Paper 4: Chronic Disease is a Circadian Problem
This paper presents a surprisingly simple, unified explanation for the ravages of chronic disease. This is a summary; you can find the full text at my website www.talkingoctopus.com.
Chronic disease, as distinguished from acute disease, roughly means the increase of an innate dysfunction rather than the introduction of a foreign infection or injury. The Four Horsemen of this strange new apocalypse might be entitled Metabolism, Autoimmunity, Insanity, and Age-Related Breakdown, with an outrider named Male Problems. Metabolism encompasses obesity, diabetes, sleep apnea, and hypertension. Autoimmunity describes allergies, asthma, autism, gluten and lactose intolerance, and Chrohn’s disease. Insanity covers addiction, major depression, anxiety, eating disorders, PTSD, bipolar disease, and ADHD. Age-Related Breakdown includes stroke, atherosclerosis, Alzheimer’s disease, dementia, and every form of cancer. Male problems include low sperm count, infertility, and erectile dysfunction. Taken together, this suite of problems is our species’ most profound and fastest growing scourge, and their increase remains to be explained.
Chronic diseases are found in the same people at the same times, so it makes sense to suspect they have a single, unified, efficient cause. Statistical methods cannot uncover causes, only correlations. Causes must be tested through experiment. For many reasons, the experiments currently allowed to study chronic disease are problematic and inconclusive. Since chronic disease is innate dysfunction, the causes must be external to the body. But because the treatment of CD is conducted within the reductionist paradigm of the current medical system, researchers have centered on the internal mechanisms of CD, rather than their possible external causes in the human niche.
However, several hypotheses have emerged, bolstered primarily by citizen science along with epidemiological study. The first is that exercise has diminished since the mechanization of farm labor, and meanwhile the shift to sugar and fat-enriched diets has been driven by urbanization and food processing and advertising technology. This is the “obesigenic environment” hypothesis. The second is a grab-bag, the notion that most laypeople seem to believe, which I call the “chemical kitchen sink.” This is the idea that there are so many novel chemicals in the built environment that even if one of them is not to blame, all of them together are the problem. Many people seem to believe both these hypotheses, and some also add a food justice theory as well to explain racial disparities in health. Other hypotheses are that microbiomes have changed irrevocably, or that the mental stress of the modern living conditions impacts our health. The last hypothesis is that sleep quality has diminished.
To identify if there are any candidates for an efficient cause, I use what I call the Extremely High Bar method of analysis. The Extremely High Bar Method goes as follows: What factor could logically be present in ALL the cases of chronic disease on earth, and absent in ALL the healthy patients on earth who do not suffer from a chronic disease? Then the second bar is this: Which, among the logically possible factors that could be present in every case, could not logically be caused or compounded by any other factor?
The “chemical kitchen sink” fails on the grounds that the chemicals in the built environment are all tested for health and safety, while the chemicals in natural environments are not, and are obviously full of hazards. The diet, exercise, microbiome, and stress explanations fail at the second bar: no one has been able to show that they are not effects of the problems they are supposed to cause. If chronic disease had another cause, stress, diet, exercise, and the microbiome would be virtually certain to change as downstream effects. This basic problem with these hypotheses then has never been adequately answered. The sleep quality hypothesis fails on this test as well, but there is a catch.
It turns out that there is a link between sleep and a quirk of the human circadian rhythm. Our circadian clock is extremely sensitive to light, especially in the blue end of the spectrum. The endogenous circadian rhythm is a critical feature of virtually every cell in every life form on earth, so it must be fundamentally important to life. With no knowledge of the danger of resetting our circadian clocks by using artificial light in increasingly myriad devices after nightfall, we may have been inadvertently interrupting the basic circadian rhythms of our bodies to greater and greater detriment. Poor sleep quality has been shown to damage every system of the body in a profound way.
If there is indeed an initial efficient cause that sets in motion all the other factors as mediators, it is bound to be extremely widespread and also very subtle, because it takes decades to take effect. The highest risk factor for every chronic disease is age, but perhaps this is because only after decades of unrepaired damage are the deleterious effects of sleep and circadian degradation seen. People of African descent have also been shown to have less labile circadian rhythms than Europeans, which suggests they may be at higher risk from nighttime blue light stimulus.
The one thing we can be sure of is that one of the most predictable features of our environment during our evolution was the light-dark cycle. Perhaps, having abandoned this feature, we have yet to understand the costs we have paid in our health outcomes.
