The Health Decision Formula Hidden in Netflix's 'Apple Cider Vinegar'
Like millions of others, I just finished binging Netflix's latest hit show "Apple Cider Vinegar." While the entire series is thought-provoking, there are two scenes from episode 2 that really stuck with me.
Scene 1: Milla gets called out for not having the Hirsch Institute book. Her mom follows up with her and Milla replies back, “It’s ok, I read the articles.”
This interaction highlights how we all get wooed by clickbaity articles that are based on data on mice or an anecdote of one person and then we get hopeful that these solutions will work for us when that couldn’t be farther from the truth.
Scene 2: When Mila's mother confronts the head of the Hirsch Institute about their policy of not recommending scans for 8-12 months, we witness a masterclass in evasion. The director's only response? A vague comment about how scans might actually make people sicker.
This interaction highlights a crucial question we all face: How do we know if our investments – whether of time, money, or hope – are actually paying off? Beyond the temporary high of feeling like we're doing something good for ourselves, how can we verify we're achieving real, lasting results?
Three principles to support your health decision-making:
1. Ask for the data
When asking for evidence, you'll encounter several types of research. Evidence can vary in quality.
Randomized Controlled Trials (RCTs) sit at the top of the evidence hierarchy. These studies randomly assign participants to different groups while controlling for variables and bias. They're designed to isolate the effect of a specific intervention by comparing it to a control group. Even more powerful are meta-analyses that combine results from multiple RCTs, giving us a broader and more robust picture of effectiveness.
Observational studies come next in the hierarchy. While less rigorous than RCTs, they provide valuable insights, especially for long-term outcomes or rare conditions where controlled trials might be impractical or unethical. These include:
Cohort studies that follow groups of people over time
Case-control studies that look backward to identify patterns between people with and without certain conditions
Cross-sectional studies that take a snapshot of a population at a specific point in time
Real-world evidence, including clinical practice data, patient registries, and even properly analyzed user data from health apps, can complement traditional studies by showing how treatments perform outside controlled research settings. This data often better reflects actual patient experiences in day-to-day life.
Be particularly cautious of anecdotal evidence or testimonials. While personal stories can be compelling and provide context to data, they don't tell us about statistical significance or account for placebo effects and can be selected to show only positive outcomes.
Don't be intimidated—you don't need a medical degree to ask questions about evidence. Simple questions like "What studies support this approach?" or "How many people have been studied using this method?" or “What criteria were used to include participants in the study?” can yield valuable insights.
2. Know which metrics matter
Different health goals require different measurement approaches. When evaluating any health intervention, it's essential to identify the specific outcomes that will truly indicate success. Here's a framework for understanding health metrics:
Objective Clinical Measurements
These are quantifiable metrics typically measured by healthcare professionals:
Laboratory tests: Blood work (cholesterol, glucose, hormone levels), urine analysis, inflammatory markers
Vital signs: Blood pressure, heart rate, respiratory rate, temperature
Physical measurements: Weight, BMI, waist circumference, body composition
Diagnostic imaging: X-rays, MRIs, ultrasounds, CT scans
Specialized tests: Cardio stress tests, pulmonary function tests, bone density scans
Functional Capacity Metrics
These measure what your body can actually do:
Strength indicators: Maximum lifts, grip strength, resistance levels
Cardiovascular fitness: VO2 max, heart rate recovery, endurance measures
Flexibility and mobility: Range of motion, specific movement assessments
Balance and stability: Static and dynamic balance tests
Activities of daily living: Ability to perform routine tasks independently
Symptom-Based Metrics
These track the presence, frequency, and intensity of health problems:
Pain scales: Location, intensity (0-10), frequency, duration, triggers
Symptom diaries: Tracking specific issues like migraines, digestive problems, skin flares
Frequency counts: Number of episodes (asthma attacks, panic attacks, etc.)
Severity scales: Standardized questionnaires for conditions like depression (PHQ-9) or anxiety (GAD-7)
Medication usage: Changes in dosage needs or frequency of rescue medications
Quality of Life Indicators
These reflect how your health impacts your overall wellbeing:
Sleep quality: Duration, continuity, deep sleep percentage, morning alertness
Energy levels: Stamina throughout the day, fatigue patterns
Cognitive function: Memory, focus, mental clarity, decision-making ability
Emotional wellbeing: Mood stability, stress resilience, presence of positive emotions
Social functioning: Ability to participate in relationships and community activities
Productivity: Work performance, ability to complete daily tasks
Long-Term Health Trajectories
These show progress over extended periods:
Disease progression markers: Tumor size, joint deterioration, plaque buildup
Relapse rates: Frequency and duration between symptom recurrences
Complication development: Secondary conditions arising from primary health issues
Longevity indicators: Biological age markers versus chronological age
Preventive health milestones: Reaching and maintaining target ranges for key health indicators
3. Decide on a fast vs slow approach with your doctor
Speed in health interventions has two dimensions: how quickly you need to act and how soon you can expect results. Life-threatening situations should always be addressed with urgency under the care of a board-certified doctor.
Moving Fast:
Acute conditions with risks of rapid deterioration
Symptoms that significantly impact quality of life
FDA-approved pharmaceuticals that can deliver results in a faster timeline than lifestyle changes
Moving Slow:
Chronic, stable conditions
Preventative health measures
Lifestyle modifications requiring long-term adherence
The key is matching your approach to your situation while maintaining open communication with healthcare providers. Early stages of chronic disease and preventive health could be candidates for either approach depending on your personal goals and circumstances.
Our Lifestyle Quiz is a great first step to decide on your approach for preventive health. By taking the quiz, you get a clear sense of some of your focus areas that can have the most impact on your health and quality of life—get the quiz today.