<b>An argument that health is <i>optimal responsiveness</i> and is often best treated at the system level.</b><p>Medical education centers on the venerable “no-fault” concept of homeostasis whereby local mechanisms impose constancy by correcting errors and the brain serves mainly for emergencies. Yet it turns out that most parameters are not constant; moreover despite the importance of local mechanisms the brain is definitely in charge. In this book the eminent neuroscientist Peter Sterling describes a broader concept: <i>allostasis</i> (coined by Sterling and Joseph Eyer in the 1980s) whereby the brain anticipates needs and efficiently mobilizes supplies to prevent errors.</p><p>Allostasis evolved early Sterling explains to optimize energy efficiency relying heavily on brain circuits that deliver a brief reward for each positive surprise. Modern life so reduces the opportunities for surprise that we are driven to seek it in consumption: bigger burgers more opioids and innumerable activities that involve higher carbon emissions. The consequences include addiction obesity type 2 diabetes and climate change. Sterling concludes that solutions must go beyond the merely technical to restore possibilities for daily small rewards and revivify the capacities for egalitarianism that were hard-wired into our nature.</p><p>Sterling explains that allostasis offers what is not found in any medical textbook: principled definitions of health and disease: health as the capacity for adaptive variation and disease as shrinkage of that capacity. Sterling argues that since health is <i>optimal responsiveness</i> many significant conditions are best treated at the system level.<br></p>
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