Eating our way to illness (Oregonian Article)

Eating our way to illness


September 19, 2009, 9:40AM
Avi GerverThe 2004 film "Super Size Me" took dead aim at obesity in the United States as director Morgan Spurlock ate nothing but McDonald's fare for 30 days to test the effect fast food has on the human body.

The American diet, and obesity, is the biggest threat to our health system

By MICHAEL POLLAN

BERKELEY, Calif. -- To listen to President Obama or to just about anyone else in the health care debate, you would think that the biggest problem with health care in America is the system itself -- perverse incentives, inefficiencies, unnecessary tests and procedures, lack of competition and greed.

No one disputes that the $2.3 trillion we devote to the health care industry is often spent unwisely, but the fact that the United States spends twice as much per person as most European countries on health care can be substantially explained, as a study released last month says, by our being fatter. Even the most efficient health care system that the administration could hope to devise would still confront a rising tide of chronic disease linked to diet.

That's why our success in bringing health care costs under control ultimately depends on whether Washington can summon the political will to take on and reform a second, even more powerful industry: the food industry.

According to the federal Centers for Disease Control and Prevention, three-quarters of health care spending now goes to treat "preventable chronic diseases." Not all of these diseases are linked to diet -- there's smoking, for instance -- but many, if not most, of them are.

Annually we're spending $147 billion to treat obesity, $116 billion to treat diabetes and hundreds of billions more to treat cardiovascular disease and the many types of cancer that have been linked to the so-called Western diet. One recent study estimated that 30 percent of the increase in health care spending during the past 20 years could be attributed to the soaring rate of obesity, a condition that now accounts for nearly one-tenth of all spending on health care.

The American way of eating has become the elephant in the room in the debate about health care. The president has made a few notable allusions to it, and, by planting her vegetable garden on the South Lawn, Michelle Obama has tried to focus our attention on it. Just last month, the president talked about putting a farmers market in front of the White House and building new distribution networks to connect local farmers to public schools so that student lunches might offer more fresh produce and fewer Tater Tots. He's even floated the idea of taxing soda.

But so far, reform of the food system has not figured in the national conversation about health care reform. So the government is poised to go on encouraging America's fast-food diet with its farm policies even as it takes on added responsibilities for covering the medical costs of that diet. To put it more bluntly, the government is putting itself in the uncomfortable position of subsidizing both the costs of treating Type 2 diabetes and the consumption of high-fructose corn syrup.

Why the disconnect? Probably because reforming the food system is politically even more difficult than reforming the health care system. At least in the health care battle, the administration can count some powerful corporate interests on its side -- like the large segment of the Fortune 500 that has concluded the current system is unsustainable.

That is hardly the case when it comes to challenging agribusiness. Cheap food is going to be popular as long as the social and environmental costs of that food are charged to the future. Lots of money is to be made selling fast food and then treating the diseases that fast food causes. One of the leading products of the American food industry has become patients for the American health care industry.

The market for prescription drugs and medical devices to manage Type 2 diabetes, which the CDC estimates will afflict one in three Americans born after 2000, is one of the brighter spots in the American economy. As things stand, the health care industry finds it more profitable to treat chronic diseases than to prevent them. There's more money in amputating the limbs of diabetics than in counseling them on diet and exercise.

As for the insurers, you would think preventing chronic diseases would be good business, but, at least under the current rules, it's much better business simply to keep patients at risk for chronic disease out of your pool of customers, whether through lifetime caps on coverage or rules against pre-existing conditions or by figuring out ways to toss patients overboard when they become ill.

But these rules may well be about to change -- and, when it comes to reforming the American diet and food system, that step alone could be a game changer. Even under the weaker versions of health care reform now on offer, health insurers would be required to take everyone at the same rates, provide a standard level of coverage and keep people on their rolls regardless of their health. Terms like "pre-existing conditions" and "underwriting" would vanish from the health insurance rulebook -- and, when they do, the relationship between the health insurance industry and the food industry will undergo a sea change.

The moment these new rules take effect, health insurance companies will promptly discover they have a powerful interest in reducing rates of obesity and chronic diseases linked to diet. A patient with Type 2 diabetes incurs additional health care costs of more than $6,600 a year; over a lifetime that can come to more than $400,000. Insurers will quickly figure out that every case of Type 2 diabetes they can prevent adds $400,000 to their bottom line. Suddenly, every can of soda or a Happy Meal or chicken nugget on a school lunch menu will look like a threat to future profits.

When health insurers can no longer evade much of the cost of treating the collateral damage of the American diet, the movement to reform the food system -- everything from farm policy to food marketing and school lunches -- will acquire a powerful and wealthy ally, something it hasn't really ever had.

Agribusiness dominates the agriculture committees of Congress and has swatted away most efforts at reform. But what happens when the health insurance industry realizes that our system of farm subsidies makes junk food cheap, and fresh produce dear, and thus contributes to obesity and Type 2 diabetes? It will promptly get involved in the fight about the farm bill -- which is to say, the industry will begin buying seats on those agriculture committees and demanding that the next bill be written with the interests of the public health more firmly in mind.

In the same way much of the health insurance industry threw its weight behind the campaign against smoking, we can expect it to support, and perhaps even help pay for, public education efforts such as New York City's bold new ad campaign against drinking soda. At the moment, a federal campaign to discourage the consumption of sweetened soft drinks is a political nonstarter, but few things could do more to slow the rise of Type 2 diabetes among adolescents than to reduce their soda consumption, which represents a full 15percent of their caloric intake.

That's why it's easy to imagine the industry throwing its weight behind a soda tax. School lunch reform would become its cause, too, and in time the industry would come to see that the development of regional food systems, which make fresh produce more available and reduce dependence on heavily processed food from far away, could help prevent chronic disease and reduce their costs.

Recently a team of designers from the Massachusetts Institute of Technology and Columbia University was asked by the foundation of the insurer UnitedHealthcare to develop an innovative systems approach to tackling childhood obesity in the U.S. Their conclusion surprised the designers as much as their sponsor: They determined that promoting the concept of a "foodshed" -- a diversified, regional food economy -- could be the key to improving the American diet.

All of which suggests that passing a health care reform bill, no matter how ambitious, is only the first step in solving our health care crisis. To keep from bankrupting ourselves, we will then have to get to work on improving our health -- which means going to work on the American way of eating.

But even if we get a health care bill that does little more than require insurers to cover everyone on the same basis, it could put us on that course.

For it will force the industry, and the government, to take a good hard look at the elephant in the room and galvanize a movement to slim it down.

Copyright: 2009, The New York Times

Michael Pollan, a contributing writer for The New York Times Magazine and a professor of journalism at the University of California, Berkeley, is the author of "In Defense of Food: An Eater's Manifesto."

Diabetes Information Sheet

Diabetes Information Sheet

Definition:

Type One or “childhood onset”: a disease in which the pancreas does not manufacture adequate insulin for the body to regulate and transport glucose in the blood into individual cells. It results in excessively high serum glucose levels.

Type Two, insulin resistance or “adult onset diabetes”: an acquired disease in which the pancreas still produces insulin, but unhealthy and high levels of glucose remains in the blood stream, unable to be transported to individual cells. This, the most common form of diabetes has a strong relationship to diet and life style.

Serum or blood glucose levels: a snapshot measurement of the level of glucose in the blood at a given time. Diabetics are encouraged to do morning glucose tests (monitoring) to assure that diet or medications maintains a level in the normal range. This range is typically from 70-110 as a mg measurement in a cubic centimeter of blood.

HgA1c, hemoglobin A1c or glycocylated hemoglobin: a blood test which measures saturation of red blood cell walls with glycogen. It indicates whether blood sugar has been well regulated over the past 3 or more weeks.

Primary health risks of diabetes: Uncontrolled blood sugar, sustained at a high level is an inflammatory condition that damages the cardiovascular system and through impaired circulation often leads to nerve damage and neuropathies. This may lead to high blood pressure, heart attacks, neuropathies that require amputation and eventually kidney failure.

Simple Nutritional Considerations: It is important that people with diabetes limit foods that have a high sugar content or a high glycemic index. White sugar and high fructose corn syrup are two of the most harmful foods for the diabetic. Honey, maple syrup, white refined flour, white rice, pasteurized fruit juices and other foods that contain sugar or corn syrup (like soda pop, alcohol) are all to be limited in the diabetic diet.

The ADA (American Diabetes Association) diet seeks to limit simple sugars but is primarily concerned with counting carbohydrate levels (sugar) to make certain that medical control with insulin or hypoglycemic medicines is sustained. Dr. Neil Bernard, an endocrinologist from George Washington University advocates a vegan diet and has research that shows a much better long term outcome for diabetics than that achieved by the ADA recommendations.

Whole foods, use of raw vegetables and fruits and limited simple sugars are the simple guidelines for controlling diabetes. Trace minerals (especially chromium) and B-vitamins are also helpful in reversing insulin intolerance.

Check out the 5 most fattening foods ever!

According to Web MD, these are the 5 most fattening foods ever!

http://www.webmd.com/food-recipes/features/5-most-fattening-foods-ever?ecd=wnl_chl_090109

One out of 3 americans have genes for Type 2 Diabetes

Hey Loyal Friends

Have you ever wondered about your risk for getting cancer? Have you ever been concerned about what you or your loved ones can do to greatly reduce your risk for getting it? If so, this workshop is for you! Fresh Start Restorative Health Services is presenting the next workshop in a year long series of health and wellness workshops, because we care about your health. Dr. Steven Bailey (Nationally renowned author and lecturer on health) and Amy Rutherford-Close (personal trainer and Nutritionist) will be presenting on "Reducing Your Cancer Risk", on Saturday, October 3rd from 10 to 11 AM. The Lecture will be at 8131 N. Denver at Kilpatrick, in the Mahalia Jackson Hall - inside Celebration Tabernacle. It can also be reached by Trimet lines 4, 6 and yellow Line Max to Kenton)

Admission is free and so are the snacks. So again, if you'd like the knowledge to live a healthier, more vibrant lifestyle from a natural perspective, or if you're concerned about the health or nutrition of your loved ones, you owe it to yourself to come! For more information contact Robin Gordon at 503-890-5393 or Michael Hunter at (503) 936-3704. Or, check out our website at www.freshstarthealth.org.

Lecture this Saturday on Understanding Diabetes

Hey loyal friends, this next seminar is special for me as we will be talking about understanding DIABETES. Some of you know, but we’ve had one of our pastors, my good friend, recently pass away from diabetes. It has truly helped me to understand more about how serious this disease is.

I urge you to come out, and even if you're not suffering from it personally, you very likely know someone who’s suffering from it, or is at risk for it.

What makes this information different from what you would receive from traditional medical sources? Well, traditional medical sources have a tendency to address symptoms of diseases rather then addressing the cause or the source. We in this seminar will address the sources of diabetes and how address the disease through natural methods!

So, if you concerned about your health or the health of a loved one then this workshop is for you! Dr. Steven Bailey (Nationally renowned author and lecturer on health) and Bev Bromfield (program manager for the American Diabetes Association) will be presenting on "Understanding Diabetes", on this Saturday, September 5th from 10 to 11 AM. The Lecture will be at 8131 N. Denver at Kilpatrick, in the Mahalia Jackson Hall - inside Celebration Tabernacle. It can also be reached by Trimet lines 4, 6 and yellow Line Max to Kenton)

Admission is free and so are the snacks. So again, If you'd like the knowledge to live a healthier, more vibrant lifestyle from a natural perspective, or if you're concerned about the health or nutrition of your loved ones, you owe it to yourself to come! For more information contact me at 503-890-5393.