Despite spending 17.7% of our GDP on health care, which is nearly twice the OECD (i.e. other developed nations) average of 9.3%, America has consistently ranked near last in the OECD when it comes to health outcomes since the 1980s. According to the Centers for Disease Control, 33% of adults and 17% of our children are now obese, and rates of childhood food allergy and asthma have more than doubled in the last 10 years. One in 68 children – and 1 in 30 boys – born today will develop autism spectrum disorder. All these trends predict sharp increases in health care spending and a work force saddled with more disease and disability at ever young ages.
We must reverse these trends. To do that, we must shift from a focus on healthcare to health. Creating more health is the most effective way to reduce health care costs, maintain a robust workforce, and reduce the disease-related drag on our economy.
Choices kill or heal
I am a clinical professor of medicine at the University of Iowa and I see patients in a clinic that was created specifically for complex chronic diseases. When patients first come to me, they are often on more than 20 medications: pills for pain, mood, blood pressure, diabetes, and/or potent immune-suppression, costing many thousands of dollars a month.
We often blame our illness on our genes, and think there is nothing we can do besides taking more pills. However, Dr. Walter Willett reported in Science that 70% to 90% of your risk of developing high blood pressure, obesity, diabetes, heart disease, and cancer, which are the top causes of death and disability in America, is due to just three things: diet quality, physical activity level, and smoking status.
Our diet and lifestyle choices have far more power in determining our health than our DNA does, but changing public policies around commodity and food supports to improve the quality of what we eat would be a slow and contentious process. U.S. Dietary Guidelines, published by the U.S. Department of Agriculture, require approval from the Dietary Advisory Committee, which is stacked with individuals who have financial connections to the pharmaceutical and food industries. There is plenty of science documenting that diets that emphasize sugar and white flour over vegetables and berries damage health. But the sugar, wheat, and corn industries (with a huge financial stake in high fructose corn syrup) will resist any policy change.
But we do not have to wait for public policy to change to make a difference in our individual health or the health of our children. That is because every day, we choose what we eat and do. These choices speak to our genes, turning genes “on” and “off,” changing how your cells run the chemistry of life. Your grandmother was right: you are what you eat. Poor choices shift what should have been a healthy, disease-resistant body into an inflamed, sickly, disease-prone one.
Disease begins with broken biochemistry, and for most Americans their broken biochemistry begins with a diet filled with sugar and white flour and relatively devoid of vegetables. If you eat the 150 pounds of sugar and 130 pounds of white flour that the average American eats each year, you activate the disease-promoting genes. And if you eat few vegetables, you silence the health-promoting genes and declining health is the result.
During World War II, Americans self-provisioned their food with “victory gardens” so our industries could focus on the war. Stuart Kallen, author of The War at Home, reports that up to one third of all American vegetables produced during that time came from such gardens. We need victory gardens once again, this time to defeat the epidemic of chronic disease. We should replace urban blight with urban farms as they have in Detroit, Atlanta, and Oakland—all of which are among the top ten worst “food deserts” in the United States, areas with poor access to fruits and vegetables.
If we returned to cooking meals at home, replacing sugar and white flour with vegetables, our health as individuals, families and as a nation would improve dramatically. That is because, in bodies fed this way, cells start conducting the chemistry of life more correctly, repairing the body and restoring and our ability to resist and even reverse disease.
This is not theoretical. I have seen it over and over in my clinics: when my patients drop the sugar and white flour and instead eat six to nine cups of vegetables a day, their blood pressures and blood sugars normalize, pain fades away, brain fog dissipates, and mood improves. I see people who look and feel ten years younger than when they first came to see me. Even autoimmune symptoms fade away. Many are eventually able to stop taking medication after medication, including their immune-suppression drugs. They begin thriving again.
In short, when people adopt a diet and lifestyle designed specifically for optimal function of their cells, their health steadily improves – and their health care costs steadily decline. I do support policy changes to improve access to healthcare. However the top causes of death and disability are driven by diet quality, smoking status and physical activity level. We must create more health.
This is the real solution to the real healthcare crisis in this country: changing our individual (and collective) behavior so that our health (and our country’s health) steadily improves leading to less need for drugs, procedures, and time away from work. I am teaching my medical students, resident physicians, patients, and anybody else who will listen. Washington may not be listening, but I hope you are.