In our daily lives, most of the actions we carry out go against biology. The human body is not designed to spend eight hours a day sitting in front of a screen, consume more than 2,000 calories, and sleep less than seven hours each day. "Our culture and the economic drive of the Western world have led people to a set of norms that unfortunately do not lead to an optimal cellular state. In other words, we are destroying ourselves from within without realizing it. Modern life does not support the ends of biology."
Casey Means, who utters these words, knows it well. And not only because she graduated with honors from Stanford University School of Medicine and completed her specialization in Head and Neck Surgery at Oregon Health and Science University, but also because of the pace of life she led in that chapter of her life: "I worked over 80 hours a week. I did two or three night shifts at the hospital. I lived under profound stress with life-or-death surgeries. I would arrive and leave at night. I barely saw the sunlight. I didn't exercise. I ate at the school or hospital cafeteria..."
These were routines that were undermining her health. Habits that, if we stop to analyze them, are shared by the vast majority of society. Until a scare comes, and you go to the doctor... or several. "I went to the gastroenterologist for irritable bowel syndrome. To the psychologist for depression. To the dermatologist for acne. To the orthopedist for chronic neck pain."
The solution for each of them was to set up a medicine cabinet. "Seriously? That couldn't be the remedy," Means recalls. "I went from being healthy to being a sick medical student. Why was the answer to take a pill instead of simply changing my life to what really kept me healthy?"
That was part of the germ that years later would become "The good energy", an essay that condenses all her conclusions into a kind of self-help book focused on preventive medicine. "My experiences, the pancreatic cancer that took my mother, my patients, and all the science I have delved into in a new and different way are the result that I capture in the book," she says.
Means lost her mother to a pancreatic tumor in just six months. "It was devastating." And she pauses to recall how things unfolded: "Before the diagnosis, my mother spent over 20 years going from one doctor to another because something was wrong... She had two medical children and access to top specialists. If you go to five different doctors in a month, you think you are doing things right for your health. And it wasn't enough."
"I went from being healthy to being a sick medical student. Why was the answer to take a pill instead of simply changing my life to what really kept me healthy?"
Here, the surgeon raises a complaint, not only for her mother but because she embodies the example of that "siloed" medicine: large specialists who see the body as puzzle pieces but do nothing to fit them together. Nowadays, little by little, this is changing thanks to multidisciplinarity: medical teams formed by different specialists, as is increasingly common in cancer, where oncologists, radiologists, pathologists, and surgeons, among others, discuss decisions for each clinical case, patient by patient. "Here you have someone [her mother] who has been concerned about her health for 20 years, but no one has been putting the pieces together. In fact, the system is designed to actively keep them separate."
Fighting and achieving an almost 180-degree turn is complicated. And even more so in health. But she has sought ways to start and make her message of prevention and fighting for public health reach further. Means is behind Make America Healthy Again (MAHA), the equivalent of Make America Great Again (MAGA) that brought Donald Trump to the White House. "There is an incredible grassroots movement that supported Robert F. Kennedy Jr. to become the Secretary of Health and Human Services of the United States, which is one of the largest government organizations with the most important budget," she says. "MAHA seeks to promote everything I gather in The good energy in terms of holistic and preventive health. And, above all - she emphasizes - changing incentives to promote health in the US."
Objective: change US public health policies
Means details all the work ahead for Kennedy Jr.: "He will work with the National Institutes of Health, the Centers for Disease Control and Prevention, the FDA (which regulates food and drugs), and other divisions. With a leadership truly focused on root causes, there is enormous potential to make a change in the next four years."
Among the main changes that the surgeon points out is the "perverse" relationship between food industry lobbies and healthcare administration. And here, Means doesn't hold back: "We should not allow processed food companies to pay the people who create dietary guidelines." And she justifies her statement. "Every five years, the US publishes the dietary guidelines from the USDA, which dictates what constitutes a healthy diet. In the last round of guidelines, 19 out of 20 members of the advisory committee had conflicts of interest with the processed food industry." A blatant case that "we should not allow." "It only leads to headlines and articles saying that a diet full of ultra-processed foods would be healthy, which is not true. These lead to chronic diseases and obesity."
But she doesn't stop there. She also targets criticism at agrochemical companies. "There is confusion about whether genetically modified foods are better. There is a lot of money flowing between the government and these big companies, like Monsanto, China Chem, and Syngenta. The first thing to do is to eliminate the conflict of interest between scientific health and the government. The second, and similarly, with the National Institutes of Health, which funds scientific research here with billions of dollars and its purpose is to help create a healthy America."
"Many of our cheapest products are unhealthy. How is it possible that taking 15 ingredients, putting them together in a factory, packaging them, and shipping them is cheaper than a piece of fruit?"
Means ensures that "since 2012, there have been over 8,000 significant conflicts of interest" between researchers funded by the NIH and the industry. "It is a big problem because ultimately, the client of the NIH should be the American population, but in reality, it is the industry that pays these researchers," she says.
All this leads to the fact that eating healthy is expensive today. "Many of our cheapest products are unhealthy. How is it possible that taking 15 ingredients, putting them together in a factory, packaging them, and shipping them is cheaper than a piece of fruit?" she wonders. "The reason is purely political." Here she provides a figure that illustrates it: less than 1% of the agricultural bill, which is the law that subsidized these farmers, is allocated to organic Whole Foods.
A book full of advice to avoid the pitfalls of poor health
Means' book, halfway between an essay and a compendium of tips to regain energy, is sprinkled with these types of notes that underline the drift of public health that has neglected prevention. "The miracle of modern medicine was the drugs that help against infectious diseases, but we have forgotten that chronic diseases are the ones that shorten life," she says.
"What harms us are the problems derived from the lifestyle that develops over time." Diabetes, obesity, heart diseases, cancer... The list goes on. Means argues that they all have something in common: cell degradation, which manifests differently in each organ. And a piece of advice: "Stop, but we never do."
She admits that it's not easy. "It's not about changing everything, but about making small gestures that make a difference." Means doesn't ask for much, but she emphasizes that people need to understand the key to thriving: "We need to take the best of the modern world, all the wonderful things it offers us, and then shape our lives within it without it being toxic."
That's what she did and summarizes in her book: "I left my residency, I was very disillusioned with the healthcare system. I founded Levels with my brother. And I try to help people understand the concept of metabolic dysfunction." In other words, what to do to not destroy cells. How? "Go back to basics: eat as naturally as possible, respect sleep hours, engage in active leisure [she insists that the sofa and screen duo is not good, we need to spend more time outdoors], and manage chronic stress."