Philip J. Goscienski, M.D.
September 2008
The well-worn adage, "It's too late to lock the barn..." is a perfect description of our healthcare dilemma. Seventy percent of Americans are overweight, 8 percent have type 2 diabetes and more than half suffer from illnesses that were rare a little more than a century ago. Incomprehensibly, the barn door is still wide open; preventable conditions are increasing in spite of near-miraculous advances in medicine.
The most dramatic improvement in life expectancy and the burden of chronic disease won't come until we accept the fact that good health begins before conception. If a young woman arrives at the childbearing period of her life with poor nutrition, an underdeveloped skeleton and more body fat than nature intended for her she'll deliver an infant whose brain is below par for the species, whose bones will break more easily even during childhood and who will have high blood pressure, sick blood vessels and abnormal blood sugar before reaching voting age. If that sounds like an alarmist scenario for the future, be assured that it's already here.
There's a spooky similarity between the health crisis and the energy crisis. In the early 1970s we groused about the rising price of gasoline as we impatiently idled our cars in long lines at the gas pump every other day. Since then our domestic oil production has leveled off, we stopped building refineries and started driving SUVs and humongous Hummers. Consumers complain about gas prices as politicians piddle and nothing is happening.
Also in the 1970s our kids started drinking less milk and more soft drinks, french fries became their vegetable of choice and for reasons that range from PCs (more of them) to P.E. (less of it) they started getting fatter. During my 35 years in pediatric practice I watched the rate of obesity quadruple in children and pediatricians now in practice treat children for "adult-onset" diabetes.
In my senior year of medical school I helped to deliver a 13-pound baby whose 330-pound mom had to be weighed on the hospital's loading platform scale. Women of that size are no longer rare and super-scales that accommodate 1000 pounds are found on medical wards. Gestational diabetes, a direct consequence of obesity, doubles among our pregnant population approximately every ten years. Overweight women have more complications during pregnancy and they deliver sicker babies but I see no urgency for reversing that trend or even slowing it down.
Consumers complain about the cost of health insurance and physicians ignore preventive care. Again, politicians piddle as kids are getting sicker younger.
Communities and organizations that are attacking the problem of childhood obesity at the elementary school level deserve support and proper funding from legislators but we need to start earlier. Unless there is a massive shift in how we prepare young women for pregnancy not much will change.
To be sure, turning our obstetric clinics into nutrition education centers won't solve the problem but it's an important step, one that is simply not being addressed.
Philip J. Goscienski, M.D. is the author of Health Secrets of the Stone Age, Better Life Publishers 2005. Contact him at drphil@stoneagedoc.com.