Meta-analyses of health outcomes studies show that medical care affects long-term health outcomes by about 10%, genetics determine about 20%, and the other 70% is a combination of social determinants – environment and behavior. Despite these percentages, the focus of the health care industry and policy makers in the United States is on the 10%. Americans are treated with more catheterizations, angioplasties, bypass surgeries than in any European country. Moreover, the US has three to five times the MRI scanners of England or Canada, it has the highest percentage of people who receive diabetes treatment within six months, and the highest percentage of people referred to a medical specialist who are seen within a month. Despite these resources, the US continues to fall behind other industrialized countries in many important health outcomes such as life expectancy. As an example, it was recently projected that a third of the population of Mississippi will be diabetic by 2030.
In order to make a real impact on health outcomes, it is not enough to improve access to health care, but to also manipulate the ‘other’ 90% that determines health outcomes. While, the oncoming ‘omic’ (genomic, proteonomic, epigenomic) revolution will be able to influence outcomes in the near future, the large chunk (70%) of what impacts long term health outcomes (ie environmental and behavioral factors) must be effectively controlled to significantly improve health outcomes in the United States. Whereas, air quality and other environmental toxins are largely out of our immediate control, the single most immediate intervention that can influence health outcomes is our nutritional status.
As a society, we are calorically overnourished but nutritionally undernourished. Currently, more than 78 million adults and 12 million children in the United States are obese. Approximately 35% are mired in the mostly preventable and predominantly diet-related insidious death cycle of metabolic syndrome. People with metabolic syndrome are twice as likely to die from and three times as likely to have a heart attack or stroke compared with people without the syndrome. Additionally, people with metabolic syndrome have a five-fold greater risk of developing type 2 diabetes. Available evidence supports the emerging hypothesis that metabolic syndrome may be associated with the risk of some common cancers. Various epidemiological studies have shown that type 2 diabetes and metabolic syndrome are highly correlated with Alzheimer’s disease. This syndrome is the single largest health crisis facing the United States and it can essentially be prevented via dietary controls.
To further exacerbate the crisis, our calorie dense diet is woefully deficient on key vitamins and minerals. More than 93% of US adults 19 years and older do not meet dietary intake recommendations (called Estimated Average Requirement, or EAR) of vitamins D and E, 61% for magnesium, about 50% for vitamin A and calcium, and 43% for vitamin C. The known biological functions of vitamins and essential minerals are to maintain normal cell function, metabolism, growth and development, through their roles as essential cofactors in hundreds of enzyme reactions and other biological processes. While a well-balanced diet is the best way to get all of one’s essential nutrients, the reality is that Americans don’t get enough of them through diet alone. Without these nutrients we are even more susceptible to the vicious sequelae of metabolic syndrome.
The double whammy of a calorically dense and nutritionally deficient diet is drowning our healthcare system with the overwhelming burden of chronic diseases. These diseases account for 75% of the dollars spent on health care. Approximately 60% of cardiovascular deaths under the age of 60 are preventable. Additionally, the World Health Organization (WHO) projects that the number of preventable cancer cases will almost double to reach 12 million a year by 2035. Most of us look to allopathic therapeutic interventions to cure our ailments, however, altering our diets is the single most effective medical intervention we can make to optimize our health, maximize our life quality, and curtail our chronic disease burden.