Wednesday, December 9, 2009


What does “preventive medicine” mean to you?

Most of us, I think, see it as periodic physical exams, routine blood tests, mammograms, colonscopies, and so on. But those procedures aren’t actually preventive; they’re worthwhile attempts to catch diseases in early stages.

Though illness can seem to just happen, much prevention resides in the way we live. Our diet, exercise habits, stress management, relationship skills, social support, and other factors—most of them under our control—are the major determinants of health. A large number of people are saddled with poverty and ignorance, and some with pathogenic genes, but many, many of us can effect healthy choices.

Let’s take as one example obesity, a major risk factor for early death from a variety of causes. Obesity is determined by a formula, “body mass index” (BMI), which compares the body’s weight to its surface area. “Overweight" is defined as a BMI above 25 kilograms per square meter, and “obese” as a BMI  greater than 30.

You probably expect cynical old me to slight my fellow Americans as world-class fatties, but the fact is that we’re relatively svelte. According to WHO estimates, more than 75% of women older than thirty are overweight in countries as diverse as Barbados, Egypt, Malta, Mexico, South Africa, and Turkey. Estimates are similar for men, with over 75% overweight in Argentina, Germany, Greece, Kuwait, New Zealand, Samoa, and the United Kingdom. In the Western Pacific islands of Nauru and Tonga, nine out of ten adults are overweight.

Even so, American figures are no cause for a confetti parade. The U.S. Center for Disease Control reports overweight incidence of 57% among adults, and, more disturbing, 32% among children. Beyond overweight, the CDC finds 16% of American children obese, and an unfortunate 11% “extremely obese.” Should current trends continue, 75% of American adults are projected to be overweight and 41% obese by 2015.

Considering the propensity—indeed, the virtual certainty—of long-term obesity blooming into serious disease, we’re headed toward a major train wreck. In my October 22, 2009 rant in this blog, "Healthcare Reform? In Your Dreams," I tried to make the case that whatever current reform package Congress adopts, from “Single Payer” to “Enrich Industry CEOs Beyond Their Wildest Dreams,” healthcare costs will eventually bankrupt our nation. Unless, of course, we individuals amend how we choose to live…

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