Friday, December 11, 2009

Overfed and Undernourished

I recently had the opportunity to participate in a conference call with Geetha Raghuver, MD MPH. Dr Raghuver is a pediatric cardiologist and public health researcher at the University of Missouri, Kansas City. Her research made headlines last year when she published her findings comparing carotid ultrasound testing of her patients 8-16 years old with a control group of 45 year olds. Much to her surprise, the degree of occlusion was similar in both groups. This finding was extremely important since the carotid arteries supply blood to the brain and their condition quite often correlates with the health of the coronary arteries which supply blood to the heart. The inference drawn from this study is that these youngsters have the real cardiovascular age of a 45 year old.

Dr Raghuver sees many patients as young as 8 who are hypertensive, morbidly obese, and suffering from type 2 diabetes. In further correspondence, Raghuver stated that" universal health coverage and health care reform will get nowhere in containing costs if prevention efforts beginning in the first decade of life are not stepped up". She also stated that "this is the first generation of children whose life expectancy will be less than the previous generation".

The phenomenon of overfed and undernourished is not only relegated to the Midwest. We in the "enlightened" Bay Area are experiencing a similar pattern, particularly in our inner city schools. Many of these children come from dire circumstances, socioeconomically speaking, and often their only opportunity to obtain a healthful meal is at school. However,this meal can’t compete with nearby fast food chains, all of which are directly or indirectly subsidized by the Dept of Agriculture.

Michael Pollan and Marion Nestle have both written extensively about the "real cost" of cheap food. We experienced first hand the influence of ”Big Agri-business” during last years farm bill maneuvering. In my view, it remains to be seen whether Alice Waters and Sam Cass’s Edible Garden will make a dent in this intractable problem.

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