Monday, December 5, 2011

NO CHILD LEFT WITHOUT A BEHIND

The first article I ever published, in Co-Evolution Quarterly in 1980, was entitled “Insurance and the Abandonment of Responsibility.” It pointed out that all else equal, those who take better care of themselves will subsidize, through medical insurance premiums and taxes, the healthcare of those who don’t. Nothing has changed since then.

A major reason healthcare is so expensive is that we simply use too much of it. Americans engage in a number of pathogenic (disease-causing) behaviors until florid disease erupts, and then ask physicians to repair them. We harbor the notion, reinforced by incessant marketing, that medical science can correct just about anything. I can mistreat my heart all I like because when it finally caves in, I can get a new one.

Arguably our most common pathogenic behavior involves diet, obesity being alarmingly endemic. Three-quarters of Americans are overweight or obese, but what’s more distressing is the kid rate, now estimated to be 15-25%. Obesity leads to type II diabetes, cardiovascular disease and hypertension, not to mention disability associated with carrying around all the extra baggage. It’s estimated that obesity costs our society $117 billion annually, exceeding the healthcare costs associated with both smoking and drinking.  

Obesity’s become part of our accepted social landscape. Clothing catalogs standardly offer women “plus” sizes, and men, “big and tall.” Airlines debate installing larger seats, or charging passengers double if their bulk flows over the armrest. A man recently sued a burger chain because its seats wedged him in too tightly.

Last week I encountered evidence that obesity is no passing fad. Visiting another town where a new hospital is being constructed, we learned its special obesity ward will feature a ceiling fitted with a mechanical lift system since a good number of patients are now too heavy to hoist without industrial machinery; in addition, too many of the hospital staff themselves can barely carry their own estimable bulk, let alone their patients'.

Someone’s bound to cavil that some obesity is genetically programmed. Right: that proportion is about one in five hundred people. The rest comes from what’s eaten, period. Many pathogenic diets are a product of poverty. Try feeding your family a healthy diet on a minimum wage income. Unable to afford fresh organic groceries, you’ll opt instead for processed foods notoriously richer in preservatives than nutrition. These imitations are cheaper than the real thing, by the way, thanks to government subsidies their manufacturers wangled. Consuming these empty calories, you’ll plump out without being nourished. If people mattered as much as corporate profit does, we’d help them find their way to genuine food.

Too many families who can afford decent nutrition opt for the convenience of prepared foods, and children in these families grow up learning no alternative. If you’d like a shock, watch this video,  http://www.youtube.com/watch?v=bGYs4KS_djg&feature=results_video&playnext=1&list=PL35762311C5A7EF37, in which chef Randy Oliver asks a second-grade classroom to identify tomatoes. The poor kids haven't a clue. Maybe they've seen a sliced tomato on a McGutbuster, but never a whole tomato.

I recently related in this blog a report by a prestigious medical board (http://www.nhlbi.nih.gov/guidelines/cvd_ped/summary.htm) about American childhood obesity. The board recommended testing kids for serum cholesterol levels beginning at age nine. It also recommended, between page after page of pharmaceutical interventions, “intense lifestyle management” without spelling out what that might be. Of course, everyone suggests behavioral change along with medications, but in practice that amounts to meds alone. Testing kids and putting them on “corrective” drugs will, of course, keep the wheels of commerce spinning (especially since kids will need additional drugs to deal with side effects), but it won’t do a thing to increase the national health. As a certified curmudgeon, I’m amazed, astonished, and appalled that we evince such impressive expertise in chemical engineering, but are so little interested in a national program to promote personal health responsibility.

4 comments:

  1. The whole issue of obesity in children is very distressing to me.

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  2. Dr. J, having read your blog, I know you can say more about that...

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  3. The biggest problem is all you *&#%+*% doctors who have NOT read up and still think it's fat that causes obesity, and not sugars and starches!! You, personally, may be better educated (I just found your blog, so I don't know your level of knowledge) -- but this whole low-fat, high-starch thing the govt is pushing (and so the docs are pushing) is the CAUSE of the "diabesity" epidemic! A day or two of research might rock your world!

    Start with Tom Naughton's excellent YouTube documentary called "Science for Smart People" (the one recorded on the Low-Carb Cruise) and follow-up with his (funny AND scientifically sound) documentary: "Fat Head" available through Netflix, Hulu, and iTunes. Try reading some excellent written material: the blogs Mark's Daily Apple, Dr Mike Eades' Protein Power blog, -- or most telling -- Gary Taubes': his blog and his books "Good Calories, Bad Calories" if you want an immersion in medical studies and peer-reviewed references; and his newer, less heavy-going, "Why We Get Fat and What to Do About It."

    As long as doctors are mired in the WRONG beliefs (cause the science shows otherwise!) nothing will ever be fixed!

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  4. ..."all you *&#%+*% doctors"??

    I agree with you that the problem is carbs, not fats. But your apparent anger, along with your focus on one thin sliver of the problem suggests to me a perspective too strident and narrow to be effective.

    Yeah, Americans eat too much crap, including sugars and especially high-fructose corn syrup and other processed Frankenfoods. That's only a surface manifestation, though. WHY do we allow such toxicities in our bodies?

    First, crap is cheaper, thanks to government subsidies to corporations interested only in profit. Second, overeating is usually a metaphorical attempt to fill an existential void. As eating-disorder guru Geneen Roth puts it, "You can't get enough of what you don't really need." Primarily a materialist and consumerist society, we're spiritually almost bankrupt. We can educate folks all we like about real nutrition, but they'll continue to gobble mindlessly unless the spiritual questions are raised and addressed.

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