In 2013, the Journal of the American Medical Association published a report identifying the top risk factors related to premature death and years lived with disease. In the 34 countries investigated, poor diet emerged as the greatest contributor to ill health out ranking other factors such as: smoking, high blood pressure, high body mass index, high fasting glucose and physical inactivity.1
In a similar study conducted in 2011, the Oxford Academic Journal of Public Health announced that poor diet had the greatest impact on health care costs, tallying up to £5.8 billion. A high body mass index followed with a cost of £5.1 billion. The cost of smoking and alcohol use were both £3.3 billion, and physical inactivity came in at £0.9 billion.2
Worldwide, it is clear that whether it be due to hunger or malnutrition, inadequate diet poses the greatest threat to our health and to the economic burden of disease. In the US, while hunger is an issue and should not be discounted, malnutrition is an even bigger issue. Malnutrition refers both to undernutrition and overnutrition, as well as to conditions arising from dietary imbalances leading to diet-related chronic diseases.
In the 2013 study listed above, the Institute of Health Metrics and Evaluation tracked 14 dietary risk factors related to malnutrition. These factors included dietary trends ranging from diets low in fruit, vegetables, nuts and seeds, to diets high in trans fats, sodium and sugar.
While the trends for some of these dietary risk factors appear to be improving, overall diet in the US population remains poor with less than 1% of adults meeting the American Heart Association’s definition for “Ideal Healthy Diet”.3
How is it possible that 99% of the population is falling short?
When it comes to identifying the barriers to healthier eating, the top culprits are lack of knowledge of what to eat, the complete bombardment of processed foods, and misleading advertising.
Think about it: nutrition is not taught in the regular school system, nor is it taught in most medical schools. Even if physicians have the desire and knowledge to educate patients, they simply lack the time to do so.
Then we have the complete bombardment of processed foods. Grocery stores are lined with prepackaged, ready to go, “just-throw-in-the-microwave”-kind of meals. Convenience stores and fast food joints are located on every street corner, and overall it is much easier to find a decadent treat than it is to find healthier alternatives, even in hospitals. Meals have clearly decreased in quality, but even worse, these unhealthy options have increased in quantity.
Next, we have misleading advertising. Manufacturers have preyed on the public’s fear of fat by labelling foods as “low fat” and “cholesterol free”. There has also been a trend to prioritize low calorie options despite being entirely sugar based and devoid of any nutrients.
This all seems very grim, until you consider the good news which begins with the fact that health and disease are multifactorial, and an avenue already exists to combat the barriers to healthier eating.
When diet is improved, the results impact much more than the stats related to diet alone; blood pressure decreases, obesity rates and BMI are reduced, and fasting glucose improves, reducing the risk of diabetes. In addition, when diet is improved, energy levels increase. Greater energy usually results in increased activity, better sleep, and a greater sense of well-being.
If poor diet is the greatest contributor to ill health, improving it will have massive positive implications.
That’s excellent, but it still doesn’t address the question of how we can educate people and target a large enough audience to make a dent in the problem.
This is where disease prevention programs come into play. Disease prevention programs provide an excellent platform to provide education in the key areas of health. By targeting the workplace, disease prevention programs have the opportunity to reach a large audience. As noted above, health and disease are multifactorial; when you improve one risk factor, or when you modify one contributing lifestyle habit, health improves exponentially. It is because of this that while nutrition might play one of the main roles to our well-being, and absolutely needs to be addressed, an ideal disease prevention program must also include the other lifestyle factors that follow close behind. We must tackle physical activity and we must investigate the behavioral motives to our decision-making process and readiness to change. Promoting sleep and stress management are also key.
What about addressing the issue of abundance and availability of unhealthy foods? With full-time employees spending most of their waking hours in the workplace, it’s now up to us as employers to become more aware of what we’re offering our employees. We can easily support workers by offering appropriate foods during meetings and in the cafeteria, or by offering vending machines that have healthier options. At the very least, we can provide a clean and safe eating area equipped with refrigerators and microwaves so that meals can be stored and prepared appropriately.
The advantage to all of this of course, is healthier and happier employees, reduced employer costs, and a great start to reducing malnutrition.
And that’s a win for everyone.