Healthcare: The High Cost of the American Diet
31 Oct, 2009
The headlines have lately been filled with news of the Obama administration’s proposed healthcare plan. Strongly worded opinions, both pro and con, are being volleyed from each side of the political fence. But one aspect of healthcare not being adequately addressed in the plan—as well as not mentioned in most of the pro or con arguments—is the basic American diet. How healthy can a person be when consuming chemical-laden and nutrient-deficient food with an emphasis on carbohydrates, bad fat, salt and sugar? How many healthcare billions are being spent to address health issues that have their roots in poor diet? It’s a hard number to come by, but according to the Centers for Disease Control and Prevention, three-quarters of healthcare spending goes to treat “preventable chronic diseases.” Treatment for obesity alone runs a tab of $147 billion, and that doesn’t figure in diabetes ($116 billion) or cardiovascular disease.
It’s an issue that has been increasingly attracting attention from many quarters. One very important sector that has begun to vocalize their concerns is the medical community.
While many physicians may have only recently jumped on the sustainable-food bandwagon, Dr. Preston Maring, Associate Physician-in-Chief for the Kaiser Permanente East Bay Medical Center in Oakland, California, has been patiently working throughout the last seven years to help bring a healthy diet to society at large.
Dr. Maring fully understands the impact of non-nutritious food on the cost of healthcare. “I think if you look at the healthcare of the nation, it is sort of a pyramid,” Dr. Maring told Organic Connections. “At the base of the pyramid you have primary care, and at the top of the pyramid you’ve got the complicated care. Our healthcare system struggles to find enough money to pay for all of the care throughout that pyramid, but there doesn’t seem to be enough money to cover it all. I believe that if good food were solidly under the base of the pyramid as a foundation, and if our people were able to eat healthier food throughout their lives, there would be enough money to pay for healthcare, because we would reduce the disease burden of those at the base of the pyramid who otherwise wouldn’t get as sick and require as much complicated care at the top.”
For food quality to be attracting attention from the medical community, something must be very wrong—and it is. As the quality of our diets has deteriorated over the last 50 years, certain diseases have become rampant. “Directly related to food, you hear a lot of talk about obesity-related problems in terms of diabetes, coronary artery disease and high blood pressure, and those happen in both men and women,” Dr. Maring said. “Those are the general categories of ailments; there are also many specific diet-related disorders.”
The health risks of our food system are not simply the result of lower nutritional values. We also have many chemical compounds used in food production today that have become part of our bodily environment.
“Given that we’ve created a society with around 80,000 industrial chemicals, there’s a lot to talk about with regard to food-borne pollutants,” Wallinga said. “Many of those chemicals end up in the food chain one way or another, through drinking water or because they are intentionally put into food packaging or because they are pollutants that accumulate up the food chain. Being at the top of the food chain, we often get the most exposure to these pollutants.”
Dr. Wallinga is a medical doctor who has, for the last nine years, been involved in examining the health impact of consumed food and how it is grown and produced.
“Most of the ‘conventional’ produce that we eat now is contaminated with residues of at least one and often many different pesticides,” he continued. “There are also many issues with meat and poultry. We did a study years ago showing that perhaps as much as 70 percent of the chickens grown in this country are routinely given a form of arsenic in their feed—not because they need it but just because it makes them grow faster. That’s a practice that was never approved as safe in Europe.
“Antibiotics are used heavily in the raising of farm animals. Anytime bacteria are exposed to antibiotics, it tends to make them more resistant to these drugs, which is true whether the antibiotics are used in hospitals, in communities or on farms. The problem is that the bacteria don’t really respect the boundaries between those places, so they travel from farms to people to hospitals. And so the scientific consensus now is that with the overuse and misuse of antibiotics in the farm setting, we’re helping to create drug-resistant superbugs that affect humans.”
Do We Need More Technology?
“There seems to be a big focus on how we need more technology to help fix some of the problems in agriculture, and I don’t think that’s true,” Rebecca Spector, West Coast Director of the Center for Food Safety, told Organic Connections. “We don’t need genetically engineered crops. We don’t need food irradiation to get rid of E. coli. We need to clean up our farms and clean up the way our food is processed to get rid of E. coli. We want to fix the real problem; we don’t want to look to band-aid solutions, such as irradiation, to try and fix some of the problems in our food system.”
The Center for Food Safety (CFS) is a national non-profit environmental organization with a goal to ensure that the US has a healthy and safe food supply.
A Better Food Future
With all that has gone on with our food system in the last 50 years, all three of these experts believe there is indeed a bright future ahead and see numerous ways to bring it about.
“I definitely think one of the key parts of the solution is that we need to focus on education,” Rebecca Spector remarked. “We need to help people make the distinction between real food and processed food so that they understand what actually makes healthy food, and to show them how to prepare real meals and incorporate cooking and family mealtimes back into their busy lives.”
CFS has a program through which they are not only educating people on the choice of sustainable food but also increasing their awareness of food processes and what can be done about the harmful ones. “We have a membership of about 85,000, and we send them regular information on new food technologies that are being proposed, opportunities to comment on food legislation, and opportunities to write to both federal and state agencies,” said Spector. “We’re really trying to empower people to express their concern about these issues.”
Dr. David Wallinga sees a good amount of positive change occurring in agricultural methods. “The one thing that you can’t really get away from is that agriculture is inherently ecological. To pretend that in the long term you can grow food without really thinking about its impact on soil erosion or on the quality of ground water and its pollution with heavy metals is just folly. I think that the people in public health and medicine and other health sciences are waking up to this fact. For example, the American Medical Association recently passed a new policy concerning sustainable food. It’s pretty good. It talks about finding ways to produce food without squandering antibiotics, as well as ways that contribute less to climate change.
“They’re not the only organization; both the American Dietetic Association and the American Public Health Association have something very similar.”
With a view much like Rebecca Spector’s, Dr. Preston Maring sees the problem as primarily an educational one. He first considered it a problem of getting out nutritional, sustainably grown food so that people would know it was there—a problem he began solving by opening a farmers’ market right next to the very medical center where he worked. The program has become an integral part of Kaiser Permanente’s operation, and there are now 37 farmers’ markets at Kaiser locations around the country. The food is purchased by staff, visitors and patients and taken back to neighborhoods and kitchens throughout their communities.
Dr. Maring also believes in simply teaching people to cook. “I think the first priority is to just help and encourage people to get started cooking fresh foods, even if they’re grown using conventional agriculture,” he said. “You then encourage people to eat sustainably grown local produce. I’m getting more and more convinced, as time goes by and I talk to people in various groups, that probably the best thing we could do for public health is to teach people how to sharpen a chef’s knife and how to use it, and have a couple of cutting boards and salad spinners. That could transform the whole experience for people of preparing good food at home.”
In conducting this education, Dr. Maring takes time to demonstrate the economy of making your own meals—such things as replacing a three- or four-dollar jar of salad dressing with 25 cents’ worth of garlic, red wine vinegar, olive oil, Dijon mustard and chopped parsley; the remainder of the money can then be spent on some good fresh fruit or fresh vegetables. “A little bit of simple instruction about how to mince garlic, how to dice onions, how to pan-sauté some foods, and it would be easy to show people how to put together a meal for 4 to 15 bucks instead of spending 30 or 40 or 50 out at a local family restaurant,” Dr. Maring said.
It even comes down to competing with fast food. Not long ago, Dr. Maring was talking to a group of 30 or so high school students at his local farmers’ market and asked them how much they spent, for example, on a bag of potato chips. One student was able to answer immediately: $1.29. Based on the actual potato content of the chips, Dr. Maring calculated the cost of potatoes for the bag to be about $16 a pound, and he took the students over to one of the stands where he found red potatoes for $1.50 per pound. He then advised the students on how to roast potatoes. Pointing out the $10 to $12 price for a pizza, he next talked them through how to make a pizza for half that cost—with wholesome ingredients.
Dr. Maring concluded with a story that truly brought home the point. Recently he spent the day at the Kaiser Permanente Center in Watts, Los Angeles—one of the most economically depressed neighborhoods in the nation. “While I was there, a little boy came up to me and asked, ‘Sir, what’s healthier, white or green asparagus?’ I said, ‘You know, I think they are both really healthy, and it’s just important every day to eat multiple different colors.’ Then I said, ‘Listen, I’m going to do a cooking demo; would you help me?’ He said, ‘Sure.’ This boy was probably 10 and had never used a chef’s knife before. I taught him how to mince garlic and how to mince a shallot, how to make a vinaigrette and how to chop some parsley. He made a red wine vinaigrette and put it on a little tiny salad he’d prepared and served it to the various people coming to the market. He was thrilled, and at the end he said, ‘Thank you very much. You’ve opened a new door for me.’ It’s a day I’ll never forget.”
In the end, it’s our healthcare system and our country, and while a growing number of us are shopping for fresh, local and organic food, the majority of Americans who end up in our healthcare system are not. Thus there is always a need for constant outreach and education.