But by the end of the 20th century, the dieting trend was starting to decline. The reality that diets very rarely produce sustained weight loss started to sink in. People gradually shifted their emphasis from shrinking their size to improving their health.

The Health at Every Size and Body Positivity movements were central to this shift. And the Dove brand received widespread praise for its Real Beauty campaign, featuring models with full-figured bodies.

By the 2010s, polls were showing record lows in the percentage of people who wanted to lose weight, and news outlets were reporting that fewer than 1 in 5 people in the US was dieting. All this spelled trouble for the weight loss industry.

Fast forward to the present day, and — shazam! — the semaglutide drugs Ozempic and Wegovy have hit the scene. It turns out that people still want to lose weight after all.

The New Weight Loss Drugs

If companies needed reassurance that weight loss can still be big business, they’ve gotten it. Novo Nordisk, the Danish corporation that makes Ozempic and Wegovy, is now the most valuable company in all of Europe, with a market capitalization of $425 billion dollars, an amount greater than the entire economy of Denmark.

But what are these drugs, and how do they work? Are they really that effective for weight loss? What are the benefits of being on them, and what are the side effects? And, more importantly, are they safe?

There are indeed some surprising benefits — and also eye-opening risks — to semaglutide drugs for weight loss. And in this article, we will cover all of them. We’ll even introduce you to an alternative approach that research shows produces weight loss results equal to Ozempic and Wegovy, without the negative side effects. (Hint: it’s not weight loss surgery, and Big Pharma is not involved).

But first, we need to start at the beginning. Should people even try to lose weight in the first place? And why have conventional approaches to weight loss failed them?

A Rise in Obesity and its Health Effects

Over the last 50–75 years, the average weight of the human population has risen steadily, in lockstep with dramatic changes to our food supply.

According to the World Obesity Atlas, by 2035, fully one-half of all people worldwide, over four billion people, will be living with overweight or obesity. And that’s not good news, for many reasons.

There is still a tremendous stigma associated with excess weight, making overweight and obesity difficult to live with, both socially and psychologically. Obviously, we should continue to strive to reduce that stigma. And people should aim to be healthy, and to love and respect themselves, their bodies, and the people around them, no matter their size.

If negative stigma were the only issue, universal size acceptance and body positivity would be the straightforward answer. However, research continues to confirm that body size is not at all irrelevant to human health.

Furthermore, health-promoting efforts like exercise do not fully offset the risks of carrying excess weight. For example, in a large study of over 50,000 people, researchers found that even robust levels of physical activity don’t neutralize the profoundly damaging toll that obesity takes on cardiovascular health.

Alas, excess weight is simply not benign. It’s linked with mental health conditions like depression and anxiety, conditions of poor well-being like fatigue and chronic pain, potentially life-ending conditions like heart disease and 13 forms of cancer, and, of course (as we were all reminded by the media over and over in 2020 and 2021), severe illness and potential death from diseases like COVID-19.

Bringing our body composition in line with the body fat ratios that our ancient ancestors used to have may well be the healthiest for longevity, not to mention quality of life along the way.

The Truth Behind Weight Gain and Weight Loss

So, what’s driving all this weight gain?

It’s easy to assume that our sedentary lifestyles are to blame. But research shows that active people in hunter-gatherer tribes actually burn no more calories than sedentary people in the Western world.

How can that be?

It turns out that, when we’re very active, the body compensates by burning significantly less fuel the rest of the time, resulting in little to no change to overall daily energy output.

Keep that in mind the next time you think you’ll go to the gym to “burn off” the food you’ve just eaten. You can do that workout, and it will absolutely be healthy for you overall. But when you come home afterward, your body will shift into low gear. (And after a few days, you will have burned no more total calories than if you had just stayed home.) This is part of the reason why exercise won’t make you thin.

Ultra-Processed Foods

More and more experts are starting to converge on the opinion that the true cause of the obesity pandemic is all the ultra-processed food we’re eating. And indeed, solid research shows that ultra-processed foods drive us to eat more and gain weight quite rapidly.

In fact, even when controlling for total presented calories, energy density, and grams of protein, carbohydrate, fat, fiber, sugar, and salt, on a processed foods diet (versus an unprocessed diet of nearly identical composition), participants in the above trial ate significantly more and gained weight in as little as two weeks.

People eating ultra-processed foods don’t just gain weight, though. Their brains and bodies change. Inflammation rises, baseline insulin levels go up, and triglycerides increase. Together these changes are associated with leptin resistance, a condition that means the brain never gets the signal to stop eating.

Plus, ultra-processed foods are addictive, creating the same deficit in dopamine receptors that’s characteristic of cocaine and heroin addiction. And this change in brain chemistry causes powerful food cravings that further drive people to overeat.

This is all bad news for humankind because ultra-processed food consumption is only becoming more and more prevalent.

Today, a full two-thirds of the calories children consume is not what their grandmothers would have called “food” at all, but rather industrial concoctions born in a factory and poured into a plastic wrapper. And the trends aren’t stopping — they’re just going global.

Every 10 hours in 2023, a new McDonald’s opened in China, with a record 900 new franchises added by the end of the year. That’s on top of the roughly 1,200 new KFC and Pizza Hut stores that opened in China as well. The US has spread its “cuisine” around the world — with devastating effects.

How the Brain Can Sabotage Weight Loss Efforts

On a personal level, for the 70% of people in industrialized countries today carrying excess weight, the conundrum is that once weight is gained, it’s incredibly difficult to shed for good. And this is by design.

The brain is happy to allow us to gain weight. After all, fat stores are what will keep us alive when food becomes scarce over a long winter. But the brain fiercely protects our current body weight (even if it’s too high for optimal health) by launching a full-fledged hormonal assault when we lose weight. It very deliberately toggles our hormonal dials: lowering thyroid hormones (reducing our metabolism), increasing ghrelin (triggering hunger pangs), and lowering leptin (so the brain comes to think we’re starving), making sustained weight loss about as easy as holding our breath while climbing a long staircase.

Many people engage in yo-yo dieting and ultimately find themselves demoralized. In a nutshell, diets don’t work. People tend to lose perhaps 2–7% of their starting weight (when they might be aiming to lose several times that much). And then, almost always, they gain it back. Indeed, weight loss programs don’t tend to publish results beyond one year, because after that, weight regain is the norm.

Enter Ozempic and Wegovy

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No wonder people are looking for a different solution. And for people who have tried everything else, the new weight loss drugs are offering much-needed hope again. Celebrities of every ilk, from actors, models, and comedians to business magnates and even the former Prime Minister of the UK, are talking about their use of these drugs. But is the hype warranted? Let’s dive in.

What Are the New Weight Loss Drugs and How Do They Work?

Semaglutide drugs were originally designed to help control blood sugar levels in people with type 2 diabetes. They work by mimicking the hormone GLP-1, which has an appetite-suppressing effect.

Tirzepatide drugs, which are also part of the current weight loss trend, mimic both GLP-1 and the hormone GIP, but overall have a similar effect. They increase insulin released from the pancreas and decrease glucagon from the liver, which balances out blood sugar. As a result, people lose weight because they become less interested in eating.

Additionally, these drugs modulate dopamine levels in the addictive centers in the brain, resulting in fewer cravings and decreased anticipation of pleasure from eating. In animal models (FRN’s stance on the use of animals in medical research is here), these drugs were able to reduce cocaine, amphetamine, alcohol, and nicotine use, too. And in fact, reports are flooding in that people on Ozempic and Wegovy are not just eating less, they’re also smoking fewer cigarettes and losing their taste for alcohol.

With the double whammy of less hunger and fewer food cravings, weight loss results can average upwards of 15% of starting body weight. This is many times greater than what people can expect from a conventional weight loss program.

From that perspective, it definitely is the case that semaglutide drugs can work for weight loss. However, from the perspective of a 300-pound person looking to lose perhaps 35–60% of their body weight, the prospect of losing 15% of their starting weight isn’t exactly a home run.

For context, the average person getting Roux-en-Y gastric bypass surgery — the approach that results in the most dramatic weight loss but also comes with a 3.34% mortality rate — can expect to lose a lot of weight initially and then regain a fair bit, settling at a net loss of about 25% of their starting weight after five years. Certainly, weight loss surgeries are far more invasive and involve a host of risks. But are weight loss drugs risky, too?

Is Semaglutide Safe?

The question “Are they safe?” requires us to consider our standards for safety and our tolerance for risk. Is driving a car safe? Flying in an airplane? Jumping out of an airplane with a parachute?

One might argue that carrying a lot of excess weight isn’t “safe,” which means it really comes down to managing risk. So, what are the risks of semaglutide and other weight loss drugs?

Gastrointestinal Symptoms

The main side effects of semaglutide drugs are gastrointestinal in nature, and they can range from very mild to severe. Many people who start on these drugs experience symptoms like nausea, vomiting, diarrhea, constipation, sharp pain, belching, gas, bloating, or intestinal blockage.

For some people, the side effects are problematic enough that they stop taking the drug. In fact, many prominent celebrities have done so because it made them feel too sick. But most people find that the side effects subside with continued use. Starting on a low dose and then gradually increasing it can reduce the likelihood that GI symptoms will be debilitating.

Unfortunately, we don’t have any clear long-term data on what these drugs do to the gastrointestinal system over time.

Thyroid Cancer Risk

People taking semaglutide drugs may also have an increased risk of developing thyroid cancer, so people with a family history of the disease are cautioned not to take them. As a result, the FDA has put a black box warning (its highest level of warning) on the Ozempic and Wegovy packaging for thyroid cancer.

That said, a meta-analysis of 45 randomized controlled trials showed an increase in thyroid disorders, but not thyroid cancer. Because these instances are rare occurrences, more research is needed.

Muscle Reduction

Finally, many outlets have reported that semaglutide drugs reduce lean muscle mass (rather than just fat mass). But there are also several studies that contradict that claim — so the jury is still out on this point.

How Much Does Ozempic or Wegovy Cost?

One of the biggest downsides to semaglutide drugs for weight loss is the financial cost. Getting a weekly injection (and yes, most of these drugs are administered by injection) of Wegovy can cost over $1,300 per month in the US — that’s around $16,000 per year. The drugs are priced significantly lower in other countries (although still expensive). But these sky-high prices are resulting in insurance companies dropping these medications from their plans, so getting coverage can be difficult.

There are innumerable plans, and policies change frequently, so a Google search is not likely to help you determine whether insurance will cover Ozempic or Wegovy. If you have health insurance, the best way to find out is to contact your insurance provider directly. There are some coupons and programs that help people pay for the drugs. But the bottom line is that the financial investment is likely significant.

And the cost doesn’t just impact the user. Any time insurance providers, even including governments, pay for an expensive treatment, the cost is ultimately absorbed by everyone in their covered pool — through higher premiums and/or taxes. This means that if costly weight loss drugs come to be used widely, the price of medical insurance could go up for just about everyone.

Weight Regain

If you’re not prepared to be on the drugs for the rest of your life, then it’s also important to know that, once the drugs are discontinued, most of the weight tends to come back rather quickly.

One large study found that participants regained two-thirds of the total weight they’d lost within the first year of stopping the medication. This is perhaps not surprising. When you stop taking cholesterol medication, you expect your cholesterol to go up again. The same logic applies to semaglutide drugs.

It would be nice if the brain would adapt to your new, lower weight and allow you to maintain it as a “new normal.” But it doesn’t. This means that someone taking the drugs for weight loss will either need to prepare to be on them for life or adopt new lifestyle interventions that will allow them to manage their weight when they wean off.

The trouble is that, when appetite and cravings are artificially suppressed, motivation is not strong to adopt rigorous new eating habits. If the person could have done that in the first place, they would have lost weight without the drug.

Are There Long-Term Studies on the New Weight Loss Drugs?

Unfortunately, no. We don’t have a lot of long-term data on Ozempic or Wegovy. But the first GLP-1 agonist to be approved for type 2 diabetes was Byetta (Exenatide) in 2005. You can think of it as a first cousin to Ozempic and Wegovy.

That drug does have a study on long-term outcomes. Results showed that Exenatide continued to provide blood sugar stabilization to type 2 diabetics with no unexpected adverse events for seven years.

Semaglutide drugs also seem to protect people from death and adverse events from heart disease, so much so that the FDA has approved Ozempic as a treatment for heart disease.

In a double-blind, randomized clinical trial with 17,604 patients, weekly semaglutide injections were found to reduce cardiovascular events like strokes and heart attacks by 20%.

Are There Alternatives to Ozempic and Wegovy?

Since the Ozempic and Wegovy craze has hit the world, reports have been coming out that eating more fiber (the kind naturally found in whole, plant-based foods) can have a semaglutide-like effect.

Interestingly enough, just the act of chewing increases GLP-1 release. It also decreases the release of ghrelin, the hunger hormone. That’s super interesting because ultra-processed foods are designed to minimize chewing, and experts have highlighted the stark difference in chewing intensity and frequency between eating the standard American diet versus a diet of whole, real foods.

In short, it’s reasonable to conclude that, if you’re eating the right foods, the results that people are getting with Ozempic and Wegovy should be achievable through diet alone.

And, there is a line of research that shows exactly that. Over the past nine years, a habit-based program focused on eliminating ultra-processed foods and eating only whole, real foods, Bright Line Eating, has published weight loss results comparable to semaglutide drugs.

Full disclosure: I developed this program, which grew out of my decades of research in the field, and I’m the CEO and owner of an organization that champions bringing this body of work into the world. The following graph shows the weight loss results, published in peer-reviewed scientific journals, of many of the most common commercial weight loss programs, compared with Bright Line Eating and semaglutide drugs.

References:

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Bright Line Eating is the only commercial weight loss program that addresses the addictive nature of ultra-processed foods. Indeed, it’s tailored mainly for people who score between 7 and 10 on a Food Addiction Susceptibility Scale that goes from 1–10. By taking this short quiz, you can see how you score.

Research also shows that losing weight within a community like Bright Line Eating is associated with positive “side effects” such as higher energy, greater feelings of connection, better quality of life, decreased depression, and fewer days of poor mental health — and that with this way of eating, hunger and food cravings go steadily down.

The Future of the Weight Loss Industry

Without a doubt, the genie is out of the bottle. Weight loss drugs are here to stay. And the development of further drugs in this category is progressing rapidly.

Currently, the drugs approved for weight loss require regular injections because the peptides in semaglutide don’t absorb well through the digestive system. But Novo Nordisk has innovated a pill form of semaglutide called Rybelsus that the FDA has already approved for the treatment of diabetes.

In November of 2023, the FDA also approved Zepbound, a new tirzepatide drug developed by Eli Lilly, for weight loss. Given the multibillion-dollar market that’s available here, there’s no doubt that the rapid development of new options will continue. And as generics come out (Novo Nordisk’s patent on Ozempic expires December 5, 2031), the cost will eventually come down at least somewhat from the current stratospheric levels.

About 45% of people polled in the US say they would consider taking a weight loss drug. That comes down to 16% if it’s not covered by insurance. But these are people who have come to believe that sustained weight loss is largely impossible without a pharmacological or surgical solution.

But the results of Bright Line Eating highlight the reality that lifestyle-based approaches are worth pursuing, and that ultra-processed food addiction needs to be addressed for people to be successful.

Losing weight when you’re hungry and plagued by food cravings is unsustainable. We now live in a world where there are drugs that can take away excessive hunger and addictive food cravings. But emerging evidence shows that we can eat to reduce hunger and cravings as well. Not to be Twiggy, but to be healthy.

Tell us in the comments:

• Are you trying to lose weight or have you tried to in the past?
• What do you find most challenging about weight loss?
• Do you plan on trying a semaglutide drug like Wegovy or a more natural alternative?

Featured Image: iStock.com/CR

Read Next:

• What No One Tells You About Weight Loss
• 11 Top Weight Loss-Friendly Foods

The post Are Semaglutide Drugs Like Wegovy and Ozempic Safe and Effective for Weight Loss? appeared first on Food Revolution Network.

Before long my fever was raging at 104 degrees, and I was so weak I was unable to muster a cry.

I’m grateful that my parents took me to a doctor, who put me on antibiotics. Within hours, my fever was down, and my sickness had reversed.

That antibiotic prescription may have saved my life.

What Exactly Are Antibiotics?

Alexander Fleming, a professor of bacteriology at St. Mary’s Hospital in London, discovered penicillin — the first antibiotic — in 1928.

He’d been experimenting with colonies of Staphylococcus bacteria growing in Petri dishes. And he noticed that one dish had a spot of mold with a clear ring around it. This ring was a secretion from the mold that prevented further bacterial growth. It turned out to be penicillin.

Fleming and his colleagues worked to isolate penicillin, discovering its ability to attack other bacteria, like streptococcus, meningococcus, and diphtheria bacillus.

In later years, researchers developed new antibiotics that were effective in killing different classes of bacteria.

Altogether, antibiotics have saved millions of lives worldwide — overpowering such potentially lethal diseases as meningitis, tuberculosis, and cholera.

When used appropriately, antibiotics are a blessing and a welcome arrow in humanity’s medical quiver. But the reality is that they’re vastly overprescribed.

According to the CDC, in 2021, health care professionals prescribed 211.1 million antibiotic prescriptions — and many of these prescriptions are unnecessary.

Many health care professionals prescribe antibiotics at an alarming rate. Sometimes they prescribe them without making sure the drug will effectively attack whatever germ is involved — or without confirming that it is a bacteria and not a virus. (Antibiotics are completely ineffective against viral infections.)

And this lax approach doesn’t come without consequences.

The Dark Side of Antibiotic Use

Antibiotics don’t just target harmful bacteria in your body. They’re destructive to all microbes, which can leave your body’s natural microbiome unbalanced and damaged.

And this ecosystem won’t always go back to normal unless you consciously make an effort to make it so. Odds are, if your microbiome is currently out of balance, past antibiotic use has significantly contributed to your condition.

It’s also likely that the health care professionals who prescribed those antibiotics to you didn’t discuss how to counteract the collateral destruction of good bacteria in your body.

A couple of years ago, I was considering taking antibiotics to fight a strep infection. I asked my doctor if he could recommend any protocol for repopulating my body with healthy bacteria.

He replied that he didn’t learn anything about that in medical school, so he couldn’t offer me any advice. “My wife took a nutrition class online,” he told me, “so she’d be a better person to ask.”

It’s pretty crazy, if you think about it, that our medical system is so good at destroying a bacterial ecosystem but so ineffective at rebuilding it.

For more on the importance of gut health, and the use of prebiotics, probiotics, and postbiotics, read our in-depth article here.

How Antibiotic Overuse Is Creating “Superbugs”

Not only do antibiotics damage good bacteria, but their overuse encourages the widespread development of “superbugs,” or bacteria that display antibiotic resistance.

Bacteria, you see, are very much like accountants. No matter how much you change the tax laws, there will always be wily accountants who will find a way around them to escape taxes. Similarly, when you increase the dose of antibiotics or engineer new ones, some bacteria will find a way to mutate and resist them.

As a consequence of antibiotic overuse, we’ve had to start turning to “last-line” antibiotics, or medications typically only used as a last resort when the usual medications no longer work.

These drugs are meant to be used sparingly in human medicine to limit bacterial exposure to them, in the hope of preventing the development of antibiotic resistance. Unfortunately, because antibiotic resistance has increased, the prescription of last-resort antibiotics has also increased.

Antibiotic Resistance Can Be Deadly

Antibiotic resistance is leading to more and more deaths that were once preventable. That doesn’t sound like the kind of progress we’ve come to expect from the field of medicine.

In the United States, nearly three million people contract an antibiotic-resistant infection each year — with more than 35,000 people dying. Worldwide, antibiotic-resistant microbes are estimated to cause nearly five million deaths per year. And these numbers are rising.

Superbugs now threaten to make many common infections, such as urinary tract infections and pneumonia, lethal once again.

Many public health authorities fear that we could be on the verge of entering into a “post-antibiotic world” that threatens to kill millions of people annually by 2050. Antibiotic resistance already costs over $55 billion in medical treatment and hospitalizations just in the US. And this number is expected to rise dramatically in the coming decades.

It shouldn’t come as a surprise, then, that the World Health Organization has declared antibiotic resistance to be one of our greatest global threats to health, security, and development.

But is the medical overuse of antibiotics really the primary cause of the rise of the phenomenon of antibiotic resistance?

Antibiotics in the Livestock Industry

Factory farms, also known as Concentrated Animal Feeding Operations (CAFOs), were created as a way to keep up with an enormous demand for animal products that’s emerged in the last century.

Modern farms look far different from farms of the past. The images that leap to mind when many of us think of a farm — the iconic red barn or a green pasture full of animals happily grazing in the sun — no longer represent how most farm animals spend their lives.

To say that animals in CAFOs endure close quarters and overpopulation would be an understatement. The average chicken raised for meat has less than one square foot of space per bird. And modern broiler operations have bred birds to grow so quickly that they often become unable to walk. As a result, these birds spend their lives sitting in feces. Animals regularly get sick, injured, and even die as a result of these miserable conditions.

So how do modern CAFOs cope with the threat of disease wiping out their livestock? Antibiotics to the rescue! Antibiotics are routinely administered (through injections or medicated feed) not just to livestock who have become sick, but rather to every single animal housed in these filthy and brutally inhumane conditions.

In addition to helping keep animals alive in an unsanitary environment, antibiotics serve another purpose, too. It turns out that antibiotics make animals gain weight faster — which increases producer profits.

How Do Bacteria Become Antibiotic-Resistant in CAFOs?

When bacteria have continual exposure to low doses of an antibiotic, any of the microbes that are resistant to the drug will survive and reproduce. The rest die off, resulting in a new bacteria population resistant to the antibiotic.

Modern factory farms provide continuous low doses of antibiotics to billions of livestock — thus creating the perfect conditions for breeding antibiotic-resistant bacteria.

If, for some diabolical reason, someone wanted to create conditions that would breed antibiotic-resistant bacteria, they would be hard-pressed to do better than the conditions prevalent in industrial meat production today.

The Truth About Food Recalls

Already, the breeding of bacteria that are resistant to antibiotics in modern meat production is hurting human health in many ways.

Have you ever gotten sick after eating at a restaurant? It’s an experience that’s not easy to forget. You just ate the most delicious meal, yet hours later, you’re regretting ever leaving the house that day.

Foodborne illnesses — such as salmonella, listeria, and E. coli — affect one in six Americans every year. That’s more than 55 million people annually. About 128,000 of them have to be hospitalized for their symptoms. And 3,000 of these people end up dying.

Two of the most common foodborne pathogens, Salmonella and Campylobacter, cause a combined 660,900 antibiotic-resistant infections in the United States each year.

Where do these bacteria come from? The truth is most pathogens that cause food poisoning originate with the intensive, confinement-based livestock production methods used in factory farming.

The US federal government tests supermarket meats to track trends in bacteria and resistance. Recent findings show that 73% of bacteria that FDA testing found on ground turkey were resistant to tetracyclines, the most widely used antibiotic in farm animals and a critical medicine to treat serious bacterial infections in humans.

Additionally, one in five strains of Salmonella in chicken meat were resistant to amoxicillin — the second most frequently used antibiotic on farms and the number one medication prescribed to children. And 1 in every 25 packages of raw chicken is said to have Salmonella contamination, according to the CDC.

E. coli has also been found to contaminate 40% of raw chicken samples tested. But beef is the most common source of E. coli exposure for humans. This bacteria is thought to cause up to 85% of urinary tract infections each year. It’s also a major part of the Salmonella risk.

What About Food Recalls from Vegetables?

“But, wait!” you say. “What about the E. coli that have been found in plant foods, like romaine lettuce or tomatoes? Aren’t vegetables as risky as animal foods?”

It’s a reasonable question to ask, given the media coverage of E. coli outbreaks. But the truth is, E. coli lives in the intestines of animals.

Last I checked, romaine lettuce and tomatoes don’t have intestines. The only way any vegetable can be linked to E. coli is to be contaminated by the feces of animals.

Usually, this contamination happens because there’s a factory farm upstream (or up-manure) from a vegetable farm. It’s remarkable how often these plain facts are not conveyed in media coverage of E. coli scares.

Pathogens, like E. coli and Salmonella, are abundant in animal waste, which can run downhill during a rainstorm or seep into underground aquifers, ultimately getting into nearby water systems that spread the pathogens elsewhere.

These hardy pathogens can spread not only to raw meat products but also to produce (through water or soil contamination) and to cooking surfaces where food is prepared. When you consume this contaminated food, that’s when you may get sick.

The largest multistate E. coli outbreak in over a decade, related to romaine lettuce, occurred in the spring of 2018. It ended up affecting people in 36 states, resulting in 210 illnesses, 96 hospitalizations, and 5 deaths. What caused it? All evidence points to a large industrial cattle farm near the affected romaine crop in Yuma, Arizona.

How Factory Farming Drives the Problem with Antibiotics

It’s true that antibiotics are overprescribed to people, and that is a problem. But antibiotics are used and abused even more egregiously in animal agriculture.

According to a study in the Proceedings of the National Academy of Sciences in 2015, the world uses about 63,000 tons of antibiotics each year to raise cows, chickens, and pigs. That’s roughly twice as much as the volume of all antibiotics prescribed by doctors globally to humans.

In fact, 80% of the antibiotics used in the United States are not given to sick humans, but to animals on CAFOs.

And antibiotics are typically NOT used to cure disease on CAFOs. Rather, they’re used to promote growth or prevent diseases from keeping animals in unsanitary conditions.

What’s worse, last-resort antibiotics for humans are commonly used in CAFOs. So it’s no wonder that resistant bacteria are rampant in industrial meat products.

Regulatory Efforts Have Been Botched

Attempts have been made to better regulate antibiotic use in CAFOs.

In January 2012, the FDA prohibited the use of cephalosporins in food animals. This didn’t make much difference, though, because this class of antibiotics makes up less than 1% of the antibiotics used in the United States on food animals every year.

A study published by researchers at Ohio State University in 2016 warned of the very real potential of a post-antibiotic age. The study was sparked when bacteria that was resistant to last-line antibiotics was found on a Midwestern hog farm.

The FDA eventually took action in 2017, stating that farmers were no longer allowed to give antibiotics to animals for the purposes of weight gain, nor could they buy antibiotics without the oversight of a veterinarian.

But even after the 2017 attempt to crack down on CAFO antibiotic use, government records show that things haven’t changed as much as many had hoped. While sales of antibiotics for agricultural purposes dropped right after the 2017 ban on use for growth promotion, they’ve somewhat leveled out since then. Officially, there’s no ban on using antibiotics to prevent or treat diseases in animals — and so many animals in CAFOs are unhealthy, that this could potentially allow for very widespread use. The fact is that many companies that pledged to reduce antibiotics in their food supply haven’t followed through.

Beef suppliers for some of the largest fast-food corporations, like McDonald’s and Taco Bell, are still using the highest priority, critically important antibiotics (HP-CIAs) on farm animals, despite the risks to human health. USDA testing shows that between 2017 and 2022, all 10 of the biggest meat packers in the US were using at least one HP-CIA on livestock. And according to reporting by The Guardian, the dosages used are identical to the ones used previously to fatten up cattle.

Because there’s no universal ban on antibiotics in the food supply, companies seem likely to continue finding ways to exploit regulatory loopholes.

Antibiotics Aren’t Only Used for Land Animals

Just as we’ve industrialized agriculture for land animals, we’ve done the same to aquatic animals. And although fish aren’t what typically comes to mind when we envision factory farms, that doesn’t mean that farmed fish are living in better conditions. Antibiotic use runs deep in the aquatic environment, too — and so does antibiotic resistance.

Farmed fish are often packed tightly together in huge, unsanitary pools. Just as happens in the factory farming of land animals, the fish are given antibiotics (and other drugs, like pesticides) to prevent the spread of disease.

A 2015 study published in the Journal of Hazardous Materials sheds light on this hidden problem. Researchers looked at 27 fish from 11 countries. The researchers found residues of five antibiotics — including tetracycline and other drugs used to treat human infections.

Remarkably enough, they even found residues in farmed fish with an antibiotic-free label. It turns out that farmed fish don’t have to be given antibiotics directly to carry them because many are eating antibiotic-contaminated fish meal.

Levels of antibiotic-resistant bacteria in seafood have exploded in the past 30 years.

For more on the true cost of farmed fish, see this article.

What Can You Do About Antibiotic Resistance?

The hope, of course, is that one day, governments will take stronger action against antibiotic use on factory farms.

Some countries have done so already, including Denmark, Sweden, Germany, and the Netherlands. And they are seeing significant reductions in antibiotic overuse.

Whether or not government policy grows more enlightened, we can all take positive actions now to help preserve the efficacy of antibiotics and to support better industrial food practices.

The most significant contribution we can each make is to transition to a plant-powered diet. And for those who opt to consume animal products, it’s best to go organic since the use of antibiotics is not permitted under organic certification. If enough of us make these changes, we’ll drastically reduce consumer support for industrialized animal agriculture — the inhumane industry that’s fueling this public health crisis.

The American Society for the Prevention of Cruelty to Animals (ASPCA) has made avoiding factory-farmed animal products easier than ever with this handy Shop With Your Heart Grocery List.

How to Change the Future Right Now

Antibiotics are a miracle of medicine. But now, thanks to factory farming, antibiotic overuse has become a driver of what could become one of the most terrifying public health emergencies in history.

Unless we take action to preserve the viability of antibiotics for future generations, millions of lives will be lost.

The problem of antibiotic-resistant bacteria isn’t one that any of us can solve all by ourselves. Slowing its spread is going to take collective action from governments, farmers, corporations, and concerned citizens around the world. It’s also going to take reducing the frequency with which doctors prescribe antibiotics to humans.

But just because you and I can’t solve it all by ourselves doesn’t mean we should refuse to do what we can.

As a concerned citizen who wants a safe future for humanity, the number one step you can take is to boycott factory-farmed animal products. You can also go a step further and urge restaurants and supermarkets to do the same.

We should ensure a future in which, if a crisis arises, every baby’s life can be saved by these miracle drugs the way mine was when I was three months old.

Tell us in the comments below:

• Have you ever encountered antibiotic-resistant bacteria?
• Does this help you understand antibiotic resistance and how antibiotic use on factory farms affects humans?
• What did you find useful, interesting, or surprising in this article?

Featured Image: iStock.com/branex

Read Next:

• Unhealthy Conditions for Farm Animals are — No Surprise — Bad for Humans, Too

The post The Surprising Truth About Antibiotics, Factory Farms, and Food Recalls appeared first on Food Revolution Network.

Why the precipitous drop in the popularity of this softball-sized, sweet, and bitter fruit? Two things, really.

The first was the decline of the Grapefruit Diet, a Hollywood-led fad that took off in the 1930s thanks to its movie star endorsements and was revived again in the 80s as the “10-day, 10-pounds-off diet.” This fad diet came about from the erroneous notion that eating a grapefruit before every meal triggered some kind of magical fat-burning reaction in your body. But by the 1990s, this theory had been debunked, and new fad diets arose to fill the vacuum.

The second factor leading to grapefruit’s decline has been a pharmacological debate over whether the fruit is dangerous to people taking certain medications. Funnily enough, this property of the grapefruit — the ability to interfere with many prescription drugs — was discovered by accident during a clinical trial looking for something else entirely.

In the 1980s, researcher David Bailey was trying to assess the impact of drinking booze on a blood pressure medication called felodipine. He needed a way to blind his test subjects, so they couldn’t tell if they were receiving alcohol or a placebo. His solution was to spike both liquids with grapefruit juice (I’m told that grapefruit juice with vodka is known as a “greyhound.”) Imagine his surprise when the juice caused levels of felodipine to rise in both the treatment and placebo participants.

Over time scientists went on to determine that grapefruits could theoretically interact with about half of prescription drugs on the market. And thus, grapefruit’s fall from grace was complete. Not only did it not miraculously burn calories, but it could render some pharmaceuticals either inert or aggressively dangerous. Yikes!

But for all its marketing problems, grapefruit is a proud member of the citrus family and is a good source of vitamin C and other antioxidants. So what’s the scoop on grapefruit? Nutritional hero or villain?

In this article, we’ll look at the science behind grapefruit’s actual health benefits, and review its potential downsides, particularly, who should exercise caution to avoid unwanted medication interactions.

Types of Grapefruit

Grapefruit is part of the citrus family. But unlike most of its other citrus friends, which originated in Asia, the grapefruit was first cultivated in the Caribbean, likely on the island of Barbados.

Its botanical lineage is also complex. Grapefruit’s parents were likely a sweet orange and a pomelo, but the orange itself is a cross between a pomelo and a mandarin. I’m guessing that family reunions can get awkward.

Because of its hybridization, grapefruit comes in a range of flesh colors, from white to pinkish, peach, red, and even golden (this last is a mutation derived from white grapefruits). The color signals the fruit’s nutritional content; the redder the flesh, the higher its concentrations of lycopene and carotenoids.

The most popular grapefruit varieties sold for eating are red-fleshed grapefruits grown in Texas. Florida boasts the more common pink and white fruits that typically end up in bottled grapefruit juice.

Grapefruit Nutrition

Like its other citrusy cousins, grapefruit is a rich source of many important nutrients. In addition to vitamins A and C, and the mineral potassium, the fruit delivers a list of phytonutrients that deserve their own verse in “My Favorite Things”: flavonoids, limonoids, carotenoids, terpenes” (feel free to sing along), as well as coumarins (which I couldn’t fit into the song’s meter but are just as important as the others).

Two of those flavonoids are named naringin and narirutin, which sound like Grimm fairy tale characters who disappear in a puff of smoke if you guess their names. In reality, they’re potent free-radical scavenging antioxidants that give grapefruits their distinctive bittersweet taste.

Other phytonutrients in grapefruit include beta-carotene and lycopene, which as we’ve seen, contribute to the flesh tone of the redder varieties.

Grapefruit is a pretty good source of fiber, too, which is severely lacking in the modern industrialized diet. If you eat grapefruit rather than drink its juice, you’ll get roughly four grams of fiber per fruit. Grapefruits are also low in calories, being mostly made up of water. That’s why those Grapefruit Diets appeared effective — in the short-term — because they did cause weight loss due to being very filling and very low calorie.

The Health Benefits of Grapefruit

Although grapefruits aren’t a miracle weight loss tool, they can contribute a significant number of health benefits. So let’s look at what the evidence says about how grapefruits can benefit your health.

Can Grapefruit Help You Lose Weight?

Since many people still associate grapefruits with extreme dieting, let’s begin by looking at the evidence that eating grapefruit can help combat obesity and its accompanying metabolic syndrome.

There’s reason to believe that adding grapefruits to your diet — in moderation (please don’t eat three a day while severely restricting all other calories) — can help you lose excess weight. While most research has been done either in test tubes or on animals (our view on the use of animals in medical research is here), there are a number of studies showing weight loss as being linked to grapefruit or grapefruit juice consumption in humans.

One possible mechanism for this involves naringenin, a metabolite of naringin that can promote thermogenesis, or the conversion of white adipose (fat) tissue into heat (which might be even better than turning straw into gold).

A clinical trial conducted in 2012 found somewhat conflicting results: six weeks of half a grapefruit prior to each meal didn’t lead to greater weight loss than the placebo group. The grapefruit group did, however, exhibit more favorable cholesterol readings at the end of the trial compared to other participants.

Grapefruit and Blood Sugar

Grapefruit may also positively impact blood sugar balance. That 2006 study I just mentioned also found that those who consumed whole (unjuiced) grapefruit lowered their insulin resistance, which is a key driver of type 2 diabetes. And a 2019 review article notes that naringenin has displayed antidiabetic properties in many test tube and animal studies.

Is Grapefruit Good for Blood Pressure?

Beans may not be the only “fruit” that’s good for your heart. A 2017 meta-analysis of three randomized human trials found that grapefruit consumption was associated with significant reductions in systolic blood pressure. And a 2022 study of post-menopausal women used lots of words that I’m unfamiliar with (multi-omics analysis, anyone?) to basically say that the flavanones in grapefruit juice appear to protect the heart by moderating the expression of genes that regulate inflammation and vascular function.

Grapefruit and Cancer

Grapefruit may also enable the body to fight cancer more efficiently. Sounding a lot like C-3PO in Star Wars, researchers in 2015 identified “grapefruit-derived nanovectors coated with inflammatory-related receptor enriched membranes of activated leukocytes” as having the potential to deliver therapeutic drugs to tumor sites.

One of the coumarins (natural chemical compounds found in plants) that’s relatively abundant in grapefruit, bergamottin, may inhibit the growth of prostate cancer cells, as well as promote apoptosis (programmed death) in those cells. It has achieved promising results across a number of different cancers, including multiple myeloma, leukemia, and cancers of the skin, lungs, liver, stomach, breast, and prostate.

Grapefruit Medication Interactions

Now that we’ve sung grapefruit’s praises, it’s time to tackle that unfortunate problem of unwanted grapefruit-medication interactions. To give you a sense of the scope of the issue, check out this four-page list of pharmaceuticals with known grapefruit interactions.

Basically, grapefruit blocks certain enzymes that help your body metabolize drugs. And it turns out that just a few enzymes perform this trick on a vast array of drugs, which explains the long list of impacted medications. One of these enzymes, CYP3A4 (no relation to C-3PO, as far as we know), serves as the main “garbage disposal” for these meds. And naringin from grapefruit essentially gums up the works of that disposal system, allowing the drug to remain bioavailable and active in the body far longer and in far higher concentrations than normal.

Naringin can also block transporters that allow you to absorb certain drugs and may even decrease the amount of other drugs. In some cases, grapefruit could make the medication more potent. In others, it may render it less effective. In some cases, it could alter the impact of certain medications. And in others, it might do nothing at all.

If that sounds confusing, consider that the severity of any grapefruit-medication interaction depends on the amount consumed, the particular drug in question, and your own unique metabolic response to that drug (and to the grapefruit, for that matter).

Some of the drugs that may interact with grapefruit include:

• Statins (to lower cholesterol)
• Calcium channel blockers (to treat high blood pressure and coronary heart disease)
• Anticoagulants and antiplatelet medicines (to prevent clots that can lead to heart attacks and strokes)
• Ciclosporin and immunosuppressants
• Entocort (for Crohn’s disease)
• Cytotoxic medicines
• And central nervous system (CNS) agents (including psychiatric drugs)

How about taking your medication a few hours apart from consuming grapefruit? Not a good idea. If you’re taking any of these pharmaceuticals, you may really need to avoid grapefruit entirely. Grapefruit’s ability to affect medication can last up to three days.

Is Grapefruit Dangerous?

Now, I don’t want you to get needlessly alarmed here; there’s a vigorous debate about whether these grapefruit-drug interactions are all that serious for the average medication user. Some clinical researchers see danger across the board, while others downplay the risks.

When David Bailey first started sharing his findings in the 1990s, a common reaction was, “Where are the bodies?” While morbid, what the question is really asking is, if this is a big problem, why hasn’t the medical establishment been seeing its effects for decades — with lots of people killed by grapefruits? Possibly because it isn’t that much of a problem; and also possibly because no one knew to look for it until Dr. Bailey handed out those fateful placebo greyhound drinks in 1989.

But better to be safe than sorry. So, whenever you receive a new prescription, you may want to talk to your healthcare team if you include grapefruit in your diet, to avoid a potential medication interaction. And if you’re currently taking prescription medications, you may want to talk with your team before adding grapefruit, to make sure it’s safe for you.

How to Eat a Grapefruit

Almost as popular as cute animal videos, “the right way to cut a grapefruit” is practically its own YouTube genre, suggesting that a lot of people have been wondering how to do so for a while. If you’re able to eat grapefruit, there are several ways to enjoy it without having to rip it apart with your bare hands or get a sharp splash of juice in your eye as you stab it with a spoon.

On its own, the classic way to eat grapefruit is by cutting it in half and scooping out the pulp and juice one spoonful at a time. This becomes a lot easier when you use a grapefruit spoon, which is serrated on the sides.

Here are three other ways to cut and serve grapefruit:

You can use grapefruit in recipes, including salads, mocktails, smoothies and smoothie bowls, frozen desserts like popsicles and n’ice cream (that’s ice cream minus the dairy), and sauces and dressings both sweet and savory (think salsas).

You can also squeeze grapefruits and drink their juice. The downside of this is that you’ll lose most of the fiber, which not only promotes satiety but also slows down the absorption of the fruit’s sugars. Eating the whole fruit is generally a healthier option, especially if you have an issue with blood sugar regulation.

That said, if you really want a cup of citrus juice in the morning, grapefruit juice delivers less sugar than orange juice and is far more palatable than lemon juice.

Grapefruit Recipes

We hope these fresh, bright, and zingy grapefruit recipes spark a few new creative ways to get your grapefruit fix. Even if you’ve been a grapefruit detester in the past, trying out these grapefruit recipes may bring newfound admiration for this bitter and juicy fruit. That said, no matter which way you decide to enjoy grapefruit, we’re sure these recipes will dazzle and delight your tastebuds!

1. Caramelized Cinnamon Grapefruit

While cinnamon and maple syrup might not be two flavors you associate with grapefruit, the flavor combination is surprisingly delightful. The natural sweetness from the maple syrup and the earthiness of the cinnamon balances the tart bite from the grapefruit, making it a delicious and refreshing snack. There are also bursts of nutrients like vitamin C and lycopene in this unique, plant-based pairing. Give it a try — we hope you love it as much as we do!

2. Summer Citrus Salad

This Summer Citrus Salad is as refreshing as it sounds. Juicy grapefruit, sweet and floral oranges, and tart blackberries are tossed in bright and zesty lemon juice. Together these tantalizing fruits create the ideal balance of sweet and sour that is simply a must-try! If you’ve been on the fence about enjoying grapefruit solo due to its bitterness, this salad is a great way to mellow out some of that flavor. If that’s not enough to convince you to give it a try, the sweet and zesty smells of all the fruits together may get your mouth watering.

3. Minty Grapefruit Tea

Minty Grapefruit Tea may sound a little unique when it comes to melding strong flavors together, but trust us — it works! When steeped, mint leaves produce a slightly sweet flavor in addition to the cooling menthol. And grapefruit adds a bit of citrusy brightness and zing. Together, they create a comforting and cozy cup of tea that’s comforting and uplifting. Enjoy this refreshing tea, hot or iced, with or without your preferred sweetener of choice.

Grapefruit Can Be a Great Fruit!

Grapefruits have long been associated with health and weight loss, often without any scientific basis. But despite its prominence in fad diets of days past, grapefruit does offer a number of real health benefits to consider.

If you are taking prescription medications, however, you may want to avoid or modulate your intake of grapefruit and grapefruit juice. But if that isn’t an issue for you,  grapefruit can be a wonderfully healthy addition to a diverse diet for its vitamin, antioxidant, fiber, and flavonoid content. Not to mention its zesty flavor!

Tell us in the comments:

• Do you eat grapefruit? If so, what’s your favorite variety?
• Have you ever been told by a healthcare professional to avoid or limit grapefruit consumption?
• What’s your favorite way to cut and eat grapefruit?

Featured Image: iStock.com/ValentynVolkov

Read Next:

• 7 Heart-Healthy Red Foods to Help You Thrive
• Bitter Is Better! Why Bitter Foods Can be Good for Your Health
• Why Daily Vitamin C is Good for Your Immune System

The post Grapefruit Benefits and Risks You Need to Know About appeared first on Food Revolution Network.

But if that country were the United States, you’d be severely disappointed. When it comes to health care results, the US ranks 22nd out of 78 developed countries, according to the US News 2021 Best Countries Report. Compared to 10 other high-income countries (Australia, Canada, France, New Zealand, Norway, Germany, the Netherlands, Switzerland, the UK, and Canada), the US is dead last in performance. Despite spending significantly more than the others, the US trails the field in access to care, administrative efficiency, equity, and — most tellingly — actual health outcomes. In other words, we’re paying for the Tesla and driving out of the lot with a 1987 Yugo.

There are a lot of reasons for the US’s dreadful performance. Many of them are political, as the rancorous health care debates of the past 30 years clearly show. And the issue of health inequity and differential access to care makes everything worse, as we’ve witnessed over the last few years around racial disparities and COVID-19 health care. But there’s an underlying problem that, until addressed, means that there will never be enough money to take care of everyone properly.

And that problem is, the US health care system — isn’t.

It’s actually a disease-care system. It focuses not on preventing disease but treating it once it occurs. Even the elements we call “prevention,” like health screenings, are about detecting an already occurring disease process sooner rather than later, rather than actually preventing it. (Which, to be clear, is usually a good thing, as sometimes early detection of a problem, perhaps even before symptoms appear, can lead to more effective and less invasive treatment options.)

Unfortunately, once a problem is diagnosed, the disease-care system often focuses on managing symptoms rather than addressing root causes. We can lower blood pressure with medication without ever examining what caused hypertension in the first place. We can manage blood sugar in patients with type 2 diabetes with insulin and alpha-glucosidase inhibitors and never explore what is preventing their cells from absorbing glucose from the bloodstream.

Taking Your Health Back from the Disease-Care System

If you want to be healthy — truly healthy, as in as free as possible from the conditions that foster disease, rather than relying on pills and procedures as first and only resorts to manage disease — then sometimes you need to take matters into your own hands. Because as the field of lifestyle medicine has made clear in the last several decades — and healers from around the world have always known — our diets, lifestyles, and environments determine, on average, at least 80% of our health outcomes. By ignoring these inputs, the US medical system more or less dooms its consumers to suffer preventable disease, disability, and premature death, for the largest price tag of any “health care” system on the planet.

Given all that, how can you take more control over your own health and health care? How can you head off problems before they manifest clinically, in decreased function and increased pain? How can you treat illnesses at their root rather than masking symptoms while the underlying process gallops on?

Becoming Proactive Rather Than Reactive With Your Health

At Food Revolution Network, we’re all about the science of lifestyle and health. We share information about healthy diets, healthy lifestyle practices, and steps you can take to mitigate environmental toxins that could damage your health.

And we also know that stuff happens. Eating the world’s healthiest diet puts the odds in your favor, but can’t guarantee that you’re not going to experience health challenges. Similarly, exercising regularly, meditating, taking ice baths, immersing yourself in nature, and practicing gratitude and forgiveness will not stave off all illnesses.

So it’s important to be proactive with your own health, and not wait for a reactive health care system to, well, react. Diagnostics, including lab testing, is a key tool for both getting to the bottom of things and helping to prevent health problems in the first place. Trying to get the most benefit from lab tests can be a daunting task in the current system in the US. But why?

Why You Can’t Always Rely on Doctors

First, many doctors are so focused on disease symptom management, that they don’t even know what tests to order that might be useful in prevention. And even when tests are conducted, lab results aren’t always shared automatically with patients. You often have to request them, which means you have to remember to call to follow up (sometimes multiple times).

Access to your test results isn’t enough. You also have to understand what they mean. And many physicians don’t take the time to explain what the numbers mean and how different results may relate to one another — or they may not even know. Under most managed care plans, you only have a few minutes with your physician, which is rarely enough time to get all your questions answered (unless you’ve both been to auctioneer school). Unless you’re a frequent visitor with the same provider, they don’t really know you. They just know your vitals and symptoms in that appointment.

Plus, many physicians are under-informed or even misinformed about how to interpret test results. And few medical schools teach how to implement diet and lifestyle factors to address emerging conditions.

Exercising Control Over Your Own Health

The bottom line is, it’s important to take charge of your own health. If you feel like you don’t know much about your health right now, it just means that now is a great time to start learning! After all, you are your own best advocate.

You’re the one who knows better than anyone if something is off or doesn’t feel right with your body and your health. And everyone is different in how they’re affected by symptoms. Not all diseases and conditions present the same way in everyone, and only you know what your healthy “baseline” feels like.

Knowledge is power. You and your trustworthy health care provider can make better decisions for your health when you know where you stand, and have objective data to help inform your choices.

Part of being able to make the best health choices stems from knowing what you can and can’t control. You can’t do anything about your age (except lying about it, which doesn’t count) or your genetics (sorry, The Fly is science fiction, and anyway, Jeff Goldblum didn’t exactly come out on top there). On the other hand, you do have some control over your lifestyle choices. And those choices can in turn help control how certain genes are activated or shut off, which in turn affects your susceptibility to disease. So, some of the best areas to focus on for optimal health control include your sleep, nutrition, exercise, smoking, social support, mental health, and reducing inflammation.

And when it comes to diet — which we know plays a huge role in our health — sometimes emphasizing certain foods, eliminating certain foods, or favoring certain supplements, can make a world of difference.

You don’t have to figure it out all alone, either. Part of taking charge of your health is knowing who and when to ask for help. Most doctors and other healthcare providers aren’t well trained in diet, lifestyle, or disease prevention — but some of them are. And when you get the right people on your side, it can make a world of difference. (Keep reading to the end for some resources to help you do just that!)

Ordering Your Own Blood Work: Direct Access Testing

Part of taking control of your own health can include getting the diagnostic tests that are most relevant to you. If your regular doctor will prescribe them for you, and insurance will cover them — hooray! But you may also need to take the initiative yourself.

In most US states, as well as some other parts of the world, you can order your own blood work and other lab tests. This is called direct access testing (DAT), which seeks to share the physician’s power to diagnose with their patient. One of the earliest examples of DAT was the availability of over-the-counter urine glucose tests in the 1950s.

While this is a positive direction, DAT has its limitations. For example, not all labs provide an interpretation of the results. You may have a false sense of security if your results are within the “normal” or “reference” range, even though such numbers may actually be problematic for you in particular. And, on the flip side, you may panic if you see an “abnormal” result, even though it may not represent any kind of a problem.

Two recent examples of this illustrate the point: One person, whom we’ll call Darnell, eats an incredibly clean plant-based diet. Darnell went for a checkup where they drew blood for a lipid panel. When he got the results, he was shocked at his sky-high triglycerides, which looked more like those of someone whose meal staples were pepperoni pizza and cheeseburgers. It turns out that the lipid panel is a fasting test, which Darnell’s doctor neglected to mention.

Another person, whom we’ll call Florence, got back a worryingly high alkaline phosphatase number on her comprehensive metabolic panel (a test we’ll discuss below), and immediately googled what it meant. She was overwhelmed with scenarios of liver damage, bone disorders, and cancers. When she talked to a physician friend, Florence was reassured that high numbers are usually temporary, and not to worry; just take the test again in a month. Again, her own doctor didn’t communicate any of this.

Without professional insight, you could be on your own to figure out what the numbers might mean for you. (Hence the value in working with a lifestyle-competent health care provider who can help you make sense of the results, and take positive action with them.)

Who Can Use Direct Access Testing?

And DAT isn’t available everywhere. Direct access testing state laws vary from state to state. Currently, 37 states and the District of Columbia allow direct access testing in some form, either with or without restrictions.

What about other parts of the world? The United Kingdom has home blood testing available. However, as of this writing, they’re experiencing a shortage of blood test tubes, so blood testing is being limited. Canada allows DAT, but all blood test requests must be made through a licensed doctor. There are also some Canadian companies, like LifeLabs, who will come to your home to do your blood tests. Australia also has DAT.

If you use DAT, which can be a great tool, it’s still best to work with a trusted health care practitioner, so you have the context you need and an advocate to help you make sense of the results and come up with action plans.

Your Lab Work on Your Terms

If you’re located in the US and want to order some bloodwork, one great DAT resource is Yourlabwork.com, a direct access cash-based lab testing platform. All you have to do is order the tests you want online, schedule a blood draw appointment with one of their 4,000 draw stations around the country, and receive your online lab report usually within 48 hours. (If you’re nervous because of painful shots when you were a kid, good news: there have been huge advances in technology, and a well-trained phlebotomist can insert the needle so that you hardly feel it.)

A List of Lab Tests and What They Mean

You’re probably wondering what lab tests should be on your radar. The point of lab tests is to assess your current state and monitor it over time, so you can take timely and effective action to maintain or restore your health should problems emerge.

Below is a list of common lab tests that many people (including whole foods, plant-based eaters) find useful.

Blood Tests for Inflammation

Tests: Hs-CRP, ESR (Erythrocyte Sedimentation Rate)

High-sensitivity CRP (hs-CRP) looks for one of the major markers of inflammation, c-reactive protein (that’s the “CRP” in the name). Researchers are discovering that inflammation is at the root cause of many diseases. If high levels of CRP are detected in the blood, this can indicate a higher risk for developing coronary artery disease or having a heart attack, for example. CRP is measured in milligrams per liter (mg/L).

Note that there is also a regular CRP inflammation test, but the hs-CRP test tends to be more sensitive to chronic inflammation and therefore may be a better investment.

The ESR (erythrocyte sedimentation rate) test can be helpful for monitoring the progress of certain inflammatory diseases. It looks at erythrocytes, or red blood cells, and their activity in your blood when placed in a test tube. If they clump together and settle to the bottom more quickly than healthy red blood cells, this can indicate inflammation. The more they fall in one hour, the stronger the inflammatory response of your immune system. (I imagine the lab technicians sitting and watching this test like it’s a red snow globe, but I could be completely wrong.)

For more on how to fight chronic inflammation, read our article here.

Lab Tests for Diabetes

Tests: Fasting Glucose, Hemoglobin A1c

The fasting glucose test tells you what your blood sugar is when you haven’t eaten recently, for example, first thing in the morning. Normally, your blood sugar rises after eating but then falls back within its normal range within 2–3 hours if you have a healthy insulin response. But in poorly managed type 2 diabetes, or when a diabetes management plan needs a little adjusting, fasting glucose may be higher than normal. As such, this test can be used to diagnose type 2 diabetes and prediabetes.

The A1c test indicates how well-controlled your blood sugar levels have been over the past three months. When levels are abnormal, it can indicate a prediabetic or diabetic condition.

To find out about the top foods to eat, and avoid, if you want to prevent or reverse type 2 diabetes, read our article here.

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Types of Thyroid Tests

Test: TSH (Thyroid Stimulating Hormone)

The TSH test, which is also called the thyrotropin test, is an excellent screening test for thyroid disease. It measures TSH, or thyroid-stimulating hormone, which is made in the pituitary gland in your brain and is responsible for regulating things like weight, body temperature, muscle strength, and mood. Depending on the levels of your TSH, your pituitary gland makes more or less of it to keep it in a healthy range. So when a TSH test indicates that your levels are out of this range, it can indicate that your thyroid isn’t working properly. Elevated TSH results indicate that your body is working hard trying to stimulate your thyroid gland to produce more thyroid hormones.

Blood Tests for Vitamin and Mineral Levels

Tests: Vitamin 25(OH)D3, Vitamin B12, Homocysteine, Iron, Ferritin, Zinc, Selenium, Magnesium, Omega-3/Fatty Acids

It can be helpful to know your blood levels of some key nutrients, to make sure you’re getting and absorbing enough of them. Some nutrient deficiency tests are especially recommended for plant-based eaters who may need to supplement in order to have adequate levels.

• Vitamin D: For our article on vitamin D click here.
• Vitamin B12: For our article on vitamin B12 click here.
• Homocysteine: For more on homocysteine tests and what they mean, click here.
• Iron and Ferritin: While many people are concerned about getting enough iron, some of us actually get too much. And there are different forms of iron, that impact the body in unique ways. For our article on iron, click here.
• Zinc: For our article on zinc, click here.
• Selenium: For our article on selenium, click here.
• Magnesium: For our article on magnesium, click here.
• Omega-3s: For our article on omega-3s, click here.

Blood Test for Cholesterol (Lipid Profile, Lipid Panel)

Tests: Total Cholesterol, Triglycerides, LDL (bad) Cholesterol, HDL (good) Cholesterol, Total Cholesterol/HDL Ratio, Lipid Profile

Understanding your cholesterol and other blood fats levels is important, because high levels of certain kinds of cholesterol can indicate a higher risk for heart disease, heart attack, and stroke. Health care providers often do a lipid profile at an annual wellness exam.

Total Cholesterol: Cholesterol is a waxy substance found in your cells, and total cholesterol is calculated by adding together HDL, LDL, and 20% of your triglycerides.

Triglycerides: Triglycerides are a type of fat in the blood. Any calories your body doesn’t use, eliminate, or burn off from food right away may be stored as triglycerides in your fat cells.

LDL (bad) Cholesterol: LDL stands for low-density lipoproteins. It’s sometimes called “bad” cholesterol because having too much of it promotes the buildup of cholesterol in the arteries.

HDL (good) Cholesterol: HDL stands for high-density lipoproteins. It’s often called “good” cholesterol because its role is to transport cholesterol from other parts of your body back to your liver, where it’s removed.

Total Cholesterol/HDL Ratio: This ratio can help indicate whether you’re at risk for heart disease, heart attack, or stroke. Some research suggests that a ratio of 3.5 or below is ideal for helping to prevent or reverse heart disease.

For more on cholesterol, read our article here.

Comprehensive Metabolic Panel

Tests: Serum Sodium, Potassium, Chloride, Serum Creatinine, Blood Urea Nitrogen, estimated Glomerular Filtration Rate, Carbon Dioxide, Calcium, Total Protein, Albumin, Globulin, Albumin/Globulin Ratio, Total Bilirubin, Alkaline Phosphatase, AST, ALT

What is a comprehensive metabolic panel (CMP)? CMP tests measure your liver and kidney function, as well as looking at electrolytes and protein stores in your bloodstream. They’re sometimes a part of lab work at an annual wellness exam, and are helpful to understand, particularly if you have concerns about liver or kidney health and need to monitor them.

For example, the Glomerular Filtration Rate (GFR) is very frequently used as it’s considered to be the best measurement of your kidney function. It’s based on a value of 100, which means that your kidneys are working at 100%. If your GFR is 65, that indicates that your kidneys are working at 65%.

As for the liver, AST and ALT are two very important liver enzymes that can help identify toxins in your liver, if you have liver disease, or if there’s liver damage. Higher than normal values of these can indicate cause for concern.

CBC (Complete Blood Count)

Tests: White Blood Cell Count, Red Blood Cell Count, Hemoglobin, Hematocrit, MCV, MCH, MCHC, RDW, Platelet Count, MPV, Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils

A complete blood count checks for anemia or any abnormal elevation in your blood cell counts. It’s also a great way to evaluate the function of your bone marrow. This is a standard test performed at many annual wellness checkups.

The CBC values indicate how many new blood cells your body is creating, as well as the number and shape of blood cells. It can also help identify anemia, bone marrow disorders, sickle cell anemia, infections, nutrient deficiencies, side effects of taking medications, and certain cancers.

For example, having a red blood cell (RBC) count that’s lower than normal could indicate anemia. You’ll likely also have lower than normal hemoglobin (Hgb) levels, because hemoglobin is carried by red blood cells. Having low ferritin levels can also indicate iron deficiency with or without anemia, as ferritin is a blood protein that contains iron.

And if your white blood cell (WBC) count is high, this most often indicates that your body is actively fighting an infection. This is because white blood cells are disease-fighting cells.

Interpreting Your Test Results

Getting your numbers isn’t enough. You also need to interpret your test results and take action where needed. And while we’re encouraging you to take charge of your health, that doesn’t mean you need to go it alone. You’ll probably want a health care provider who can help you understand what you’re seeing, guide you to make a plan, and in certain cases prescribe further tests or treatments that you can’t access over the counter or without financial assistance from insurance.

If your current doctor isn’t willing, or knowledgeable enough, to guide your journey, what kinds of doctors might be?

If you’re in the US and looking for a plant-based doctor, PlantBasedDocs is a helpful search engine that serves as a directory for health care providers who value a food-as-medicine-first approach to care. In addition to doctors, you can use this database to find registered dietitians, nurses, and health coaches that practice with a plant-based approach. Simply plug in your zip code to view local options.

You might also want to make use of a service called Plant-Based TeleHealth, which features doctors like longtime Food Revolution Network friend and frequent Food Revolution Summit guest Michael Klaper, MD. All you have to do is register as a patient and schedule your telehealth, or virtual, appointment with one of the plant-based health care professionals. They can help you interpret your lab tests and advise you with lifestyle changes and a health care plan. They advised us on the test recommendations listed in this article, and are prepared to support interpretation and action based on the results of the tests described.

Note that Plant-Based TeleHealth is a cash-pay service, and they do not accept health insurance. However, all prices are listed on the website, and you can even read about the doctors and the US states in which they’re licensed to practice. (As of this writing, they can prescribe tests and medications in all 50 US states. They can also provide coaching, but can’t prescribe medications, internationally.)

Take Back Your Power

Knowledge can be empowering, and lab testing can give you critically important knowledge. Working with a plant-based or other lifestyle-centered health care provider can help you interpret results and get you on the path to better health, whether that’s prevention, reversal, or optimization.

Tell us in the comments:

• Have you ever asked for your own lab tests or used direct access testing?
• How confident do you feel in your ability to interpret your own lab results? Do you feel supported by your healthcare provider in answering questions?
• Do you have a story to share about your experience with diagnostic testing? Leave it below!

Feature Image: iStock.com/Shironosov

The post Ordering Your Own Lab Tests: A Guide to Taking Control of Your Health appeared first on Food Revolution Network.

If we take the word literally (the prefix mal meaning poor or faulty), it should also be applied to the dietary patterns of excess that produce obesity and diet-related diseases like heart disease and type 2 diabetes. These cases of malnutrition are on the rise — 1.9 billion adults worldwide are now overweight or obese, more than four times as many as are undernourished (462 million). Although this growing gap is most pronounced in high-income countries, even the low- and middle-income countries that bear the greatest burden of undernourishment are experiencing rising rates of obesity and overweight.

“Malnutrition is the number one cause of death in our society today.”

We can think of malnutrition not only as nutrition-gone-missing but also as nutrition-gone-awry. This article will focus on the latter of these: the heavier side of malnutrition. The damage it causes is immense and ignored far too often.

Lives Lost – The Ultimate Cost

The most obvious cost of malnutrition is death.

Though it’s not typically listed as an official cause of death, many of the top causes of death in the United States have strong ties to our unhealthy diets. Consider the Centers for Disease Control and Prevention’s (CDC) most up-to-date list of the top causes of death in the United States, rounded to the nearest thousand:

• Heart disease: 647,000
• Cancer: 599,000
• Accidents: 170,000
• Chronic lower respiratory diseases: 160,000
• Stroke: 146,000
• Alzheimer’s disease: 121,000
• Diabetes: 84,000
• Influenza and pneumonia: 56,000
• Nephritis, nephritic syndrome, and nephrosis: 51,000
• Suicide: 47,000

View more facts on malnutrition in this infographic.

To a greater or lesser extent, malnutrition plays a role in virtually all of these causes of death. For example,  the informed use of nutrition could prevent up to 90% of heart disease deaths, 70% of cancer deaths, and 50% of stroke deaths. Likewise, the medical community widely accepts that better nutrition could prevent most type 2 diabetes.

If we were to adjust this list to account for “only” those percentages — to account for the shared cause propelling “only” those death rates — there would be no denying that malnutrition is the number one cause of death in our society today.

Even causes of death that do not at first seem tied to nutrition deserve a closer look. Take, for example, accidental drug overdoses (included in the broader category of accidents) and suicides. At first glance, these “deaths of despair,” which have never been higher, have little to do with nutrition. But when we consider the profound psychological damage caused by being unwell, confused about how to treat oneself, and unable to pay for expensive standard treatments (more on this in a moment) that often rely on addictive drugs and by and large fail to treat the root cause of the illness, we see just how closely entwined are mental and physical health. In short, none of these factors exists in a vacuum. The web of nutrition-related diseases is a messy tangle. So long as malnutrition exists, and so long as it is a major drain on our quality of life — producing numerous preventable diseases and their accompanying costs — it will contribute to our despair and resulting deaths.

But just how severe is this drain on our quality of life? Can we even begin to quantify it?

The Cost of Malnutrition to Individuals

Though the financial costs of managing diseases caused by malnutrition may seem more profane than the lives lost, these costs are nevertheless significant. Take, for example, the two leading causes of death listed above: heart disease and cancer. According to a paper published in the American Journal of Managed Care (AJMC), patients with established cardiovascular disease paid nearly $19,000 annually in direct costs for medical treatment, an “economic burden… substantially greater than current American Heart Association estimates.” Meanwhile, for cancer, the average cost of one round of chemotherapy ranges from $20,000 (office-managed) to $26,000 (hospital-managed).

Most Americans cannot deal with these costs. In fact, 63% of Americans cannot afford an unexpected bill of even $500. A bad diagnosis is, for the vast majority, not only a threat to their lives, but also a financial death sentence. For a poignant illustration of the resulting desperation, we need only look at the flood of fundraisers asking for assistance with medical bills. On GoFundMe alone, this category of fundraisers makes up over 250,000 campaigns per year, more than twice as many as exist for education, memorial, or natural disaster emergency fundraisers.

A well-publicized study published in the American Journal of Medicine, completed by researchers from Harvard and Ohio University, shows what happens to those individuals who are unable to raise funds elsewhere. They found that 62.1% of bankruptcies in 2007 could be attributed to medical expenses. One startling detail from that study was that “most medical debtors were well educated, owned homes, and had middle-class occupations. [And] three quarters had health insurance.” Where does that leave the uninsured? Or low-income Americans who on average suffer from a higher prevalence of poor health outcomes?

Regrettably, these numbers are not moving in the right direction. The proportion of bankruptcies attributed to medical bills in 2001, just six years prior, rose by nearly 50%! This is unsurprising, as the cost of treatment has also gone up. According to data assembled by the Peterson Center on Healthcare and Kaiser Family Foundation, “on a per capita basis, health spending has increased over 31-fold in the last four decades,” while inflation-adjusted per capita spending on prescription drugs has also increased.

The Cost of Malnutrition to Society

Although not all health care spending can be attributed to malnutrition, trends in the cost of health care nevertheless illustrate the major trends, and it’s clear from those trends that we are not on the right track. Health expenditures as a percentage of GDP in the US are more than three times greater than they were 60 years ago, and remain significantly higher than the health care spending in other high-income countries.

The CDC’s “Health and Economic Costs of Chronic Diseases” web page illustrates the problem very well. Here are a few highlights cited on that web page, from various reports listed in their references:

• Chronic conditions account for “90% of the nation’s $3.8 trillion in annual health care expenditures.”
• Heart disease and stroke cost “our health care system $216 billion per year” not including lost productivity ($147 billion).
• In 2013, more than $300 billion was attributed to arthritis care.
• Obesity costs nearly $150 billion each year.
• In 2017, “$327 billion in medical costs and lost productivity” were attributed to diabetes.
• “[T]he cost of cancer care continues to rise and is expected to reach almost $240 billion”.

But the reason this web page illustrates the problem very well is not only that it catalogs the economic toll of malnutrition-related diseases and illness, but also that it completely ignores nutrition. The word nutrition does not appear once on the entire page. Neither does diet. This absence is especially shocking given that the site does make mention of three other risk factors: cigarette smoking, sedentary lifestyles, and excessive alcohol consumption. The problem it illustrates, then, is not only that malnutrition contributes to astronomical costs, but also that so many prefer to ignore it.

How will we begin to address malnutrition if even our trusted institutions cannot admit that it exists?

The Cost of Malnutrition is a Moving Target

Finally, it’s useful to repeat the earlier questions: Just how major is this drain on our quality of life? Can we even begin to quantify it?

Ultimately, that’s what this is — only a beginning.

The cost of malnutrition is deep. It’s difficult to quantify. It’s always changing. In this short piece, we have barely scratched the surface. There are plenty of challenges to wrestle with, and the first and last challenge is the same: We must stop ignoring malnutrition and the damage it causes. We should call our dietary patterns of excess what they are, admit the primary cause underlying so many premature deaths in this country, and not be afraid to confront its consequences.

To ignore malnutrition at any step along this broken path is to also ignore a tremendous opportunity for growth.

Tell us in the comments:

• Have you ever witnessed or experienced malnutrition firsthand? What does it look or feel like?

• In your experience, what are some ways to confront the issue of malnutrition?

• In what ways would you like to see policymakers address the causes and effects of malnutrition?

Feature Image: iStock.com/ipopba

Read Next:

• Food Inequality: How Poor Nutrition Affects Health, Wealth, & Opportunity (And What We Can Do About It!)

• What Are Food Banks? (And How They Can Help Hungry People Eat Real Food)

The post How Much Does Malnutrition Really Cost? appeared first on Food Revolution Network.

Below is the edited transcript of the video above.

Ocean Robbins: Welcome to this Food Revolution Conversation. I am Ocean Robbins, your host. We’re here to talk today about inflammation, and we’re going to talk about it a little more comprehensively than most people talk about it these days.

Chronic inflammation could be, in net effect, the leading cause of death on our planet. It is underlying most of the major chronic illnesses of our times, from Alzheimers to type 2 diabetes from cancer to heart disease to autoimmune conditions.

In the context of a pandemic, we’ve also seen that people who are suffering from chronic inflammation are far more likely to be hospitalized and even to die if they contract COVID-19.

And according to our guests for today’s conversation, the chronic inflammation that is rampant in the human body is inextricably linked to a surge in inflammation in our world, showing up in the context of climate chaos, forest fires, and even war and violence.

What’s more, these have common sources. According to their new book, Inflamed: Deep Medicine and the Anatomy of Injustice — an extraordinary book — there are hidden relationships between our biological systems and the profound injustices of our political and economic systems.

The Roots of Inflammation

Ocean Robbins: Inflammation is connected to the food we eat, the air we breathe, and the microbes living inside us, which impact our brains, our immune system, and how we experience life.

Inflammation is also connected to traumatic events we may have experienced as children and to traumas even endured by our ancestors. It’s connected not only to access to healthcare, but to the very models of health that physicians practice.

So, we are here with two extraordinary people who have written this book and who are here to shed some light on all of this.

First is Dr. Rupa Marya, a physician, and activist, a mother, and a composer. She is an associate professor of medicine at the University of California San Francisco where she practices and teaches internal medicine.

She’s co-founder of the Do No Harm Coalition. It’s a collective of health workers committed to addressing disease through structural change. At the invitation of Lakota health leaders, she is helping set up the Mni Wiconi Clinic. I may be mispronouncing that — my apologies if I am — at Standing Rock to help decolonize medicine and food. She is a co-founder of the Deep Medicine Circle, an organization committed to healing the wounds of colonialism through food, medicine, story, and learning.

We’re also here with Dr. Raj Patel (PhD), a research professor at the University of Texas at Austin’s Lyndon B. Johnson School of Public Affairs, a professor in the university’s department of nutrition, and a research associate at Rhodes University in South Africa.

He’s the author of Stuffed and Starved and The New York Times‘ best-selling, The Value of Nothing, and the co-author of A History of the World in Seven Cheap Things. And he serves on the International Panel of Experts on sustainable food systems and has advised governments worldwide on the causes and solutions to the crises of sustainability.

Rupa, Raj, thanks so much for being here with us today.

Dr. Raj Patel: Thanks so much for inviting us.

Dr. Rupa Marya: Thank you, Ocean.

Inflammation, Broadly Defined

Ocean Robbins: Well, let’s jump right in here. You’re looking at inflammation broadly, including the human body and the culture, the economy, the world around us. What is inflammation, and why should we care?

Dr. Raj Patel: Well, so inflammation is the way that your body ordinarily heals itself. So in the book, we’ve got this example of a paper cut. When you get a paper cut, you’ll bleed; you’ll see redness; your body will mobilize itself to meet and live with the invaders that may have entered your body through this cut. And this process of inflammation is a way of helping your body return back to normal. That’s a sort of short version of what happens in an acute case of inflammation.

The problem with inflammation that we talk about in the book is that when your body mobilizes its resources when it’s feeling either threatened or is actually under threat or perceives that it may be under threat, that process when the threat never goes away, sends your body into a process, not of healing, but of destruction.

One could say, “All right, well, inflammation, we understand stress, and that’s all very bad and we should have less stress.” But there’s a bigger story here about how the stress that’s around us is part of a story that implicates not just our bodies, but the planet itself. Rupa sees the consequences of this in her medical practice. I wonder, Rupa, if you could tell us a little bit more about the actual sort of biological and social intersections that you see at the hospital?

Confronting Uncomfortable Truths

Dr. Rupa Marya: Yeah, so the inflammatory response is evolutionarily conserved in mammals and animals, also in other life forms. And it is a response to damage or the threat of damage. And it is the way the body or the organism restores its optimal working conditions.

I want to say that as we talk about this… In medicine sometimes, we have to make people a little uncomfortable to be able to offer some healing to offer a way of… You have to lance the wound to get the pus out in order so that a wound can heal and the inflammation can stop.

This book is an opportunity to make people who might not be comfortable with understanding the roots of colonialism, how colonial expansion has destroyed the ecosystems around the world, and the mind view that came with it has set up our structures in our society so that food is not equitably resourced in our lives — that some people have access to lots of healthy food and other people have no access to nutritional food.

So, this discomfort of maybe having to really understand science and why we really laid out the science of inflammation in the book as best as we could in ways that we hope that an average person who’s not used to thinking about these ideas could actually read it, maybe a couple of times if needed, and really understand it and really grasp what’s happening in the body and on the planet — in the Earth’s body. So that discomfort, I just say, is the way through. It’s not for the purpose of just being uncomfortable or just polarizing or just inflaming the dialogue, but it’s to offer people a way of understanding what they’re seeing around them.

The Need For Connection and Community Healing

Dr. Rupa Marya: For me, this was most strikingly seen when I had a patient who was from Muscle Shoals, Alabama — a woman who grew up in a community where she was forced to drink the well water of a polluted watershed: the Tennessee River Valley Watershed.

When she was — in UCSF, where I work as a hospital medicine doctor in the ICU — sick for months, and her son shows up with white supremacist tattoos around his eyes and sits there, and we have a conversation about where they lived, and what their lives are like, and what they’re exposed to, he comes out of the room just crying and motioning to hug me. And I hold him, and he’s sobbing and saying, “No one has ever asked what our lives are like; no one has really seen what’s happening in our communities and how people are dying.”

That to me was like, okay, how do we write this story in a way which will connect all of us who’ve been orphaned from the Earth and all of us who’ve been divided from each other so that we might all have the opportunity to be healthy and pursue lives with dignity? So, that’s how we translated the stories and the learnings from the bedside of patients with the work that Raj and I both do in the communities we serve and work with.

Ocean Robbins: Thank you. I’m moved by your metaphor because I’m thinking if I had cancer, I’d want to know about it; I wouldn’t want to be told a nice story. Finding out about it might make my day a lot less pleasant – I might feel really sad — but we go to doctors for truth, not for nice stories that make us feel good. We actually count on them to tell us the truth, right? So in that sense, I think we want to go to people like yourselves to tell us the truth about the systems that we inhabit.

Embracing Biodiversity

Dr. Rupa Marya: Yeah, I just want to temper that a little bit because the word truth can sometimes scare me and come off as feeling a little religious in some way. So I would say we go to doctors for the best understanding of what’s happening. A synthesis and understanding of the data that’s in front of us. And what is your best understanding of what’s happening.

And of course, as with anything, there will be different people who have different interpretations of the data, and that’s why it is useful to get peer review and multiple ideas and thoughts. That’s what’s been so beautiful about working on this book is how many peers we brought in with us and how much we synthesize different stories.

But yes, it is important that we’re going to understand the patterns that we’re seeing in front of us and understand it with a depth that can actually advance actions that can help shift the course that we’re on right now — because the course we’re on right now is not being shifted fast enough.

Ocean Robbins: Yeah, absolutely.

Dr. Rupa Marya: Sorry to temper that.

Ocean Robbins: No, I appreciate the nuance. There is no one truth with a capital T. There are facts and realities, but there are also so many different perspectives. And we need a biodiversity of approaches, I think, to create true healing in this world. The sort of notion that there is one right way to live, one right way to think, and everything else should be shut down is part of the sickness, I think, that you’re helping to diagnose here so that we can hopefully create some healing systemically. We don’t just need one probiotic, we need a huge diversity of probiotics for a healthy gut, right? Similarly, there’s no one solution to every problem, but there is a deeper understanding of wisdom that can help us heal, I think.

The Microbiome

Dr. Raj Patel: Yeah. I’m just going to run with that probiotic idea. Because it’s true that we live in a world — and particularly in cities in the global north here — we live in a place where our gut microbiome has been seriously diluted. We may not have a window into our internal microbiome to see quite how diverse it is, but, I remember when I was a kid, we used to cycle around and used to get flies on our teeth, and the windshield would be completely smothered with the life that we were driving through. These days, that doesn’t happen. And the sort of extermination of life that we can see visibly outside is also happening inside us.

And the way to fix that is not through a pill. Because even if you try and rewild your microbiome, the only way that things inside you stay alive is through a relationship with the world outside. And you can’t just re-populate your internal microbiome and think, I’m all right, Jack. That’s not how life within us and external to us works. If the world around us is sick, then there’s no amount of biodiversity within us that will heal that world outside us and will sustain the life within us.

So, I do think, just again, to jump on that idea of the microbiome… I know a lot of people who are very interested in transforming the way that we eat, are very excited about feeding our microbiome, and that’s the right impulse. But, what we’re trying to do in this book is take that impulse outside. It’s like, oh yeah, I’ve got to look after this. My microbiome is not just me, it’s a million different things. But, if that world of chaos stops at the boundary of your skin, then you’re not taking full care of the world as it’s needed in order to be able to rewild ourselves back into a teeming and diverse world.

If the world around us is sick, then there’s no amount of biodiversity within us that will heal that world outside us and will sustain the life within us.

Raj Patel, PhD

Dr. Rupa Marya: Yes. And that’s beautifully said, Raj, because then the microbiome in the gut becomes a living reflection of a whole system of care and a whole system of relationships with the world around you. And so, that’s how you know, and that’s one of the things we talk about in the book, is that we will know we’re making progress when we start to see our bodies become less inflamed.

Complexities & Inequities in Health

Ocean Robbins: Yeah. So, you talked about your patient who came to you having drunk or actually eaten fish from a river that was polluted and now was suffering from serious inflammation that eventually, I think, took her life. And it strikes me that one of the dangers of the natural health movement is that there’s a half-truth in that we are responsible for our own health outcomes, and we need to take responsibility for them — what we eat and how we live has a massive impact on our well-being.

But the other half of it is that we’re impacted by our environment, by our ecosystem, by forces outside of us as well. And yes, personal habits and personal choices will profoundly influence how we respond to pathogens, how resourceful and resilient our organism is in the face of assaults or challenges that it may face, but it’s not the whole story.

A lot of things were shaped in the womb and in early childhood. And now here we are; we don’t get to rewrite history. So, we do the best we can, of course, with what we’ve got, right? And that’s back to the serenity prayer. Give me the serenity to accept the things I can’t change, the courage to change the things I can, and the wisdom to know the difference, right?

At the same time, I, like you, want to think systemically at how we create the conditions where less kids are inheriting wounded biology and pathogens that they then have to suffer through and figure out how to detoxify or not throughout their entire lives. And a lot of that comes back to the collective well-being and the environment on the health of the ecosystems we inhabit. Are we living in toxins? Are we breathing polluted air? Are we around diverse, healthy soil? Do we get to bring some of those microbes into our bodies? Or do we live in hyper sterile, or worse yet, hyper polluted ecosystems?

And the answers to these questions have a profound race and class dynamic to them. So, statistically, your likelihood of living in a healthy environment, in a safe environment, is different depending on your financial context and your ethnic background, and your nationality, right? And this is one of the things I think you guys are highlighting so powerfully in your work is that if we really want to heal ourselves, we need to start to heal the world. And we need to look at the fact that that doesn’t show up equally for everybody.

Dr. Rupa Marya: Absolutely.

Stress & Inflammation in the Working Class

Dr. Raj Patel: You talked about how this is a problem for everyone. It’s certainly the case. And that’s something that is true also across races, for example, when it comes to conversations about class. Because one of the things that really surprised me in working with a group on this book is just how the story of inflammation works into our body.

So, for instance, one of the things about being working class in the United States is that you are disproportionately exposed to things like payday loans. For folks who are lucky enough not to know what that is, it’s when you need $200 to make it through the end of the month, but then you have to pay $500 back within a couple of months.

Now, those kinds of loans are so bad in terms of stress of repayment and the kinds of despair that people get driven into afterward, that if we were to treat payday loans as illegal — if we were to just proscribe them and say, look, you can’t do payday loans anymore — then the suicide rate in the United States would drop by 2%. And the fatal drug overdose poisoning rate would drop by 8.9%.

Ocean Robbins: Wow.

Dr. Raj Patel: Here’s a treatment. Here’s a medicine to help people who are on the frontlines. Doesn’t matter what race you are. If you are struggling with making ends meet… Payday loans are an incredibly bad idea, and we need to take them off the table. But, understanding that actually the boundaries of medicine go beyond what the FDA approves or disapproves of and goes all the way from things like toxic financial policy, all the way to the food system, and meets in the middle. I think that part of the story that we’re telling here in Inflamed is a story about how the world of medicine, the world of food, the world of society are all conjoined in ways that we’ve been miseducated in trying to draw divisions between them.

The Divisions Between Medicine and Food

Ocean Robbins: Yes. So, we’re Food Revolution Network. We focus on food a lot. And I’ve often reflected that most doctors today act like food didn’t matter. And quite frankly, the food industry today acts like health didn’t matter, in many cases. Yet, the truth is that food is the foundation of health. And it should be the first line of defense against disease. And yet, we have this separation.

Why are there these divisions between medicine and food? And is it just purely that doctors are trained to not think that way and the food industry is just trained to look out for profits, or are there deeper sources here around this division?

Dr. Rupa Marya: Well, this is what we dive into in the book, which is really the Enlightenment-era errors that have persisted in colonial capitalist society and have structured everything from the food system to our education system.

So, all the axises of care have literally been fractured from each other. And part of this has to do with how this land was colonized — that Europeans, when they came here, separated white male property people from everybody else. And those folks were civilized and all the rest of us were uncivilized. So, once you’re uncivilized, you’re able to be dominated and extracted from. And so, that mentality of extraction, which is pervasive in the industrialized food system, and even the softer, greener, fuzzier, conscious capitalist food system, these things are extractive. At their core, they’re extractive. They’re not based in systems of relationships. And so, that’s why doctors don’t know how to think about food, or even think about that your mind and body are actually one entity, that the separation of self and other is another fiction that we have to overcome.

This is something that we really dive into in the book, is what we call the colonial cosmology, and how that underpins the architecture of all of our institutions in this society; and how that way of thinking is actually a part of what’s making us sick. Because it’s doing precisely what you’re saying, Ocean: it’s doctors not understanding why it’s important to have nutrition, nutritious food, and where that plays a role.

Nutrition and COVID-19

Dr. Rupa Marya: What we’re seeing in COVID… I just took care of a young, 37-year-old unvaccinated woman with severe COVID just yesterday in the hospital. And her nutrition markers were terrible. This is a young woman who’s a mother of three children, who has very poor nutritional markers. Because what’s available to the average person, the average working-class person, is not whole food; it’s not nutritious food. And, it’s food that’s been laced with pesticides. You’ll have traces of these pesticides and dietary chemicals, which we also know impact the gut microbiome.

And so, even if you try your best to take the right supplements and take the right probiotics, it won’t work in the face of the constant onslaught. And so that is what we’re talking about. How do we restructure our society and world so that onslaught stops, so that everyone can have the opportunity to be healthy?

Ocean Robbins: Yeah. There was a recent study, six countries, thousands of healthcare workers, and they were analyzing their diet and their COVID context. And they found that people who ate a whole foods, plant-based diet had 73% less risk of hospitalization than their peers who ate a more standard industrialized diet. Seventy-three percent reduction in risk of hospitalization. These healthcare workers were all exposed to COVID-19 in similar amounts.

And then, we have other data from the CDC showing that 95% of COVID-19 deaths in the United States have been linked to underlying comorbidities, which are, all of them, profoundly diet- and lifestyle-impacted. And —

Systemic Health Injustices

Dr. Rupa Marya: Yes. I want to say though, I just want to offer some shape to that. Because when we’re talking about obesity, cardiovascular disease, diabetes, and these are the things I think you’re referring to — those things are diet-related, and they’re also related to the history of genocide of Indigenous people. They’re also related to how much your neighborhood is policed, and how terrorized you are by police. It’s related to trauma. It’s related to having your language ripped away from you. So it’s way more whole than just are you eating the right things, and are you living the right way?

Ocean Robbins: Right.

Dr. Rupa Marya: Because, I just want to say that because for some people, that opportunity, even if they ate the best diet that they could and were exercising, they’ll never have that opportunity to counter those things.

Ocean Robbins: And just to add a data point to that… As we know, life expectancy in the United States dropped in the first year of the pandemic by a year for the white population; it dropped for three years for the Black population in the United States. So we’re seeing here that death rates were much higher amongst Black people, and also Indigenous and Latino communities than the white population. And that links to what you’re saying, the chronic inflammation that’s caused by so many other factors. Of course, there’s diet and lifestyle, but there’s also trauma and the impact of that trauma. And so, I appreciate you’re raising that larger systemic piece.

And again, it’s like we do all that we can personally, none of us wants to be a victim. At the same time, let’s look at the systemic dynamics that do victimize some people, quite frankly, in serious ways. Raj, did you want to add to this too?

Food Industry Follies

Dr. Raj Patel: Yes. The way that the food industry behaves is also worth flagging here. A report came out, a leaked report from within Nestle, pointing out the vast majority of the food that it produces doesn’t meet a basic definition of being healthy. Again, there’s a rhythm to the patterns of exposure to unhealthy food when the food industry systematically targets low-income communities and communities of people of color with the least healthy food.

So, it’s not an accident that the food industry is targeting certain kinds of neighborhoods, certain kinds of communities for advertising, for example. And, the lack of accident there has everything to do with, again, the damaging consequences of consuming the industrial food system, which is, again, premised as Rupa was saying, on a racist and exploitative and genocidal history.

Just to give some numbers here. In 2019, Americans spent $1.1 trillion on food. Just a very limited calculation of the damage caused by the food system through those purchases set the number at around $2.1 trillion. So $1.1 trillion spent, $2.1 trillion of damage, and the majority of that was precisely in the generation of these comorbidities, again, which are patterned not in a random way, but in a very targeted way that follows the contours of power in society.

And so, now we’re all familiar with comorbidities, but we all ought to become a bit more familiar with the mechanisms through which they are projected into our bodies by these large corporations. And I don’t care how conscious they pretend to be. When you’ve got Nestle saying, “We’re trying to take some sugar out of our food,” that’s — as well they know — basically pissing about around the edges, when essentially their business model depends on the production of externalities that will generate, and as they know full well, the death, in particular, of communities of people of color and low-income communities.

Identifying Solutions

Ocean Robbins: Yeah. Okay. So, some of our viewers right now might be saying, “This is really heavy stuff.” When you’re saying the dominant systems that we depend on to feed families are morally bankrupt and are causing this harm, and then you’re saying that the even greener versions are warmer and fuzzier, but they’re still fundamentally connected to the same extractive systems that are fueling a lot of the crises, what can we do about it? Personally and collectively, what’s the prescription here?

The Need for Deep Medicine

Dr. Rupa Marya: Well, the prescription is deep medicine, Ocean. And I’m happy to tell you about a project we’re doing as a model that could be replicated all over this country, all over the place.

So, we started an organization called The Deep Medicine Circle. We are a collective of non-Indigenous and Indigenous people working together to advance systems of farming that prioritize Indigenous principles of earth care and people care. We are working on re-matriating, returning 38 acres of land to the Ramaytush Ohlone here, the original people of the San Francisco Peninsula. And we’re working under their leadership to create food to give away to people oppressed by hunger in the city.

So we’re in the peri-urban areas; we’re like 40 minutes south of San Francisco. All the food that we’ll be growing will be, I call it morganic because it’s not just organic. But we’re working on improving soil biodiversity. We are working on area median income wages for our farmers so that they’re employed and healthy. And they’re also being valued for the work of stewardship that they’re doing for the soil and for the food.

And then that food is just liberated from the market economy. It’s going to people whose gut microbiome needs it the most. And then we see how that shifts our narratives of health and wellness. So, we can flip the food system on its head and prioritize care, or we could keep it as it is and try to eke out a profit as we try to do these things. The profit motive of the food industry, as with the healthcare industry — as we’re watching in the United States — is always going to make it less effective and efficient at conveying care.

And what we need right now is care. We need care and repair of the damage that’s been done to our soils, to our water, and to our Indigenous people. The IPCC report on climate change did say that Indigenous people and their systems of knowledge are critical to addressing climate change throughout the world. So it’s a great time to give land back, give all the land back, and start working under Indigenous people’s understandings of how to be in right relationship in this land.

And I know that might sound like, “Whoa, how do you do that?” Well, you do it in little bits, and you do it in big bits, and it’s happening right now. There are many projects all over Turtle Island, all over this land, and all over the world, frankly, where people are starting and have been building these movements of peasant farmers and small to medium farmers, who’ve always fed, always created the most food that people eat on Planet Earth. So that’s reassuring, and it’s exciting.

What do you think, Raj?

A Duty of Liberation

Dr. Raj Patel: I think people should give to the Deep Medicine Circle of which I am a treasurer and, therefore, I need to declare an interest. But I do think that there are… Part of the debilitating moment here is, the reason this feels so big and unwieldy is because we’ve been so conditioned into our powerlessness, thinking that the only way that we can change the world is by shopping and really spending quite a lot of money on the right probiotic. And if that’s what we think, really the only way that we can save the world is through our shopping habits, we let go of perhaps the most important levers of change that we have, which is our relationships with one another and the rest of the web of life.

And, to reconnect to that is, it can feel like some sort of woke duty. And for those folk who are entering this conversation and thinking, “Look, I get it that there are things wrong with the world, but there’s so much to do.” The one way to frame it is to feel it as a duty of just suffering and of abnegation. But the other way, and I think possibly the better, in fact, definitely, the better and the more correct way of understanding this is a duty of liberation.

And the reason it feels so difficult is that’s the sort of voice inside your head that makes you feel powerless and overwhelmed by everything as opposed to ready for transformation and change. And the more we’re in the readiness for transformation and change space, the happier we’re going to be because ultimately changes are coming. We’ve seen what climate change is doing, and it’s only getting worse as well we know. So why not lean into the need for change and understand it as a liberation rather than as a kind of retreat into a smaller, shallow life when in fact the opposite is the case.

Ocean Robbins: Thank you.

Dr. Rupa Marya: And that’s really the space of the imagination. I think what we’re talking about here is it’s so sad that arts funding has been cut so much in school because so much of this work is the act of imagining new ways of being together that we’ve never actually had an opportunity to ever experience on a large social scale. What does that look like? What does it feel like to escape from the social structures that have been imposed upon us that we’ve internalized? And we’ve been unwitting recreators of that violence. It’s an opportunity to open up that consciousness and step through another door. And through that, the richness of relationships is so exciting and actually invigorates new possibilities, new economies, new ways of carrying out our daily living, which is exciting.

Opening The Door of Opportunity

Ocean Robbins: Yeah. Thank you for that.

I think that many of us feel, deep in our bones, that the world we’ve been fed isn’t satisfying to us anymore. So many people feel this longing for another way of living, feel a sense of isolation and loneliness, feel a sense of disconnection, and feel as if we’re stuck in a rat race, so to speak — trying to survive and win a race that even if we win it, are we really going to be happy? Even people who succeed at the top of the heap often feel deeply lonely and bereft inside like, “I’ve got everything I want, but for what?” And then so many other people feel like if they could just get a little higher on the ladder, then they’d be okay. Meanwhile, they’re struggling just to survive. And so many of us are wondering, “Is there something more? Is there something deeper?”

And the notion that the breakdown of established systems and institutions and even ecosystems might open the opportunity for some kind of a breakthrough to another way of living in harmony with our own rhythms, in harmony with the Earth as a community, rather than just as a way to try to get to the top, is liberating I think. To something… It’s humanizing in the deepest sense.

And so, now I really want to thank both of you for shining such a brilliant light on what’s possible, for sharing, in very sobering terms, what we’re up against and the costs of the status quo. Because we’ve got to face that, I think, to really have the impetus to change it. As long as it’s sort of okay, we’d rather take what’s tolerable to the unknown sometimes. But when we realize how broken things are, and, in fact, maybe they’re not broken, maybe they’re designed for something that isn’t what we want to be designed for, then we start to realize, wow, what else is possible? And you’re helping shine that light and the notion that we could be healthier; we could be happier, and we could contribute to a healthier and happier world is a beautiful one. So, I thank you both.

Any closing words you’d like to share from our time today?

Choosing Care Before Consumption

Dr. Rupa Marya: One of the scholars we talked to, Sam Grey, who is just so amazing, she brought up this concept of being orphaned — that we’ve all been orphaned from our mother. I remember she said that, and it just really hit my heart. Like, “Oh my God. Why am I born here in Ohlone territory? Why is Raj? Where have we been dragged about from our families, these diasporas, these refugees of colonial terror?” We’ve all been separated from our homelands. The people who’ve been colonized here. We’ve all been cut off.

So what we must do is heal and repair those connections wherever we are. And that really is contending with these systems of domination that put us in places of really illegitimate privilege, that we must challenge and invite ourselves to overturn. And what wealth of relationship comes on the other end of that. It’s tremendously exciting.

I can tell you, I’m a songwriter. And this work I’m doing right now with Deep Medicine Circle is the opera of my life — the most beautiful symphony I’ve ever heard. And so, I invite everyone to find that work in their own orphanhood. It’s time for us all to come home.

And so, I’m excited. It’s healing work. It’s deep work. It’s confronting trauma. It’s hard work. And if we all do it together, it can be a beautiful journey.

Ocean Robbins: Yeah. Thank you. Raj?

Dr. Raj Patel: I couldn’t say it better than that. So I… Yeah. I think this work of care for one another and recognizing how big the community is that’s caring for us and for whom we can care is just a revelation. And it’s so much better to care than consume.

And I think ensuring that we all care so that we can all consume fairly, I think, is definitely the message we’ve got in Inflamed. And I’m just very grateful to have written it with Rupa. And Ocean, that you’ve invited us here and that you’ve spent so much time with the book and with its messages. It’s a privilege.

Ocean Robbins: Thank you both. We’ve been talking with Dr. Rupa Marya and Dr. Raj Patel, authors of Inflamed: Deep Medicine and the Anatomy of Injustice. Fantastic book; critically important message. Thank you again.

Dr. Rupa Marya: Thank you, Ocean.

Tell us in the comments:

• Were you inspired by this interview?
• How do you see systemic inflammation surfacing in your life?
• How could you connect with your community to confront collective trauma?

Feature Image: iStock.com/Boonyachoat

Read Next:

• Prescription For Disease Prevention: An Interview With Sean Hashmi, MD
• Embracing Indigenous Wisdom of Land & Spirit: An Interview with Indigenous Activist Lyla June

The post Systemic Inflammation & the Need for Deep Medicine: An Interview with Raj Patel, PhD and Rupa Marya, MD appeared first on Food Revolution Network.

Below is the edited transcript of the video above.

Ocean Robbins: Welcome to this Food Revolution Conversation. I am Ocean Robbins, co-founder and CEO of Food Revolution Network, and we are here today to talk about healthcare, disease symptom management, and the critical difference between the two. We’re going to talk about systems, and why it is that we in the United States spend 19% of our gross domestic product on disease symptom management, but still have the fattest and sickest population in the history of the world. We’re going to talk about the underlying symptoms and systems that create that. More importantly, we’re going to talk about solutions. And we’re doing that with a brilliant doctor who is one of the foremost leaders in the movement to transform healthcare, and to truly promote health for humanity. He’s Dr. Sean Hashmi, and he is a practicing nephrologist and obesity medicine specialist at Kaiser Permanente, Southern California.

Dr. Hashmi serves as the Regional Director for Clinical Nutrition and Weight Management at Kaiser Permanente, Southern California. In this role, he’s responsible for developing a comprehensive obesity management strategy involving lifestyle medicine and obesity medicine for the 4.6 million members that Kaiser Permanente serves. He is driven by a lifelong commitment to be of service to others. He also provides evidence-based health, nutrition, and wellness research through his nonprofit organization, SELF Principle.

Dr. Hashmi and I got to talking a little while back as I was trying to understand what it was that Kaiser Permanente was doing that has put it at the forefront of many of the efforts to transform healthcare in the United States. I wanted to know who was behind that, who was making this happen — because this is a big corporation with all the same forces that are pushing the insurance industry, the hospital industry, and the medical care industry in the directions that they have been going for so long, which ultimately are about treating the symptoms of disease. I wanted to see what’s happening that’s causing Kaiser to start to do some things differently. And I think I might’ve found the answer. This man is absolutely at the forefront of changing the way medicine is thought about and the way it’s practiced, by emphasizing lifestyle first. Dr. Hashmi, thanks so much for being here and for all that you do.

Dr. Sean Hashmi: It’s such an honor to be on the show. I’m delighted to be with you guys. You and I had a chance to talk, and I was so fascinated by our conversation — to see how much we both have in common and how passionate we both are about pushing the right type of message out there.

A Passion for Medicine

Ocean Robbins: Absolutely. Well, it’s urgent, and it’s very personal for you, too. In 2004, I believe it was, you lost your sister to an epileptic seizure. Can you share how that experience impacted your life and your relationship to healthcare?

Dr. Sean Hashmi: There are very few things that happen in your life where all of a sudden, you find your why. As tragic of an event as that was for me, it also helped me to define my why and make it very clear what my purpose in life was. My sister, who was four years older than me, was very much into nutrition, and health, and so forth. She had epilepsy. One evening when I came home from work — I used to teach martial arts; I would stay up really late at the classes and studio, come home very tired, and go straight to bed. I remember my mother, she ran in my room at five o’clock in the morning, yelling, “Wake up, your sister’s dying!”

I jumped out of bed. I ran into her room, and my father had picked her up off the floor and laid her in bed. I called 911. I didn’t know how to do CPR. The 911 operator tried to guide me, but I couldn’t open her mouth.

The hardest part of that experience was that my sister had enrolled me in an EMT class (an emergency medical technician class, where they teach you how to do CPR). The class was going to start the following week, and you know how tragic life is sometimes. If it were a few days later, would it have made a difference? Knowing what I know now, the answer is probably no. But try telling that to your heart; your heart doesn’t want to believe that.

So there’s this fire that’s inside you that’s always burning. And every time you get a chance to help somebody, you also get a chance to make somebody live a little bit longer, so they get back to their loved ones. It heals you a little bit.

And it sounds strangely selfish, but by helping others, I feel better. So that’s always been my true passion: to find a way to give back to the world and do what I do around nutrition, which is putting out the fire before the fire starts. There’s so much beauty in that.

Barriers to Quality Care

Ocean Robbins: Well, bless you for that. There’s the old saying that what doesn’t kill us makes us stronger. And some things maybe kill parts of us and strengthen other parts of us. I mean, there are losses that we can never really recover from, but somehow, we find a way to make some meaning out of them, to gain some value from them, to make something good of them. And some things like the loss of your sister are just too heartbreaking for them to happen in vain, right? So what an honoring of her life and memory that you’re carrying on serving others and helping so many other people not to lose their sisters and their mothers and their daughters and their friends because you’re helping them make changes that mean they never need medical interventions in the first place — or need a lot less of them.

So that’s always been my true passion: to find a way to give back to the world and do what I do around nutrition, which is putting out the fire before the fire starts. There’s so much beauty in that.

Dr. Sean Hashmi

I’m also curious how you think that healthcare access might’ve played into all of that and how that influenced your journey.

Dr. Sean Hashmi: I think that’s probably the hardest part. We grew up in a very poor family. And we didn’t have insurance at that time, so we relied on the county system. My sister, my mother, and I would take three buses to get to the county hospital, which was about two hours away. The bus rides made it very, very difficult. And when we would get there, it was so hard to spend time with the doctor and for the doctor to understand how hard was it for us to get there. That left a very deep impression on me.

As doctors, we’re not just healers or teachers. When people come to our office, they put the most precious thing they have into our hands. What an honor, what a privilege for us to be able to take that extra minute to do something. And all of the basics that go into preventative care, that wasn’t something that we heard about. My mother, later on, had colon cancer, and we looked at all of the things that we could have done differently to prevent that from happening: my father’s prediabetic status, my uncle who died of diabetes — all of these are conditions that we associate with lifestyle that could be changed.

Preventing Disease Before it Starts

Dr. Sean Hashmi: In the hospital, I’m a kidney specialist. The number one cause of kidney disease that leads to dialysis is diabetes. And, of course, high blood pressure and obesity are tied together, so when we look at the healthcare system, we have such an amazing opportunity to be able to influence people early in the game, instead of waiting till something actually bad happens. That’s where I wish we were more proactive in healthcare in general.

Ocean Robbins: So there’s an increase in screening for disease, whether it’s Pap smears or various other tests that can be done, hoping to catch diseases earlier before they become too widespread or perhaps fatal. And that’s called prevention, but it’s really not prevention. It’s just early detection, right?

Dr. Sean Hashmi: Yes.

Ocean Robbins: But prevention is creating the circumstances out of which no disease happens in the first place.

Dr. Sean Hashmi: Right.

The Economics of Prevention

Ocean Robbins: You’re saying there isn’t much focus on that yet. And there’s this question I want to hone in a little more on, this question of how long does the patient have to stay in the insurance plan for it to become cost-effective to pay for prevention?

There was a recent study at Tufts University looking at the cost-effectiveness of Produce Prescription Programs. The researchers basically concluded that when doctors prescribe fruits and vegetables, or even more broadly, healthy foods, to their patients, that they can get significant results in terms of quality of life added and reduction in risk of cardiovascular disease and many other ailments. They ended up concluding that the cost per quality-of-life-year was generally considered on the lower end compared to a lot of the other things that are covered. And yet, we still don’t see this happening on a wide scale.

I wonder if most insurers are thinking, “Well, my gosh, our patients could leave next year and go to some other insurer. So what incentive do we have unless they have enough retention to bring down our long-term costs?” Do they even want to bring down their costs? Some people say that the bigger the pie is, the more they spend, the more they can charge, and that’s their game. How do the economics work here? And is that really one of our central problems in enhancing preventative care?

Dr. Sean Hashmi: It depends on how a healthcare organization is structured. The organization that I work for, that I’m very proud to work for, is designed as a nonprofit. What that basically means is we are designed to save money — not to do extra procedures to make more money — because Kaiser and Permanente, the Kaiser is the insurance arm. So we have our own insurance model, which means our model is built around the idea that the less we do, the better it is. What I mean by doing less is that the more we spend on prevention, the more we save down the road. What we find (at least with Kaiser Permanente) is that our members stay with us for a very, very long time. In fact, when we look at it, we will oftentimes find three generations of people that are already part of Kaiser Permanente. Three generations, already! We’ve been around since the ’60s. So as a result of that, there’s a huge incentive.

From Diet to Lifestyle

Dr. Sean Hashmi: But what you speak of is a really important point, which is: What we know from the data is that food prescription models work. The reason for that is that there is so much confusion on what to eat. Everybody’s an expert when it comes to this four-letter word — it’s just awful; it’s “diet.” Some clever person added a “t” to the word “die.” Now everybody’s running around trying to focus on a diet. But when we look at places like the Blue Zones, where there are the largest living populations of centenarians, what we find is that they don’t know the word “diet.” They just actually practice a way of life, which is to eat a predominantly whole foods, plant-based diet. They don’t even realize it has a name. It’s just, this is what we’ve always eaten.

For doctors, our first job really is to learn about this because there is a gap. It’s making sure that we have educational opportunities. Part of why I started our nonprofit, SELFPrinciple.org, was that out of all the research I did reviewing thousands of studies, there were four main concepts: sleep, exercise, love, and food — that is, SELF. So SELF Principle came up because those four concepts — as simple as they are — if you follow those, you have won two-thirds of the battle right there.

Now, when we look at things like genetics and everything, the biggest role genetics plays is about 30% in your life. Seventy-percent is lifestyle factors. And if you focus on that 70%, you can do great. For organizations, the more they invest in programs like partnerships where they’re giving patients easy access to fresh produce, easy access to fruits and vegetables, the better. We’re not talking anything fancy, just something like having farmers markets. One of the things I’m so proud of is that aside from the COVID time, we’ve always had farmers markets. What’s fantastic is I do a lot of my shopping once a week at our farmers market, which is right on our campus.

Changing Medicine From the Inside Out

Ocean Robbins: Yeah. That’s so inspiring. I’m a Kaiser Permanente member. And to walk in for an exam or a visit and literally walk through a farmers market on the way — on the hospital grounds — is so heartwarming. There’s a pharmacy with a “ph.” And now there can also be a “farmacy” with an “f,” as well. A place where patients can really see that this matters and that this is actually in the center of the hospital in some cases. Wonderful! So important.

I was also struck… I have to say, I had minor shoulder surgery a couple of years ago. And my surgeon actually recommended that I do this visualization. They sent me an audio track before the surgery. And they said studies show that people who listen to this track and visualize with it before, during, and after surgery have improved outcomes. They heal faster; they’re more likely to get the desired results; they have lower inflammation and less stress. I was like, “Okay, great.” And here’s the funny thing: I’m the kind of person who would do that. I’m the kind of person who might’ve written a recording like that, but I still probably wouldn’t have sought it out if my doctor didn’t actually send it to me.

So I listened to the recording many times before the surgery. And I pictured how my body was going to respond, how I was going to be relaxed and at peace, how angels were going to surround me, and I would be protected and guided and my shoulder would prepare to open up to receive the knife even before it came. Then my shoulder would heal right up perfectly. And the surgeon would be guided to do just the perfect thing. I saw all that, and I don’t know if it actually changed my outcome, but I certainly healed very quickly.

They also recommended that I have headphones on during the surgery to listen to another recording they had specifically for that moment, and then there was another one for afterward. Some people might call that woo-woo or whatever, but when my doctor told me to do it and said there was science backing up its efficacy, I was like, “All right, I’m in!” And then I thought, wow, the world is changing. If a major hospital has a farmers market in it, if there are no vending machines for Coke or Pepsi in Kaiser anymore, which is also true, by the way. Thank you for your leadership on that. If we’re being prescribed visualizations before, during, and after surgery, these are big changes happening.

A Changing Culture

Ocean Robbins: I also notice that after every physical exam with my doctor, I get a follow-up email with a little quiz asking, “Did your doctor discuss diet and lifestyle with you?” And I’m thinking that this data is being gathered because somebody wants to track it. Because there’s a system-wide encouragement for doctors like mine to discuss diet and lifestyle with their patients. I’m thinking there are probably not a lot of other healthcare systems doing this, but Kaiser really is leading the way. Do these kinds of changes give you some hope?

Dr. Sean Hashmi: Oh my God, absolutely. When I go to work every day, I’m surrounded by incredibly passionate people. So in Southern California, where I serve in my current role, which is the regional director of clinical nutrition and weight management, I have physicians who are absolutely passionate about this work. They’re doing the research; they’re bringing the studies; they’re giving lectures to other doctors. There is so much knowledge that’s being distributed right now! It’s incredible. We have people who are getting boarded in lifestyle medicine and people getting boarded in obesity medicine. Now, we have people getting dual-boarded in both of them because they want to know all of the details.

In the work that I do, we lay nutrition and lifestyle as the foundation. Before we talk about anything else, we find that that’s the most important conversation — and we always want to meet the member where they’re at. We ask for permission to talk about these things, so they never feel like the doctor is telling them, “You have to go out and do this.” No. “Mrs. Spit, what are you able to do? Let’s talk about it. Can I have permission to talk to you about your weight today? What works for you? What are your barriers?” And you’re fascinated by the stories and how difficult it is.

Starting With Small Changes

Dr. Sean Hashmi: You find that they don’t need to go and do something drastic, even as simple a thing as adding a few more fruits and vegetables to their plate is a great start. Next time they come, we talk about something else. So, those little incremental things are kind of like what BJ Fogg talks about in his book, Tiny Habits. It’s amazing that organizations value that, that we have physicians who value that. And we serve primarily as teachers of patients, and teachers of other doctors.

Ocean Robbins: Yeah, thank you so much for that. In case anyone’s wondering, this is not an advertisement for Kaiser Permanente. We’re here to talk about healthcare and how we transform the system. Kaiser has got a long way to go, too. But we are here to share stories of solutions and possibilities because I think they give us hope and show what’s possible – not just at Kaiser, but for everybody. Kaiser is only in about 12 states, but we’re working all over the world here. A lot of people don’t have access to Kaiser. But all of us can learn something here about what’s possible and can advocate for more change everywhere in medicine.

Dr. Hashmi, I’ve often thought that a doctor who doesn’t know about food is a little bit like a firefighter who doesn’t know about water. Food really is the foundation of health. What you eat literally becomes you, and it dramatically impacts your likelihood of dying of certain diseases or living a long, healthy life. Do you see it similarly?

Eating for Health

Dr. Sean Hashmi: I think the challenge, at least on the physician’s side — when it comes to training, it’s not that we have a lack of knowledge. What’s happening is, there’s so much misinformation that it’s making the whole process very, very confusing. Sometimes, I’ll have physicians come and talk to me about the ketogenic diet. They’ll say, “I have patient X, who’s lost 150 pounds on the ketogenic diet.” My response to that is, okay, that’s wonderful that you were able to get somebody to commit to healthier changes. Now, we know about the ketogenic diet and weight loss. We get it. But I can also starve you, and you’ll lose weight. The question is, are we getting weight loss, or are we getting health?

What I tell every single person when I give a talk is that if you go for weight loss, you get weight loss. If you go for health, you get a better brain, better vision, a better heart, better lungs, better kidneys, a better GI tract, and you get weight loss with it. So, from that perspective, our job is to focus on health. If we get you down the right healthy road, we can stop the body-shaming because that’s a very real aspect. Patients may have lost 150 pounds, but the doctor tells them, “You need to lose more weight.” Let’s celebrate what you have done because if I celebrate with you, you feel more connected to me. And you’re more likely to listen to me.

A Simple Prescription

Dr. Sean Hashmi: When it comes to organizations, the best we can do is to start with medical schools, start with the education piece in medical schools. If you start teaching students there, they are open; they’re receptive. It’s before the point where they’ve had so many experiences that make it really hard to break down those walls. Then, in residency, to actually have dieticians involved so that there’s a way to understand. Right now, we have a different diet for CHF, a different diet for diabetes, a different diet for kidney disease.

If you go for weight loss, you get weight loss. If you go for health, you get a better brain, better vision, a better heart, better lungs, better kidneys, a better GI tract, and you get weight loss with it.

Dr. Sean Hashmi

One of the things I told, at least our local folks, was that it’s all actually the same diet. It’s not a different diet. We’re confusing people by making all of these nuanced statements. But it turns out if you’re looking for a low sodium diet, it’s a whole foods, plant-based diet. If you’re looking for a diet that’s ideal for kidney patients that’s lower in protein, that’s a whole foods, plant-based diet. If you’re looking for a diet for diabetics that is lower on the glycemic index scale, that’s also a whole foods, plant-based diet. You have all of the same concepts found in one dietary pattern.

Ocean Robbins: Yes, so true. I often reflect that if you drive your car into a brick wall, the death certificate might say, “impalement by a brick wall.” But the truth is, it was your driving that was the real cause of death. The modern diet and lifestyle are kind of a recipe for chronic illness of all kinds, and we don’t know whether it’s going to show up as cancer, type 2 diabetes, obesity, heart issues, or maybe all of the above in many cases. But, some sort of disease is inevitable when we don’t treat our system optimally. So, I think it’s so important that you’re learning how to bring the significant authority that you carry as a doctor to your work with patients who trust you with their health and their lives, to try to help them make changes.

Sticking to the Plan

Ocean Robbins: That said, I’m struck by how often people who know what to do still can’t do it. Sometimes people will even have a leg amputated. They could see it coming, and their doctor said, “You need to eat differently.” They actually couldn’t do it, even with everything at stake like that. Do you see this happen? And what do you think it is that keeps people from doing what they know they should, even when their lives are on the line sometimes?

Dr. Sean Hashmi: This is probably one of the hardest parts of my job. As a kidney doctor, one of the things we take care of is patients whose kidneys fail, who end up on dialysis. When they end up on dialysis, some patients — not all — some patients feel like, “Look, I’ve already lost the battle, what’s the point?” Sometimes it’s even harder for them to follow your advice. I’ve had patients where they’ve lost both of their legs; they’ve lost their arm; they’ve lost fingers; they’ve lost eyesight in one or both eyes, and yet, they still can’t give up their junk food.

You see, when we talk about things that are addictive, the three most addictive substances that we have in food are salt, sugar, and fat. And the most addictive is when you combine all three in one. You can look at something like potato chips and wonder. I remember there was a brand, Lay’s, that always had that commercial: Bet you can’t eat just one. They are absolutely right because when you see the portion of the brain that it lights up, and you see the high that people get, it’s the same place that things like cocaine and heroin light up, so you know how powerful that statement is.

Dealing With Food Addiction

Dr. Sean Hashmi: When we look at a whole foods, plant-based diet, the reason it works so much better is that it’s naturally low in salt. Naturally, it has beautiful amounts of fiber and water. When you’re getting sugar from fruits, it doesn’t have the same effect as when you’re getting sugar from sodas. People say things like, “I have this craving, and I want to get diet sodas.” And the issue you face is, as long as they go for their diet drinks, which are anywhere between a couple hundred times sweeter and as much as 26,000 times sweeter, you are creating this massive addiction to sweetness. That’s why when you have an apple, it doesn’t taste as sweet.

So this barrier is an addiction; it’s a food addiction. The problem is that as a society, we haven’t gotten to the point of saying, “How many of us have some degree of food addiction?” I would say every single one of us. We were designed to like stuff that was sweet, and we were designed not to like stuff that was bitter. That’s evolutionary. We just made the sweet portion 26,000 times sweeter.

Ocean Robbins: Yeah, absolutely. And we live in a society where — just to follow the metaphor — it’s as if cocaine and heroin were available on every corner, and we were shamed by family members for not consuming them, and they tasted good. So we can see how hard it is to overcome those addictive pulls. We’ve got baby bottles with Coca-Cola logos on them. We are trained from early childhood to develop these addictions. And we’re evolutionarily wired for it. It’s a lot to overcome. And, sometimes pain pushes. Sometimes people really are motivated to make big changes by feeling that their life is on the line. Other times vision pulls us — we see a possibility and we want to move into it.

The Missing Information

Ocean Robbins: It doesn’t help, though, when doctors are fundamentally clueless about the link between food and health. My aunt was dealing with serious cancer issues. We didn’t know if she’d live or die. She ended up making it — thank goodness — after life-altering surgery and immense amounts of treatments that were devastating for her health and well-being. But not once in the entire journey did any of her oncologists say a word about diet. I’m sure they thought that they were being kind, that they didn’t want to add more stress, that she was going through enough already, that it was hard enough for her to eat. Or why on Earth would they want to make her scared about the foods that are familiar? So they thought they were being reassuring and loving.

But I don’t think it was so loving because my aunt wanted to live. Now that she’s on the other side of it, the last thing she wants is a recurrence, or for cancer to pop up somewhere else in her body. Her doctors were not telling her the data, which is, of course, no diet is a cure-all against cancer. But you can cut your risk by 50% or so with diet and lifestyle. Someone in her position who wants to do everything possible not to end up back there again, or worse, should at least be told what the information is, and she wasn’t.

Unfortunately, she doesn’t always listen to me. Maybe she’ll listen to you. But we have work to do, don’t we?

Dr. Sean Hashmi: We do.

Ocean Robbins: I’m curious, how do you see medicine changing? I know that right now, doctors are less likely than the general population to be overweight or obese. But 40% of doctors are still overweight. And one in four are obese. A lot of doctors have their own habits to deal with here. What’s it going to take to truly get food front and center here?

The Obesity Paradox

Dr. Sean Hashmi: With modern medicine becoming more and more expensive, more and more organizations are starting to look at this concept, especially on a governmental basis as we start to have folks like yourself who are making such a strong push for programs that actually support nutrition education, support looking at preventative care, which makes such an impact. Healthcare, the way it’s going right now, is going to become so expensive that it will be impossible unless we’re able to add these very basics in.

I’ll tell you, when you were talking about your family member’s story about cancer, there used to be an old saying  —and this is not going back years ago — where there was this concept of an obesity paradox. The obesity paradox was this: If you had somebody who was older, or if you had somebody with cancer, the paradox said that if they lost weight they actually did worse. So in the old days, what the oncologist and a lot of other folks did — and especially as patients got older — was they would never ask people to lose weight. Even in end-stage renal disease, it was the same obesity paradox.

My research was looking at what I called “the obesity paradox paradox.” What that essentially showed was that if you lost weight, it wasn’t that you lost weight and then your mortality went up, it was the loss of lean body mass that could be a problem. What that meant was that if you ate healthy foods, you would naturally lose body fat, and there was nothing wrong with that. If you moved more, you would build lean muscle. If anything, all that actually improved your chance of survival.

The Healthy Plate Model

Dr. Sean Hashmi: So this concept that they had back in the day was just a lack of information. And now, with healthcare organizations, we have a lack of information where it feels like people are thinking things like, “Why don’t we come up with a pill that costs a million dollars that we know nobody can truly afford?” Instead, we could start these people on eating lots of leafy greens early on in the game, and focus on a healthy plate model (not a pyramid model). That’s why, personally, I’m a big proponent of the healthy plate, which has half your plate full of fruits and vegetables, and a quarter of your plate full of protein. Tofu, by the way, is a wonderful source of protein, and so are beans and lentils. The quarter of your plate that’s leftover is healthy starches; whole grains are an excellent source. If you do that, that’s your healthy plate model.

One of the programs that I’m involved in for weight loss we built around the healthy plate. Harvard has one; Health Canada has one. All of these organizations are promoting the same message. So, there is a movement. But I have to tell you, the work that you’re doing has a lot to do with the amount of pressure that these organizations are facing in driving this change.

Addressing Systemic Problems

Ocean Robbins: Well, thank you. One of our campaigns has been to work with the American College of Lifestyle Medicine to change medical school education. We realized that a lot of schools teach to the test, and that the National Board of Medical Examiners has a bank of questions that are given to medical school graduates. They have to pass the test in order to become licensed as physicians. And in these tests, out of 15,000 questions in the bank, how many do you think related directly to diet and lifestyle for disease prevention? If you guessed zero, you’re pretty right on.

So we worked with the American College of Lifestyle Medicine to create a bank of 1,000 questions that are all rigorously researched and academically on point, and these are now being added as a resource for the medical schools. The next step is to advocate to get enough schools to use them that they become part of the mandatory portion of the bank instead of the optional portion. But, certainly, I think it’s an important step. And our members stepped forward and helped raise the funds to move this along.

We’re now focused on two other campaigns: the Produce Prescription Program and Double Up Bucks. I want to talk about Double Up Bucks for a second, and the equity and social justice side of all this. Because, as you well know, a lot of people can’t afford healthy food. In the current context, Twinkies has 14 government-subsidized ingredients, and broccoli has none. We have tens of billions of dollars in taxpayer subsidies that are bringing down the price of commodity crops. And this is essentially subsidizing factory-farmed meat, high-fructose corn syrup, white flour, and processed junk food. And they’re not bringing down the price of fruits, vegetables, nuts, and seeds — the things we should all be eating more of. It’s creating a marketplace distortion, essentially.

Creating Sustainable Systems

Ocean Robbins: On the other side of things we have a glimmer of hope, I think. The SNAP Program — which unfortunately more than 50 million Americans depend on in order to feed their families — is a critical lifeline for a lot of people. The good news is that Wholesome Wave has a program for doubling the value of SNAP dollars for fruits and vegetables. This is currently being accessed by about 500,000 people on a pilot basis in 20 states. What they’re finding is that when people are given access to this, they buy more fruits and vegetables; they eat more fruits and vegetables, and, of course, they’re healthier because of it. So, I find a lot of hope in that.

If we want healthy, ethical, sustainable food for all, which is our mission at Food Revolution Network, I think that one of the key things we have to look at is how we can create systems that make it easier for especially the people that are having the hardest time to do the right thing. Right now, unfortunately, we have almost the opposite, where it can feel like it costs your whole paycheck to eat whole foods because of the subsidy systems.

So I’m curious how you think we can bridge this gap because right now so many people are struggling to make ends meet. And, statistically, the poorer you are, and the darker your skin color, the more likely you are to struggle to feed your family healthy food, and the more likely you are to die prematurely from lifestyle-induced illness. Do you have any insights on this and on any steps you think we could take as a society to help shift things?

Food Access and Inequality

Dr. Sean Hashmi: Well, I’ll tell you, when I came to America, I was 10 years old. I grew up in Gardena, which is in southern California. And I went to school in Compton, which unfortunately has been popularized for all of its negatives and none of its positives. But I can tell you that every grocery store we ever went to had all of the fast food available. The moment you walked in, it was right there for you. And I remember being really, really hungry. I had either a quarter or 50 cents in my pocket, and there was Taco Bell or some fast food place I could rush into. It was very, very cheap, and it was easily accessible.

If you want people to eat more fruits and vegetables, and you have already created an unfair advantage for every other processed food to be easily accessible and cheap, the only way to level the playing field is exactly what you’re describing. You have to make food readily available and cheap, make fruits and vegetables subsidized, have these big corporations get involved in the partnerships, and be able to say, look, yes, we will do the Double Up Bucks. We will go ahead and create opportunities for people to be able to focus on these foods more. That becomes so important.

One of the trends that I’m seeing now — and I’m glad that people are starting to think about a whole foods, plant-based diet — but a lot of the new products that are coming out, frankly, the people who are very poor can’t afford them. So even though there is a movement for shifting away from meat and moving towards fruits and vegetables, my fear is that the gap between the haves and the have-nots is actually getting bigger. Even in our plant-based movement, I believe that it’s getting bigger. We need to look at those people who are barely making rent, who are working two or even three jobs and coming home dead tired, and their bellies are hungry, and their children are hungry. What they want is cheap and fast.

Reversing the Vicious Cycle

Ocean Robbins: Right. And when you’re in a state of stress, you’re more likely to want things that relieve that stress quickly, which are going to tend to be things that give you a rapid burst of blood sugar, for example. So, there’s also a biological craving at a time like that. No one is inclined to save water if their house is on fire. When you’re in a state of emergency, you’re inflamed systemically, and your family is hurting and struggling and scared, you’re much more likely to take short-term action that helps you make it through the day rather than think long-term. These things create vicious circles, and, unfortunately, they deepen because the primary cause of bankruptcy in the United States is medical care. So we have generation after generation of people who are dying penniless, unable to leave anything to their children because whatever they may have accumulated or saved over a lifetime of hard work gets eaten up by medical bills at the end. To me, this is tragic.

But it’s also a little glimmer of hope. Because here’s the thing, folks: If we can turn some of these cycles around, then we can end intergenerational cycles of poverty. We can actually start to shift the economic context if we strategically invest in the health and well-being of low-income communities. In time, they will become less low-income because there’s nothing more debilitating to your earning power than physical pain, brain fog, fatigue, and chronic illness. There’s also nothing more debilitating to your bank account than chronic disease that robs your family of whatever meager resources you may have accumulated.

Knowing Your Why

Ocean Robbins: So, we’re at a place now where any caring human who wants to see economic opportunity and freedom for all needs to ask, how can we up-level the health of the communities that are struggling the most right now? You keep coming back to this point that a lot of people are really confused about what’s healthy, and I think that’s critical because there’s no shortage of doctors telling their patients they need to eat better. But what does that actually mean? I think Michael Pollan said it pretty well: “Eat food, not too much, mostly plants.”

Dr. Sean Hashmi: Yes. My seven favorite words that I have used in every single lecture I’ve given for the last 10 years. So, yes.

Ocean Robbins: Absolutely. So I’m curious, this is a question you may not get too often, but you have a background in Taekwondo. And I’m curious what martial arts has taught you about the principles that are needed to create positive impact in the world and to move through life in a good way.

Dr. Sean Hashmi: It’s really interesting. Well, first, I’ve never been asked this question, so that’s fantastic. But I think the beauty that I found in martial arts was that it gives you self-discipline. As you start to develop that self-discipline, and you start to get that confidence in your own abilities, what you also start to notice is the most important thing in your life, which is your why. My whole life is all about what is mine. Why am I here? I’m grateful to my mom and dad. I’m lucky to be born. I’m lucky to have health, and so forth. But what am I really doing?

Part of martial arts, what it teaches you, is to help your fellow man — whoever that person is in front of you. If they’re in need, and you have the ability to defend them, it teaches you to defend them against wrongs — to promote justice. There are all these codes that I remember from my Taekwondo studio. Every day when we would start a class, we would take an oath. We would start our class with the oath that we would defend whoever was in need. Well, what I do now is I defend the people who are in need; I defend the defenseless. This whole conversation today is about how we promote this message of health. How do we get large organizations to focus on prevention, not just treatment, not just waiting till the disease is there? That’s what martial arts is all about. Yes, it’s great to be able to learn all the moves and strengthen yourself. But, really, martial arts is designed to make you a better human being. And the definition of a better human being is, what are you going to do for the person in front of you?

A Part of the Solution

Ocean Robbins: Yeah. Well, that’s a beautiful definition, isn’t it? What are you going to do for the person in front of you? I remember Abraham Lincoln once said, “I care not much for a man’s religion whose dog and cat are not the better for it.”

Animal rights activists have built upon that and said, “Okay, look, we need to treat animals like sentient beings that deserve our respect.” We could also apply that to every domain of life, couldn’t we?

At the end of the day, who you are as a human being has a heck of a lot to do with how you impact those around you. Are you a source of love, of health, of wellness, of contribution? I believe that in a world that is hurting like ours is today, with so much suffering and pain, there is something of a moral imperative in each of us to be a part of the solution.

Standing by is really not an option anymore, not with all that’s at stake. As human beings, I don’t think we were born just to live and cope and survive and die. I think each of us was born with something to give, something to contribute, something to bring to the world. So the question is, what now? How can we be a part of the solution on this planet? And to me, health is a means to an end; it’s not an end in itself. I want to be healthy, so I can love more, live more, and serve more. So I can help others be healthy, so they can love more, live more, and serve more. So that we can all do what we were born to do and bring about more beauty, peace, dignity, freedom, and joy on this planet.

So, Dr. Hashmi, I just want to thank you for your leadership, your wisdom, and the profound impact you’re having — not just on your patients, which is tremendous, but on so many other patients, on the way that medicine is practiced, on the way that it’s thought of. And I hope that one day, doctors really will be applying lifestyle medicine first, second, and third (and, of course, implementing all of the medical technologies, drugs, surgeries, and so forth when necessary). If they do, it will be in no small part because of you and others like you that have led the way.

Dr. Sean Hashmi: I look forward to that day, and I hope in our lifetimes we both get to see that!

Ocean Robbins: Yes, me too. All right, thank you so much.

Dr. Sean Hashmi: Thank you for having me.

Tell us in the comments:

• Did you learn anything from this interview that inspired you?
• What barriers to healthcare and/or healthy food have you experienced?
• Of Dr. Hashmi’s four SELF principles — sleep, exercise, love, and food — which are you doing well with?

Feature image: iStock.com/id-work

Read (and Watch) Next:

• Bridging the Health & Nutrition Gap: An Interview with Benjamin Perkins of Wholesome Wave
• Fight Disease With an Anti-Inflammatory Diet + 7 Foods That Fight Inflammation
• Food Inequality: How Poor Nutrition Affects Health, Wealth, & Opportunity (And What We Can Do About It)!
• VIDEO: John Robbins Interviews Michael Pollan

The post Prescription For Disease Prevention: An Interview With Sean Hashmi, MD appeared first on Food Revolution Network.

Below is the edited transcript of the video above:

Ocean Robbins: Welcome to this Food Revolution Conversation. I’m Ocean Robbins. And I am so thrilled to be here with you right now to talk about one of the most important topics of our times, which is how we can bridge the health gap and the nutrition gap to support healthy, ethical, and sustainable food for all. 

And we’re going to pay special attention to the communities that need support and are struggling the most right now. The communities that are suffering the most egregious consequences from a toxic food culture. 

And we’re going to look today at what’s possible, at hope, at visions, at how we can truly up-level the health and the well-being of all communities everywhere — and at practical examples of what works. 

And we’re here today with the perfect person to be in this conversation with, Benjamin Perkins. He is a social justice practitioner, an intellectual, and a creative thinker, and he is the CEO of Wholesome Wave.

Wholesome Wave is probably one of my favorite nonprofit organizations on the planet. They are creating partnership-based programs that enable underserved consumers to make healthier choices by increasing affordable access to healthy and locally and regionally grown foods. 

Ben has worked in the public health field for two decades. And since 2014, his focus has been on ending health disparities and inequities. He’s worked for the American Heart Association as Vice President for Multicultural Health Initiative and Health Equity and as Vice President of Health Strategies. And at Wholesome Wave, he is championing positive, practical, community-based solutions that can bring health and wellness where they’re needed. 

So Ben, thank you so much for being here today, and thanks for your amazing work.

Benjamin Perkins: Thank you for having me. Thanks for that great introduction. I sound interesting.

Food & Nutrition Insecurity

Ocean Robbins: Well, you are interesting. And we’re thrilled to be with you. 

You’ve talked about how food insecurity and addressing food insecurity is about providing enough food to those in need. But nutrition insecurity and addressing it is about providing the right food to prevent or alleviate diet-related diseases. 

So, tell us a little bit about what nutrition insecurity means to you, and why you think it’s so important in the world right now.

Benjamin Perkins: That’s a great question. I think in terms of thinking about food insecurity and nutrition insecurity, I was talking to someone last night. And I was saying that one of the ways to think about food insecurity, or nutrition insecurity, is to think about it as a subset. If you had a little Venn diagram, nutrition insecurity would be inside of food insecurity. In that, food insecurity is addressing the lack of food that folks might have. So issues of hunger. But nutrition insecurity… And this goes back to co-founder of Wholesome Wave, [Chef] Michel Nischan’s sort of assertion, that it’s not just about getting people food. It’s about getting people the right food and healthy food. 

And I think embedded in that is this concept of human dignity. That it is not just feeding people anything, but it’s about getting at healthy foods where people can thrive — particularly folks who are on the margins, which is a large part of the population that we pay especially close attention to.

Obese but Nutrient-Starved

Ocean Robbins: In the world right now, we have, perhaps for the first time in human history, more people who are obese than people who are starving. Right now, there are almost a billion people on the planet who are in danger of literal starvation — who have fundamental core food insecurity on a daily basis. But there are also over a billion people on the planet who are obese. In the United States, it’s now 40% of our population. Mexico is right up there with us. 

And there’s an interesting and really painful corollary here that people who are in poverty are more likely to starve. But they’re also more likely to be obese because they’re fundamentally fueling from maybe enough calories, maybe too many calories, but they are nutrient-starved.

Benjamin Perkins: Yes. That difference between energy dense and nutrition dense. And it really sort of drives home exactly the point you’re making. This idea that foods that are energy-dense often aren’t nutrient-dense. And there’s that sort of chasm between those things potentially.

Food 3.0

Ocean Robbins: Yeah. The way I look at it, food 1.0 is about survival. If you can get enough calories to fill your belly, then that’s success. Food 2.0 is governed by commerce. It’s the buying, selling, and marketing of goods. And it’s a step up for a lot of people to be able to have choice and authorship and some mobility around food. But unfortunately, it’s morally bankrupt. And it’s brought us nutritional and health disasters for many of the world’s people. 

And that’s why at Food Revolution Network, we’re calling for what we call food 3.0, which is a food system based around health. Health for our bodies and health for our planet. 

And it seems like what you’re doing is addressing how we can kind of leapfrog, for people who are on the margins, straight from Food 1.0 to Food 3.0. How we can move from, get enough calories; yes, of course. I mean, if all you can eat is a bag of potato chips, and that’s all you got, for goodness sake, eat the potato chips. But at the same time, what would happen if we focus on nutrient quality and nutrient density and how we create those opportunities for people? 

Addressing the Cost of Healthy Food

Ocean Robbins: But a lot of folks struggle with the cost of healthy food. I mean, Whole Foods has the unfortunate nickname, “Whole Paycheck.” And we see a lot of people who just feel like they have to pay an arm and a leg just to do the right thing. It’s almost like you’re being fined for wearing your seatbelt. You want to feed yourself and your family right, you have to pay extra. How are you guys trying to address that?

Benjamin Perkins: Another great question. How we’re trying to address it is… And you had mentioned SNAP, for instance, and that concept of doubling up SNAP bucks, which is one of our claims to fame. One of our co-founders, the late, great Gus Schumacher, who was the undersecretary of agriculture during the Clinton administration. He was a big proponent of the idea of incentivizing SNAP so that you could get more for your dollar by buying healthy produce, healthy fruits and vegetables. 

Now, the idea there is still giving people choice, but incentivizing healthier choices so that folks might be more drawn to those healthier choices. Because exactly what you said, if the perception is that healthy foods cost more, and I only have a limited pool of resources — namely dollars — I’m going to gravitate towards the cheaper food, the more energy-dense food, and less nutritionally-dense food. And so, that’s one of the ways we think about it. 

The Double Up Food Bucks Program

Ocean Robbins: So the Double Up Food Bucks program basically says for somebody who is on food stamps, who has food stamps, and there’s about what, about 42 million Americans who are a part of that?

Benjamin Perkins: Fourteen percent of the population.

Ocean Robbins: Fourteen percent of the population, and a lot of them kids, are dependent on this program to eat right now. And we could debate until the cows come home, what’s the right role of government. And I don’t think any of us want to see a world in which people depend on SNAP dollars to feed their families. Everyone wants to be self-reliant and have the resources they need to provide for themselves, but that’s not the world we live in right now. 

But at this point in time, we have a lot of people who are marginalized, who are on the edge, and who depend on SNAP in order to eat and live. 

Unfortunately, most SNAP dollars are not buying healthy foods. A lot of them are going to foods that are making people fat and sick and increasing their likelihood of getting diabetes and heart disease and cancer and Alzheimer’s, and fueling ADHD in kids who then have a harder time in school because they don’t have the nutrients they need to thrive. 

So you guys created this program where for every dollar SNAP recipients spend on fruits or vegetables, they’re getting double bucks, right? That means they go twice as far. So instead of paying a dollar for X amount of broccoli, you now only pay 50 cents, which means you can get twice as much broccoli. So it creates this financial incentive to buy more fruits and vegetables, specifically. 

Health Outcomes & Nutrition Incentives

Ocean Robbins: So when that happens, do people buy more fruits and vegetables? And maybe, more importantly, do they eat more fruits and vegetables? How many people are in the program? And what kind of results have we seen in terms of any possible health impact so far?

Benjamin Perkins: Yeah, so the research suggests that people, when presented with the opportunity, and I think this is something that’s really important to highlight, regardless of which program we’re talking about. When people have the opportunity to do healthier, to engage in healthier behaviors, namely eating healthier fruits and vegetables and foods in general, that they do. That’s the bottom line. 

The other thing to know about SNAP, specifically, is… So you’ve got 42 million people on SNAP. The research on SNAP beneficiaries tells us that they are twice as likely to die of cardiovascular disease and three times more likely to die of diabetes complications.

So you see, there is a huge need in terms of that population to do whatever we can to incentivize consumption of healthier fruits and vegetables. So things like looking at the drop in A1C, looking at drops in systolic and diastolic blood pressure, those sorts of things. All of those health outcomes tend to improve with nutrition incentive programs. And the thing is, right now, this is all proof of concept. 

Now, certainly, I would argue, and I think most people would argue that it seems pretty intuitive that people would get healthier. But what we have to do is we have to make the case. So all that we’re doing now is creating a gigantic proof of concept, marshaling all the data from all of the studies that we are a part of, all the work, and then using that data in the service of making the case so that, ultimately, these kinds of things can be embedded in federal and state policy in a long-term, sustainable way.

Expanding the Program

Ocean Robbins: Yes, absolutely. And there are about 882,000 people who are participating in the Double Up Food Bucks Program, in more than 20 states. And is that all funded by private donors so far? Or has the government pitched in?

Benjamin Perkins: There’s a mix. So Gus Schumacher, who I mentioned before, part of his legacy was that there was a farm bill in 2014; there was $100 million earmarked for these kinds of programs. And then he died in 2017. So in 2018, when that farm bill got reauthorized, it was renamed the Gus Schumacher Nutrition Incentive Program, or what we affectionately called GusNIP. 

So that came in at $250 million over five years. That’s not a lot of money for an entire nation. So part of the program really looks to public-private partnerships. So the government put some money in. But also, we’re looking for matching dollars. So whether it’s corporations or foundations that are also interested in the health of communities and populations, they bring dollars in from private donors. And these partners match the federal dollars.

Community-Based Nutrition Education

Ocean Robbins: Got it. Thank you. So I guess the cynic might say, “Well, if people get double the value for fruits and vegetables, they might buy more fruits and vegetables because it’s sort of like it’s on sale, so to speak, but will they actually eat them? Or will they just rot in the fridge? Will people know what to do with them?” And so, do you have any thoughts about that? Have you brought in any sort of culturally appropriate recipes, or cooking techniques, or lifestyle habit education?

Benjamin Perkins: Yeah, that’s a great point. And yes. 

So part of it is that we also want to embed nutrition education programs. And so, at Wholesome Wave, our program directors work closely with community partners in health systems to, first of all, assess what kinds of resources they have. And then, we provide resources, which might include a nutrition education component. Because to your point, it’s great that people have access to healthy fruits and vegetables, but if they don’t know what to do with them, then, of course, we’re talking about the potential for food waste. 

It’s great that people have access to healthy fruits and vegetables, but if they don’t know what to do with them, then, of course, we’re talking about the potential for food waste.

Benjamin Perkins

The other piece of it that you alluded to that’s critically important, and this is a part of the dignity component, is it’s not just about getting people healthy food. It’s about understanding the particular culture because if you can get healthy produce that’s culturally specific, then the chances are greater that folks will know what to do with it in the first place.

The Produce Prescription Program

Ocean Robbins: Yeah, absolutely. Fabulous. Okay. Well, let’s look at another program your team has been running called the Produce Prescription (Rx) Program. A lot of Ps there.

Benjamin Perkins: Yeah.

Ocean Robbins: So the Produce Prescription Program, as I understand it, you’re piloting this. And the concept is that, at least for Medicare and Medicaid recipients, and perhaps, ultimately, all insurers could get in on this, that doctors can prescribe produce. Like go to the Farmacy with an F, not the pharmacy with the P-H, and essentially get your produce.

Diet Responsive Conditions

Ocean Robbins: It’s interesting because, for somebody who has heart disease or type 2 diabetes, which are extremely diet-responsive conditions, they can get results fast. I mean, arguably as quickly as with going on statin drugs, for example. They can bring down their LDL cholesterol levels. They can bring down their blood pressure rapidly with diet and lifestyle choices. This is proven in study after study. 

And unlike with drugs, the side effects are all positive. They’re also bringing down their risk of dementia and cancer, and they’re probably going to feel better and maybe even have a better sex life too. 

So my thought is that if their doctor tells them they need to change their diet, sure, some people will struggle. But if they really know what’s at stake, for those people who are in these conditions where it’s life or death, a lot of people are willing to make choices, even if it’s a little less fun, even if it requires some work or some new habits because they get what’s at stake. 

So obviously, we need doctors who are informed about nutrition and motivated and who give it appropriate gravitas. But then, we also need the resources so that they can not just say, “Hey, you need to eat better. Good luck with that.” And send somebody off on their own into the wild world of a toxic food culture. But rather somebody who can specifically prescribe specific things. Like saying, “I want you eating broccoli every day.”

So is this specific to produce, or do you include any other foods? How widely has it been used so far? And what’s the strategy here?

Better Health & Nutrition Access

Benjamin Perkins: I’ll start with the first question. The strategy is really, as you detailed, the idea that someone who has a specific and chronic health condition, namely cardiovascular disease and diabetes, would be prescribed produce. So fruits and vegetables, primarily. Although, there’s now talk about the role of legumes, but that is it right now. Now, that may evolve at some point, but for now, our focus is really on the healthy fruits and vegetables. 

So if you have a chronic health condition, or you are trending — and this is important — trending towards one… So you’re prediabetic, or you have a history of hypertension or those sorts of things, and the doctor really identifies that you are at risk, the idea is that they would then give you the produce prescription in the form of a credit card that you could use at a specific outlet grocery market. It could be a gift card that can be used at a certain venue. Or it could be our work with certain fulfillment vendors who will get you the produce. It can even be delivered directly to your home.

The idea is they’re enrolled; they’re able to get their healthy fruits and vegetables and are monitored over six months to a year. We actually like it to be as long as possible, but six months to a year is best, although some of the programs have been shorter.

The idea is to give them the fruits and vegetables, and then to look at the health outcomes. So things like their blood glucose or A1C, their systolic and diastolic blood pressure, their BMI, and see what the trends are over the duration of the prescription program. And that data is the data that we use to make the case for why this is impactful. And we look at things like the reduction of cost burden to the system. Improved health outcomes mean that the burden in terms of healthcare costs gets decreased. 

We’re also looking at improving patient quality of life, and that’s all part of this notion of the triple aims of value-based care now, which is a huge part of a paradigm shift in healthcare overall.

Improving Health Markers

Ocean Robbins: So what does the data say so far? Do you have any results back yet?

Benjamin Perkins: The data is compelling. One of our programs in Ohio, this is a Produce Rx program, saw a 0.5 point drop, a half a point drop in A1C, which if you know how A1C works, a half a point drop is quite significant. So a 22.3 point drop in systolic blood pressure, 14.2 point drop in diastolic blood pressure, and 4.9 point drop in body mass index or BMI.

Ocean Robbins: Wow. And that’s after what? Six months? A year of produce?

Benjamin Perkins: We usually look at, on the short end, about a four-month program. On average though, six. And the gold standard is getting it as close to a year as possible. Because what we know is the longer you have someone in these, the longer amount of time they have to build those habits and get that reinforcement that’s essential to sustain long-term health changes.

Ocean Robbins: Yeah. So Double Up Food Bucks and Produce Rx Programs are two brilliant strategies. 

Incentives for Scaling Up Programs

Ocean Robbins: Let’s talk about implementation and scaling and what could happen. So what would it take for the USDA to expand the Farm Bill to make Double Up Food Bucks normal throughout SNAP in the United States for the 42 million or so people who use SNAP to feed their families?

Benjamin Perkins: That’s a great question. And the question cuts right to the heart of the necessity for there to be both a public, so the role of the government, certainly, easily billions and billions. And we’re talking about every year. But also, in addition to the government, the private sector could play a really critical role. 

And one of the things you alluded to is about insurers. So the idea that insurers could play a key role in this. Because, guess what? If people are healthier, they’re less likely to need to avail themselves of medical visits that the insurer has to pay for.

Ocean Robbins: Sure. There’s a lot of incentives here. Employers have incentives, too, by the way. A healthier workforce is going to save them insurance premiums in the long run, especially for those that are self-insured, but it’s also going to give them better productivity. Their teams will have clearer minds on the job, and get more done. They’ll have fewer sick days. They’ll feel better. And all of that is good for company success as well. 

So employers have a stake in it. Public health initiatives have a stake. All of the insurers have a stake. The government social safety nets have a stake because a healthier population is going to be wealthier. It’s going to be more productive. It’s going to be more capable and able to respond to challenges in life effectively. 

And, of course, humanitarians and philanthropists have a stake here too. For anybody who’s got a little extra, these are places that you can invest in that could have an incredible bang for the buck in terms of net impact on human quality of life.

Utilizing Medicare & Medicaid

Ocean Robbins: I want to talk about the Produce Rx Program for a moment and a study that Tufts University did in 2019 on this. They looked at what could happen if this was scaled, on a large scale, through the Medicare and Medicaid program, which combine for 27% of federal spending. And if we implemented Produce Rx Programs throughout the Medicare and Medicaid system, for those people who are dealing with lifestyle responsive health ailments, what would happen?

Well, the first co-author of the study ended up commenting: “We found that encouraging people to eat healthy foods in Medicare and Medicaid, healthy food prescriptions, could be as or more cost-effective as other common interventions, such as preventative drug treatments for hypertension or high cholesterol.” 

Giving out the big numbers, they concluded that if they were to implement a program where people were not just prescribed fruits and vegetables, but also legumes and nuts and seeds, and they also added in there seafood and plant-based oils — because these are all things that have been found in studies to be beneficial for health. And if they provided a 30% coverage for those things, essentially through the Produce Rx Program, that the total cost would come in at a couple hundred billion dollars over the course of a long period of time. We’re also talking about savings of a hundred billion dollars in immediate health care utilization within just a five-year period.

Long-Term Healthcare Savings

Ocean Robbins: But we’re also talking about long-term savings that go far beyond that. The conventional cutoff point for a medical intervention to be considered cost-effective is if it’s less than $150,000 per quality of life year gained. If costs are less than $50,000 per quality of life year gained, those are considered highly cost-effective and medical best buys. 

Well, here we wound up with looking at around $13,000 in net intervention cost per quality of life year gained. And half of that comes back through reduced medical savings within a five-year period. And obviously, there are so many other benefits to it from the humanitarian perspective, public health, economic productivity, etc., not to mention just caring about people’s lives and wanting them to be happy and well.

They found that the Produce Rx Program could, in a five-year period, prevent 120,000 cases of diabetes. It could prevent 3.28 million cases of cardiovascular disease. And again, it will be as or more cost-effective than a lot of currently covered medical treatments. 

Ben, when you hear about these numbers, what goes through your mind?

Health Promotion Over Disease Management 

Benjamin Perkins: Let’s do it. I mean, you marshaled all of this data. And as I was saying, a lot of our work is around marshaling more data through these programs. But there is tremendously compelling evidence already. 

And one of the things I think you alluded to, which a lot of us are aware of, is in the United States, our health system is really disease management and not health promotion. And so, when you ask yourself, where are the incentives to doing stuff like produce prescription if there’s more money in medication and those sorts of things? It really sort of leads you to some uncomfortable kinds of conclusions about how our system is configured in the US.

In the United States, our health system is really disease management and not health promotion.

Benjamin Perkins

Ocean Robbins: Well, I mean, the bottom line is nobody’s getting rich from prescribing broccoli right now. I have often thought if reimbursements were the same for prescribing broccoli as prescribing chemo drugs, we’d see more broccoli prescribed, and we’d probably see fewer chemo drugs prescribed. The reality is that food is medicine, and it prevents the need for other medicines. But unfortunately, we have a healthcare system that sometimes acts as if food didn’t matter. 

Navigating a Toxic Food Culture

Ocean Robbins: And, of course, we have a food system that acts as if health didn’t matter. And at the end of the day, in this context, it’s up to each of us to take as much personal responsibility as we can, to not be a victim of the status quo, which is a fast track to disease and premature death.

But a lot of folks in this system do not have the means, the resources, the time, or the money to be able to exercise that kind of self-authorship. Because when you’re working two jobs, and you’re barely able to pay rent, and you’re super stressed out, it’s really hard to learn a whole new way of cooking and feeding your family. And it can be hard to afford it.

So what you all are doing is hitting the nail on the head on how to address that issue. I know of no other organization in the world that is addressing, so directly, this core problem we face right now, so pragmatically and so effectively, with solutions that really could change the entire game.

So Ben, what’s your vision, what’s next? How do we make this happen? And how can folks help you?

The FED Principle

Benjamin Perkins: So the vision for me, as someone who stepped into this role of leading this organization, is really to help us live out our core values. And so, one of the things that I have sort of coined is this concept called The FED Principle, which coincidentally, as an organization that does work in nutrition security, is kind of fun to play with. But FED stands for Fidelity to communities, Equity, removing barriers and improving access, and Dignity — the acknowledgment that human beings have inherent worth and, therefore, are entitled to healthy food. Nutritious food is a human right.

So that FED Principle is our north star. And so, everything that we do in terms of how we think about our work needs to measure up to that. That is the measure by which I am gauging our success. 

And ultimately, the vision is that we can get things like produce prescriptions embedded in federal and state policy. Because what we know is that that policy lever plays such a vital role in the health and well-being of not just communities, but entire populations. Because we know that, ultimately, there’s a deeply structural element to this. And one of the ways you get at structural issues is through policy levers. So that is key to how I see us in the future moving forward.

The Link Between Illness & Poverty

Ocean Robbins: Yeah. I’m just reflecting on how illness, chronic illness, is a leading cause of bankruptcy in the United States. There’s a direct connection between illness and generational, and even intergenerational, poverty. When someone dies penniless, they leave nothing to their children. And so, cycles of poverty continue across generations. 

And I think it’s not too bold an assertion to suggest that if programs like what you’re talking about were implemented, let’s say we even just, let’s just talk about Double Up Food Bucks for a second. If that was implemented on a broad scale, I think that within a generation, we would have fewer people dependent on SNAP because we’d have less grinding poverty because we’d have a healthier population. 

And by focusing on those communities that are the most impacted by chronic disease, and that are struggling the most, and giving them a leg up on their health outcomes, we can change the whole game. We can build a fairer, more equitable society that empowers people and families to save instead of depleting their resources on medical expenses they can’t afford. And maybe we can turn things around. That gives me a lot of hope. I’m so grateful to you. 

Supporting Wholesome Wave’s Mission

Ocean Robbins: And, of course, it goes without saying, but this is a nonprofit organization, Wholesome Wave. And it should be said, anybody who can, please contribute. Spread the word. Share this video. Share their website. 

And if you can, donate money. 

People can support Double Up Food Bucks programs or Produce Rx Programs, and they can also support the organization that’s seeking to leverage tens of billions of dollars in public funds to make these things happen. 

We’re probably never going to get all the way there, just with private donations. We can pilot stuff with private donations, but the goal here is much, much bigger. So, investing in this organization really is leveraged in a huge way.

And if we can establish the data that shows that this stuff works, and I think it’s inevitable that that data is going to come out more and more, then it’s just a question of getting folks in power to act on that data. And I think we can get something done here.

So Ben, thank you. Bless you.

Benjamin Perkins: Thank you.

Ocean Robbins: It’s been wonderful to have this time with you. And we look forward to doing a lot more together in the future. And by the way: Food Revolution Network is a major supporter of Wholesome Wave. My dad and I, and our whole team, are on board. And we invite all of our members to join us. Ben, thanks so much.

Benjamin Perkins: Thank you.

Note: Find out more and support the work of Wholesome Wave, here.

Tell us in the comments:

• Do you struggle with the cost of healthy food?
• Were you aware of Wholesome Wave or their Double Up Food Bucks program?
• Are you aware of any other programs or incentives to encourage healthy eating among low-income individuals?

Feature image: iStock.com/PeopleImages

Read Next:

• What Are Food Banks? (And How They Can Help Hungry People Eat Real Food)
• From Food Deserts to Food Oases: Addressing Access to Healthy Food
• Increasing Health & Opportunity for All: An Interview with Terry Mason, MD

The post Bridging the Health & Nutrition Gap: An Interview with Benjamin Perkins of Wholesome Wave appeared first on Food Revolution Network.

But this concept of instant feedback impacting actions and habits isn’t new. Consider the story of a 1970s Amsterdam housing development.

Like many subdivisions in those days, all the houses there were pretty much identical. But for some unknown reason, some of the units had their electric meters in the basement, while others had theirs in the front hall.

Then the energy crisis struck. OPEC (Organization of the Petroleum Exporting Countries) embargoed oil, prices skyrocketed, and individuals and governments started paying attention to their energy consumption. That’s when someone from the Dutch authorities noticed that the houses with their energy meters in the front hall, in full view, had 30% lower energy usage than the houses with the meters tucked away in the basement.

This was a huge deal. Simply placing a feedback mechanism where the residents could see it on a daily basis did more to reduce energy consumption than all the public service announcements, incentives, and social pressure the government or the free market could muster.

Business theorist Peter Drucker is often quoted as saying, “What gets measured, gets managed.” And some of the world’s most successful organizations deploy this kind of well-timed feedback relentlessly, as evidenced by the emphasis on KROs (key results and objectives) that has swept top Silicon Valley companies like Google, Intel, Facebook, and Dropbox.

Health trackers utilize this kind of visible, measured feedback, allegedly making it a lot easier to measure results and create motivation and accountability.

Health and Fitness Trackers Are Here to Stay

Even a decade ago, such monitoring would have been possible only with expensive, bulky equipment provided to you by a medical professional. Now, you can purchase and use a small device and track health info on an app.

As the costs of medical care threaten to sink our entire economy, some insurance companies even provide them or give discounts to encourage healthy living. Healthcare professionals can help their patients and clients more effectively when they have a clearer picture of how they’re doing beyond notoriously inaccurate self-reports and intermittent assessments. And having numbers at their fingertips empowers ordinary people to take control of their own health.

One thing’s for sure: as a result of their ease of use, accessibility, and affordability, the health and fitness tracker industry is booming. The use of wearable technology has more than tripled in the last four years.

But what are the actual benefits of health tracking? Are health trackers worth it? Does the data support their use? And what are some of the top options out there if you want to get started with a health tracker?

What Is a Health Tracker?

Health trackers, also known as fitness trackers, activity trackers, or wearable technology, are electronic devices designed to track and collect personal health and exercise data. Health trackers commonly take the form of a watch. But other types are available in the form of a ring, a band, a chest strap, or even a patch. They track biological phenomena like heart rate and breathing, as well as activity like steps, oxygen saturation, distance traveled, steps climbed, and so on.

Not only do these devices provide ongoing feedback, but they maintain logs and can measure and report on your progress over time.

But keeping track of health parameters isn’t enough by itself to change behavior. The true power of these trackers is their ability to provide real-time feedback, so you can make better choices.

You can set up alerts and reminders to exercise, drink water, go to bed, meditate, or pretty much any other activity. These can be time-based reminders (take a deep breath every afternoon at 3 pm) or conditional (“Hey, you’ve been sitting on your butt for an hour; get up and go for a walk”).

Many of the health and fitness trackers available also work with smartphone apps, so you can aggregate data from many sources into a single “personal trainer in your pocket” that tells you what to do to maximize your health.

Benefits & Downsides of Health Tracking

Remember that Peter Drucker insight about the benefits of measurement, that’s quoted all the time in the business press, the one I shared at the beginning of this article? Two things about that: First, he never said it. The line first appeared in a 1956 paper by V. F. Ridgway that argued against obsessive and mindless tracking. Secondly, this is what the full quote actually says: “What gets measured gets managed — even when it’s pointless to measure and manage it, and even if it harms the purpose of the organization to do so.”

Just because you can measure something doesn’t mean it’s the right thing to measure, or that you’re measuring it accurately. While some forms of tracking are helpful, others can actually distract you from what’s important. Like that old joke about the person looking for their keys under the lamppost because the light is better there, you can focus on what the trackers tell you at the expense of what really matters. So let’s take a thoughtful look at the benefits and downsides of health tracking.

Benefits of Health Tracking

Pay Attention to Different Areas of Health

On the upside, health tracking can offer insights into different aspects of your health. Just as the bathroom scale can tip you off that it’s time to ease off the desserts, a wearable can let you know that you’ve been going to bed too late, or that your heart rate accelerates whenever you visit your cranky Aunt Minerva.

Wearables can also clue you in to new areas of your health to consider.  For example, recognizing the association of sedentarism (the practice of sitting for long periods of time each day) with poor health and early death. Many trackers automatically alert you when you’ve been sitting for more than 45 minutes and urge you to stand or do a few stretches to wake up your body.

Easier to Achieve Goals

Health trackers can also amp up your motivation and make it easier to achieve your goals. As the companies that manufacture and market these devices deploy behavioral scientists to increase compliance and effectiveness, many adjust their interface to make the data more useful. Apple Watch, for example, offers a gamified experience in which wearers can build “streaks” and earn badges.

And when you get accurate feedback on your progress, you can take smarter steps to get the results you want. For example, with some trackers, you can get an instant alert that your heart rate variability (HRV: a measure of the resilience of your nervous system and a proxy for overall health) has dropped, which could motivate you to take proactive steps to support your overall health.

Accountability & Social Sharing

Since we know that social pressure is a powerful motivator, some trackers allow for activity sharing with friends and family to increase accountability — or even to create some friendly competition.

Monitor a Health Condition

Trackers also enable you to monitor a health condition, or to potentially alert you of one. If you have a problem with a slow heart rate, for example, the device can tell you if your heart rate falls below a certain number. Or, if you have trouble sleeping, the tracker can analyze your sleep cycles, heart rate, oxygen saturation, and help you optimize them. You may find that you sleep better when you go to bed at a certain time, exercise a certain amount, or partake in or avoid specific habits or activities close to bedtime.

Some people have said their health tracker made the ultimate difference in their lives. In 2018, a Tampa Bay teenager was rushed to the hospital after her Apple Watch instructed her to seek medical attention immediately, after her pulse shot up to 190 beats per minute. The care she was able to receive for what turned out to be kidney failure saved her life.

Improve Your Habits

The benefits aren’t always that dramatic, of course. A tracker may simply inspire you to improve your lifestyle habits over time. In general, people who use health and fitness trackers move more and are less sedentary than others. One study found that people wearing a tracker walked nearly a mile more per day than those who didn’t. And the results persisted over 13 weeks.

And people who exercise are more likely to engage in other health-promoting behaviors, like eating well.

Affordability

As the market has grown, the prices for health and fitness trackers have dropped. Depending on included features, you can find a health tracker anywhere from $25 to $400. But if you have a smartphone, you might already have a health tracker and not realize it. For example, Apple Health, an app that’s on every iPhone, will count your steps, measure your average step length, and even report on any asymmetries between your right and left leg strides.

Downsides of Health Trackers

Even with all those potential benefits, there are some disadvantages to health trackers as well.

Privacy Threats

The best publicized of these downsides to health tracking is the threat to your privacy. If you don’t read the dozens of scrolling pages of fine print, you might not realize that the app you’re using may share your data, or sell it to advertisers and social media companies.

If you don’t want Facebook to know about your heart rate at any given moment, or where you are in your menstrual cycle, you might want to read the fine print or reconsider that tracker.

Fortunately, there’s a bipartisan bill, introduced to the US Congress in February, 2021, called the Smartwatch Data Act, that would prohibit the sharing of data from wearables with advertisers and social media companies. (As of this writing, the bill is being reviewed by the Committee on Health, Education, Labor, and Pensions).

Inaccuracies

Trackers tend to be better at measuring some things than others. A 2017 study out of Stanford University Medical School found that wristband fitness trackers can measure heart rate accurately (within 5%), but fail to accurately account for calories burned (with an average error of 27%, and the worst one off by 93%). Even heart rate isn’t a sure thing, as the data can be skewed based on the wearer’s skin color and body mass index.

A 2018 study out of British Columbia assessed the various tracking functions of Fitbit devices. Researchers found that the pedometer function was pretty good at counting steps, but the sleep tracking was way off. Also, the Fitbits underestimated distance for faster-paced walking, and did a poor job of accounting for upper body workouts.

Anxiety

Just as people can become addicted to video games and smartphones, we can get obsessive about monitoring the results of our wearables. A 2020 study reported in the Journal of Medical Internet Research found that heart patients ages 55-74 were as likely to feel anxious, doubtful, and confused by the data they received from wearables as they were reassured and empowered. Some felt nudged into good behavior, while others felt pressured or experienced the interface as nagging.

Accessibility

Like a lot of technology, trackers are designed for a “default” human being, which in this case appears to be an able-bodied Caucasian. Just as people of color may find that their wristband device doesn’t accurately measure their heart rate, people with mobility impairments may not benefit much from a movement tracker. The devices aren’t set up out of the box to recognize wheelchair activity, for example.

There is also a need for activity recognition that supports a wider range of human movement, including what’s known as exergaming (video games that require various forms of physical movement to interact with the controller, and which can also track various forms of health data internally).

Types of Health Trackers and What They Offer

One way to categorize health and fitness trackers is by their form factor.

Wristbands

The majority of health and fitness trackers look like wristwatches. The most well-known examples include the Apple Watch, various models of Fitbit, and the Amazfit. These are among the most comprehensive of all such devices, tracking a variety of health categories: sleep, exercise, steps/distance traveled, heart rate, water consumption, blood oxygen, etc.

Other wristwatch trackers appeal to athletes, capturing data and providing prompts to help runners, cyclists, and swimmers improve their speed, stamina, and efficiency. Garmin, Coros, and Suunto are three popular brands that assist in training and races.

Many of these trackers integrate with apps on a smartphone, and can be used to track data like food consumption, weight, menstrual cycle, and so on. The more features (including waterproofing, scratch resistance, GPS, music storage, customizable watch faces, and actual telephone capabilities a la Dick Tracey), the more expensive these devices tend to become.

Personal anecdote: I got a Fitbit Sense in 2020 and have loved it. Since I got it, I find myself sleeping more and exercising more. I find it fun to track my activities, sleep hours, and heart rate, and notice myself checking (perhaps a bit too often!) how many steps I’ve taken, how much time I’ve spent with accelerated heart rate, and even what my sleep score was the previous night. For me, the information is fun and motivating.

Clip-on Devices

The main feature of most clip-on trackers is their ability to count steps like an analog pedometer. But some go much further, tracking sleep, workouts, and menstrual cycles. Cyclists often use clip-ons with GPS that can display route details as well as biometrics. Because they can clip onto bike handlebars as well as clothing, wearers can keep an eye on their maps and stats without having to look at a watch.

Examples of clip-on manufacturers include Omron and Garmin.

Rings

Less obvious, but often more costly, are tracking rings that you wear on your finger like jewelry. Because they lack displays, you have to pair them with a smartphone to view data. The chief advantage of a ring is also its main disadvantage: because it’s so small, it’s easy to lose if you take it off (or if it slips off during exercise).

Examples of ring trackers include Oura, which claims to capture highly accurate sleep data with its finger sensors, and SleepOn, which tracks not only heart rate, but blood oxygen saturation (which drops during sleep apneas), and vibration (with the ability to alert the wearer to their own snoring and nudge them into a different sleep position).

I’ve tested out the Oura ring, appreciated the aesthetic (it’s a ring, after all!), and found it very effective for tracking sleep. However, I was frustrated that it didn’t track heart rate during the day, and found its fitness tracking components minimal at best. So if your primary interest is in tracking your sleep, it could be a great option. But for fitness — maybe not so much.

Chest Straps

These are usually not stand-alone trackers, but require an additional device to which they can transmit the data they collect — like a smartphone stationary bike, treadmill, or rowing machine. Chest straps mainly focus on heart rate, assessing the pulses in the chest with greater accuracy than those in a finger or wrist. Examples of chest strap brands include Polar, Coospo, and Wahoo.

Is Health Tracking for You?

Biometric trackers can be a valuable tool for gleaning actionable information about your health and habits — and for increasing accountability and positive motivation. If you decide to get one, the best choice for you will likely depend on what health information you’re looking for, cost, ease of use, and aesthetic considerations.

In general, people who get biometric trackers tend to form healthier habits. But at the end of the day, the value of data is in how you use it. If you use a biometric tracker and become obsessive and anxious, or beat up on yourself, it may be wiser to find other ways to motivate positive activities. But if you’re able to use health and fitness wearables to celebrate victories and motivate positive action, then it could be a potent ally to your health and life goals.

Tell us in the comments:

• Do you currently use a health tracker? What are the main numbers you care about?
• What health habits could a wearable assist you in installing or improving?
• Is there a particular type of health or fitness tracker that you’re curious to try?

Feature image: iStock.com/Rocky89

Read Next:

• Sleep Hacks: How to Sleep Better with Diet and Lifestyle
• The 15-Minute, Strength-Building Bodyweight Routine for Plant-Based Athletes 
• The 4 Scientifically Proven Pillars of Heart Health

The post Health Trackers: Benefits, Downsides, & the Top Types to Consider appeared first on Food Revolution Network.

Below is the edited transcript of the video above:

Ocean Robbins: I am so excited for this conversation with Dr. Terry Mason. We’re going to be looking at food and health and you. We’re going to be looking at the inequities of health opportunity and access in our world today, and, more importantly, what we can do about it, so we can have healthy, ethical, and sustainable food for all.

Dr. Terry Mason is a retired urologist and public health official who champions holistic approaches to health management. He serves as the CEO of Trevention Incorporated. That’s Trevention — as in treatment and prevention. Trevention seeks to combine treatment and prevention and to reduce the burden of chronic disease through education and empowerment.

Dr. Mason has been responsible for leading public health programs and services for one of the nation’s largest metropolitan health departments. He shares his holistic approach to health as an internationally recognized health educator and an inspirational speaker, and also on his popular radio show, which is on WVON 1690AM. It’s called “The Doctor in the House.” He’s been doing it for more than 21 years. And Terry is a champion of helping bring health education, and nutritional awareness, and opportunity, and access into all of the communities that need it the most.

Terry, thanks so much for being here with us today.

Dr. Terry Mason: You are so welcome, and I’m grateful to be here.

From a Steak a Day & a Blocked Artery …

Ocean Robbins: So, you practiced urology for more than a quarter-century in Chicago. And for most of that time, I gather, you were someone who literally ate a steak a day. Is this true?

Dr. Terry Mason: That is correct.

Ocean Robbins: But something happened, through your own practice of urology, that shifted your eating habits. Can you tell us about how that unfolded?

Dr. Terry Mason: Well, as you properly noted… I ate a steak a day. I loved Porterhouse and T-bone. And I had my butcher cut them and individually wrap them, so I had one for every day. And, obviously, the stresses of residency, and I was hypertensive already… What happened was I was on a treadmill trying to work out and ended up with chest pain. I called my cardiologist from the treadmill and met him at the hospital. Next thing I knew, I was on the cardiac cath tape, and he had discovered a significant blockage in a major artery.

And while he had the catheter in my artery, in my heart, and he was going to do a balloon angioplasty, I was trying to negotiate with him to let me come off of the table. I wanted to go out to Sausalito, California, where Dean Ornish had his program. I had been out to see Dean before. And I said, “Look, I’d really like to do this instead of that.” He says, “No, I got you on the table. I can’t let you get off this table and get on a plane, not knowing what might happen.” So that ended that conversation. I ended up with a stent.

… to Zero Animal Products & Low Cholesterol Levels

Dr. Terry Mason: So then he said, “But you’re going to have to take this drug for the rest of your life, this statin.” And I said, “No, I’m not going to take it.” And he said, “Why?” I said, “Because I know what that does to your muscle tissue. I’m not going to take that medication.” And I said, “But here’s what I will do. I will promise you that I won’t put anything in my mouth that contains any cholesterol or bad saturated fat. And I will come to your office every month for you to verify my results with a lab test.” And that’s what happened.

Ocean Robbins: What happened then? What happened to the lab test? What happened to your heart?

If we eat the right food, we could never need medicine. So the food is really a self-correcting agent. That is the only thing that we have that actually works on the cause of our problem and not just manages a complication.

Dr. Terry Mason

Dr. Terry Mason: Well, I get checkups from time to time. Everything is fine. I’m still checking my cholesterols because I promised him I would. And they’re always very, very low. And I haven’t had any animal or dairy products since that time. And that’s been over, maybe, 15 years ago or more.

Ocean Robbins: So you’ve had a very direct, personal experience with the power of food.

Dr. Terry Mason: If we eat the right food, we could never need medicine. So the food is really a self-correcting agent. That is the only thing that we have that actually works on the cause of our problem and not just manages a complication.

Health Disparities in America

Ocean Robbins: The CDC recently came out with a report telling us that in the first half of 2020, life expectancy in the US dropped by a year, overall. But among the Black population, it actually dropped quite a bit more than that. By 2.7 years, in fact. In one year, it fell down to 72 years, as compared to 77.8 years for the population overall. So there’s a life expectancy gap of almost six years, along race lines, right there. And everyone, of course, is struggling. But Black people, a lot more.

We know that Black Americans are hospitalized with COVID-19 at about 2.9 times the rate of white Americans and die at about 1.9 times the rate. The CDC is saying that the primary reason for the drop in life expectancy is COVID-19 related. But it’s not impacting everybody equally. So, from your perspective, what are the core causes of this inequality?

Dr. Terry Mason: Sure, the health outcomes have always been disparate. The economic outcomes have been disparate. The opportunities for professional placement are disparate. I did a lot of work in the areas of disparities. And I had a slide at the beginning of my presentation that asked the question, “Why do racial disparities exist?” And then, in nice big, bold letters, “Because they’re supposed to.”

And people would ask, “Well, why do you say that?” I said, well, you don’t do need to do more than a cursory review of the history of America to understand that we were different, and we were disparate, from the beginning of our association with the people who are the arbiters of slavery and everything else. So why would you expect that it’d be a difference?

I did some conversations around what we were fed as we were people that had to work these fields. And many of us developed things like beriberi and scurvy and things of that nature because we were just given cornmeal and bacon.

Ocean Robbins: Yeah.

Dr. Terry Mason: And when you saw the lynchings and all the other things, not just of African-Americans, but what happened to the indigenous people here who were actually taken off their land by force and massacred. So these disparities exist because of the history of this country. And the way people have been treated, not just in the last 10 or 15 years, but over 400 years.

Ocean Robbins: Yeah. So it’s not by accident. It’s functionally by design that we have these, the enormous disparity and opportunity and resource and access and in health outcome, that so often plays out along lines of race.

Uplifting Health, Opportunity, & Knowledge

Ocean Robbins: At the same time, there are some of us who would like to change that with whatever resources we have, whatever opportunities we have. And you’ve obviously dedicated a lot of your life to trying to uplift health and opportunity and knowledge in communities that have been the most struggling the most.

Dr. King said, “The arc of the moral universe is long, but it bends towards justice.” For those of us who want to help it bend a little faster… For those of our members, whatever their skin color and whatever their class background, who want to be a part of the solution… When you look at the health disparity in America today, what do you think we could advocate for at a policy level, or invest in as individuals, that might make a bit of a difference?

Changing Food Subsidies

Dr. Terry Mason: Well, that’s a great question. And it’s a multi-layered question, as you can obviously imagine. One of the things that I would say is that as Americans, we ought to be lobbying our government not to be complicit in the leading causes of death, by allowing the food manufacturers and other people to continue to promulgate using all manner of technology and the opportunities that advertising gives them, and the subsidies that we provide for certain foodstuffs that we know are not helpful. We need to be advocating for those to be changed.

We need to be advocating for it not to be more expensive to buy organic food, for example. We need to be subsidizing the food that’s better for us, instead of making the food that is worse for us cheaper. Because in poorer communities, these are the foodstuffs that people are going to be eating.

Dr. Terry Mason: We need to be certain that we allow the science that we know to speak, not to be censored, when it comes to simple things, like the International Agency for Research on Cancer. We know that these particular things like hot dogs, as they mentioned, or four pieces of bacon, as they mentioned, are group one carcinogens that increase the risk of colorectal cancer for everybody, not just for Black people, but for everybody by 18%.

Getting Antibiotics & Hormones Out of Our Food

Dr. Terry Mason: So there are a number of things that we need to know, and we need to do, and we could do those things. We need to stop the subsidy that drives the prices of the foods so low, but the products are so bad. And we’ve got so many antibiotics and so many hormones and different things in our meat supply. And we are feeding, probably, better grains to our livestock than we’re getting in the artificially created cereals that we eat so much.

Addressing Food Deserts

Dr. Terry Mason: There’s a great paper that came out in about 2010, done by Mari Gallagher. She coined the term food deserts in that paper. She looked at the relative distances for good food, stores that sold good food, relative to where people lived. And she did a very nice computation that showed that the further those things were, the more likely people were to suffer from bad health outcomes. And what she coined was the term that a lot of people began to use called food deserts.

Food is Generational

Dr. Terry Mason: So what we did at the American Public Health Association, we took it one step further. And it wasn’t just that these foods were not available, but it looked as though after a certain period of time, perhaps one generation, people were not familiar with eating the foods I grew up eating. I’m one of 10 kids. And my mom, we didn’t have much. But she always had a great big pot of beans on the stove. We had lots of beans. We ate lots of rice, and we only had meat very rarely, maybe on the weekend.

Ocean Robbins: Yeah.

Dr. Terry Mason: When people have been bereft of the real good foods they should eat for long enough, and it looks like it’s about a generation, they lose their taste for the better foods. And even if the stores are sometimes there, no one will know how to cook it. No one will know how to prepare it. And so this is what’s happening, not just in Black America, but in America in general.

A Biodiversity of Solutions

Ocean Robbins: Yes. So there are so many levels at which we can tackle this problem. And I sometimes think that we need a biodiversity of solutions because you never know quite what’s going to work. And the truth is it takes all of it. So I’m hearing you saying that we need to address the subsidies. Which, you know, tens of billions of dollars a year, for those who don’t know, in federal taxpayer money are going to subsidize commodities crops, which is bringing down the price of factory-farmed meat, high fructose corn syrup, white bread, and all sorts of junk foods. And very little of that money is reaching fruits, vegetables, nuts, and seeds — the very foods we should all be eating more of, according to tens of thousands of studies published in peer-reviewed medical journals.

I’m also hearing you say, we need to address the food desert issue. And part of how we can do that is through education and through sharing culinary wisdom that’s culturally appropriate, I would add, in all of the communities that exist.

So for everybody who thinks that when you’re just cooking something good in the kitchen that’s healthy, that’s just a selfish thing, I say: No, you’re actually preserving a cultural tradition. And hopefully, you’ll share it with other people. Because the best doorway, they say, to a man’s mind is his stomach, right? [LAUGHS]

Dr. Terry Mason: Yes.

Wholesome Wave’s Double Up Bucks Program

Ocean Robbins: So if you want to influence people, sometimes feeding them good food can be powerful work. Another thing I think we can do if we want to address the food desert issue, as well as education, is economic empowerment through, of course, resources in communities that need it. We’ve got to stop the redlining and a lot of the other historical practices that have unfairly discriminated against certain communities and people. But we can also double the value of the SNAP program for fruits and vegetables.

There’s an experiment being done around this led by an organization called Wholesome Wave. And what they’re doing is called the Double Up Bucks Program. There are 500,000 Americans right now that get double value for fruits and vegetables in almost every state. They’re testing it out. And what they’re finding is that when that happens, people buy more fruits and vegetables, demand for fruits and vegetables increases in their community; they eat more fruits and vegetables, and they’re healthier because of it. So to me, if we’re going to subsidize anything, we should be subsidizing healthy food in the communities that need it the most, rather than subsidizing the junk food industry.

Dr. Terry Mason: Yes, that was my entire point. And we were part of the Double Bucks Program when I was at the county. We actually had RX bags, prescription bags. And one of our primary care doctors, Dr. Jifunza Carter, helped to devise bags that had certain sorts of vegetables that were better for people who may have some kidney failure, people that had high blood pressure, elevated cholesterol, different things. And then, she went over those so that people walked out with a prescription that was food. And also, with a methodology to cook it, that would not reverse the good things that the food would do, but would be able to accommodate the cultural tastes that people had in a way that would not make them ill.

So, you’re right. And then, the hospital itself poured more money into the Double Bucks Program to extend it so that more people could get the double bucks.

Stopping the Programming

Dr. Terry Mason: But you’re absolutely right. These are the things that could be done. We can make good food cheap and widely available in America, and that’s what we ought to do. But at the same time, we’re going to have to stop the programming, and the programming that makes people go buy these foods that are not good for us. And the fact that nowadays, if you’ve got a 50-inch television set in your bedroom, and you happen to wake up in the morning, you could see a 50-inch burger. And so, we’ve got to start thinking about that.

And lastly, we have got to make sure that we do what we can to make sure that the good foods also taste good so that we could begin to reprogram the taste buds of our youth in a positive way.

Ocean Robbins: Yes. Good call.

COVID-19 & Comorbidities

Ocean Robbins: I want to talk COVID-19 for a second.

Dr. Terry Mason: Sure.

Ocean Robbins: A CDC report analyzed more than 1.7 million US cases and 103,000 deaths. They concluded that people with underlying medical conditions like heart disease and diabetes were hospitalized six times as often and died 12 times as often as those without those underlying conditions.

Terry, do you think that comorbidities and overall health status have a major impact on COVID-19 outcome and that we should be putting more attention there as a society if we want to stop COVID-19?

Dr. Terry Mason: Yes. Basically, what we need to do is to do the things that help our bodies fight this, and to make our bodies less of a victim to the ravages of the coronavirus. And this is the thing that is difficult, and what I’m trying to get people to understand is that it’s the food. It’s the food that is inflammatory.

Inflammatory Foods

Dr. Terry Mason: And we want to call it heart disease and this and that. But what we have is system-wide vascular inflammation caused by these foods that we eat, these processed foods, these foods that are fried, these foods that have the milks and the creams and the butters. And these are the things that are causing this inflammation. Not a lot at one time, but a little bit all the time. And eventually, just as if you scrape your knee once, if you give it time, it will heal. But if three hours later, or four hours later, you scrape it again. And then, four hours after that, you scrape it again — it never heals. And that’s what we do.

We’ve been programmed to think we need to eat far more than we need to eat. We’ve made bad things that are very inflammatory, easy for us to have access to. And we have misguided information as to what causes these diseases.

So everybody thinks, or many people think, that diabetes is caused by too much sugar, when in fact it isn’t the sugar at all. It’s the saturated fat that kills these beta cells in the pancreas.

Obesity

Terry Mason: So we really do need an education program that speaks the language that people understand. And I know our commercial industries know how to do this.

The other thing is that we’ve got to have people stop believing they need to eat more. We’re eating almost 75 pounds more meat per person now than we did in 1950. And yet, the human being has not changed in terms of who we are and what we are in that same period of time, except that we’ve grown wider, not necessarily taller.

Ocean Robbins: Yes, we have grown wider. Obesity rates are now approaching 40% in America. More than two-thirds of our population are overweight. We have, I think, the dubious distinction of having the fattest population on the planet, right?

Dr. Terry Mason: Yes.

Ocean Robbins: And I think we’ve passed Mexico again on obesity rate. And, of course, this is all fueling disease.

Dr. Terry Mason: Absolutely.

Ocean Robbins: It’s not just an aesthetic thing; that’s not even the core issue. The core issue is that that’s a marker for higher risk for cardiovascular disease and type 2 diabetes, and so many other issues.

Cardiovascular Disease & Erectile Dysfunction

Dr. Terry Mason: I want to add one thing about that. Language is so important. So when I talk to people, I say, “Look, guys, if you have vascular disease anywhere, you have it everywhere.” So this whole notion that you just got some blockages in the blood vessels of your heart is wrong. If they’re in your heart; they’re in your legs; they’re in your stomach; they’re everywhere. And if you’ve got damage to these inside lining cells, these endothelial cells, anywhere in the body, you have them everywhere. I learned that while I was in practice treating erectile dysfunction.

And there’s a journal article published in JAMA, I think in 2009, that actually correlates the clinical onset of certain diseases with erectile dysfunction. And they found that men who complained of erectile dysfunction went on to have heart attacks and strokes. Why? Because it’s all the same disease.

So what we have to do is we have to change this language because it confuses people. And we need to talk about how ubiquitous these diseases are everywhere. So when you get a blood clot, or you get a blockage of blood flow in your leg, that’s not different from the blood flow to the heart, or that’s not different from the blood flow to the brain. It’s the same process caused by the same thing.

We don’t need different solutions. We need the only real solution that we have, and that is to reverse these things by eating just the opposite of the foods that cause them.

The Impact of a Plant-Based Diet on African American Health

Ocean Robbins: Yes. Well, hear, hear to that. You were one of the authors of a study conducted by researchers at Rush University. And the study was looking at vascular health. And it tracked, I believe, 44 African-Americans. Some of them were given a plant-based diet for five weeks. Can you tell us what happened in the study? And what did we learn from it?

Dr. Terry Mason: Well, Dr. Kim Williams was the professor and chair of cardiology at Rush University Hospital and the past president of the American College of Cardiology, who’s always been very, very community-focused. And I said, “You know, I’d really like to think about how we can begin to prove that Black people can improve.” We always hear about how bad we are, but we never talk about how we improve.

So we designed a small study. Actually, because of funding, it was small. We’re actually now in the process of trying to get more money to do a much bigger study. So we could only take about 50 people. And our church had well over 5,000 people that attended. And just before I got the announcement out for the first service, we had 200 people in the room wanting to sign up.

And what we did was we contracted with a company so we could make sure everybody had an isocaloric diet.

Participants were getting food deliveries, and they were supposed to only eat what they got delivered to them. But we told them, if you don’t, if you cheat, just write it down.

Ocean Robbins: Yeah.

Improvement in Health Markers

Dr. Terry Mason: And people were very compliant. And we also did a bunch of biometric measurements. We measured particularly inflammatory markers, like trimethylamine N-oxide (TMAO), which does a lot of damage and has now been implicated in cancer and everything else. We had a lab that we send the blood for the pre- and post-TMAOs, as well as the lipoproteins. And we assessed cardiac risk, and insulin levels, and everything else.

What was the most startling thing is that the TMAO dropped 41% in five weeks. In five weeks, just on a dietary change.

Ocean Robbins: Wow.

Dr. Terry Mason: Forty-one percent. There’s no medicine out there that can do that. And the other markers dropped too. The low-density lipoproteins, the C-reactive proteins, all of these things.

And what we’d like to do is we’d like to get 200 people to do this because we need more power in the larger numbers. But it just goes to show you. And people were astonished. And my motivation was to show that… Because we never saw information like this on the African-American population. We always see the bad stuff.

And here is something that shows that, “Hey, good things can happen when we do this. And when we change what we eat, we can change our internal biochemistry, which then changes our life and gives us a new lease that we didn’t know existed before.”

And this is not just our opinion. I always say, in God we trust; all others must have data. So this was the data. And right now, we are in the process of trying to recruit some other folks to help raise the money we need for a larger study. It looks like it’s going to take us about 1.5 million dollars to do the study in the way that it really needs to be done.

Saving Trillions on Healthcare Costs

Dr. Terry Mason: And I just spoke to one of our senators. I’m like, “Guys, you’ve got to shake some money loose from someplace because what we’re telling you is you don’t know how much we could save in pharmaceuticals, hospitalization, surgeries, and what have you, if we began to get this message out. Now, some of your donors may not like it because we’re going to be talking about the causes of this.” For the rest of my life, I cannot be engaged in just prescribing pills. That’s why I quit conventional medical practice.

Ocean Robbins: Yeah.

Dr. Terry Mason: I have to give people what they need to reverse the disease.

Ocean Robbins: How much do you think we might be able to save if we truly made food the foundation of health in the United States?

Dr. Terry Mason: I would say, if we got really serious about it, not all at once, but I think that we could comfortably say we’re spending about three trillion dollars now. We should be able to cut that in half.

And the fact that we’re spending three trillion dollars is a great cartoon. I don’t know if you’ve ever seen it. It’s a picture of a sink. And the sink is stopped up. And the water is running. And the water is running over the sink. And you got a bunch of guys in a room with mops trying to mop up the water. But nobody goes over to turn the water off on the sink or to pull the stopper out.

And I’m saying that we’re spending three trillion dollars on basically mopping efforts. If we really wanted to get serious about this, we could spend less than half of that if we just pull the sink stopper out and turn the disease off. And how do we do that? We do that with changing, using the power of our advertising machine to start getting people to eat the right things.

Ocean Robbins: Yeah. It’s pretty stunning, if you think about it, that we could save, according to that estimate, 1.5 trillion dollars per year. That means in about 18 years, we could repay the entire national debt. We could create a kind of utopia with just those savings. Seventeen percent of gross domestic product in the United States, maybe more, goes to medical care or disease symptom management. And yet, people say we can’t afford healthy food. Well, individuals can’t when the subsidies are stacked against them and when the whole economic system is stacked against them.

Saving the Environment in the Process

Ocean Robbins: But if we were serious about valuing health and human welfare, we could make so many good things happen.

Dr. Terry Mason: Not only that, but do you know what we do to the environment? Because now we wouldn’t be killing all these animals; we wouldn’t need to grow all these animals; we would be able to stop the methane that’s coming from these animals that are contributing the greenhouse gases. You know, more greenhouse gases come from that than from all of the transportation, cars, planes, boats, trucks, combined.

Ocean Robbins: Yeah.

Dr. Terry Mason: So we could literally clean our air in a generation.

Ocean Robbins: Yes. More than 80% of the Earth’s land, of agricultural land service, is being used for animal agriculture. For 17% of our calories. So yeah, tremendous savings possible there.

Lactose Intolerance

Ocean Robbins: I want to turn to another kind of more specific topic, which is lactose intolerance. It affects 65% of humanity, the vast majority of whom are people of color. And yet, milk is advertised as nature’s most perfect food. Of course, it is for a baby calf, but not necessarily for humans. Do you think that our milk and dairy obsession is, in any way, functionally, an expression of racism?

Dr. Terry Mason: Well, you know, that’s a great question. And the fact is that there are some people that are not Black that are also lactose intolerant, but far fewer.

I happen to be a lactose intolerant person. And I didn’t even know what it was, and my parents didn’t know what it was. I just know that whenever I tried to eat certain things, I would end up in the bathroom. So I think that the fact that we’re not being aggressive to do something about it is racist.

And I have to commend guys like Neal Barnard. We went to the AMA a year or two ago, where they were trying to say that lactose intolerance was a disease. And we said no, it’s not a disease. There’s nothing wrong with people who are lactose intolerant other than they rightfully do not have the enzyme to break down milk that does not come from their human mother.

Breastfeeding & Milk Consumption Past Infancy

Dr. Terry Mason: We talk a lot about how cow milk is the absolute perfect milk for baby cows. Because we had a huge breastfeeding campaign in the Department of Public Health that we championed. And we had marches, and we had parades to celebrate women who choose to breastfeed and to give them the support that they need to do that and to create spaces in all of the businesses. We call the rooms the Milky Way rooms so a woman could go and breastfeed her child, or pump her breasts, to get the milk that her child needs. And we need to make that a national practice and to make it far more comfortable for women to breastfeed.

Ocean Robbins: Yes. Humans are the only species on Earth that drinks milk past infancy, though. And we’re also the only species on earth that drinks the milk of another species. So although consumption of milk from other bovine lactating mammals has been normalized in our society, it is, from an evolutionary perspective, perhaps a little bit odd.

Black Veganism & Vegetarianism

Ocean Robbins: There was a recent poll that found that 3% of Americans identified as vegans. Eight percent of Black Americans, however, identified as vegans. Another poll found that 31% of people of color in the US say they’re eating less meat intentionally, compared to 19% of white respondents who said they were eating less meat intentionally. 

Can you shed any light on why you think it is that so many Black people and people of color in the US are moving away from animal products at a dramatically higher rate than white folks are? Any sense of the cultural elements of that, or what’s making that happen?

Dr. Terry Mason: I think it’s a number of things. We’re seeing more of some of the celebrities who are vegan. I mean, I was with one of the basketball players who is a vegan and talks about it. We see more of these iconic people who are openly vegetarian or vegan. We’re hearing more about this than we used to hear.

Look at the movies that have come out. Everything from Forks Over Knives to Diet Fiction to The Game Changers — all of these things that have helped to change the psyche. And Game Changers, especially, because men were probably the most confused around what being a plant-based person will do or not do. But when you look at a guy like Rich Roll, who is an ultra-athlete, who does these amazing athletic feats, or the strongest man in the world who is lifting untold pounds of weight, almost a ton — you can’t argue with it anymore.

And I’m just grateful to all those people that produced these films for us because some people get things in different sorts of ways. And certain kinds of genres are better than others. But I’m just so happy to see this because I’ve been able to see this transformation in a very short period of time.

Advocating for Accessible Health

Dr. Terry Mason: So, this is good, Ocean. This is good. I just thank God for what you guys do and to make this information so easily available in language that people can understand is absolutely amazing. And I thank you for it.

Ocean Robbins: Well, thank you so much, Terry. And I thank God for the work that you do.

You know, in a sense, you retired from medical practice because you didn’t want to push drugs and surgery, and you wanted to advocate for health. But your work as a healer was just beginning.

Mother Carr’s Farm

Ocean Robbins: I understand that you and others acquired farmland that you’re using to grow food for distribution in underserved neighborhoods in Chicago. I also understand you’re employing folks recently released from prison who served time for non-violent offenses.

Can you tell us about this project, what you’re aiming to achieve, and how it’s going?

Dr. Terry Mason: First of all, thank you for asking. It was an outgrowth of a project led by a pastor by the name of Dr. Gerald January from a church called The Church of God. And it’s a thing that started out as a small garden of one of its parishioners — Mother Carr is what they called her.

They’ve subsequently moved from their old church to a new site that’s 76 acres of land that the church acquired. They were going to build a much bigger sort of commercial park with things like Starbucks and all that sort of stuff, but for a number of reasons, that didn’t happen.

So, they decided to use a little bit more of the land for what was called Mother Carr’s Farm. And we went from just maybe an acre or so. And over the last year, we doubled the space that we had because it got up to like nine, and now we’re almost at 18 acres. Last year, for the first time, we actually grew watermelons. We had about 300 watermelons that we grew, both red and yellow meat watermelons, in addition to our kale, our Swiss chard, our radishes, our onions. We have our own bees. We had almost 20 gallons of organic clover honey.

Enriching the Lives of Underserved Communities

Dr. Terry Mason: We have a wonderful farm manager. His name is Mr. Anthony Williamson, who has done all of this without using any pesticides, no chemicals of any sort because of the richness of this soil that this church bought, which was an old farm. And the nutrients were still there. And we’re in the process now of putting manure and other things to sort of replenish some of those nutrients.

Our plan is to build this up. We want to double it again. And we’d like to eventually, within a year, hopefully, get up to half of the capacity that we have.

The young men that we brought out are what we call returning citizens. This has made such a difference in their lives. And we’re actually now trying to figure out how we might be able to get some temporary trailers with some solar power to provide them a place to live while they’re there. And we also bring in some of the troubled teens from the schools in the southern suburbs that have had some brushes with authority.

None of these folks had ever even seen a farm or even been involved with picking food.

CSA Boxes

Dr. Terry Mason: We sell shares in this. So a full share is $450 for the growing season. That allows you to get a box that is usually somewhere, without the watermelon, somewhere around 12 to 18 pounds of fresh vegetables. And those vegetables are picked on Friday. And they’re picked up on Saturday. So, they never see a refrigerator. Just take it out, and we put a little water on it, and just a little ice, and people come up the next day and pick it up.

Ocean Robbins: And that’s a box every other week throughout the growing season.

Dr. Terry Mason: And whatever we have. And that includes honey and whatever else is there. It’s picked, and it’s picked up. Our plan is to try to raise money to buy more farm equipment to make it a bit more efficient as well as to create a place where we can do some degree of post-processing. Because we now have demand from the restaurants.

We took some of the food to a few of the restaurants, and it’s amazing. They would pick some of this stuff on Friday. And on Friday evening, these vegetables would be on the plates of people in these restaurants. And they didn’t understand why this tasted so different. And it tasted so different because it had never been stored in a refrigerated place. One buyer went from just testing it out to buying over 350 pounds of kale from us every week.

Ocean Robbins: Wow.

Restoring Human Dignity & Health

Dr. Terry Mason: So, we’re really, really trying to expand both our commercial business, but we also want to reach out to our seniors. We’re trying to create a delivery service so that they don’t have to drive. It’s a bit of a drive to come out to the farm. We’re working with some people to create some drop-off points.

And we’re also working on getting more farm implements and on being able to bring and hire… Because we want to pay these young people a livable wage. We want them not to have to sleep out in a trailer. We want them to have enough money to be able to rent a small apartment and to feed themselves. And so that’s the other part of what we’re trying to do. And we started a GoFundMe page.

Ocean Robbins: Well, it’s a labor of love. And I’m thinking about the ripples this sends out. When I think about those 350 pounds of kale, when I think about those CSAs, every single box that you’re delivering equals fewer heart attacks, fewer people living in misery, fewer kids losing their parents too young.

Every box you’re delivering also represents more people employed who otherwise might have been on the streets doing who knows what. It means more human dignity restored. And it also means more regeneration of our soils. Land that might’ve been fallow is now growing food which, when well managed, can sequester carbon, can become a part of the solution on Planet Earth. So it’s like everywhere you look, you see these ripples of goodness and health and wellness flowing from this one simple act.

Vernon Park Church of God

Ocean Robbins: So, if people want to get involved, do they Google to find it?

Dr. Terry Mason: Just go to Vernon Park Church of God, and everything is right there. They can see pictures of the farm. We didn’t have money this year, but we wanted to try and get a little movie so that we could put it up on the website. We’re trying to raise money for our tractor so that Tony and the guys can do their work far more efficiently than they’re doing it now.

Our goal over the next year or two is to raise enough money to put in our own little greenhouse, so we can do all our starter plants here rather than have to drive and cart them all the way back from Champaign.

Ocean Robbins: Beautiful. So, for everybody watching — please pitch in if you can.

Healthy Food for All

Ocean Robbins: Terry, it’s been such a privilege talking with you and sharing this time. I’m so grateful that your waiting room essentially expanded to include all of humanity and the whole planet.

Dr. Terry Mason: [LAUGHS]

Ocean Robbins: We’re all grateful for what you’re doing. Thank you so much for your wisdom. Thank you for your leadership. Thank you for your courage. And thank you for walking the talk. Who knew that when you were healing your own heart and your own cardiovascular system years ago, you would be having epiphanies that would change, fundamentally, everything you do in your life.

Dr. Terry Mason: [LAUGHS] Yes.

Ocean Robbins: And now, you’ll be helping so many other people.

Dr. Terry Mason: Well, I so want to thank you, Ocean, for what you and your publications and your conferences, you know… It’s just wonderful, and I’m so grateful. You’re the reason why we have more people that are eating vegan. And the people that you bring on, and the programs that you produce, those are the reasons why we have more people who are choosing to love life more abundantly by eating the things that we were designed to eat. And I thank you for it.

Ocean Robbins: Why thank you.

We’ve been talking with Dr. Terry Mason. And thank you so much, everyone watching, for your time, for your attention, and for your participation with us in this food revolution.

Tell us in the comments:

• Do you feel inspired by this interview?
• How has culture or race influenced your eating habits?
• What are some of the health-promoting projects and organizations that inspire you?

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The post Increasing Health & Opportunity for All: An Interview with Terry Mason, MD appeared first on Food Revolution Network.