Mary-Jo Murphy, MS, RN, CDE, certified diabetes educator
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Hindsight, Foresight and Insight

3/16/2012

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Heredity and environment influence health. The first is our inheritance, the second our investment. Luck also plays a part.


Recently while having my teeth cleaned, the hygienist delivered this line, “Let me guess; you don’t floss very often.”

I indicate that I have something to say. She retrieves her fingers. (Lucky for her) I peer into her friendly eyes, thinking of how much I invest in this project of trying to keep ahead of my receding gums.

“If I miss one day all year, that’s unusual.” I take a deep breath to calm myself. “And I have my teeth cleaned every four months,” I continue. “This gum disease is hereditary,” I say with emphasis as I close my eyes, lie back and open my mouth, willing myself to be more pleasant.

I should be, because the truth is I have that same urge to make observations and assumptions and the same compulsion to offer anxiety-provoking advice.

After the polishing phase, she encourages me to continue my “good habits,” but warns that my gums aren’t likely to last through old age without some surgery.

I thank her, and on the way out make an appointment for early summer. Driving home I feel discouraged. I am doing all the right things and still my heredity has dealt my poor gums a deathblow.

As we gallantly try to keep one step ahead of our genetics, ours health care providers may offer advice we find less than inspiring.

I get it, and I’m afraid my very competent hygienist does too. Some of our health problems are a combination of bad genes and bad luck. But not all of them. Our job is to sort out the difference and push in a positive direction.

We may be carrying around Grandma’s pancreas, Grandpa’s blood vessels, Dad’s weak lungs, Mom’s waistline and Aunt Lizzie’s gums.When it comes to health we should consider our heredity. But if you are a little short for your weight, you might also consider your environment, in other words the things over which you do have control.

We all have heard accounts of someone who was overweight and lived a long life; someone who smoked daily and lived to be 100; someone who drank excessively, never wore a seatbelt, ate burgers, never wore sunscreen, never flossed and had a long, healthy and toothful life.

Even though they gambled and beat the odds, I think my hygienist and I would agree that these people shouldn’t be role models.

Last year, while waiting for Crazy Heart to start, I sat in the darkened theater and watched Kirsti Allie promote her new show. First she gained 75 pounds, then lost it, then gained the 75, plus a few more.

Mark Twain said, “Losing weight is easy. I’ve done it hundreds of times.” Dr. Walter M. Bortz II, MD in his piece in Diabetes Wellness News, February 2010, reminds us that Jared Foyle, the “Subway Boy,” publicly lost 145 pounds on his sandwich diet. He continues his campaign to eradicate childhood obesity, but he too has relapsed. In a past issue of Endocrine Today, Dr. George Bakris, observes that, “all long term studies demonstrate that weight loss can be maintained for six to nine months, but after one year there is regression to the mean.”

What he’s trying to tell us is that when our weight yo-yos, our bodies get programmed to go back to some midpoint between our high and our low. Our set point creeps up, whether we are Oprah or Kirsti. Weight gain after the original loss is not surprising. Nor is nicotine relapse, even if you are the president.

People who succeed at any goal go slowly. They understand that maintenance after the initial push for change is the most important part of the process. They embrace the concept of progress not perfection.

When the movie finally came on, there on screen was Jeff Bridges, playing a BMI challenged, chain-smoking, hard-drinking country singer, a guy whose environment has gotten the best of him.

After an auto accident, (in which he wasn’t wearing a seatbelt) his doctor has a 20 second, change-or-die, heart-to-heart talk with Bridge’s character, Bad. Within 60 seconds, Bad, is back to his old ways. No surprise to me or likely to my hygienist.

I love stories of redemption! I won’t ruin the movie for you, except to say that Bad has an epiphany.

During this month of the wearin’ of the green, when we wish for a pot of gold at the end of every rainbow, I wish for epiphanies, and offer you sentiments that came my way during a trip to Ireland a few years ago.

May you have the hindsight to know where you’ve been, the foresight to know where you’re going and the insight to know when you’ve gone too far.

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