No Health Care Reform Without Diet Reform

I’ve waited the requisite 24 hours to interrupt the celebration for some curmudgeonly ranting.  The health care bill will indeed bring coverage to around 30 million people.  This is good.  This will save lives.  But let’s not forget the 20 million or so who are still without coverage.  Our health care system is still inferior to that of most industrialized nations and we still need a great deal of reform.  If we don’t do something to control the costs, however, an equitable, efficient health care system of the highest quality will always be out of reach.

Most people know that obesity is one of the major factors driving health care costs. According to 2008 CDC estimates medical costs associated with obesity $147 billion and “the medical costs paid by third-party payors for people who are obese were $1,429 higher than those of normal weight.”

More recent studies estimate national health costs resulting from obesity are $190 billion, or 20.6 percent of overall health care expenditures.

Yet we have been astoundingly ineffective in figuring out what’s caused the epidemic or how to stop it.  The drug companies have done a great job funding research and providing drugs to treat obesity related illness.  The FDA approved a new diet drug yesterday–hallelujah.  But where is the research on WHY we are so fat when we weren’t a generation ago?  The answer is, in part, that it’s out there–the U.S. government and our health care professionals are just ignoring it.

On Tuesday, Dr. David Ludwig from Boston’s Children’s Hospital told CBS This Morning (CTM) : “All of the refined carbs that invaded our diets with the low-fat craze seems to lead to metabolic changes not only making us hungrier, but causing metabolism to fall.  And that combination is a recipe for weight gain.”

But this isn’t exactly a news flash.  Research about the correlation between carbohydrate rich , low-fat diets and obesity has been out there for nearly 100 years.  (Read Gary Taubes‘s Good Calories, Bad Calories–a dense, impeccably researched tome on the effects of carbohydrates on the body.) The research was out there when I was a kid and the USDA put out its food pyramid recommending we eat 8-10 servings of grains a day and minute amounts of fat.

Now, when there is even more evidence pointing to low-fat, high carb diets as a cause of obesity, the USDA recommends a low-fat diet with ¼ of  calories coming from whole grains.  They list coconut oil and butter as a fat you should limit and Canola oil  and Corn oil as “healthy” fats (I’ll write about how this is a recipe for poor health on some other post).

The CDC still insists, “Overweight and obesity result from an energy imbalance. This involves eating too many calories and not getting enough physical activity.” When there is so much evidence telling us the opposite, that it is flat out irresponsible to say this.  Yes, the research about the causes of obesity is a morass of confusing information.  Yes, some studies support the “calorie in/calorie out model”.  But the scales seem to be tipping (ha ha) in favor of the “good calorie/bad calorie” model.  And it’s up to organizations like the AMA and the CDC to sift through research and provide us with some meaningful advice on how to stop getting fat.

Our government and health care professionals can tell us all they want to eat more “healthy whole grains”  and fewer “bad fats,”  to walk the block to the grocery store instead of driving and that an appropriate portion of chicken is the size of your palm, but we will still keep getting fatter.  If they don’t start telling us the truth about WHY we get fat and how to STOP getting fat, we will keep getting fatter.  If we keep getting fatter, we will increase the burden on the health care system–and health care reform may never become a reality for this generation.


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