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New obesity prevention grocery store rules in Britain require that no food high in salt, sugar or fat can be placed within 2 metres of a checkout or queueing area and restricted to certain areas in the store.

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How Integrative Medicine, changes in lifestyle and diet, yoga and exercize, meditation, no smoking habits, can add up to changes in the nation's health that work more effectively than new drugs to prevent or delay the onset and progression of chronic diseases like diabetes, asthma, heart disease and of obesity, etc that consume 75% of the costs in the $2.1 trillion spent on medical care in the USA. Shockingly 95% of these costs are incurred after the onset of the disease, proving that prevention is simply not an important part of the equation.

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Marty Makary, John Hopkins surgeon, is the DJT nomnee for head of the US Food and Drug Administration, FDA. Here a colleague of his at John Hopkins offers her experience working with Makary.  Leanna Wen says Makary is concerned about plastics, dyes, preservatives and chemicals that are entering our bodies and causing disease. Diseases that were not so prevalent one or two generations back are widespread today, says Makary. Makary wants to know why. Why has obesity quadrupled among young people in the US?Makary is also asking questions about why rates of childhood obesity are 5 times lower in Japan. Makary tell this Post reporter that ultra processed foods that are loaded with chemicals such as preservatives, artificial dyes and thickeners , take up 60% of calories Americans consume. This and poor food habits of today can cause diabetes, cancer, heart attacks and dementia. Pesticides and microplastics can cause early onset Alzheimer's and autoimmune diseases, attention-deficit/hyperactivity disorders. Makary wants medicine practiced in the US to direct resources to prevention, not simply hand out medicines with increasingly risky side effects. ...

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The public and the NHS pay a lot for childhood obesity. Starmer is doing something about it. He plans to put junk food television ads past 9 pm, ban high sugar and salt, high fat food online ads. Ban on high cafeeine energy drinks. And giving councils power to prevent fast food outlets opening near schools.

The plan includes checkups at workplaces for adults.

Starmer said-

There’s diet, there’s healthy lifestyle, we are going to have to get into that space. I know some prevention measures will be controversial but I’m prepared to be bold, even in the face of loud opposition. Some of our changes won’t be universally popular, we know that, but I will do the right thing for our NHS, our economy and our children.”

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About 40% of Americans are obese with BMI, body mass index of over 30. About 71% of Americans are overweight or obese with BMI over 25. This is a finding in a new report by the Centers for Disease Control and Prevention. This report does not mention a separate finding covered in the Guardian online newspaper showing less than 15% of Americans get the daily recommended intake of fruits and vegetables, crucial in preventing major diseases such as heart disease, cancer, diabetes. The cost to America for obesity related or weight related medical bills is estimated at $190 billion a year, in three years this would help renovate the aging U.S. infrastructure if people changed their habits and education was designed to help change the way Americans live. Even harder to understand is that only 2% of America's farmland grows fruits and vegetables, according to the Guardian report which says this would need to be 4% to meet the needs of the people in the U.S.. These are alarming facts and need more public awareness by this being getting widespread attention on the internet. ...

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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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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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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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The Washington Post survey of 1200 readers on how the Republican healthcare plan of Speaker Ryan and the House of Representatives looks to them, how it affects them in their lives. Here Somasekhar of the Post gives the stories of 5 Americans. Some see the prospect of losing their insurance under the Republican plan even as they reach an older age, others a smaller segment says the Post, whose premiums jumped under the Affordable Care Act say they faced high premiums and high deductibles. The Post says the large majority of opinions have expressed anxiety over the proposed Republican Ryan House plan for healthcare. One of them is an uninsured poor farmer, Mr. Woosley,  income about $18000 who gained benefit from expanded Medicaid under the Affordable Care Act,  one Mr. Smith, 32 years, a personal injury attorney who faces paying $10,000 if he did not take insurance and $10,000 if he took insurance because of high premiums so a wash either way deciding to do without it, one a tech worker Mrs. Powers, 62 years, income $22,000 on year and $4000 the next, from middle class during the tech boom but facing fewer opportunities and uncertain income from part time work, hit by the deep recession facing fewer opportunities as she gets older and now the prospect of losing insurance without government subsidies, one who is from the middle class who sees little benefit from the Affordable Care Act and is forgoing insurance because of the high premiums yet faces a penalty for not being insured under the ACA, another Mr. Blanchard, 52 years, is from the middle class, a computer programmer who lost his job in downsizing, earns $100,000 as a consultant self-employed, pays $767 in premium a month and relies on the Affordable Care Act which helps him gain freedom from working at a company that could downsize,  another is a middle class programmer Mr Riffle,age 44, and his wife, who does not qualify for a subsidy with a $71,000 family salary from working 4 jobs between himself and his wife- this person finds it too expensive for his salary to buy insurance $900 a month and $14,000 deductible under the Affordable Care Act. His views are worth listening to as they go to the crux of the problem- he says he may not be any better with the Republican plan. He sees the real problem as the high cost of health care in the U.S. and the only way this can be fixed is for members of Congress to be asked to use the insurance exchanges they create. If this sample is representative it shows that there are real problems with both the Affordable Care Act and the Republican plan, that the high cost of health care the problem lurking behind every plan that does not squarely address this, and till that happens and members of Congress experience what ordinary people face, this problem can never by fully solved.   Woosley, Smith, Powers, Blanchard, Riffle, and their personal experience is at the crux of what is right and wrong  with the Affordable Care Act, and also with the new Republican plan of Speaker Ryan and the House of Representatives. For every Woosley, Powers and Blanchard who benefit, there is a Smith and a Riffle who are indifferent or are affected by the high cost under Affordable Care Act and the current system of medical care with its high cost. The Affordable Care Act does not  tackle high cost, for that to happen the culture in America that makes it possible and acceptable to charge high prices must change. Another problem apart from bringing health care costs is that any solution needs to have the whole country behind it. If the notion that all people are entitled to basic health care is to stand, the whole country needs to believe it as they do in countries like France, Britain, Germany and Japan. If this has to be made a workable proposition health care has to be offered at a price that makes this possible to achieve, and that idea also needs the deep and broad sense of support from the culture in America similar to that in these other countries. Until that happens politicians in America will get elected and turned out of office in turns on issues such as health care, based on which side they take and which problems they choose not to face squarely and responsibly. ...