Thinking Downstream

Illustration © D. Yael Bernhard

I grew up in the Hudson Valley, and have driven up and down the length of that noble river all my life. The Hudson River watershed is immense, and for people living here, the river is like the spinal column of the region, stretching from the Adirondack Mountains to the Atlantic Ocean.  

So when I taught a nutrition program at a local middle school a few months ago, I decided to use the Hudson as a metaphor for a human lifespan. A river, after all, moves through both time and space, broadening as it travels toward the sea. We do the same thing over the course of our lifetime, beginning as nothing more than a tiny trickle, and gaining complexity with time. If you think of your lifespan as a river, the headwaters began before you were born, and the river returns to the sea when your body dies. 

As I was talking to the students, I showed a slide of Lake Tear of the Clouds, the source of the Hudson River at the base of Mt. Marcy, the tallest mountain in New York State. The fresh, clear waters of this lake are beautiful and pristine – just like you were when you were born. But as soon as you begin traveling downstream, everything that enters that pure water – or the pure flesh of a newborn babe – begins to shape the future health of that body of water, or that child. Many of these effects are cumulative and take years to develop – like decades of pollution dumped into the Hudson, killing wildlife, turning the water toxic, and making fish from the river unsafe to eat.  

If we were animals of prey, many of us would be unsafe to eat, too. 

Fortunately, a massive collective effort has been made in recent years to clean up the Hudson, and to put better practices in place going forward. We teach our children to think ahead in caring for the environment – but do we guide them in laying a foundation for their own future health?  This is why I targeted my program for teens: because for young people on the cusp of making their own dietary choices, it’s important to think about long term health now. Few people in my generation were given this advantage, and as we reach middle age and older, we’re suffering the effects of our long-ago choices. I want to give young people what my peers and I never had: the knowledge they need to make conscious choices and to set the stage for a lifetime of good health. 

What would happen, I asked the students, if you threw a bottle of weedkiller into that pristine lake?  One young man raised his hand. “The lake weed would die.” The class giggled at the obvious answer. And so would some of the algae, I quickly added, which in turn would negatively affect the fish that live on those plants, the insects that lay eggs there, the birds that eat those fish and bugs – in other words, the entire ecosystem of the lake would be harmed.

The class was no longer laughing. I pressed my question further. What would happen if you walked down the river and threw a bottle of weedkiller into the water every day for a month? More damage to the creatures of the food chain. What if you did this year after year? By the time you reached the George Washington Bridge, what would the river be like?

Not very healthy. Yet driving over the bridge, the water sparkles in the sun. The damage may not be visible on the surface – nor can its source be pinpointed to any one day or any one bottle of chemicals. The effects are cumulative, building up gradually, invisibly. Similarly, human health builds or degrades with time, an expression of its own history. Health is a given at birth for most of us, but as we grow into adulthood it’s no longer automatic – it must be created and sustained. Students are taught to have a “college-bound attitude” in thinking about their careers and ambitions, but what about a “health-bound” attitude? In our culture it’s not cool for young people to think about health. Vending machines in public schools offer a frightening array of fake foods unfit for human consumption, and cafeterias put out a mix of good and bad choices at best. Health classes typically take up only half the school year, and only briefly cover nutrition. American medical students spend even less time on nutrition than the average high school health class. No wonder we’re the world’s leading developed nation when it comes to chronic disease and the size of our health budget – a staggering $2.73 trillion for 2023.¹ 

The Hudson River is an estuary, with tides from the ocean reaching 153 miles upstream – fully half the river’s 315 mile length. Native Americans called it “the river that flows two ways.” Striped bass swim upstream with the tides during spawning season each spring. Living along its banks in my late thirties, I found seashells washed up on shore when the tide went out.    

From the mountains to the sea, there’s no stopping the flow of this massive body of water. The force of the tides pushes against the current, introducing salt water from the ocean, and any pollution it may carry. We, too, are immersed in our environment, facing a mingling of influences and forces beyond our control.  

Yet if we teach our children to think downstream – and if we can model this behavior ourselves – parents can do a great deal to give their kids a healthy start in life. We can also give ourselves a healthy start to the next chapter of our own lives, for positive change, when it comes to nutrition and health, is always within reach.  

Looking upstream to my childhood, I see how my own behaviors have shaped my present-day health. I didn’t care much for ice cream, preferring crunchy textures to cold slippery sweets. I was a “cookie monster” kind of kid, with a TV character to back me up. So when my family walked to town on weekends to get the Sunday Times and treats, I dashed into the pastry shop and got my favorite jelly cookies, while my parents and sister went to the ice cream shop next door. Why did I end up with blood sugar problems, and my sister didn’t? Perhaps it was because whole milk ice cream – the only kind you could get back then – contains plenty of protein and fat, which slows down digestion and produces less insulin than baked goods. Cookies are made of white flour, which breaks down directly into sugar, adding greatly to the total sugar content and the amount of insulin released – with no protein and little fat to buffer it. Even worse, the “free fructose” (fruit sugar separated from its fiber) in the jelly spiked my insulin even higher. The cumulative effects of these insulin spikes gradually built up, until by the age of 15 I was diagnosed with hypoglycemia (low or unstable blood sugar), which typically leads to diabetes. Had I eaten hundreds of ice cream cones instead of thousands of Chips Ahoy cookies all those years, I might not have suffered this downstream effect, which continues to trickle down in my life to this day. None of the ice cream eaters in my family developed this problem. This is not to say ice cream is a health food – but minus the sugar, it might be. But even unsweetened cookies wouldn’t be, because flour breaks down into sugar in the gut. Simply put, protein and fat are healthier than carbohydrates.

My experience sparked my interest in nutrition at an early age. Striving to free myself from increasingly frequent dizziness and headaches, I followed my doctor’s advice and gave up refined sugar and white flour. The results were immediate, and empowering.  In less than two weeks my symptoms vanished. Here was a chain of cause and effect that was real – as real as the experiments I was doing in my high school chemistry class. Instead of feeling a sense of loss, I took secret pride in being an exception to the norm. This fit my teenage mindset as a self-identified non-conformist, and made the sacrifice easy. I was on my way to becoming a nutrition geek.   

Looking downstream now, I see I have new choices to make.  My decisions today will determine my health twenty years from now, and affect the length of my lifespan.  How will I preserve my musculoskeletal health as I age?  How will I maintain the minerals and protein my body needs as my ability to synthesize and assimilate diminishes?  To preserve muscle mass, I go to my local gym three times each week and use the weight machines. As a nature-lover I don’t relish the artificial environment, but I enjoy great music while working out, and try to buddy up with a friend driving there and back. For bioavailable minerals I drink daily herbal infusions – basically a strong tea, or water-based extract – of plants such as nettles, red clover, oat straw (the green portion of the oat plant), and comfrey leaf. I began this practice way upstream in my twenties, and lately have increased my intake of these nourishing brews. You can learn how to make herbal infusions here.²

Lifespan isn’t the only consideration. In my nutrition program, I introduced the concept of a health span – the portion of your life in which you are able to fully function and enjoy good health. Many Americans have a health span that is twenty or thirty years shorter than their lifespan. And for the first time in history, the average life expectancy in the United States is beginning to decline.³ 

The river of time flows inexorably onward. Walking along its banks, you might notice small changes in the environment as you lose altitude and the river deepens and widens. There will be different plants growing along the edges, and different fish colonizing the water. More manmade vessels ride the currents and more pollution is introduced as you move further downstream. Our lives are like that river. Let’s teach our children – and ourselves – to think downstream before we get there, and to respect the river from source to mouth.   

It’s no coincidence that a watershed makes an apt metaphor for human health. Our inner ecosystems are microcosms of the larger one we live in. More about that in my next article.

To your good health –

Yael Bernhard
Certified Integrative Health & Nutrition Coach

Yael Bernhard is a writer, illustrator, book designer and fine art painter with a lifelong passion for nutrition and herbal medicine.  She was certified by Duke University as an Integrative Health Coach in 2021 and by Cornell University in Nutrition & Healthy Living in 2022.  For information about private health coaching or nutrition programs for schools, please respond directly to this newsletter, or email dyaelbernhard@protonmail.com. Her art newsletter, “Image of the Week,” may be found here. Visit her online gallery of illustration, fine art, and children’s books here.

Information in this newsletter is provided for educational – and inspirational – purposes only.

1. https://www.usaspending.gov/agency/department-of-health-and-human-services?fy=2023

2. http://www.susunweed.com/How_to_make_Infusions.htm

3. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220831.htm