Updated: Sep 18, 2019
The Standard American Diet Will Kill Hundreds of Thousands in 2019. Does Anyone Care?
The hardest job of a nutrition advocate is getting people to appreciate the full gravity of our nation’s truly grim health crises. Not surprisingly, I’ve found that the more embedded into “business as usual” a crisis is, the more denial and despair people will express in reaction to the facts. The enormity of the avoidable suffering can be overwhelming to reflect on, especially when the solutions require disrupting the status quo of an entire system. And in a world awash in personal strife, clarity and the mere ability to take reasoned action often feel like luxuries.
But, despite how we may feel, whether anxious or apathetic, the facts and realities remain and continue to worsen.
That said, honesty and awareness also sow the seeds of motivation to do something, which in turn is necessary to effect positive change. So, ahead of describing the urgency of the situation, I want to reassure you that, collectively, we are not helpless, and change requires that more of us be willing to take a path of greater resistance. Action is the remedy not only to our malaise but also to the health crises in question.
And while each of us is facing challenges in our own lives, the diet-related illnesses we experience as individuals share a common origin in our destructive, profit-driven food system.
People deserve to be educated and, maybe, more importantly, inspired to take concrete measures against the erosion of our autonomy over the food environment and over our collective health and wellbeing.
Let’s begin with a bird’s eye view of the state of America’s health.
According to the Centers for Disease Control, fully six in ten adults, or about 117 million people, suffer at least one diet-related disease, and four in ten adults suffer two or more.
These diseases are largely preventable — some even reversible — and include cardiovascular disease, cancers, and diabetes, among others. To be clear, these diseases are our nation’s deadliest killers. And, as a common denominator, poor diet is the leading cause of illness, disability, and premature death.
The toll is sobering: nearly 700,000 Americans die every year from diet-related disease.
Which begs the question, when an issue this massive impacts nearly every single family in the country, why don't more people care?
For many, it’s easy to read the words “cardiovascular disease” and “cancer” and feel no visceral reaction. For instance, it’s unlikely that the first thing you think about when you hear the word “diabetes” is blindness, limb amputation, or death. These maladies, on paper, seem too distant and abstract to apply to us.
And yet, an average American’s lifetime risk for developing cancer is more than one in three — not much better than a coin toss. The lifetime risk of dying from cancer is an alarming one in five. Chemotherapy, often the first treatment cancer patients receive, is not only excruciating to endure for many, but, sadly, contributes a mere 2% to all cancer survival in the United States. It is not nearly as effective at saving lives as preventive dietary measures, which have the added benefit of greatly reducing the need for such a grueling treatment to begin with.
But it gets worse. Longevity in the United States has been on the decline for the last three years. While the opioid crisis explains much of the decline, the fall in women’s life expectancy is largely due to women dying at younger ages from the usual diet-related diseases, particularly heart disease. In fact, for both men and women, the death rates have gone up from multiple diet-related illnesses, including diabetes, stroke, and Alzheimer’s. Heart disease remains our number one killer, and advances in modern medicine are no longer improving the survival rate from it.
For many years, rising life expectancy belied the fact that we were only growing sicker and living with more disability for longer periods of time. But now, it appears as though we’ve hit a wall with our pharmacological and surgical Band-Aids as decades-long positive longevity trends reverse.
Most regrettably, children’s health is on the decline. Between 2000 and 2009, the prevalence of type 2 diabetes in children ages ten to 19 increased by over 30%. In case it bears repeating, diabetes is a leading cause of death in the United States. Childhood obesity, which quadruples the risk of type 2 diabetes before age 25, is still on the rise in 2018. Thirty-five percent of children ages two to 19 are overweight while about 20% are obese. Disturbingly, the largest increases in obesity prevalence were seen among two- to five-year-olds. And while diabetes is deadly, it’s not even the deadliest chronic illness associated with obesity.
Thus, it’s obvious why public health researchers are concerned that today’s generation of youth will experience worse health and shorter lifespans than their parents did.
The exploitation of human susceptibility for pecuniary gain by the food industry is nowhere more brazen than in its assault on our youth. Children in 1995 were already consuming five times as much fast food as children in 1977, and today, the clustering of fast-food establishments around schools has been linked with lower diet quality and a greater odds of overweight and obesity among students.
Franchises and food service companies are increasingly edging their way into school cafeterias, and many lunch items resemble typical fast-food fare. What’s more, children are mercilessly targeted by food industry advertisements both in and out of school, ensuring that highly palatable, disease-promoting foods remain entrenched in our culture and our national palate.
Diet-related disease touches all segments of our population and transgresses race, class, and sex. However, health disparities along lines of ethnicity, income, and education level make poor diet not just a public health issue, but a social justice issue, too. Sixty to 70% of youth with diabetes come from low-income households; these proportions are higher among children of color.
Unhealthy food environments and food apartheid play a heightened role in disease development and further entrench a cycle of disenfranchisement as poor nutritional status impacts academic performance, results in greater health expenses, and may lead to fewer opportunities for socioeconomic advancement.
Our food and healthcare systems are atrocities that continue to go under-addressed by those who hold the most power to fix them. Time and again, they give us the same excuses: the necessary measures aren’t feasible, affordable, profitable, reasonable, or easy.
We are told that health is an individual problem — that a quadruple bypass is routine and normal, but replacing processed meats with plant proteins in school and hospital meals is somehow extreme.
Yet, no fewer than one in three Americans experience negative outcomes associated with poor nutrition. When over one hundred million people are involved, can we really afford to continue blaming individuals? At what point do we hold the system accountable?