The 80/20 Principle and Your Health
When I see patients in clinic, generally within the first 5 minutes of the visit I have a pretty good idea of what the problem may be and what I should do about it.
After this, the rest of the visit is about collecting information that supports or refutes my initial belief. I do run the risk of anchoring, but after the initial information is collected the incremental value of each additional piece of information diminishes. The majority of the value comes from a minority of the information.
Imagine I tell you that you have low thyroid hormone. Then, imagine I show you the specific breakdown of the individual hormone levels, and how they have varied throughout the last year. Then, imagine I show you how your thyroid levels compare to a cohort of your age matched peers.
What is most valuable piece of information here? How much value does each incremental piece of information add? Ultimately, regardless of how much detail I show you, the problem is still that you have low thyroid hormone and we should probably do something about it.
The 80/20 Rule
Vilfredo Pareto was an Italian engineer, economist, sociologist and philosopher who lived in the 19th and 20th century. He studied the wealth distribution in European society and discovered that much of the wealth accumulates to a select few. Specifically, he discovered that about 80% of the wealth was distributed amongst 20% of the population — this is called the 80/20 Rule. The 80/20 Rule is a power law, meaning the results are skewed rather than sharing a linear distribution — one quantity varies as a power of another.
For example, in 2018 the highest paid actor was George Clooney, making about $239 million dollars. How many unknown actors in the world practice their craft day in and day out without even making 10% ($23.9 million), 1%, ($2.39 million) or even 0.1% ($239,000) ? Although George Clooney is one man, he accrues a large portion of the wealth — an example of a power law.
Compelling to think about; but what does this have to do with health?
On Average
Let’s pretend I am the average Canadian adult — I consumes one can of pop or full sugar juice per day and I eat out for two meals per week. I also consume less fruits and vegetables than are recommended on a daily basis. I spend about 70% of my waking hours being sedentary and walk less than 10,000 steps per day. These average health and wellness behaviours culminate in an average body mass index (BMI) of about 27, which is classified as overweight.
In my lifetime I will have a 50% chance of developing cancer, a 50% chance of having heart disease, a 35% chance of developing diabetes, a 16% chance of having a stroke. Doesn’t sound great for me, does it?
Applying the 80/20 Rule
Let’s say I decide I am not happy with being of average health and I want to take measures to improve my lifestyle. My goals are to decrease the risk of chronic illness and to lose weight.
What are the highest yield ways to achieve this? If we apply the 80/20 Rule, then 80% of the value will come from 20% of the interventions.
Therefore, I can get the most bang for my buck by cutting out the sugary drinks, eating more fruits and vegetables, eating out less and exercising more. Combined with time, a few small, simple interventions can lead to powerful outcomes.
Should I do a lemon juice cleanse? What about the liver detox? What about the blood type diet? What about the low carb diet? What about the self hypnosis for weight loss? What about the P90 X workout routine? What CBD oil? What about green tea extract? What about raspberry ketones?
“80% of success is just showing up”- Woody Allen
I can do the extra stuff and work on the finer details, but the majority of the value (80%) comes from the first few big interventions (20%). Think about it this way — if over the long term I can cut out the pop and eat more fruits and vegetables how much extra value does that Blood Type Diet really add?
I should be clear that my point isn’t to hate on current health trends and fads, but rather making a change doesn’t need to be hard or complicated. Making change is hard enough as we are wired to maintain our status quo . Overcomplicating it — i.e. “I want to get healthy so therefore I’m going to start following the Keto Diet while taking green tea extract seven days a week” — can make it harder than it has to be. Increasing the complexity can make it harder to sustain and can limit success.
The power of the 80/20 Rule is that you don’t need to have the fine details sorted, as the majority of the value comes from the minority of the changes. Therefore, simple changes — i.e. “I want to get healthy so therefore I’m going to start eating more fruits and vegetables” — can have big power.
