Just the other day I had a new patient who remarked that he “did not have a regular doctor.” I replied that “he would probably live longer.” On January 14, 2007, Parade magazine echoed the Center for Disease Control (CDC) report that the US is number one in only one category concerning health care and that is the amount of money spent. The US spends more money on health care than any other industrialized nation, yet lags far behind every other nation in overall health in all categories. The bad news is the other countries are not doing so hot either.
The New England Journal of Medicine (January 18, 2007; 356(3):213-15) reports that globally, the prevalence of chronic, non-communicable diseases is increasing at an alarming rate. About 58 million people die every year from cardiovascular disease, for which diabetes and hypertension are predisposing factors. Propelling the upsurge in cases of diabetes and hypertension is the growing prevalence of being overweight and obesity which The Lancet (2005; 366:1197-209) reports during the past decade has joined underweight, malnutrition and infectious disease as major health problems threatening the developing world. The aforementioned New England Journal of Medicine article also reports that in the last 20 years, the rate of obesity has tripled in developing countries that have been adopting a Western lifestyle involving decreased physical activity and over consumption of cheap, energy-dense food.
Population-based surveys of 75 communities in 32 countries show that diabetes is rare in communities in developing countries where a traditional lifestyle has been preserved. Until recently, the average people did not think that their diets could be accused of causing any health problems. It is not uncommon to read a statement from a reader to a “health” columnist that they are in good health, but taking cholesterol lowering medications, blood pressure medications, etc. Actually, the term “health care” is most commonly a misnomer. Think about this, a drug store advertises itself as a “Health Mart” with an almost unlimited supply of products listing an alarming number of unwanted adverse side effects. Furthermore, these so-called health products are usually found in the back of the store while in the front are items commonly recognized as unhealthy (i.e., cigarettes and other tobacco products, candy, soda pop, alcoholic beverages, etc.) that customers have to pass on their way to acquire drugs. Doctors are the third-leading cause of death in the US, causing 225,000 deaths each year, according to the Journal of the American Medical Association (July 26, 2000; 284(4):483-5). Doctor Barbra Starfield of the Johns Hopkins School of Hygiene and Public Health conservatively describes how the US health system possibly caused deaths: 12,000 from unnecessary surgery, 7,000 from medication errors in hospitals, 20,000 from other errors in hospitals, 80,000 from nosocomial (hospital acquired) infections and 106,000 from the negative effects of properly prescribed drugs. As if these figures are not sobering enough, according to another report in the New England Journal of Medicine (March 26, 2005; 352(21):2211-21), “Most major drugs are effective in only 25-60% of patients and more than 2 million cases of adverse drug reactions occur annually in the United States, including 100,000 deaths.” In essence, up to 75% of drugs do not work as intended.
The leading cause of death in the US continues to be cardiovascular disease, and drugs have not helped; in fact, they often do damage. The Journal of the American College of Cardiology (2005; 46:1225-8) states that the introduction of statins nearly two decades ago marked a turning point in the effort to develop pharmacologic agents to reduce morbidity and mortality from coronary disease.
However, despite the development of increasingly potent statins capable of markedly lowering cholesterol levels, coronary disease remains the leading cause of death in the Western societies. In addition to the obvious lack of help, several studies, like the one reported in the Journal of the American Medical Association (2003; 289:1651- 90), relate that how statins injure is not clear, but they are associated with rhabdomolysis and myositis and are exacerbated by hepatitis, renal, hypothy- roid, and diabetes. The New England Journal of Medicine (March 23, 2006; 354(12):1307-09) admits that, to date, no drugs specifically target arterial plaque. Even though it is well documented that healthy lifestyle habits, diet, nutritional supplements, essential fatty acids, exercise, and chelation therapy will reduce plaquing, the search continues for therapeutic interventions to act as anti-atherosclerosis agents.
Now, Bill Gates, the founder of Microsoft and a global health philanthropist, expressed his belief that there is no reason we can’t cure the top 20 diseases. However, international health organizations will need to greatly expand their efforts, especially in low-income countries, to prevent and treat non-communicable diseases. It is amazing to me how someone who is smart enough to store a thousands songs on an instrument that is about the size of a matchbook cover can’t understand that we already know what causes 90% of our illnesses. It certainly is not due to a deficiency of drugs or being born with too many parts. Dr. Julian Whitaker once remarked that if the doctor of today does not become the dietician of tomorrow, the dietician of today will become the doctor of tomorrow.