys think about the influence of social media on loneliness across all age groups. Because on the one hand, on the surface, maybe if you don’t look too deeply, you could say, oh now we have the capacity to like make connections with hundreds or thousands of people. Whereas in a Paleolithic environment, it might have been 70 to 100 people total that we would ever know in our lifetime. So how could that contribute to loneliness? But there’s a little bit more to the story, isn’t there?

Louis Francescutti:  Yeah, we all know that it takes about 40 adults to raise a child properly. And if you look back, that’s exactly what extended families had, about 40. And then Robert Putman wrote that book, Bowling Alone, [which] started warning us that we don’t want to do things together anymore. And I don’t think people notice that book and the importance of it. And then, we do a chapter in the book on happiness, because happiness is something that everyone is striving for. But if happiness was 100 percent, what is it? Fifty percent of it is genetic. You either have it or you don’t. So you can’t do much about that. You can only get about 10 percent happier by being wealthy or having stuff. And I always worried about people that need to have a lot of brands around them like Louis Vuitton, Gucci, BMW, Mercedes, Montblanc, because you’re not buying those things for yourself, you’re buying them for others. So others look at you, and, like Rob said, think that you’re important.

All you have to do is travel around the world. And after you meet somebody for the very first time and you talk about the weather, what’s the first thing that they ask about you? They want to know what you do for a living, and by that, they establish what social status you have and whether they want to talk to you or not. But your listeners should know that there’s something immediately in their control that can make them 40 percent happier, four zero percent happier. And that’s volunteering. And the reason it is, is because volunteering then puts you in contact, like you said, with real people, with real lives, and then you can connect with them. And it gives you a feeling of doing something, and you get these immediate benefits. I still volunteer. And actually, yesterday, I was volunteering for a palliative care residence that we created. In the last two years, we raised $16 million, opened a 12-bed freestanding unit. Anyone can go in there free of charge and have the best experience for their last days. And I’m helping them set up a program. And I’m doing it all for free.

And you know what? When I left there, I was going, “Man, that made me feel good.” And so, if your listeners have not volunteered, get them to volunteer and they’ll see this immediate sense of, wow, that feels good. And that feel[ing] good is what then builds into other things—making them healthier, reducing stress in their life or reducing inflammation, and the list just goes on and on.

Finding Meaning and Purpose in Your Life

Chris Kresser:  You touched on something with volunteering, of course, that I’d love to know if you both have looked into in any depth, which is meaning. One of my favorite books ever is Viktor Frankl’s Man’s Search for Meaning, and I’m familiar with some research on meaning and the relationship between meaning or lack of meaning and mental health and behavioral health. I’m wondering how that figures into your work if it does.

Louis Francescutti:  Well, I can summarize that with this one beautiful saying that somebody taught me a long time ago, was the two most important days of your life are the day you’re born and the day you figure out why. So the sooner people can figure out why they were put here on earth and start living that dream, the sooner they’re going to be a complete individual.

So, this isn’t just platitudes. Rob and I live this stuff, and I have a lot of folks that I mentor. And once they start putting these pieces into place, it’s like, oh my gosh, is it really that simple? And once you have your base of Maslow’s hierarchy of needs met, yes, it is really that simple. We just have to regain that sense of purpose. And I’m really, really, really hopeful that after [the] COVID[-19 pandemic], just like after the plague they went through [in] the Renaissance, we’re going to be going through a period that baby boomers are going to say, “Wow, I’ve got to do something different with my life.” Baby boomers now are retiring, they have time, energy, money, experience. And if we can get this generation to really collectively decide it’s time to do something for each other, I think there’s going to be great things happening as we come out of COVID[-19]. I feel very positive and energized by it all.

Risk Tolerance and COVID-19

Chris Kresser:  I’m happy to hear that. So I want to shift gears a little bit and talk about some broader factors. One that’s particularly relevant to COVID[-19] and I think where we are [at] this moment in time with COVID[-19], specifically, which is risk homeostasis, risk tolerance, and how we think about and evaluate risk. We’re at this point now, where there’s, I see a broad distinction between two different approaches or proposed approaches to navigating the next stage of this pandemic, one of which might be referred to as zero COVID, the goal to drive down cases to zero and basically do whatever is necessary to make that happen. And I would submit an example of this as the policy by the municipality of Peel, which I believe is near Toronto in Canada.

Robert Barrett:  Yes.

Louis Francescutti:  Yep.

Chris Kresser:  You guys are Canadian, right? [This policy] was recommending that even young children at the daycare age, if they were exposed to COVID[-19], be physically isolated in their bedrooms with no contact with anybody else in the household as a way of reducing transmission.

And then you have a different approach [to] harm reduction strategy, which is more aimed at reducing the overall amount of harm that could be caused by COVID[-19]. And that’s not just reducing cases, but that’s also looking at other harms, like social isolation and economic harms, and things like that. And it seems to me that that’s really the crux of it at this point. But that human, I don’t know whether this is an innate trait. This is what I want your opinion on. Or whether it’s societal or where we are in time, but we’re really not good at evaluating [the] risk of COVID[-19] and then contextualizing that, versus other risks that we take on a regular basis.

So I’m just curious because I know you both, you’ve written about risk homeostasis and this idea in your book. So I’m curious about your thoughts on that?

Robert Barrett:  Well, I’ll start out on that one and then I’ll maybe let Louis talk about some of the interventions with COVID[-19] at the societal level. First of all, risk homeostasis. And I imagine your listeners are quite converse with some of these terms. But in case they’re not, we’re talking homeostasis, of course, meaning the ability to maintain that proper equilibrium.

So when we talk about it in the book, and there are many ways, of course, to understand why we do the things that we do and how we make those risk judgments. But the one that we tended to prefer and talk about was the risk homeostasis, which is the sense that if you are in an environment where you sense that it is not very risky, then you adjust your behavior to be slightly more aggressive and to take more risk. And that brings you back up into a kind of a happy zone for risk. And conversely, say, if you’re driving your car and it’s a snowstorm, and you can’t see very well, you’re going to adjust your behavior back and make it more conservative in a sense that you are going to reduce that risk level back into your happy place. So your behavior then is changing that risk so that you’re happy with that.

So that’s part of the equation. And we see that happening over and over. We give lots of examples in the book about how that plays out in our day-to-day lives. But the other side of the equation, which is really interesting, and if we get into some of the judgments that we make on COVID[-19], is how we’re getting the information today. And not to go back to the media all the time, but in the book, we talk about the fact that if you have the internet, you have at your fingertips tens of thousands of articles that have to do with medicine. For example, how to live a better life, but yet we often default to what somebody said on Twitter. Perhaps a celebrity said something about a diet, [and] we jump on this. So it’s also how we get our information. We’re not going through and reading all of these abstracts to try to make an informed decision on the risk that we take in our lives and the behavior. We’re getting this from little sound bites. And that’s part of the danger in terms of how we decide to make judgments on handling big things like COVID[-19].

And in Canada, for example, we’ve seen a lot of the decisions that have to do, that come down to what is the public thinking about this? Or is the public concerned right now about this? Well, let’s steer the policy to make sure that that is part of our policy platform. Now the public may not be necessarily getting all of their information from the best sources. And so that’s part of the equation, as well. So I’ll let Louis round out the answer on that one again.

Louis Francescutti:  Yeah. Chris, I think your listeners just need to Google Taiwan in the number of cases of COVID[-19] deaths in Taiwan. I’m finding there [are] nine deaths and 955 cases. The [United States] has got like 29 million cases and half a million deaths.

Chris Kresser:  Yes.

Louis Francescutti:  So risk assessment. When [severe acute respiratory syndrome] (SARS) showed up, Taiwan listened very carefully to what the scientists were saying about how to handle the next pandemic. And the moment they got wind [of] that from Wuhan, which they had dozens of daily flights going from Taiwan to the epicenter of the pandemic, they were able to activate a system that was based on risk assessment and control it so that Taiwan society today is operating normally. And the figures speak for themselves.

So that’s why I said earlier, it’s not as if we need more money to solve these problems. What we need is a new kind of thinking and what we need is some leaders that are not only visionary, but they’re innovators and willing to take risks. It’s 2021; we have all the answers as to what we need to do. We just don’t have the willingness, unfortunately, to do it. So that’s why we appreciate the opportunity to challenge people to think differently than the way they’ve been thinking up to now.

Robert Barrett:  I’ll add one thing to there, as well. We see this, and Louis mentioned that we’ve done work on the safety world, as well. In the safety world, in the conflict world, and in the health world, prevention is tough, and it seems to be a tough sell. And it shouldn’t be. It shouldn’t be a tough sell. And Louis talks about thinking differently. So right now, and this speaks [to] much of your work, as well, Chris, we should be spending much more of our effort into primary prevention. But we spend so much of it in secondary and third, where we are detecting a disease, and then we’re trying to manage [the] disease.

But can we do something before we even have to detect the disease? Can we do something at the prevention level? And that is part of our risk assessment. It’s a huge part of it. And whether you’re in the safety world, or whether you’re in the health world, or the conflict mitigation world, those are tough. And we have to do a better job at trying to figure out how to make that a viable sell and sell that to people.

Louis Francescutti:  I always try [to] tell politicians just remember three numbers: three, four, and 50. Three risk factors, smoking, inactivity, and poor nutrition, contribute to four major diseases, certain cancers, diabetes, respiratory illnesses, and cardiovascular illness. And that accounts for 50 percent, five zero percent of the total health burden. And [in] any given year in North America, it’s only about 5 or 6 percent of the population that’s consuming 65 percent of resources. So it’s not as if we don’t know what to do, we just need to do it.

Humans Are Hardwired: Information Is Not Enough To Change Behaviors

Chris Kresser:  Well, this is why I have become so interested in health coaching as a modality. Because information is not enough to change behavior. We know that now or we should know it now. We have about 6 percent of people who follow the top five health behaviors that have been identified by the CDC on a regular basis. And it’s not because people don’t know that they shouldn’t be smoking or they shouldn’t be drinking excessively, or they shouldn’t be eating highly processed and refined foods, it’s that that knowledge is not enough to change behavior. And I think, again, this goes right back to your hypothesis hardwired.

So what’s happening here? And given, if we accept that premise, that it’s not about information, it’s about overcoming this hardwiring that, again, protected our survival in a natural, in an ancestral environment, but is actively harming it today. What is the way forward if it’s not just information?

Louis Francescutti:  Well, I think that we’ve got to look at soda drinks and junk food as the equivalent of the cigarette when we discovered just how bad cigarettes were for us. There’s an industry out there that has figured out every last possible combination for salt, fat, and sugar, and we’ve fallen for it. And what we need to do is understand that we have to approach it, similar to how we approached tobacco and tobacco companies. There’s a lot of people out there that are addicted to disease, and the more disease, the better. And so, what we need to do is break that addiction to disease. And that’s why we dedicated a whole chapter to how dangerous hospitals were, to try and get people to realize you really don’t want to go to a hospital unless you absolutely have to. Rob can talk about just how dangerous hospitals are. I’ve got to be careful talking about it working in one.

Chris Kresser:  Yeah, bite the hand that feeds you.

Louis Francescutti:  Yeah, it’s probably best that Rob talk[s] about it. But I can tell you, these accredited facilities are killing people. So that talks to you about accreditation and the value of it, right?

Chris Kresser:  Yeah.

Robert Barrett:  I think just to answer or to add to what Louis was saying, too, with the last one is that yeah, you look at, obviously, the sugar industry and pushing all the simple sugars. But the idea that, maybe it’s a question for all of us, too, if the hardwiring is so powerful, which is what Louis and I have written throughout the book, then, as you say, how do you overcome it? And I guess, what we said in the book, too, is that the idea that you can just simply overcome this, it may be naive, actually, because we are pushing against millions of years of evolutionary history, and it’s so strong.

So, as Louis mentioned, we almost need patches or that updated software patch, to get around it. And that’s what we put in the last chapter we talked about. And Louis mentioned it, as well, coming out of the black plague was the Renaissance and the idea that you can feed this hardwiring in a positive way. And so this gets into flipping the conversation around from avoidance of bad things to how do we feed our hardwiring in a positive way? And I think that’s a really important question.

So we looked at the Renaissance and say, hey, there’s amazing art, science, philosophy, medicine breakthroughs at a time, and life was improving dramatically. And it was feeding our hardwiring. And all that dopamine that we would get from all that bad stuff is actually being fed in a positive way, as well. And we’ve seen this with athletes. I have an athletic background, too, where there is this, almost an insufferable discipline to get through these workouts. But then on the flip side, there is an allowance for [a] reward that alleviates some of the willpower that took for them to get through that in the first place. And that replenishes that gas tank and allows them to then do another one of these grueling workouts. So it’s about understanding our evolutionary hardwiring in it to the degree that we can work with it instead of against it. And I think that’s part of the core message for us, as well.

Chris Kresser:  Yeah, that’s definitely what we focus on in our health coach training program is how to understand our hardwiring and our behavioral biases. It’s almost like an Aikido approach like you’re talking about. Not to oppose force with force, but to learn to flow with it and redirect it in more positive directions. I think that’s really the only hope that we have. Because if you, as almost anybody who’s ever followed a very calorie-restricted diet, or any kind of thing that goes directly against our evolutionary programming, you can do it for varying lengths of time, depending on your willpower, but it’s not going to be a long-term solution. And as you pointed out, willpower is a limited resource, and it tends to decline with stress and other things. So if we try to set up the solution to the problem as just being more willpower, more effort, we’re pretty much doomed to fail.

Robert Barrett:  Totally agree. Absolutely.

Protecting the Health of Children

Chris Kresser:  So I want to talk a little bit for just the remaining few minutes that we have about children’s health. I’m quite concerned, as I’m sure both of you are, with the impact that the pandemic is having both in the immediate term and also in the immediate to longer-term on kids. We were already arguably experiencing an epidemic of behavioral and mental health disorders in kids. There are more prescriptions for antipsychotic medications than there are people in the [United States]. One in 10 Americans overall [are] taking antidepressants. Lots and lots of kids. A growing number of kids are being prescribed medication for behavioral and mental health disorders. And now we’re in a situation where many kids are doing school online with Zoom. They’re isolated from their peers and they’re not getting outside and getting exercise like they normally would. So let’s talk a little bit about both the longer-term issue with kids and then how COVID[-19] is contributing to this and maybe some things that parents might consider as a way of protecting the health of their children.

Louis Francescutti:  Well, I can start and Rob can wrap up on this one. Just to say a few things. So parents should know that pediatric societies around the world, I really warn parents not to introduce any sort of electronic gadgetry before the age of two. So between 18 and 24 months should be the limit of when you can introduce gadgets. And I see it, unfortunately, with kids in our emergency department that are screaming, and then you have parents pull out these devices and the kids become fixated and almost entranced by them.

The other thing is, you’ve got to make absolutely sure that you’re spending the time with kids. If you’re going to have kids, you need to spend time with them. You need to read, you need to show them stuff, you need to go around, you need to have downtime, you need to make sure that they get outside in nature, you need to make sure that they’re properly nourished and protected, and they’ve got those 40 important adults around their lives, as well. And we don’t do that, unfortunately. And so, I think we’re over-medicating our kids. I think we’re overdiagnosing our kids. And I think exposure at an early age is rewiring the circuitry of their brains. Most kids go to school, and you ask them at the end of the day, how was school? Boring. What did you learn? Nothing. Well, can it be that we have the same curriculum across the country that’s not meeting the needs of our kids?

I don’t know if you’ve heard of Indigo schools, but Indigo schools are schools that really aren’t schools and that allow children to learn by their inquisitiveness. And we’ve got to do a far better job in how we’re raising the next generation of kids. Because as a university professor, I can tell you, these kids are stressed to the max.

Robert Barrett:  Yeah, I’ll just finish off, onto what Louis was saying there. We looked at, in the book, we talk about some of the worst cases imaginable for stress for kids. Like growing up in a war, for example. So UNICEF says about one in 10 kids globally grows up in a conflict zone. We see this in Syria. So there are kids that have never known a day in their life without war.

So we look at those, we look at cases where kids have been taken from their homes, really high-stress stuff and how that affects the brain, and especially the development. That architecture that Louis was mentioning, where the brain starts developing from the bottom up towards the forebrain. So you’ve got that, the oldest part of that brain, the hindbrain, and then the midbrain and the forebrain. And that forebrain being the most human and advanced part of the brain in the sense that it develops late, and it’s where our decision-making and judgment is. But that gets interrupted, and Louis mentioned it actually can change the architecture and the functioning of parts of the brain where the kids get stuck in a fight-or-flight response because of the toxic stress environment.

Now, we don’t want to compare modern kids on screens to those who grew up in war, but the same parts of the brain are also being affected by very flashy screens. Screens that are moving. Where the imagery on the screen is moving at a pace that is much faster than real life and the brain is struggling, the young brain is struggling to make sense and keep up with this strange world on the screen, and they get stuck in this kind of fight-or-flight response. And what we see in kids that have grown up in conflict zones is that it can affect them for their whole life. So 60 years later, they can have even their stature, their height can be affected. All sorts of parameters that, and metrics of health can be affected, as well. So this is a big problem that we have to deal with. Now we throw on top of that, what’s happening in teens and adolescents with the way that we communicate on social media and how important it is to have that social comparison. It’s even changing the way that we communicate.

So if you have a face-to-face conversation, there’s a fairly high percentage of that conversation where you are actually genuinely interested in what the person has to say to you about themselves. So you have that exchange, and that is how we have been for millions of years with the way that we communicate. On social media, which is becoming a primary way of communicating, as you say, Chris, especially during [the] COVID[-19 pandemic] for kids, now that two-way conversation changes to where it’s about 80 percent me and about 20 percent you. And again, that starts to exaggerate the way that we communicate, the importance of the self and how we communicate, and it’s actually damaging the ability for us to communicate with each other in a proper and functioning environment.

So these are also going to be playing out in the long-term, and we have to get our arms around this and be able to manage it more effectively.

Louis Francescutti:  I just want to add one thing. You can correlate the number of adverse childhood experiences with problems of adults later on in life. And in the emergency department, I don’t have to ask too many questions to find out why adults are there. I probe back and find out how many bad adverse childhood experiences they had. And there’s a direct correlation between the two, and we’re not talking enough about that. Fraser Mustard, a Canadian physician, [had] been talking about this. He’s gone now, but [he’d] been talking about this for years. And yet, policymakers don’t understand this notion that what happens to a child early in their life is going to have an impact on them when they’re an adult.

Chris Kresser:  Yes. And even in utero now, we know that it extends back that far.

Louis Francescutti:  Absolutely, at the genesis.

Chris Kresser:   And generations back. Doctors Barrett and Francescutti, it’s been a pleasure to have you on the show. This is really a fascinating conversation. I know the listeners will really appreciate it. So the book is called Hardwired: How Our Instincts to Be Healthy Are Making Us Sick. It’s on Amazon. Anything else? Any other places [where] listeners can go to learn more about you guys and your work?

Robert Barrett:  Our websites. So Louis’ website is www.DrLou.ca, and mine is www.DrRobertBarrett.com.

Louis Francescutti:  And that’s doctor, Dr.

Robert Barrett:  Yeah, yes.

Chris Kresser:  Great.

Louis Francescutti:  Thanks, Chris.

Chris Kresser:  And thanks, everyone, for listening. Keep sending your questions in [to] ChrisKresser.com/podcastquestion, and we’ll talk to you next time.