How to Save a Trillion Dollars

[Guest guest]

In the scheme of things, saving the 38 billion bucks that Congress seems

poised to agree upon is not a big deal. A big deal is saving a

*trillion*bucks. And we could do that by preventing disease instead of

treating it.

For the first time in history, lifestyle diseases like diabetes, heart

disease, some cancers and others kill more people than communicable

ones<http://www.cdc.gov/nchs/fastats/lcod.htm>.

Treating these diseases — and futile attempts to “cure” them — costs a

fortune, more than one-seventh of our GDP.

But they’re preventable, and you prevent them the same way you cause them:

lifestyle. A sane diet, along with exercise, meditation and intangibles like

love prevent and even reverse disease. A sane diet alone would save us

hundreds of billions of dollars and maybe more.

This isn’t just me talking. In a recent issue of the magazine Circulation,

the American Heart Association editorial board stated

flatly<http://www.ncbi.nlm.nih.gov/pubmed/21262990>that costs in the

U.S. from cardiovascular disease — the leading cause of

death here and in much of the rest of the world — will triple by 2030, to

more than $800 billion annually. Throw in about $276 billion of what they

call “real indirect costs,” like productivity, and you have over a trillion.

Enough over, in fact, to make $38 billion in budget cuts seem like a

rounding error.

Similarly, Type 2 diabetes is projected to cost us $500 billion a year come

2020, when half of all Americans will have diabetes or pre-diabetes. Need I

remind you that Type 2 diabetes is virtually entirely preventable? Ten

billion dollars invested now might save a couple of hundred billion annually

10 years from now. And:

hypertension<http://www.webmd.com/hypertension-high-blood-pressure/guide/blood-p\

ressure-causes>,

many cancers <http://www.cancer.gov/cancertopics/factsheet/Risk/obesity>,

diverticulitis<http://www.johnshopkinshealthalerts.com/reports/digestive_health/\

861-1.html>and

more are treated by a health care (better termed “disease care”)

system

that costs us about $2.3

trillion<http://economix.blogs.nytimes.com/2010/01/12/big-government-health-care\

/>annually

now — before costs double and triple.

It’s worth noting that the Federal budget will absorb its usual 60 percent

of that

cost<http://economix.blogs.nytimes.com/2010/01/12/big-government-health-care/>.

We can save some of that money, though, if an alliance of insurers,

government, individuals — maybe even Big Food, if it’s pushed hard enough —

moves us towards better eating.

The many numbers all point in the same direction. Look at heart disease: The

INTERHEART study of 30,000 men and women in 52 countries showed that at

least 90 percent of heart disease is lifestyle related; a European study of

more than 23,000 Germans showed that people with healthier lifestyles had an

81 percent lower risk.

And those estimates might be on the low side. Dean Ornish, the San

Francisco-based doctor who probably knows more about diet and heart disease

than anyone, says, “My colleagues and I have found that more intensive diets

than those studies used can reverse the progression of even severe coronary

heart disease.”

In his latest book, “The

Spectrum,”<

recommends that people at risk eat stricter diets (more plants,

higher fiber, lower saturated fats and so on) than those who are generally

healthy, but it’s not all or nothing — the more you change your diet and

lifestyle, the healthier you are. “What matters most,” he says, “is your

overall way of eating and living. If you indulge yourself one day, eat

healthier the next.” I’ve been preaching similarly for years. But the

trillion-dollar question is, “How do we get people to eat that way?”

I don’t have an easy answer; no one does. But it for sure will take an

investment: it’s a situation in which you must spend money to make or save

money. (Yes, taxes will go up, but whose taxes?) Some number of billions of

dollars — something in the rounding error area — should be spent on research

to figure out exactly how to turn this ship around. (The NIH, which pegs

obesity-related costs at about $150 billion, just announced a new

billion-dollar

investment<http://www.highlighthealth.com/weight-loss/new-strategic-plan-for-nih\

-obesity-research-seeks-to-curb-epidemic/>.

Good, but not enough.)

Corny as it is to say so, if we can put a man on the moon we can create an

environment in which an apple is a better and more accessible choice than a

Pop-Tart. Some other billions of dollars must go to public health. Again: we

built sewage systems; we built water supplies; we showed that we could get

people to eat anything we marketed. Now all we have to do is build a food

distribution system that favors real food, and market that.

Experts without vested interests in the status quo come to much the same

conclusion: Only a massive public health effort can save both our health and

our budget.

Can we afford it? Sure. Dr. Ludwig, a Harvard-affiliated pediatrician

and the author of “Ending the Food

Fight,”<http://www.endingthefoodfight.com/>says, “The magnitude of the

deficit is small when you consider costs of

nutrition-related disease; the $4 trillion that the Republicans want cut

over a decade is about the same as the projected costs of diabetes over that

same period.”

In last week’s issue of the Journal of the American Medical Association,

Ludwig made a number of concrete suggestions, like restructuring subsidies,

regulating the marketing of food to children and adequately funding school

lunch programs.

His most novel ideas use existing and future technologies to help the food

industry retain profits while producing less junky products: devising a

method of preserving polyunsaturated fats, for example (dangerous trans-fats

are widely used simply because they are stable) or making bread with real

whole grains instead of refined ones. (His research demonstrates that people

who eat ultra-processed grains rather than whole grains for breakfast go on

to consume 600 to 700 calories more than other people each day.) “I’m not

arguing that the food industry should be philanthropic,” he says. “Its

purpose is to make money. But the goal of the government should be to

encourage industry to make money by producing more rather than less

healthful foods.”

The best way to combat diet-related diseases is to change what we eat. And

if our thinking is along the lines of diet improved = deficit reduced, so

much the better. If a better diet were to result *only* in a 10 percent

decrease in heart disease (way lower than Ludwig believes possible), that’s

$100 billion project savings per year by 2030.

This isn’t just fiscal responsibility, but social responsibility as well.

And the alternative is not only fiscal catastrophe but millions of premature

deaths.

--

Ortiz, MS, RD

*The FRUGAL Dietitian* <http://www.thefrugaldietitian.com>

Check out my blog: mixture of deals and nutrition

New movie: Dietitian meets the Mis-guided Health Food

Clerk<

* " I plan on living forever - so far so good " *