🔬 What If Health Is More Than the Absence of Disease? A New Scientific Framework Aligns with Our ERM Approach

In June 2025, Science Advances published a groundbreaking review by Alan Cohen, Martin Picard, and colleagues titled "Intrinsic Health as a Foundation for a Science of Health." Their central argument is bold yet intuitive: If we want to truly understand and promote health—not just treat disease—we need to define health as something real, biological, and measurable in its own right.

Their thesis?

Health is an emergent property—a dynamic, field-like state that arises from the interaction of three essential elements: energy, communication, and structure within the body. It’s not found in a single lab value or organ system, but in the pattern of how our biology holds together under pressure. This is the kind of thinking we believe is urgently needed—and it deeply resonates with the foundation of the ERM (Exposure-Related Malnutrition) / Stress Adaptation Framework we’ve been working on.

The Shift: From Diagnosing Disease to Measuring Resilience

Cohen et al. argue that health should be approached as a dynamic systems phenomenon—the product of how our body integrates energy flow, internal communication (like hormones and inflammation), and structural integrity (like muscle, mitochondria, or circulation). When these three systems are synchronized, we experience robustness, adaptability, and sustained performance.

This directly complements what we’ve proposed in the ERM framework: that maladaptation under chronic stress—especially when resources are scarce—leads to measurable, reversible physiological changes. These changes reflect the body’s attempt to preserve core functions while making hard trade-offs. Think of reduced muscle mass, slowed recovery, immune suppression, fatigue, or low-grade inflammation not as isolated problems, but as a pattern of survival under constraint.

Why This Matters for the Future of Medicine

One of the most striking alignments is the recognition that health cannot be captured by one biomarker. Cohen et al. advocate for cross-system modeling, composite metrics, and pattern recognition—not static thresholds. This is precisely what ERM staging seeks to do: integrate metabolic, immune, and functional markers into a pattern-based map of stress physiology and resilience capacity.

Instead of searching for a single “health score,” both models suggest that we must learn to interpret the orchestra, not just a single instrument.

And here's where the ERM model brings the intrinsic health concept to life: by offering defined stages, biomarker candidates, and pathways for intervention. We’ve already identified reversible phenotypes, challenge tests (like post-stress recovery or metabolic responses), and proxy markers (e.g., grip strength + inflammatory patterns + energy markers) that can be used to track resilience in clinical practice.

What’s Next: Turning Theory into Tools

Cohen and colleagues provide a visionary conceptual scaffold. But as they themselves note, the field now needs empirical validation, clinical tools, and translational application. That’s where the ERM framework can serve as a bridge—from idea to implementation.

Together, these models support a new kind of healthcare—one that shifts from reacting to disease toward supporting resilience, recognizing early warning signs, and reversing biological decline before it becomes irreversible.

Final Thoughts

It’s rare to see a scientific vision so closely echo the goals of an emerging clinical framework. The intrinsic health model gives us language and legitimacy. The ERM framework gives us structure and application. Combined, they can guide the next generation of precision resilience medicine.

If health is more than the absence of disease, then let’s start measuring it, supporting it, and helping it thrive.

Cohen, A. A., Picard, M., Beard, J. R., Belsky, D. W., Herbstman, J., Kuryla, C. L., Liu, M., Makarem, N., Malinsky, D., Pei, S., Wei, Y., & Fried, L. P. (2025). Intrinsic health as a foundation for a science of health. Science Advances, 11(24), eadu8437. https://doi.org/10.1126/sciadv.adu8437

#Intrinsic Health, #Stress Adaptation, #Bioenergetics, #Systems Medicine, #Resilience Physiology