9. Avoid carbs (carbohydrates). Diet matters!

One of the ironies of Emergency Medicine is that although you see the entire spectrum of human natural history, people from all social status and walks of life, the folks with less and less of everything are overly represented in the ED. The exception being the body mass index of, simply put, fatness. The proportion of ED patients with morbid obesity is greatly increased in the ED thus the hint about diet. 

Simply stated, our modern lifestyle is at odds with our evolutionally adapted biochemistry and physiology. Times have changed–our bodies not so much. So much of the common ED complaints are related to being overweight, diabetes and thus to diet, and it is the carbs in the diet that are the root of the problem–excess calories without much satiety leads to gross overeating, and a cascade of growing metabolic and physiologic problems.

As an example, picture yourself as a pre-agriculturalist (before agriculture) living your days just north of the rift valley. The migration has begun. You awake hungry from a skimpy dinner and wonder where you will get the next meal. Not much left over from last night so you go out and start searching: roots, berries, greens, small game, fish, insects, grubs, nuts, fungi, dead animals, whatever... things not in the contents of our modern store-purchased diet or the preferred diet as advertised on television. So, you keep walking and looking and eating what is available.

The metabolic diseases of modernity are just the result of the current society’s menu. Avoid the carbs and the weight and spare yourself a whole lot of problems: obesity, metabolic syndrome, diabetes, hypertension, joint problems, heart disease, depressions. Also, walking, bending, going to bed early and arising early all have salutary health benefits.