Every day my patients tell me that their health and well-being are out of synch with the pace of modern life. Chances are that you, too, share some of their complaints. Think of the last time you told yourself or someone else:
- “i don’t have time to exercise.”
- “it’s too expensive and takes too long to prepare healthy foods.”
- “i am too tired to cook; we have to eat out!”
- “there is no time left to take care of me after my family.”
- “if i had known getting old was like this, i would have taken better care of myself.”
- “these golden years aren’t so golden.” It’s true that our fast-paced existence has a strong and often negative impact on our health and that we would all feel much better if we could somehow just slow down.
it’s also true that healthcare costs are skyrocketing and that families and communities across the nation are suffering under a financial burden that will only get worse as the baby boomers move into old age. The age wave, as visionary psychologist and gerontologist dr. Ken dychtwald so aptly calls it, is reaching tsunami proportions and will change the face of healthcare and our economy as the boomers demand more services for the epidemic of chronic diseases with which they will have to live.
This next excerpt from healthy at 100 made me do a double take since my siblings and i had recently taken care of our mother with chronic, life-ending pulmonary fibrosis. “…the average twenty-first-century american will likely spend more years caring for parents than for children.”3 my siblings and i had more than adequate resources and a great family unit to take care of my mother and keep her at home, but it was hard and time consuming. I can’t imagine other families with fewer resources, or individuals with no family at all, and what kind of care they might receive. These facts, and my experience with my mother and seeing patients and families over the years, drive me to stay as healthy as i can so i can remain independent as i age and not be a burden to my daughter and society.
The big problem: chronic diseases
As mentioned in chapter 1, chronic diseases such as heart disease, cancer, high blood pressure, stroke, diabetes, chronic lung, kidney and liver diseases, parkinson’s and alzheimer’s diseases, and diabetes account for 70 percent of all deaths in the united states.4 these diseases are predominantly caused—and can be prevented— by diet and lifestyle choices. So how have we come to the extreme state of widespread ill health that we are experiencing today? In 1970, the average adult consumed five hundred fewer calories per day and weighed 19.8 pounds less than in 2000. Similarly, a child in 1970 consumed 350 calories less per day and weighed 8.8 pounds less than in 2000. The numbers don’t lie. They perfectly predict our obesity epidemic.
Being overweight: the proverbial elephant in the room
It is very easy to see when one looks back over the last century in the united states why being overweight, obesity, and inflammatory diseases are becoming more prevalent. The answers are simple: as modern society urbanizes and people’s lives center around cities, people become busier; more processed, high-calorie, and prepared foods are made available; and people eat out more frequently. American households spend more than 40 percent of their total food budget on foods prepared outside of the home, up from 25 percent in 1970.6
This is problematic because, when we eat at restaurants and fast-food restaurants, we not only consume more food, but we also eat foods with higher caloric density (i.e., added fats and oils, calorie sweeteners, cheeses, meats, refined grains). Furthermore, even the foods we eat at home now tend to be more calorie dense and less nutritionally dense than they were even a few decades ago. For the average person, eating one meal away from home each week equals approximately a two-pound weight gain each year.
These trends, along with a marked decrease in physical activity, can lead to only one thing: increased weight—and lots of it. The good news is that after a quarter-century of increases, obesity prevalence has not measurably increased in the past few years. The bad news is that obesity levels are still high: 34 percent of u.s. adults aged twenty and over. There is a greater percentage of americans overweight than obese (34.2 percent vs. 33.8 percent). In addition, we now have a new weight category—the extremely obese (> 40 bmi) at 5.7 percent of the population (overweight > 25 bmi; obese >30 bmi).8 if you add these totals up, over 70 percent of the u.s. population has an excess weight problem.