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Studies have shown that the root causes of the obesity epidemic are lack of education and cultural lift in the food intake and lifestyle of Americans, Europeans, with just moderate adjustments in the food and in exercize routines yielding as much or more than the 15%-30% improvement from weight loss drugs that when withdrawn for the low income demographic leads to further deterioration. For men these simple improvements also lead to improvements in the prostate and a healthier happier lifestyle reducing significantly the number one cause of cancer for men.  Yet pharmaceutical companies and the healthcare industrial complex in the US continues on its course like a mighty Mississippi roaring America into oblivion. This report says companies that dominated the weight loss industry are now facing knockoffs that wipe out a large part of the market of a Danish maker of weight loss drugs, with the panic facing obesity hit America hitting the healthcare complex that cares little about lifestyle education. ...

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WSJ looks at the changes in the way medicine should be practiced in the light of what we have learned from the pandemic.  Medicine practiced before the pandemic and still today relies mainly on a visit to the doctor or specialist who is short of time. There is a shortage of doctors. Patients have many illnesses as a result of decades of neglect of proper nutrition, and exercize habits. Obesity is at about 40% in the U.S. about 30% in the UK and 17% in France, and high also in other parts of the world. These high rates were unknown throughout history and result in many illnesses and increase by four times the vulnerability to the coronavirus. One authority in medicine calls obesity pouring gasoline on a fire for effects of the virus.  A doctor's appointment with doctors short of time with no coordination around a whole range of factors related to obesity, illnesses, health checkups, mental health, is now seen as a heavily handicapped way to practice medicine or for patient healthcare and wellbeing. The alternative is discussed here as the way forward. A  team will be responsible for a patient's care not just an individual doctor. The team would care for general health after a patient's checkup, cover individual illnesses, weight issues, mental health, exercize nutritional needs and other good healthcare habits. Instead of relying on doctors at a time of shortages of doctors the team would be led by nurse practitioners.  A nurse practitioner is someone with a bachelors degree and a masters degree or doctoral degree in nursing with 1000 hours of clinical training. Studies have shown that they are effective and even more effective than individual doctors. Today particularly with the problem of doctors with limited time compounded by the built up problems of decades of bad habits in nutrition and exercize and poor "cultural" habits getting entrenched, there has never been a greater need for a better way to practice real healthcare for a person's wellbeing. Particularly in rural areas with an even larger shortage of doctors the health practitioner led team will play a big role. Patients will under this setting receive more care virtually and get more followup care by phone and video messaging. The numbers tell the story- there are shortages of doctors in USA, Europe, Africa, Latin America and Asia. In the U.S. shortage of doctors is 55,000 projected to 2033 by Association of American Medical Colleges. There are 290,000 nurse practitioners licensed in the U.S. and 131,0000 physician assistants. The goal will be to get an adequate number of nurse practitioners licensed in this decade to take care of these teams. The pandemic has made virtual visits to doctors and nurse practitioners popular. Medicine reimbursement should and would be practiced on the basis of how well a patient is doing not on a fee for each micro service that is delivered. For this to happen the teams led by the nurse practitioner have to commit to patient education of the benefits from good practices and good habits for nutrition, exercize, caring for oneself. A doctor short of time is hardly the person to carry on this patient education which is where the major opportunities for a new system arise. The virtual care also provides a new medium for patient education and awareness of the risks of getting illnesses, preventive actions to be taken in advance. One approach being tested in California and Texas is for a monthly fee for patients more payments by health plans to doctors or healthcare teams if the patient is healthier. Additional health professionals are added to the team including health coaches, dietitians and medical assistants to increase its effectiveness in counseling and education and monitoring.  The nurse practitioner team approach is already being practiced in parts of the U.S. including the example of New Hampshire shown here, and is predicted to be the approach for primary care in the next decade. ...

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U.S. healthcare spending of about $3 trillion comes with poor results. The cost per person is about three times that of countries such as France, Britain, yet the results show U.S. doing extremely poorly. The author points out that less spending on healthcare and more on social services in areas such as education, nutrition, housing and other services would improve the outcomes and results. It is this missing factor that is helping other countries in Europe, Japan and China achieve better outcomes and returns per dollar spent.  Social spending can affect such things as nutrition, exercize levels, lifestyles, housing and result in dramatic improvements in obesity levels for instance, or inflammation levels in the population that play a role in many diseases. The idea is prevention. This is not happening because higher health dollar spending has lobbies to support it. Social spending also is a dollar expense that shows up immediately whereas results are spread out into the future as a longer term benefit with healthier populations that need to consume less healthcare and treatment. Elizabeth Bradley, president of Vassar College is an expert on this subject. She says social services spending gives more bang for buck  in health outcomes.  The point is relevant also for countries in South Asia and Africa that have taken some on some aspects of the U.S. health system resulting in health care spending that does not deliver the most for the dollar spent, and ignores the critical role of prevention.  The solution lies in moving these health care dollars out of the health care spending and into education for health outcomes, lifestyles, exercize habits education, and into social services that enable prevention and better health. ...

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Only 12% of Americans take the minimum daily recommended fruit for healthy living, and only 9% of Americans take the minimum daily recommended vegetables, according to the Centers of Disease Control and Prevention (CDC). The minimum for fruit is daily taking one and half cups fruit. For vegetables it is daily taking two to three cups of vegetables. Women consume a bit more at 15% for fruit. An interesting finding in this study that explains the widespread obesity in the U.S. regardless of incomes is that of affluent and wealthy Americans only about 12% consume enough vegetables. This is very close to the percentage of poor people eating the recommended 2-3 cups of vegetables a day, which is at 7%. This is an alarming fact in that all sections of society are doing very badly, creating acatastrophic effect for healthcare. A diet without fruits and vegetable brings higher rates of obesity, cancer, heart disease, diabetes. If rich and poor upper middle class and lower middle class are all sharing the same lack of awareness it points to the lack of education in eating right as the big culprit. This is one area where government, universities, and the informed private sector, can change things if they wanted to. A challenge as big as that in literacy and education for the U.S. Alarmingly even though it is in the top ten read articles in the Guardian newspaper online edition on November 16, 2017, we checked the other sites. We could not find it under Health in CNN, where other topics such as sexual harrassment, and sugar cravings, were covered. NBC covered a different CDC report showing 71% of Americans are overweight or obese with BMI over 25, but made no mention of this report by CDC. Equally alarming is the statistic cited in the Guardian from the Union of Concerned Scientists that shows only 2% of American farmland is used to cultivate fruits and vegetables. That this would have to go up at least to 4% if all Americans are to get their daily required fruits and vegetables. Meanwhile little change is to be seen, and no alarm bells are ringing in the U.S.. These facts are hardly mentioned in any healthcare discussion in media, as if they can be ignored or shoved under the carpet. This is the kind of thing that will never go viral, as a discussion on sexual harrassment or some other topic would, yet deserves just as much attention and education. ...

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British regulators say they have"absolute confidence" in the Pfizer vaccine after analysis of over 1000 pages of data on the vaccine. The vaccine was approved by the Medicine and Health care products Regulatory Agency. The first vaccines to be shipped to Britain are being packed in Belgium. Britain has secured 40 million doses enough for 20 million people. Vaccination will begin as soon as doses reach Britain. The NHS will prioritize, first care home staff and residents, then healthcare workers, followed by people over 80 years age. Clinically vulnerable people will get a jab alongside people ages 70-74. People with severe obesity and underlying conditions will get jab after people over 60 years, followed by people over 50 years. About 34% of the 66 million population of Britain is over 50 years age, which is about 22 million. This means the Pfizer vaccine ( with doses already secured by Britain enough for 20 million people) covers over 90% of these people or 19 million people and the 1.1 million workers in NHS. Rapid progress in vaccinating these people would make Britain the first country in the world to have done this, a remarkable achievement. By the end of the year the Oxford vaccine should also be available making it possible to proceed with vaccinating the rest of the population of 46 million people. ...

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Nestle will create a new subsidiary called Nestle Health Science and a research organization Nestle Institute of Health Sciences, "to pioneer a new industry between health and pharma." Nestle sees disease prevention as a big part of healthcare in the future. The new company with an investment of 500 million euros over the next ten years will work to develop new nutritional products for diseases such as diabetes, obesity, cardiovascular and Alzheimer's. After sale of its stake in Alcon unit to Novartis for $28.3 billion, Nestle is almost debt free and can invest in developing new nutritional products without needing a return in the short term.

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About the title it depends- costs have come down for food made at home and eating at home, it is the cost of eating outside that has doubled from 3% in 1960's the Kennedy years to 5.7% in 2024 as a share of personal disposable income.  Costs of eating at home are now half of what they were in the Kennedy years when they were about 13% of personal disposable income, as shown in USDA data and charts.The American public says in voting preference and other surveys  that inflation is a key concern, food prices  are mentioned as a key concern. Food prices fell by about 8% during the pandemic 2020 and rose quickly by 2022 by 12%.    Eating at home declined from about 13% of personal disposable income in the Kennedy years in 1962 to about 9% in the Reagan era in 1990 and down to 5.7% today. The real culprit in food inflation is people paying higher prices to eat outside at restaurants. In that period obesity has increased and general health has declined by these spending habits and lack of food savy cooking knowledge that not only cuts costs but also makes it possible to eat healthier by controlling intake of the fat, oil, and other poor ingredients by cooking for oneself at home. At home one avoids packaged goods and cooks the food from healthy ingredients. A correction is badly needed and will help not only health but also the family budget. Its a crazy way to do things not to educate children on healthy foods starting early in school, including in designing lunches and gradually increasing interest in making simple items from scratch. And instead to neglect food and food intake ending up with increase in cost plus poorer health outcomes. Hitting not just the family budget, also the nation's budget with higher and higher expenditures on healthcare. American habits need a change to make more at home like mothers and grandmothers in the 1960's and reverse obesity, poor health outcomes. As for the manufacturers of packaged foods President Biden talked recently about shrinkflation putting less in each bag of food at the same price. "The American public is tired of being played for suckers. I've had enough of shrinkflation. It's a ripoff." WSJ looks at food prices in 1991 and other points in the past and today. In 1991 as a percentage of disposable income food was 11.3%, according to Agriculture Department. This was after an inflationary increase in the 1970's. USDA data shows it has reached 11.2% in 2022. The public is responding by eating less outside and making its own granola and other items, and generally buying less that cuts into sales, a healthy trend. This is expected to lead grocery stores and manufacturers to reduce prices in 2024. ...

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The Federal Trade Commission says food companies in the U.S. spent $2.3 billion in 2006 for advertising to children. With the epidemic in childhood obesity in the U.S., this raises serious questions about how product packaging, images and themes affect the eating behaviour of children. New guidelines have now been written at the request of Congress. They were written by the F.T.C., the Food and Drug Administration, the Agriculture Department, and the Centers for Disease Control. The regulatory agencies say they will take comments and consider changes before submitting a report to Congress. The guidelines call for foods advertised to children to include healthy ingredients such as whole grains, fresh fruits and vegetables, or low fat milk. The foods cannot contain unhealthy amounts of sugar, saturated fat, trans fat and salt. The sugar requirement would have cereals contain no more than 8 grams of added sugar per serving. Fruit Loops for example contains 12 grams of sugar per serving. The guidelines apply to both children and teenagers. However these guidelines are voluntary. At this time an industry led effort has not produced results. The Children's Food and Beverage Advertising Initiative, which is operated by the industry, lets each company set its own nutritional criteria. The regulatory agencies see the need for the food industry to follow a uniform set of standards. Without serious action on this issue the U.S. healthcare system will continue to be burdened with high rates of obesity related illnesses in the general population, and out of control costs. And the U.S. will continue to face the urgent problem of a lack of healthy eating habits of children teenagers, and adults....

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McDonald's is seeing declining sales in the U.S. The percentage of people in the U.S. going to McDonald's declined by 12.9% in the 19-21 age group and was flat for the 22-37 years age group, according to Technomic. Younger Americans especially are seeking out healthier alternatives with emphasis on fresh food. Another competing trend is fast casual restuarants such as Panera Bread. Fast casual restaurants increased from 9000 to 21000 in the last 10 years, while McDonalds has remained at 14,000. Chipotle started in 1993 and now has 1600 locations. Five Guys has 1000 locations. Consumer Reports surveyed 32,000 subscribers and rated McDonalds as the last in taste of 20 burger chains. Consumer Reports gave as a reason millenials and younger consumers who will try hard to get the right food. Problems in Russia about sanitary conditions and declining sales in China after the government accusations about a key supplier using expired meat also add to problems. Increasing concern about healthcare and obesity also add to the search for alternatives and careful selection of meals, especially among younger educated buyers....

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The recent effort to eliminate funding for Planned Parenthood clinics in the U.S. because some of the money goes to abortions has run into a cloud of misinformation. In reality only 3% of the funding goes to abortions. Title X funds that help support these clinics cannot be used for abortion care at any time. Medicaid funds going to the clinics in 17 states can be used to reimburse abortion providers only if the life of the mother is endangered. The clinics see 5.2 million low income and uninsured women who need tests for infections, breast exams, pap smears, preventive services and screenings, contraception services. By reducing low income women's access to such health services through defunding the clinics would only increase the number of unwanted pregnancies and abortions. Planned Parenthood centers provides contraception to about 2.5 million patients each year and educates women about birth control. By burdening the U.S. healthcare system- adding most of the 5.2 million who access these clinics -with problems ranging from cancer to other serious health issues when they could have been detected by tests at an early stage and treated earlier or prevented altogether, would also add to the burden of healthcare costs. In addition the 800 Planned Parenthood Clinics in the U.S screen 3 million patients each year for other problems such as blood pressure, diabetes, smoking and obesity related issues, also help treat these problems at an earlier stage, which is essential if costs to be brought under control. ...

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Beer made from locally grown cassava and other ingredients and government tax incentives is making it possible for SABMiller and other large beer companies to make low priced beers for the African market. African governments such as Kenya have eliminated excise taxes on low priced beer, and the production of locally made Senator beer by Diageo's East Africa Breweries is increasing rapidly in East Africa. SABMiller makes low priced beer brands in Ghana, Uganda and other countries. The government sees this as a way to reduce the consumption of locally brewed beers of poor quality, and a source of revenues. Health workers expect an increase in health problems as a result of increasing consumption of low priced beer. Obesity is amajor problem in S. Africa and in other African countries. This will have effects in the higher rate of diabetes and other diseases related to obesity. Alcohol consumption in Africa per person is about 10 liters of alcoholic beverages a year, with consumption at 70 liters in S. Africa, the country with the highest rate of obesity. The figures globally are 35 liters, and 91 liters in the U.S., another country with high rates of obesity and diabetes, according to 2011 figures from Euromonitor. ...

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A study published in the British journal Lancet shows that the number of people suffering from diabetes went from 153 million in 1980 to 353 million in 2008. The study shows the U.S. having 24.7 millon diabetics in 2008, which is three times the number from 1980. About 70% of this is from population growth and aging, and the rest from obesity, lack of exercize, changing diet. The American Diabetes Association estimated the cost of treating diabetes in the U.S. at $174 billion for 2007. About 138 million diabetics live in China and India. In India there is an additional cause- malnutrition in early childhood years for the poorer segment of the population. European countries have done better than the U.S., Mexico, India and China. S. Korea and Thailand have done better than other Asian countries. And this is attributed to healthier lifestyles, diet and less obesity in these countries.

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About one in five people have diabetes in the Persian Gulf region countries of Saudi Arabia, Kuwait, Qatar, UAE, according to the International Diabetes Federation. High rates of obesity and unhealthy lifestyles are to blame for the epidemic.

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Full Yield is a startup in Boston that is trying to help address the nation's obesity problem by introducing healthier foods and meals in cafeterias. It plans to introduce a line of Full Yield branded food made from fresh items and natural ingredients for sale in corporate cafeterias and prepared food sections of local supermarkets. It is based on a simple idea that if you eat healthier food you will be healthier. A study in the Jan-Feb issue of journal Health Affairs says 75% of the $2.5 trillion in health care spending deals with obesity, Type 2 diabetes, heart disease and cancer. And how much of this traceable to obesity and bad eating habits, smoking and lack of exercize? This study says most of the cases are preventable by changing these behaviours. Dr. Kenneth Horpe, chairman of the department of health policy and management at Rollins School of Public Health, Emory University, shows that if trends continue U.S. annual health care costs related to obesity would reach $344 billion by 2018, which is 20% of total health care spending. In 2009 it accounts for 9%. Thorpe says if even the 1987 levels of obesity were reached it would free up enough money to cover the uninsured population today. For American companies the problem has grown to alarming proportions and yet no nationwide coordinated plan bringing together companies, government, universities, public interest organizations, and other groups exists in the U.S. The CEO of U.S. grocery chain Safeway, Steven Burd, says Safeway was spending $1 billion to cover health care insurance for workers by 2005, with costs rising 10% a year- this meant putting out twice in health care insurance than Safeway's earnings and hitting another $500 million by 2010. Between 2004-2009 the costs of insurance surged 31%, making this the fastest growing single corporate expense, according to Towers Perrin. This reduces incomes of workers as companies pass on part of the extra cost, and reduces the profits that can be put back in new investment for economic growth....

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Aizenman in this must-read describes the National Soda Summit and the presentation of one man Todd Putnam, a former executive from Coca-Cola that throws light on one of the truly important things that happened in the lives of Americans in the postwar period of development and growing prosperity. This is the development of marketing and advertising and its singular application in the case of Coca Cola to promoting sugary drinks. It is also related to what even business people describe as the single biggest problem in America. And it is happening at a time when the story is being repeated in developing countries such as China and India. Putnam describes the exhilaration, he and other Coca-Cola managers felt when the graphs at internal presentations showed Coke passing milk in consumption per capita in America. Several other facts stand out in Putnam's description of his experience- the ignorance on health issues among his marketing peers, the huge marketing prowess and dollars brought to bear once a goal such as increasing per capita consumption of sugary drinks was set- he was hired out of Purdue by P&G and worked at Disney before joining Coca-Cola- and the focus on the 12-24 demographic with 90% of all soft drink marketing targeted at this segment. What he regrets most is the focus on minorities who suffer some of the highest levels of obesity in America. No mention is made of the efforts underway in developing coutnries such as China and India which are seeing a surge in obesity rates and diseases such as diabetes. Coca-Cola says 41% of its sugary drinks are low calorie, but compared to milk, fruit juice and other healthier alternatives where does this rank? The cost to the nation's health care system alone would show that the performance of Coca-Cola's stock price over the postwar period came with a price tag that was never even thought about, when healthier alternatives as health drinks companies have found sell well when well marketed and formulated for different groups....

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Two of three obese people live in developing countries. About 29% of the global population is obese in 2013, according to the Institute for Health Metrics and Evaluation at the University of Washington. Between 1980 and 2013, obesity increased by 47% for kids and 27% for adults in the global population. Dr Murray of IHME says no country was the exception. Diet and inactivity are the principal culprits. About 37% of world's men and 38% of women are obese. Obesity increased rapidly first in developed countries, becoming noticeable by 1980 and slowing since 2006, and now is growing fast in developing countries. Germany is a surprise No. 8 on the list. The U.S. No. 1 ranking tells a lot about the misguided priorities of living in the U.S., lack of education on healthy eating and healthy living, and not putting healthy habits at the top of things to do above making more money. An extreme case is South Africa where 42% of women are obese. The most obese countries are by rank - U.S., China, India, Russia, Brazil, Mexico, Egypt, Germany, Pakistan, Indonesia. Middle Eastern and North African countries have high obesity rates for children. The study is funded by the Bill and Melinda Gates Foundation....

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Judith Warner coins the phrase "dysregulation," for the cultural phenomena that may be behind the lack of restraint exercized in everthing that relates to personal lives like obesity, to the lack of regulation in the gulf and financial crisis. Citing Whybrow's book, "American Mania: When More Is Not Enough," she points to a disturbance in the national psyche, something that disturbs some inner clock or mechanism, that disturbs some inner balance that is built into us from the beginnings of man in the universe.

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Chile, Mexico and the U.S. rank high in the diabetes rate for top soda consuming countries. In the U.S. the diabetes rate is at 7.7% of the population, in Chile 9.6% and Mexico 9%. Soda consumption per capita was at 165 litres in the U.S., 146 litres in Mexico and 134 litres in Chile, and 145 litres in Argentina where the diabetes rate is at 3.9%, for 2012. A new public service ad in Mexico City subway stations says it all, showing an ad with a soda bottle and the words- "Would you take 12 teaspoonfuls of sugar? Soda is sweet, diabetes isn't." The new Pacto de Mexico agreed to by all major political parties includes the soaring diabetes rate in Mexico as a problem to be tackled, including lunches at public schools and the consumption of coke and sodas by children. A particular acute problem in Mexico is the lack of clean drinking water in many areas and the dependence on coke and sodas for liquids. But bottled water could be used in its place if available at lower prices. One proposal is for a soda tax which could generate $2 billion and be used for setting up clean drinking water fountains in schools and other places. Elected officals in Mexico are firm about the need for action, as Mexico recently became the first country over 100 million inhabitants with the highest obesity rates at 7 adults out of 10 over the age of 20 obese or overweight, and the consequently high diabetes rate. Diabetes is the No. 2 killer in Mexico, and a serious health danger. Coca Cola gets its second highest revenues from Mexico after Europe, and the situation has evolved after years of heavy coke advertising to the point where Coca Cola is taken at every meal by some Mexican families, and is a sign of prestige. The company's response is to fight the public service ads with ads showing people burning off 149 calories by walking. The country now faces a long and uphill fight. Russia is one of the countries which is also conducting a similiar fight against soda drinks. The Bloomberg Philanthropy is financing efforts against soda drinks in Mexico, as part of its campaign against smoking and sodas as health hazards, and this maybe Bloomberg's bigger contribution to society than his service to New York City. Developing middle income countries such as Mexico, Chile, India, China, Brazil, are the hardest hit by soaring diabetes. And the costs to their health systems in 10-20 years from uncontrolled obesity and diabetes will be enormous. The U.S. is a developed country with similiar high rates of obesity and diabetes, with soaring medical costs, and serious problems that strangely have not received the public awareness and efforts that one should expect. ...

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A survey by GlaxoSmithKline shows that 60% of S. Africans are clinically overweight. A study by Imperial College of London, shows 75% of S. African women are overweight, 43% are obese an increase from 24% in 1980. As a result about 13% of the S. African population suffers from diabetes.