 Thank you, Kev. Well, good afternoon. All right. Well, I wanted to share with you a presentation entitled, What is optimal health? Complexity science, chaos theory, and its impact on ancestral health. Can everyone hear me? Good. All right. My disclaimer is that these comments and statements in no way reflect my employer. So that is my disclaimer that they're practicing MD and I think the other MDs in the audience can relate. But just a little bit of background about me. I'm a park surgeon and on a day-to-day basis I take care of some very sick people and have the opportunity to help them get better. And this is kind of a typical day of taking someone who's either in the emergency room or an intensive care unit very sick has a lot of medical problems taking the operating room doing some heart surgery and fixing them up and then watching them get better. The intuitive question is why me and why am I here? I over the last several years have really gravitated towards the ancestral health program and information and I really found it helpful. And so last year I took the opportunity to present and talked a little bit about the tough road that physicians have in that there are medical guidelines that we have that recommend certain ways to recommend advice to our patients and then there's some emerging data that we're all experiencing here at this type of conference that is fascinating and wonderful and excellent but hasn't quite made it to the clinic yet. And so I talked a little bit about how inflammation has been an important driver of atherosclerosis and how the inflammatory markers and proteins in the cells are very similar to the atherosclerotic proteins in the cells and there's probably a crossover there and how the ancestral diet does decrease biomarkers for inflammation and that could and probably will and does decrease and deflect the heart disease risk to a much lower state. This year I wanted to change and use a different topic or tackle a different topic and this is a kind of a big question is what is optimal health because if you go to different groups or different physicians or different people and ask them what does it mean to be healthy or oftenly healthy you're going to get different answers. So for example if you go to a conference of vegans for example and ask them what optimal health is their answer in their road path to that is going to be different than going to a different type of group. And so the other question is if we have optimal health how do we know it when we see it? Is it possible to even quantify or measure truly optimal health? How do we measure it and how do we achieve it? Those are some of the questions that I'm going to address today but at the end of the day when we're talking about an ancestral health program or ancestral health diet there's three components that really make up the ancestral health program and I think that everyone in this room would appreciate there may be different variations and various different takes but it does involve three things change in diet exercise or movement sleep or relaxation and so I think all those three components are necessary to really have a successful and ancestral health program and you can see here that obviously there are a lot of different variables that go into optimizing each of those individual categories. So the question is inherently what does ancestral health have to do with chaos theory and likewise what does chaos theory have to do with ancestral health? Well I hope by the end of this talk that you'll agree with me that there is a very important contributor to the ancestral health program from chaos theory. Well we all think of chaos in many different ways and sometimes we think of chaos as a bad thing but hopefully by the end of this talk we'll end up thinking of chaos as actually a good thing. It was really introduced into the vernacular so to speak in 1988 with this book about the first introduction to chaos theory and some quotes from that are that alongside relativity and quantum mechanics it is being hailed as a 20th century third revolution and we got introduced to this concept that sounds a little bit fanciful but it actually is somewhat relevant. It's called the butterfly effect. This effect grants the power to cause a hurricane in China to a butterfly slapping its wings in New Mexico. That sounds somewhat fanciful but it's not. It actually is compliant with the chaos theory and many things that we'll talk about today. So the intent behind the butterfly effect is that small changes in initial conditions can lead to a drastic result depending on the starting conditions. And for this talk and in preparation for this lecture I really had some inspiration from these really wonderful I think excellent books so first one is where medicine went wrong by Bruce West and I'll talk a little bit about that and use some of the references and complexity in medicine the elephant in the waiting room. If anyone has any more interest in this I really encourage you look up these resources and references they are fantastic they're well written they're easy to understand but they really address a situation that not a lot of people are talking about. As we've heard this morning Archive Amy has been a proponent of this and I also drew inspiration and information from the new evolution diet and obviously in the scene with our speaker this morning I also used him as an inspiration although I've got a little bit of a different take on it than he does. So as we get into this material I want to begin with a foundational principle. The foundational principles were pretty much laid out by Stephen Jay Gould in this book called Full House and in that book his whole thesis was that the human mind has a trusty device for simplifying a complex world. We reduce the averages and identify trends so we take all this complexity and we try to make it simple and sometimes we fool ourselves but that's in our inherent nature and Stephen Jay Gould also said our culture encodes a strong bias either to neglect or ignore variation. We tend to focus instead on measures of central tendency and as a result we make some terrible mistakes often with considerable practical import. So really that quote about ignoring variation is really important because chaos theory and complexity science is all about variation and many of you have heard or seen or know about practice. Well, fractals are very interesting. They're an iterative pattern of nesting sequences with self-similarity. So if you could basically within this fractal here any point in the fractal is similar to the larger nature of the fractal and that's kind of the definition of fractal. But the human body is actually one big fractal and there's something called fractal anatomy. If you look at all the blood vessels in the body and whether they branch and divide and change size all throughout the body that is truly a fractal pattern. Likewise, you can take any other organ system in the body, the brain, the liver, the kidney, everything in the body organizing itself in a fractal anatomy pattern. And to me that's a big clue or tip-off that there's something going on that is in connection with this fractal situation. And so I want to spend a couple minutes here talking about heart rate and this is where I think some really important information has been done and I think there's a lot more work to be done in this area. So I want to talk about this article briefly called Heart Rate Variability and it is fantastic. So I want to introduce this concept of heart rate variability. So when we come in and see a patient in the clinic we get an EKG. EKG prints out a page of heart rate, heart rhythm and we look at the rhythm of the heart. And on there it says normal sinus rhythm, atrial fibrillation, it tells you the rhythm and you look at it and everything is spaced out pretty regularly in normal sinus rhythm. But if you could actually drill down and look at the actual rate of the heart rate, even the chaotic pattern of the heart rate. So I think it's really unnerving at some level to think that your heart beating at what you perceive as a normal rate is actually beating at a periodically irregular rate. And so we call this a healthy complexity. So this complexity to the heart rate actually is the state of affairs and is a state of health and is a measure of health. And in fact, when you see how this heart rate can change, the heart rate variability, it can break down in two different ways. The first is that the heart rate heart rate variability can actually decrease. So think about that. You've got decreased heart rate variability, and that is a marker or sign of illness or health or disease. The other way that the heart rate variability can break down is it can become completely chaotic, have no organized structure whatsoever, and have complete wild fluctuations. And that's another breakdown in a sign of illness or disease. And the study that I referenced earlier here is talking about heart rate variability in athletes or in trained individuals is very interesting because this table shows that it compares people that have been trained with aerobic activities versus untrained individuals or control groups. And you could see that the people that had that participated in exercise and were trained individuals had greater heart rate variability than those that were in the control group. So this is an indicator that exercise and movement and fitness is actually a driver of increased heart rate variability in a good way. So in fact, when we're doing exercises and training, we're actually training the heart rate and training the nervous system to be more irregular. Another interesting fact about the heart rate variability is that there's a natural decline of the heart rate variability with ages. So there is a loss of chaos with aging to the heart rate variability as we age. So an older individual inherently has a more organized or less chaotic heart rate variability than someone who jumped. And that raises the question. Think about all those people out there with pacemakers in the medical device industry, those pacemakers are sending out constant electrical impulses to the heart. So perhaps we need to be thinking about reprogramming those pacemakers or redesigning those pacemakers to actually have some degree of chaotic variability, or else we're actually training the heart to become disease by sending out a constant pulse. This is the thought. Well, this is really interesting. But but is this something that's super specialized? Well, no, this is actually can be done by anyone, non professional people. There are actually devices and applications out there that are non medical affiliated that you can get to actually measure your heart rate variability. And I don't have any ownership or interest in any of these. So I'm not promoting anything. I'm just sharing that, for example, you can actually plug in a on your heart rate monitor strap, and you can plug in with your app, and you can actually every day assess your own heart rate variability. And you need a baseline about two weeks of information to take your heart rate and reading every day at the same time, the same conditions, and you have your baseline. And then every morning that you get up or whatever time you choose to do it, you actually measure your heart rate variability, you can assess, is this a good day from a heart rate variability or a bad day from a heart rate variability? And you can tell based off of that, perhaps how you might change things in your lifestyle that day to compensate or address that change or decompensation of the variability. Here's another one called BioForce HRV, heart rate variability. So there are a number of commercial products available for the quantified self movement, so to speak. And I encourage anyone who has interest in this to try this. And there's a lot of people out there, you know, doing the experiments and a one out there. And I think it would be interesting to really do some more work with this and get some experience. Well, I don't want to get too far off the track, but futuristically, the potential exists to remotely monitor soldiers or military in the field by wearing special monitors to monitor their heart rate variability. And that could be an early sign that they're in stress, that they're in trouble, or that they have sustained an injury that not yet has been detected. And so this is a way that will be implemented with a heart rate variability. And for any of you who know Eric Cofill, he's been very prominent in talking about smart band-aids, and they are literally EKG monitors that you can wear on your skin with just a piece of a adhesive tape. And through these monitors, you can actually monitor heart rate. And so I think as we begin to quantify and find ways to measure the heart rate, we're going to be studying heart rate variability in greater detail. So it talks a little bit about heart rate variability and exercise. And in fact, I will say that professional athletes are using this and teams are using this to assess training of their athletes. So they will every day have their athletes assessed for heart rate variability. And if their heart rate variability is changed, they will change their training program to make sure that they're not over-trained. And this is something that's really being implemented. But we have a long way to go. This is not something that's in the clinic. It's not something that your physician, cardiologist, or specialist would actually use in the clinic. It's actually starting to get some traction outside of the clinic and will work its way in. What about diet? Can diet affect heart rate variability? That's the next question. And the answer is yes. And here's a paper that did a review article looking at Omega 3 fatty acids supplementation and heart rate variability. And in this paper, they proposed that the theory or the sequence is that Omega 3 fatty acids may modulate the automatic control of the heart, autonomic control of the heart. And we know that Omega 3 fatty acids are funded in the brain and nervous tissue as well as in cardiac tissues. And studies have demonstrated a positive association between cellular content of the Omega 3 fatty acids and heart rate variability. And supplementation with part of Omega 3 fatty acids seems to increase heart rate variability. Remember, if what we're looking to increase the heart rate variability, you do not want to decrease heart rate variability. That is a sign of illness and disease. And so we actually want to increase that. So by actually adding a particular dietary element, we can actually improve and increase the heart rate variability with a sign of health. And so this could be a possible explanation for a decreased risk of arrhythmic events and sudden cardiac death, which is sometimes observed after Omega 3 fatty acid supplementation. So yes, diet can affect heart rate variability. So we talked about exercise diet. What about sleep? Could sleep affect heart rate variability or could heart rate variability affect sleep, which came first, huh? And so there are a number of different articles. They're all small studies. So we're not talking about huge aggregate studies. We're talking about studies that say that, for example, this one is objective sleep quality and heart rate variability in human analysis patients. We did show that the quality of the sleep that the individuals have the night before did affect the heart rate variability the next day. And that was the only controlled variable study. Everything else kept the same. Here's another study. Reduced heart rate variability predicts poor sleep quality in a case control study of chronic to take syndrome. So this is the other side of the coin. So you've got decreased heart rate variability predicting that that night the individual is going to have a poor night's sleep because their heart rate variability gets declined, which is a marker of disease. So it could actually predict a lot of things. It's pretty interesting. And then finally, this is a little bit larger study, a heart rate variability sleep and sleep disorders once again showing that the quality of the health quality of the sleep can affect the health of the individual. So heart rate variability has, I think, a lot of interest, a lot of potential for helping us understand what is optimal health and healthfully giving us feedback on determining and living in health health and lifestyle. And this is part of the anticipatory medicine movement where a signal complexity can affect health and likewise health affect signal complexity. And this is not just about heart rate variability. Just in a little bit, you can look at many other ways of ordering and measuring health, such as a sleep apnea. Breathing patterns inherently are also chaotic, have the same breathing pattern variability that heart rate variability has. Likewise, brain waves are inherently chaotic in a macroscopic way. Also, gate patterns, measuring the patterns in which somebody lost is an indicator of chaos as well as chaos is reflected in a gate pattern. And the person that is discovered and really championed the heart rate variability said, we're developing and refining computational tools to pull useful information out of extremely complex data sets. So I think this is kind of the future where we're going. We've shown that that ancestral health does have a component in the chaos theory. And chaos theory may be one of the underlying components of our underlying health and physiology. And as I said about this fractal idea, we talked about fractal anatomy, every organ system in the body organizing itself in a fractal manner. We have all of our organ physiology, fractal breathing, fractal gait, fractal temperature, fractal neuron. All of them are architecturally are fractal and all of them are organized in a fractal pattern. So I'll start to wrap this up, but I want to start to finish up with this idea of a fractal gut. If you look at the way that the small bowel is organized in the body, you can see that it has a kind of a chaotic but rhythmic pattern to it. And you can see that histologically the dill eye in the small intestine are also organized in a fractal pattern very similar to the macro pattern of the small intestine. And when you look at someone who is gluten sensitive or sensitive to the effect of gluten or celiac disease, you can see they actually have a breakdown of this fractal pattern. You can see macroscopically you can see that the actual dill eye are dampened over here compared to a normal healthy dill eye. So once again it's a demonstration of loss of fractal, loss of chaos, loss of variability as a way of showing disease or representing disease. So I'm really interested and excited to explore that with you and I think we're out of time. So I will wrap it up so we have questions but I hope that we can explore this in the future. Thank you very much. All right. Thank you, Gerson. We're running a little bit behind him. We'll have a few questions so let's make them quick. Thanks for a great talk. A couple of things you mentioned, the postural issues, the sleep hygiene issues. I just wanted to mention that all in HRV disruptions shows up in very early childhood under the age of 5 and is flying way under the radar of most physicians. So it's just a comment. Thank you for sharing that. Another example of how important I think it will be. Yes. Could you speak to, I'm aware of heart rate variability and the work of the Institute of Heart Math and variability as it deals with stress and the smoothness of that. Could you say a few words about that in relationship if you could? Absolutely. That's another component. So as we talked about, we have exercise or movement, we have diet, we have sleep. But within the sleep or relaxation mode, we do have the heart math program and the heart rate variability associated with stress and mindfulness and medication. And those are just manifestations of disruption of the autonomic nervous system when you've got stress. And it's another way that we need to help control and monitor the heart rate variability. But it's not just about taking stress out of your life. It can be the other factors as well. Exercise, diet, sleep. So a lot of people think that if they take out the stress, then everything else is going to be okay. But I'm trying to show, obviously, that it takes a lot more than that. But it's a good point about the mindfulness as well. Thank you. You showed that decreased HRV associated with a disease state. But do we know for a fact that it's necessarily good to increase HRV in a seemingly otherwise healthy person? Could there be some limit on which it becomes detrimental? Yes. So that's where the over-training aspect is. That's a great question. So here, obviously, is a threshold or limit to which you want to get the HRV as to. But it really becomes a baseline, individual, interdependent. So that's where the professional athletes will check out their heart rate variability every day. And so if there's an over-training. So yes, you don't want to push yourself or train too much and then you have too much heart rate variability and then you have a problem. So absolutely that's something that's... I just wanted to ask about entropy. So you say that the HRV decreases as people age. So is that just a function of increased entropy? Or is there something else going on that is actually just a normal biological process that is... like what in the aging process is causing that? Is it an increased entropy? Is it essentially decrease in total energy? Like whatever that is defined as biologically? That's a great question. And we don't know the answer to that. The answer is not in the literature. That's obviously an area that we need to do a lot more research on. But we do know that we can see somebody when they're ill. They have a loss of heart rate variability. So that illness for that individual is not necessarily a loss of their total energy. It's just that it's a marker of their illness. So by that natural entropy over time with aging process, you think that chaos is necessary for health and that by losing that chaos over time is a sign of the manifestation of the multi-complex thing of the day. Okay, we're going to wrap up and move on to the next one. Thank you for running all the way. Thank you.