The emerging challenge of our health footprint

Health footprint is the public health burden we create from day to day activities. When we or our families get sick, in developed countries insurers or state foot the bill for healthcare who then passes the cost on to the public as insurance premium or taxes. Someone is paying, one way or the other. As populations across the globe age, health footprint could become the biggest challenge of the century.

Bangladesh lost about 16 million life-years in 2017 (up from 8 million in 1990) to premature deaths or disabilities from chronic non-communicable diseases, according to Global Health Data Exchange (GHDx), a comprehensive source of health-related data. This could reach 18 million by 2020 and 23 million by 2050, cutting away at least 10% of GDP. Add the cost of healthcare that could be diverted to other productive sectors and investment.

We should start the conversation now asking the simple and imperative question: What makes us sick? The answer is staring us in the face, several times a day: our food. Poor diet causes more than half a million annual deaths in the United States, the leading cause of mortality; the story cannot be better in emerging economies like Bangladesh, where food consumption is also a more significant means of recreation. In the coming decades, as the economy advances and population at large adopt highly processed diets, resulting human and economic costs will lead to ever‑rising health care spending, strangle family and public budgets, and diminished workplace competitiveness. Fortunately, we can prevent most of this by cultivating proper dietary behaviour through social changes and policy measures.

Recent advances in diet and health provide a road map for addressing this global nutrition crisis. The "Food Is Medicine" solution is a win-win, promoting better well-being, lower health footprint, greater sustainability, reduced socioeconomic disparities, improved economic competitiveness and greater national security. The China Study, the most comprehensive public health studies conducted so far, has shown us diet matters. China has the world's largest population with uniform racial composition and ethnic origin; any regional difference in disease related mortality is likely a result of lifestyle choices, largely diet. As you move from east to west, rate of whole plant food consumption goes up, down goes the mortality rate from cancer, heart disease, diabetes, obesity, autoimmune diseases, bone, kidney, eye, and brain diseases. This suggest a strong association between proper diet and risk reduction for those chronic disabling conditions. The study kicked off a new movement in the West, whole plant food.

More and more studies, that are not linked to special interests, suggest lifestyle changes can reverse, delay, moderate or reduce the risk of diseases like cancer, heart disease, diabetes, obesity, autoimmune diseases, bone, kidney, eye, and brain diseases. However, we still face an uphill battle against strongly-held beliefs, food addiction, peer pressure, and misinformation campaign. The cigarette industry once embarked on misinformation campaigns and kept the public confused. Today smoking is widely accepted as detrimental to public health. A similar misinformation campaign is sponsored by food industry today. Businesses sponsor research to publish and promote their products and interests, which often conflicts public interests. Look no further than anti-vaxxers, the horror misinformation can create. We need to raise awareness about special interest groups who advance their own agenda at the detriment of the public.

The battle can be made fair with policy changes, social awareness, and mass education programs. Taxes can be levied on refined food that loses nutrition content, adds harmful additives like sodium, sugar and trans fat, and animal food with deadly saturated fat and growth hormones (that can help cancer cells multiply rapidly). The money can be diverted to subsidise protective whole plant foods like fruits, nuts, vegetables, mushrooms, beans, and whole grains. Nutrition education can be made mandatory at schools and medical institutions. Hospitals and healthcare providers could update medical training, licensing and continuing education guidelines to put an emphasis on nutrition with the latest research-based knowledge; they can also offer patients medically tailored meals. Social changes, emphasising protective whole plant foods, can bring positive changes among general population in dire need of supplementing junk food with protective food, from social gatherings to household kitchens.

Responsible lifestyle, that extend healthy, productive life, is a form of charity, adding to productivity and cutting societies' healthcare cost. Irresponsible lifestyle increases health footprint, which amounts to passing personal health burden on to someone else.

Zakaria Khondker works in the biopharmaceutical industry in Boston area. He holds a PhD from the Gillings School of Global Public Health at University of North Carolina, Chapel Hill.