Sickness Inc.

While driving, I recently encountered a common sight across much of America: dozens of people waiting in line, sitting in their shiny metal boxes with engines idling. Where were they waiting? Dunkin’ Donuts. They were there to get some breakfast items, sugary treats, or coffee, as one of my associates used to call it, “go juice.” It’s an American institution with one of these places every mile, or so it seems. McDonald’s is another deeply embedded American tradition that is just as pervasive. And walking through supermarkets, it’s easy to see aisle after aisle of sodas, chips, sugary snacks, and an endless assortment of junk foods. Convenient, instant gratification, short-sighted, nutritionally deficient junk.

And it’s not only what we are eating, but how much. American food portion sizes over the past 30 years have grown massively, which has helped expand waistlines. Today’s average restaurant portion is more than four times as big as in the 1950s. A cup of soda is now six times larger. Burgers and a portion of fries have both tripled in size. A chocolate bar is now over 1,200% larger than in the early 1900s.[1] From 1982 to 2002, the average pizza slice increased by 70% in calories, the standard chicken Caesar salad doubled in calories, and the average chocolate chip cookie quadrupled. Portion sizes can be 2 to 8 times larger than the USDA (United States Department of Agriculture) or FDA (United States Food and Drug Administration) standard serving sizes.[2]

Not only have food portions increased, but the bowls, glasses, and plates have grown to match. In America, the surface area of the average dinner plate has increased by 36% since 1960.[3] In supermarkets, the number of larger sizes has increased 10-fold between 1970 and 2000.[4] Larger packages in grocery stores, larger portions in restaurants, and larger kitchenware in homes cause an unconscious perceptual shift that makes people think it is appropriate to eat more than they should.

Large-sized packages, large-sized restaurant portions, and large-sized dinnerware all have one thing in common. They all perceptually suggest to us that it is more appropriate, typical, reasonable, and normal to serve and to eat more food than smaller plates or smaller packages would instead suggest. These all implicitly influence our personal consumption norm for that situation... This is what makes these norms so powerful. Even when made aware of them, most people are unwilling to acknowledge that they could be influenced by something as seemingly harmless as the size of a package or plate.[5]

Since the Great Depression of the 1930s, with its breadlines and food rationing, many in the United States now have easy access to vast amounts of inexpensive food twenty-four hours a day. Not surprisingly, with such an abundance of readily available food, American adults have also increased in size.

As of 2018, 42.4% of Americans are now obese. Another 30.7% of adults were categorized as overweight, and 9.2% had severe obesity.[6] This means that 82.3% of American adults are overweight or heavier. Those with obesity have a higher increased risk of overall mortality, high cholesterol, diabetes, heart disease, stroke, many types of cancer, depression, anxiety, body pain, and difficulty with physical functioning.[7] As of 2019, 1,408,647 Americans died from heart disease, cancer, and stroke, or on average 3,850 every day.[8] Childhood obesity has reached epidemic levels in developed countries. In the United States, 18.5% of children and adolescents are obese, or nearly 1 in 5.[9] Medical costs due to obesity are now $190 billion per year, comprising over 21% of all healthcare costs in the country.[10]

...19 states in America have obesity rates over 35 percent, increased from 16 states just last year. A decade ago, no states had obesity rates above 35 percent! Obesity is linked to a number of health ailments, including diabetes, heart disease, stroke, and a number of cancers such as breast and colorectal.[11]

It’s not just consuming large amounts of junk food that has made us overweight, obese, or worse; it’s also a stunning lack of physical activity. Spending time indoors with our televisions, phones, computers, and video game consoles has shifted our perception, making an indoor lifestyle disconnected from nature the norm.

The statistics of physical inactivity in the U.S. are staggering and quite the eye opener. According to Healthy People 2020, approximately 36 percent of adults do not engage in any leisure-time physical activity, despite the fact that walking may be comparable to more vigorous exercise in preventing a cardiovascular event.[12]

This lack of exercise also contributes to our ever-growing sicknesses with enormous profits for the medical system.

Lack of physical activity accounts for 22 percent of coronary heart disease, 22 percent of colon cancer, 18 percent of osteoporotic fractures, 12 percent of diabetes and hypertension, and 5 percent of breast cancer. Furthermore, physical inactivity accounts for about 2.4 percent of U.S. healthcare expenditures or approximately $24 billion a year.[13]

And we are not getting enough sunshine by being inside all the time. The result is that vitamin D deficiency is very prevalent in the United States and worldwide. Approximately 30% of apparently healthy middle-aged and elderly adults are deficient.[14]

Low levels of 25-hydroxy vitamin D [25(OH) D], the principal circulating storage form of vitamin D, are present in one third to one half of otherwise healthy middle-aged to elderly adults.

A study in 2018 showed that most patients were deficient in the metabolized end product of vitamin D, which is abbreviated as 25(OH)D, and over 40% were severely or very severely deficient.[15]

Most patients [elderly] had 25(OH)D levels that were less than those currently recommended for optimal health. Furthermore, very severe and severe forms accounted for up to 43%.

Also, many studies show that low vitamin D status may also be associated with the risk of non-skeletal chronic diseases, such as all-cause mortality, type 2 diabetes, cardiovascular diseases, and colorectal cancer.

The manufacturing of vitamin D in the body is well known. It is produced by the skin from solar radiation.[16] That’s why it’s often referred to as the sunshine vitamin. Vitamin D deficiency is attributed to low sunlight exposure (specifically ultraviolet-B or UVB radiation), which is required to induce vitamin D synthesis in the skin. During winter months, there are usually drops in vitamin D because of the decrease in sunlight.[17]

Because the body makes vitamin D when your skin is exposed to sunlight, you may be at risk of deficiency if you are homebound, live in northern latitudes, wear long robes or head coverings for religious reasons, or have an occupation that prevents sun exposure.

The pigment melanin reduces the skin’s ability to make vitamin D in response to sunlight exposure. Some studies show that older adults with darker skin are at high risk of vitamin D deficiency.

Nutrients in the body do not exist in a vacuum. They often work together, and in the case of vitamin D, there needs to be a balance with magnesium.[18]

Vitamin D helps regulate calcium and phosphate balance to maintain healthy bone functions. Skeletal muscles, heart, teeth, bones, and many other organs require magnesium to sustain their physiologic functions. Furthermore, magnesium is needed to activate vitamin D. Abnormal levels in either of these nutrients can lead to serious organ dysfunctions.

Yet, the standard diet in the United States contains about 50% of the recommended daily allowance (RDA) for magnesium. It’s estimated that 75% of the population consumes a magnesium-deficient diet. Another problem is that the magnesium content of food has declined from 25% to 80% since before 1950.

In humans, subclinical magnesium deficiency is common and generates chronic inflammation, which is the common denominator of a wide range of mental and physical health problems from metabolic diseases to cognitive impairment, from osteopenia and sarcopenia to depression. It is ascertained that magnesium content in fruits and vegetables dropped in the last fifty years, and about 80% of this metal is lost during food processing.[19]

Obesity and poor health are rampant. Instead of addressing the root causes of this epidemic, we turn to medical solutions like stomach stapling, Ozempic, and statins, which aren’t really in our best interest. While these treatments are incredibly profitable, the real answers are fundamental and accessible to everyone. The solution was known over 100 years ago.

Sunshine, fresh air, wholesome nutrition, exercise, rest and the hygienic mode of living are far more effectual than all the subsequent medication in existence.[20]

Achieving better health and happiness isn’t rocket science. It’s something within everyone’s reach. By taking small, consistent steps, we can break free from the ever-increasing epidemic of chronic illness and vastly improve our well-being. Simple lifestyle changes, such as eating a balanced diet, engaging in regular physical activity, getting plenty of sunshine, getting sufficient sleep, and managing stress, can make all the difference. These adjustments enhance our physical health and boost our mental and emotional resilience. Let’s embrace these practical strategies to cultivate a healthier, happier life. If we do, we can all break free of Sickness Inc.

Parts of this article are from my new book, Moving Back From Midnight, which is available on Amazon. https://movingbackfrommidnight.com/

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[1] “How the size of an average restaurant meal has QUADRUPLED since the 1950s - with U.S. burgers now three times as big,” Daily Mail, May 23 2012, http://www.dailymail.co.uk/news/article-2148970/How-size-average-restaurant-meal-QUADRUPLED-1950s--U-S-burgers-times-big.html

[2] Dana Gunders, Wasted: How America Is Losing Up to 40 Percent of Its Food from Farm to Fork to Landfill, Natural Resources Defense Council, August 2012.

[3] Lisa F. Berkman, Ichiro Kawachi, and M. Maria Glymour, Social Epidemiology, Oxford University Press, 2014

[4] Paul Insel, et al., Nutrition - Fourth Edition, 2011, p. 48.

[5] Brian Wansink, Phd and Koert Van Ittersum, Phd, “Portion Size Me: Downsizing Our Consumption Norms,” Journal of the American Dieteic Association, July 2007, vol. 107, no. 7, pp. 1103-1106.

[6] Zeena Mackerdien PhD, “Obesity Rates Continue to Rise Among Americans”

[7] “The Health Effects of Overweight & Obesity,” CDC

[8] https://www.cdc.gov/nchs/fastats/deaths.htm

[9] Mahshid Dehghan, Noori Akhtar-Danesh and Anwar T Merchant, “Childhood obesity, prevalence and prevention,” Nutrition Journal, September 2005

[10] Susan Kelley, “Obesity accounts for 21 percent of U.S. health care costs,” Cornell Chronicle, April 4, 2012, http://news.cornell.edu/stories/2012/04/obesity-accounts-21-percent-medical-care-costs

[11] Omer Awan MD, “How Obesity In The U.S. Has Grown And What To Do About It,” Forbes, January 25, 2023, https://www.forbes.com/sites/omerawan/2023/01/25/has-the-obesity-epidemic-gotten-out-of-hand-in-america

[12] Sobering Statistics on Physical Inactivity in the U.S. Florida Atlantic University, https://www.fau.edu/newsdesk/articles/Physical%20Inactivity-AJM.php

[13] “Sobering Statistics on Physical Inactivity in the U.S. Florida Atlantic University,” https://www.fau.edu/newsdesk/articles/Physical%20Inactivity-AJM.php

[14] Zaher Fanari, et al., “Vitamin D deficiency plays an important role in cardiac disease and affects patient outcome: Still a myth or a fact that needs exploration?” J Saudi Heart Assoc, February 2015, pp. 264–271, doi: 10.1016/j.jsha.2015.02.003, https://pubmed.ncbi.nlm.nih.gov/26557744/

[15] Hasan Kweder and Housam Eidi, “Vitamin D deficiency in elderly: Risk factors and drugs impact on vitamin D status,” Avicenna J Med., October-December 2018, pp. 139–146, doi: 10.4103/ajm.AJM_20_18, https://pubmed.ncbi.nlm.nih.gov/30319955/

[16] Anne Marie Uwitonze, BDT, MS; Mohammed S. Razzaque, MBBS, PhD, “Role of Magnesium in Vitamin D Activation and Function,” J Am Osteopath Assoc., 2018, pp. 181–189, doi:10.7556/jaoa.2018.037

[17] “Vitamin D Deficiency,” WebMD, https://www.webmd.com/diet/guide/vitamin-d-deficiency

[18] Anne Marie Uwitonze, BDT, MS; Mohammed S. Razzaque, MBBS, PhD, “Role of Magnesium in Vitamin D Activation and Function,” J Am Osteopath Assoc., 2018, pp. 181–189, doi:10.7556/jaoa.2018.037, https://pubmed.ncbi.nlm.nih.gov/29480918/

[19] Roberta Cazzola, et al., “Going to the roots of reduced magnesium dietary intake: A tradeoff between climate changes and sources,” Heliyon, November 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649274

[20] Oral Hygiene, vol. 1, no. 1, January 1911, pp. 183–184.