Understanding Allostasis and Social Impact on Health with Prof. Peter Sterling
In today’s episode Friederike interviews Professor Peter Sterling, author of 'What Is Health,' to discuss his groundbreaking concept of allostasis. Peter's extensive experience in neuroscience and with socioeconomically challenged communities gave him insight on the ways that chronic social tension and stress play a significant role in conditions like hypertension (high blood pressure). The pair examine how Peter came to discover and name allostasis, the limitations of the traditional medical model of homeostasis, and the predictive and adaptive nature of our bodies in response to emotional and social cues. Peter shares practical ways to incorporate the principles of allostasis into daily life to improve health and well-being, stressing the importance of social connections and adaptive regulation and why adapting to stress is not necessarily a good thing.
00:00 Introduction
00:54 Discovering Allostasis
02:04 Hypertension and Social Tension
05:38 Challenging Homeostasis: A New Perspective
12:27 Applying Allostasis for a Better Life
14:36 Conclusion and Final Thoughts
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Peter Sterling is an American anatomist, physiologist and neuroscientist, and Professor of Neuroscience at the University of Pennsylvania School of Medicine. He is the author of What Is Health? Allostasis and the Evolution of Human Design (2020), and with Simon Laughlin, is an author of Principles of Neural Design.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Friederike Fabritius (00:05):
Hello everyone.
Welcome to a new episode of my podcast.
Today I have a very special guest and Ihave to thank my friend Ross, because he
told me about a book he's been readingthree or four times, and then I thought
I need to get my hands on this book.
And it's What Is Health
by professor Peter Sterling.
(00:25):
He's here with me in the studio.
Hello, Peter.
Peter Sterling (00:28):
Hello, Frederica.
Good to see you.
Friederike Fabritius: Yeah, good to see you. (00:30):
undefined
Peter's joining me from Panama, andI have so many questions for him.
And you will see in just asecond why I did not read his
book once, but actually twice.
And I'm planning to read it a third time.
every time I read it,I discover new things.
And so I felt like I want you tohear this from the master himself.
(00:54):
So my first question is, Peter,you're the inventor of a concept
called allostasis, can you explainto us what it is and why it matters?
Peter Sterling (01:04):
Sure.
The term allostasis describes aperspective of what we need for a
healthy life and the relationshipbetween our brain and our body and
our minds and our body and our health.
I was working in graduate schoolwhen I was studying neuroscience.
I was working in the Black ghettoin midwestern United States, a city
(01:26):
called Cleveland, where Blacks wereconfined and still are actually
to a central part of the city.
And I noticed as I knocked onpeople's doors, they came to the
door, they would be paralyzed on oneside, partially, their face would be
sagging, their speech would be slurred.
And I saw this frequently, and I'dnever seen this in the white communities
(01:47):
where I'd grown up and lived.
And, I went back to the lab and Ijust read about it and I realized
that these people had strokes,and they were hemiplegic from
being paralyzed by a stroke.
And the strokes, which were premature,these weren't old, old people, are caused
by, high blood pressure, hypertension.
(02:07):
And I sort of well wondered why is that?
And I read up, about that, and themedical texts say, and they still do, oh,
hypertension is caused by problems eitherin the kidney, or something like that.
Too much salt water inyour vascular system.
Friederike Fabritius (02:22):
Mm hmm.
Peter Sterling (02:23):
And, well, why do Black people have it?
"Well, they're, they haveunfortunate genetics.
And, it's, you know, they don't processsalt properly or something like that." And
I wondered, I doubted that, and becauseI could see the social oppression.
And I remembered that my grandfatherhad also grown up in that very community
(02:43):
when it had been a Jewish ghetto.
And he also had a stroke.
And I had a hypothesis then.
Maybe hypertension iscaused by social tension.
Friederike Fabritius (02:53):
And that was,
Peter Sterling (02:54):
that's
Friederike Fabritius (02:54):
interesting.
Yeah.
I think that makes your researchso unique because you really cared.
You did not just deliverit in the laboratory.
I think throughout your life, youalways had a cause and a mission.
And a purpose and you were willingto question the status quo.
I think you're a true rebel.
Yeah, so carry on, but very fascinating.
Peter Sterling (03:17):
It's beyond willing.
It's sort of a compulsion.
I can't really escape this, when Ireached the University of Pennsylvania,
and took my first job when I was 29, thatwas also a very, predominantly Black city.
And the section of the universitywas predominantly Black, very poor.
And, I began to work in that communityand I met a young man named Joseph Iyer.
(03:39):
And the question that had been stillwith me from my hypertension experiences,
what causes really, at a deep level,hypertension and my friend Joseph Iyer
said, you know, people who live by,hunting and gathering and foraging
and growing, crops, horticulturalists,just who live very simply.
They don't have hypertension.
(04:00):
They don't have cardiovascular disease.
And their blood pressure, ratherthan rising with age, which is the
standard, modern medical story.
It's flat with age and even oldpeople don't have hypertension.
I just was doubtful.
So I went to the library and I startedreading, and I discovered that my
friend Joe was absolutely right.
That hypertension and the general risein blood pressure with age in modern
(04:25):
society is a feature of modern society.
And for 100, 000 years, the way welived did not cause hypertension.
It's only gradually in the last 10,000 years, really with industrial
society of the last 200, 250 yearsthat blood pressure rises with age.
And in fact, I found studies that showthat it actually, it's flat in childhood,
(04:48):
but that at around age six or seven, whenchildren go to school, it begins to go up.
And by the end of high school,maybe 25 percent people in the U S
already have blood pressures thatare in the hypertensive range.
Friederike Fabritius (05:01):
So you discovered that, you know,
it wasn't anything genetic.
It was the social pressure thatincreased the blood pressure.
And how did you go from there?
I'm so fascinated by your conceptof allostasis because I think what
we learned at university was wrong.
And I would like to hear fromyou how you found out about it.
Peter Sterling (05:22):
Sure.
So, the standard ideaof how the body works.
It's called homeostasis, and it'sthe theory basically like our body
is like a collection of thermostats.
There's a set point for eachvariable, or pressure, temperature,
blood glucose, and so on.
(05:43):
And , it's held constant.
And if, if some variable departs andrises, then there's some automatic
mechanism that detects it like athermostat and triggers mechanisms
to restore it to it's set point.
And this is not completely wrong.
Our body does have these mechanisms,but it's not, it turns out really the
(06:06):
primary way that our body is regulated.
And, my objection to the problem oftreating the body is as everything
is constant and automaticallyregulated by the body is that it
leaves out the mind and the brain.
And so it doesn't provide any explanationof why, race experience of racism would
(06:27):
cause high blood pressure and it doesn'tallow the fact that if you're Black
in the U.S. and you see a policemanyour heart starts racing and your blood
pressure rises because you're afraid.
And so there was no way tounderstand that in current medicine.
So I began to read, well,what controls, blood pressure?
(06:48):
What regulates it anyway?
And is it really constant?
So the idea of homeostasis stillgrips medical science, and I think
the reason is because it provides,a sort of a no fault theory.
We have the body here, the brain doesn'tmatter and we're going to treat the
body and we don't have to understandhuman relationships or connections.
Friederike Fabritius (07:10):
Sorry to interrupt, but I think that's so powerful because
I know that when I studied neuroscience,I only learned about homeostasis.
And as you say, anything regardingthe brain and the mind is ignored.
I also think that nowadays there arelots of theories that indicate that
the brain is actually predictive.
So the brain anticipateswhat's going to happen.
(07:32):
And so your blood pressureprobably goes up even before you
enter the stressful situation.
You know, something horrible is comingup and you're already driving yourself
crazy and raising your blood pressurebefore you even meet the enemy or put
yourself in the terrible situation.
I think that's much, muchmore in line with reality.
Peter Sterling (07:52):
Right.
Yeah.
Well, you need it.
The value of the prediction is thatif you're anticipating something,
then you're preparing for it.
And so, I found another paper thatsays, when you stand up from a sitting
position, the kidney hormone rises, andit's the hormone that conserves salt water
from being spilt into the urine and itpreserves the salt water for your blood.
(08:14):
And it rises eightfold.
So this is a very slow actingthing, but it's very important.
It prepares you to stand up.
If your brain did not prepare yourcardiovascular system before you stand up.
you would fall over becausethe blood would rush from
your head and you would faint.
And so the whole body is wired toregulate our physiology predictively.
(08:37):
Homeostasis, it's about feedback.
When there's an error,it's like a thermostat.
When there's an error, a thermostatturns on some heat producing, you
know, your furnace or your body'sfurnace makes you shiver, warm up.
But the homeostasis worksby correcting errors.
And, it's costly to make an error and,you have to play catch up and it's
(09:02):
more efficient to regulate things byanticipating what is going to be needed.
So what happened was, what I found forhypertension and anticipatory regulation,
I found was also true for diabetes,for, all kinds of regulatory challenges.
The other thing I realized is that,so what's wrong with hypertension?
Why does that cause strokes?
(09:24):
Well, when you have chronic hypertension,the arteries, it's like muscles, if
you lift weights, your muscles at firstthey lift the weight and they struggle.
But if you keep doing it every day, themuscles get thicker, you get stronger.
And if you stop lifting weights, theyunfortunately go back to where they were.
(09:45):
So this is true for arteries.
So if you have chronic hypertension,the artery, walls thicken and the
lumen narrows so it's harder to getthe blood through, so you have to raise
the pressure to get the blood through.
And this is an adaptation.
The vessels, like the muscles, predict, ohyeah, we're going to be challenged today.
(10:05):
And so they adapt.
The problem with these chronic, stressfulthings is that we adapt to them.
And tho that's what causes these strokes.
And it's like a plumbing system.
If it gets a bit corroded and thepressure is high, you have breaks.
So I found, the smoking gun thatwould go from, emotional disturbance
from social tension down to thesemechanisms to cause the pathology.
(10:30):
And, by 1981, I was able towrite a paper, with Joseph Eyer.
I was invited with Joe to writea short review, about predictive
regulation, for an obscurehandbook of life stress and so on.
And I wrote this with Joe, This paper,and when I got to the end of it, this
is 1988 now, seven years after thisfirst paper, and I got to the end
(10:54):
and I said, you know, homeostasisis a word that's really embedded.
The only way to really get beyondit is to name what are new things.
So I consulted a friend of mine whowas a professor of Greek philosophy,
and I said, homeostasis is stabilitythrough constancy, I need a word to
express stability through change.
(11:16):
Our bodies, and brain and ourorganism survives by changing
constantly, adapting to new states.
And so what, what's a good word?
He says "allo", other, stasis,stability through other conditions.
Friederike Fabritius (11:32):
I think it's so interesting because there's so much
wisdom in it if you think about it.
I would like to wrap it up with a few keyinsights of how you would use allostasis
in everyday life to lead a better life,to lead a happier and healthier life,
because you started with a problem.
Right?
You discovered this through the factthat some people are not well, obviously.
(11:55):
And so how can we take these insightsand be happier, be healthier, perform
better, whatever it is we want to do?
Peter Sterling (12:04):
I think one lesson is that, our bodies, as an organism,
evolved to live at a certain pace withcertain needs that we have as a species.
We're social.
We're deeply social.
So we need time tointeract, in positive ways.
For a hundred thousand years, our work,the way we made our living was social.
(12:29):
We hunted in groups.
We gathered food in groups.
It isn't one guy or one woman goingout into the jungle by themselves.
Because life, before supermarketswas maybe somewhat more precarious.
You got some food today a lot, butmaybe tomorrow you wouldn't have it.
So you shared it with neighborsbecause the sharing, reduced
(12:53):
the fluctuations in food.
You would always have something,you would either have your own
and you would have your neighbors.
If you also reciprocated.
So, so a great deal of ourbeing, our character, many of our
features of our life, are evolvedto maintain good relationships
(13:13):
within our family and our neighbors.
And for that, you have to take time.
All of these things, I think are partof our social nature and our need
to find connections with each other.
And I think that is extremelyimportant for our health and
reducing our tensions, keeping ourblood pressure, you know, stable.
Friederike Fabritius (13:34):
Wow, Peter.
Thank you so much.
I've learned a lot.
Once you start thinking about allostasis,my feeling is you see it everywhere.
At least that's how it works for me.
You look around yourself andeverything is influenced by it.
So I think it's reallyworthwhile reflecting on it.
I would like to thank you so verymuch for sharing your wisdom.
(13:56):
Thank you so much for today, Peter.
Thank you so much and see you next time.
Peter Sterling (14:00):
My pleasure.
Thanks.
Hello everyone.
Welcome to a new episode of my podcast.
Today I have a very special guest and Ihave to thank my friend Ross, because he
told me about a book he's been readingthree or four times, and then I thought
I need to get my hands on this book.
And it's What Is Health
by professor Peter Sterling.
(00:25):
He's here with me in the studio.
Hello, Peter.
Peter Sterling (00:28):
Hello, Frederica.
Good to see you.
Friederike Fabritius: Yeah, good to see you. (00:30):
undefined
Peter's joining me from Panama, andI have so many questions for him.
And you will see in just asecond why I did not read his
book once, but actually twice.
And I'm planning to read it a third time.
every time I read it,I discover new things.
And so I felt like I want you tohear this from the master himself.
(00:54):
So my first question is, Peter,you're the inventor of a concept
called allostasis, can you explainto us what it is and why it matters?
Peter Sterling (01:04):
Sure.
The term allostasis describes aperspective of what we need for a
healthy life and the relationshipbetween our brain and our body and
our minds and our body and our health.
I was working in graduate schoolwhen I was studying neuroscience.
I was working in the Black ghettoin midwestern United States, a city
(01:26):
called Cleveland, where Blacks wereconfined and still are actually
to a central part of the city.
And I noticed as I knocked onpeople's doors, they came to the
door, they would be paralyzed on oneside, partially, their face would be
sagging, their speech would be slurred.
And I saw this frequently, and I'dnever seen this in the white communities
(01:47):
where I'd grown up and lived.
And, I went back to the lab and Ijust read about it and I realized
that these people had strokes,and they were hemiplegic from
being paralyzed by a stroke.
And the strokes, which were premature,these weren't old, old people, are caused
by, high blood pressure, hypertension.
(02:07):
And I sort of well wondered why is that?
And I read up, about that, and themedical texts say, and they still do, oh,
hypertension is caused by problems eitherin the kidney, or something like that.
Too much salt water inyour vascular system.
Friederike Fabritius (02:22):
Mm hmm.
Peter Sterling (02:23):
And, well, why do Black people have it?
"Well, they're, they haveunfortunate genetics.
And, it's, you know, they don't processsalt properly or something like that." And
I wondered, I doubted that, and becauseI could see the social oppression.
And I remembered that my grandfatherhad also grown up in that very community
(02:43):
when it had been a Jewish ghetto.
And he also had a stroke.
And I had a hypothesis then.
Maybe hypertension iscaused by social tension.
Friederike Fabritius (02:53):
And that was,
Peter Sterling (02:54):
that's
Friederike Fabritius (02:54):
interesting.
Yeah.
I think that makes your researchso unique because you really cared.
You did not just deliverit in the laboratory.
I think throughout your life, youalways had a cause and a mission.
And a purpose and you were willingto question the status quo.
I think you're a true rebel.
Yeah, so carry on, but very fascinating.
Peter Sterling (03:17):
It's beyond willing.
It's sort of a compulsion.
I can't really escape this, when Ireached the University of Pennsylvania,
and took my first job when I was 29, thatwas also a very, predominantly Black city.
And the section of the universitywas predominantly Black, very poor.
And, I began to work in that communityand I met a young man named Joseph Iyer.
(03:39):
And the question that had been stillwith me from my hypertension experiences,
what causes really, at a deep level,hypertension and my friend Joseph Iyer
said, you know, people who live by,hunting and gathering and foraging
and growing, crops, horticulturalists,just who live very simply.
They don't have hypertension.
(04:00):
They don't have cardiovascular disease.
And their blood pressure, ratherthan rising with age, which is the
standard, modern medical story.
It's flat with age and even oldpeople don't have hypertension.
I just was doubtful.
So I went to the library and I startedreading, and I discovered that my
friend Joe was absolutely right.
That hypertension and the general risein blood pressure with age in modern
(04:25):
society is a feature of modern society.
And for 100, 000 years, the way welived did not cause hypertension.
It's only gradually in the last 10,000 years, really with industrial
society of the last 200, 250 yearsthat blood pressure rises with age.
And in fact, I found studies that showthat it actually, it's flat in childhood,
(04:48):
but that at around age six or seven, whenchildren go to school, it begins to go up.
And by the end of high school,maybe 25 percent people in the U S
already have blood pressures thatare in the hypertensive range.
Friederike Fabritius (05:01):
So you discovered that, you know,
it wasn't anything genetic.
It was the social pressure thatincreased the blood pressure.
And how did you go from there?
I'm so fascinated by your conceptof allostasis because I think what
we learned at university was wrong.
And I would like to hear fromyou how you found out about it.
Peter Sterling (05:22):
Sure.
So, the standard ideaof how the body works.
It's called homeostasis, and it'sthe theory basically like our body
is like a collection of thermostats.
There's a set point for eachvariable, or pressure, temperature,
blood glucose, and so on.
(05:43):
And , it's held constant.
And if, if some variable departs andrises, then there's some automatic
mechanism that detects it like athermostat and triggers mechanisms
to restore it to it's set point.
And this is not completely wrong.
Our body does have these mechanisms,but it's not, it turns out really the
(06:06):
primary way that our body is regulated.
And, my objection to the problem oftreating the body is as everything
is constant and automaticallyregulated by the body is that it
leaves out the mind and the brain.
And so it doesn't provide any explanationof why, race experience of racism would
(06:27):
cause high blood pressure and it doesn'tallow the fact that if you're Black
in the U.S. and you see a policemanyour heart starts racing and your blood
pressure rises because you're afraid.
And so there was no way tounderstand that in current medicine.
So I began to read, well,what controls, blood pressure?
(06:48):
What regulates it anyway?
And is it really constant?
So the idea of homeostasis stillgrips medical science, and I think
the reason is because it provides,a sort of a no fault theory.
We have the body here, the brain doesn'tmatter and we're going to treat the
body and we don't have to understandhuman relationships or connections.
Friederike Fabritius (07:10):
Sorry to interrupt, but I think that's so powerful because
I know that when I studied neuroscience,I only learned about homeostasis.
And as you say, anything regardingthe brain and the mind is ignored.
I also think that nowadays there arelots of theories that indicate that
the brain is actually predictive.
So the brain anticipateswhat's going to happen.
(07:32):
And so your blood pressureprobably goes up even before you
enter the stressful situation.
You know, something horrible is comingup and you're already driving yourself
crazy and raising your blood pressurebefore you even meet the enemy or put
yourself in the terrible situation.
I think that's much, muchmore in line with reality.
Peter Sterling (07:52):
Right.
Yeah.
Well, you need it.
The value of the prediction is thatif you're anticipating something,
then you're preparing for it.
And so, I found another paper thatsays, when you stand up from a sitting
position, the kidney hormone rises, andit's the hormone that conserves salt water
from being spilt into the urine and itpreserves the salt water for your blood.
(08:14):
And it rises eightfold.
So this is a very slow actingthing, but it's very important.
It prepares you to stand up.
If your brain did not prepare yourcardiovascular system before you stand up.
you would fall over becausethe blood would rush from
your head and you would faint.
And so the whole body is wired toregulate our physiology predictively.
(08:37):
Homeostasis, it's about feedback.
When there's an error,it's like a thermostat.
When there's an error, a thermostatturns on some heat producing, you
know, your furnace or your body'sfurnace makes you shiver, warm up.
But the homeostasis worksby correcting errors.
And, it's costly to make an error and,you have to play catch up and it's
(09:02):
more efficient to regulate things byanticipating what is going to be needed.
So what happened was, what I found forhypertension and anticipatory regulation,
I found was also true for diabetes,for, all kinds of regulatory challenges.
The other thing I realized is that,so what's wrong with hypertension?
Why does that cause strokes?
(09:24):
Well, when you have chronic hypertension,the arteries, it's like muscles, if
you lift weights, your muscles at firstthey lift the weight and they struggle.
But if you keep doing it every day, themuscles get thicker, you get stronger.
And if you stop lifting weights, theyunfortunately go back to where they were.
(09:45):
So this is true for arteries.
So if you have chronic hypertension,the artery, walls thicken and the
lumen narrows so it's harder to getthe blood through, so you have to raise
the pressure to get the blood through.
And this is an adaptation.
The vessels, like the muscles, predict, ohyeah, we're going to be challenged today.
(10:05):
And so they adapt.
The problem with these chronic, stressfulthings is that we adapt to them.
And tho that's what causes these strokes.
And it's like a plumbing system.
If it gets a bit corroded and thepressure is high, you have breaks.
So I found, the smoking gun thatwould go from, emotional disturbance
from social tension down to thesemechanisms to cause the pathology.
(10:30):
And, by 1981, I was able towrite a paper, with Joseph Eyer.
I was invited with Joe to writea short review, about predictive
regulation, for an obscurehandbook of life stress and so on.
And I wrote this with Joe, This paper,and when I got to the end of it, this
is 1988 now, seven years after thisfirst paper, and I got to the end
(10:54):
and I said, you know, homeostasisis a word that's really embedded.
The only way to really get beyondit is to name what are new things.
So I consulted a friend of mine whowas a professor of Greek philosophy,
and I said, homeostasis is stabilitythrough constancy, I need a word to
express stability through change.
(11:16):
Our bodies, and brain and ourorganism survives by changing
constantly, adapting to new states.
And so what, what's a good word?
He says "allo", other, stasis,stability through other conditions.
Friederike Fabritius (11:32):
I think it's so interesting because there's so much
wisdom in it if you think about it.
I would like to wrap it up with a few keyinsights of how you would use allostasis
in everyday life to lead a better life,to lead a happier and healthier life,
because you started with a problem.
Right?
You discovered this through the factthat some people are not well, obviously.
(11:55):
And so how can we take these insightsand be happier, be healthier, perform
better, whatever it is we want to do?
Peter Sterling (12:04):
I think one lesson is that, our bodies, as an organism,
evolved to live at a certain pace withcertain needs that we have as a species.
We're social.
We're deeply social.
So we need time tointeract, in positive ways.
For a hundred thousand years, our work,the way we made our living was social.
(12:29):
We hunted in groups.
We gathered food in groups.
It isn't one guy or one woman goingout into the jungle by themselves.
Because life, before supermarketswas maybe somewhat more precarious.
You got some food today a lot, butmaybe tomorrow you wouldn't have it.
So you shared it with neighborsbecause the sharing, reduced
(12:53):
the fluctuations in food.
You would always have something,you would either have your own
and you would have your neighbors.
If you also reciprocated.
So, so a great deal of ourbeing, our character, many of our
features of our life, are evolvedto maintain good relationships
(13:13):
within our family and our neighbors.
And for that, you have to take time.
All of these things, I think are partof our social nature and our need
to find connections with each other.
And I think that is extremelyimportant for our health and
reducing our tensions, keeping ourblood pressure, you know, stable.
Friederike Fabritius (13:34):
Wow, Peter.
Thank you so much.
I've learned a lot.
Once you start thinking about allostasis,my feeling is you see it everywhere.
At least that's how it works for me.
You look around yourself andeverything is influenced by it.
So I think it's reallyworthwhile reflecting on it.
I would like to thank you so verymuch for sharing your wisdom.
(13:56):
Thank you so much for today, Peter.
Thank you so much and see you next time.
Peter Sterling (14:00):
My pleasure.
Thanks.
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