Healthcare: The High Cost of the American Diet

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.”

“Conventional” Food

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.

Dr. David Wallinga, Food and Health Program Director of the Institute for Agriculture and Trade Policy, sat down recently with Organic Connections to dis­cuss this.

“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.”

Click on any image above to see a larger version.

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.