The New Skinny Revisited

Months ago I wrote an essay called The New Skinny, where I implied that obesity was the epidemic of our time. While I was called quite a few names, including “sizeist” and “elitist,” I haven’t seen much reason to change my opinion. In follow up to that post, here is a photo taken during my recent trip to Costco. In my hand is a family sized can of country sausage gravy. In the case against rising healthcare costs, I submit it as exhibit A: the murder weapon.

I’ve had a poor diet for most of my life. Across this country, what communities of limited wealth and education lack in nutritional knowledge stands in diametric contrast to easy access of cheap, mass produced food. Only in the last couple of years have I taken gradual steps to improving my health and diet, moving from enriched flour to whole wheat and fried food and processed sugars to lean meats and green vegetables. As my lifestyle has transitioned from one of passive consumption of the marketed buffet placed before me to one of critical consideration of all potential food choices, I’ve become increasingly dismayed by the lack of healthy options and the insidious nature of the standard American diet (SAD).

As I pushed my cart through Costco’s warehouse of edible goods, I looked at every nutritional label on foods I considered for purchase. Items as inncuous as granola, peanut butter, whole grain bread, yogurt, and even canned fruits and vegetables had high fructose corn syrup (HFCS), the substance considered responsible for the rapid rise in American weight gain that has taken place since the inception of HFCS in the 1970s. I also realized that if I were to limit myself to the USDA’s recommendation of consuming less than 25 grams of saturated fat per day, most of the items in Costco’s refrigerated section would be off limits. Don’t even get me started on sodium. Let’s just say you shouldn’t bother buying anything in a can or a box. In a facility as large as Costco, it shocked me that little of what they offer is actually good for me.

Healthcare was a big issue in the recent election. Everyone agrees that the system needs reform, with the most popular culprits being the significantly higher administrative overhead costs that are not incurred in other countries with simpler health-insurance systems, the lack of a government based single-payer system, the absence of free-market competition for pharmaceuticals, a healthcare system that allows for wasteful duplication of services, a lack of preventative care, higher treatment costs triggered by our uniquely American tort laws (defensive medicine), and higher prices for the same health care goods and services than are paid in other countries for the same goods and services. However, what we don’t hear as much about is the biggest threat to our healthcare system:

Us.

In an essay in the New York Times Magazine, Michael Pollan, the Knight Professor of Journalism at the University of California, Berkeley, offered advice to the next president on a wide range of issues, including how the American diet has impacted the U.S. healthcare system. Pollan argued that "one of the biggest, and perhaps most tractable," reason for increasing healthcare costs "is the cost to the system of preventable chronic diseases. Four of the top 10 killers in America today are chronic diseases linked to diet: heart disease, stroke, Type 2 diabetes, and cancer. It is no coincidence that in the years national spending on healthcare went from five percent to 16 percent of national income, spending on food has fallen by a comparable amount -- from 18 percent of household income to less than 10 percent." Pollan stated that healthcare reform will depend on "confronting the public-health catastrophe that is the modern American diet."

While some trends show that there has been a shift toward a more healthy diet, the current epedemic is clear. Diabetes, which has exploded among the American population, was responsible for 218 billion dollars in healthcare spending last year—nearly 10 percent of all U.S. healthcare spending. Cardiovascular disease was twice that amount. The Journal of the American Medical Association recently reported that “13 percent of American adults -- about 26 million people -- have chronic kidney disease (CKD), up from 10 percent, or about 20 million people, a decade earlier,” and most people who have CKD don’t even know it. According to researchers at Northwestern University's Feinberg School of Medicine, “because of rising obesity levels, for the first time, the life expectancy of the next generation may be lower than the current one."

Enjoy your Thanksgiving holiday.