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Sunday, August 9, 2015

The health implications of U.S. gluttony

Saw this NY Times Op-Ed:
Incurable American Excess

A few years ago, Americans and Europeans were asked in a Pew Global Attitudes survey what was more important: “freedom to pursue life’s goals without state interference,” or “state guarantees that nobody is in need.” In the United States, 58 percent chose freedom and only 35 percent a state pledge to eradicate neediness. In Britain, the response was the opposite: 55 percent opted for state guarantees and just 38 percent for freedom. On the European Continent — in Germany, France and Spain — those considering state protection as more important than freedom from state interference rose to 62 percent.

This finding gets to the heart of trans-Atlantic differences. Americans, who dwell in a vast country, sparsely populated by European standards, are hardwired to the notion of individual self-reliance. Europeans, with two 20th-century experiences of cataclysmic societal fracture, are bound to the idea of social solidarity as prudent safeguard and guarantor of human decency. The French see the state as a noble idea and embodiment of citizens’ rights. Americans tend to see the state as a predator on those rights. The French ennoble the dutiful public servant. Americans ennoble the disruptive entrepreneur...

Individualism trumps all — and innovation, it is somehow believed, will save the country from individualism’s ravages. Paarlberg notes that: “Americans eat alone while at work, alone while commuting to work in the car, alone at the food court while shopping, alone at home while watching TV, and alone in front of the refrigerator both before and after normal mealtime.”

But if all that eating continues to generate obesity — as it will — Americans tend to put their faith in “improved bariatric surgeries, and new blockbuster diet drugs” that “will be challenges welcomed by America’s innovative and responsive private market institutions.” Rather than cut back, they prefer to consume more — whether fuel or food — and then find ways to offset excess...
Some of the reader comments were interesting:
IMO, there is an element that Mr. Cohen missed. We, as a nation was [sic] blessed with great natural resources, a brilliant Constitution, an individualistic approach to solving problems, two oceans isolating us from the brutal upheavals of the Twentieth Century and an abhorrence of socialism, which stood us well for a while; however, the human frailty of greed has gripped us because our institutions did not factor in a safety net. The result is an increasing cutthroat, inhumane system where people grasp at money because, in the US, it's the only means of surviving.

We stuff ourselves with food, worship the car to the point of polluting our air and choking both ourselves and our cities and consume emotionally for the illusion of well being. We are in denial because we naively believe American know-how will solve our problems with pills and quick fixes. This country will eventually collapse because of its excesses. We'll deregulate ourselves to death.


The problem is that the American individualism that you describe leaves Americans open to being herded, just like livestock. Over-consumption, in any form, represent enormously profitable businesses for one large corporation or another. These entrenched entities, in turn, exert outsize influence on the political process through the corrosive effects of campaign funding by corporations and their wealthy beneficiaries. Fundamentally the problem isn't American individualism, it's large corporations which have insidiously colonized the American people.

...."are hardwired to the notion of individual self-reliance."

I can think of no one less self-reliant than Americans who depend on processed food for nutrition, mechanical devices for the most minimal of efforts (leaf-blowers? come on!) and drugs and surgery, rather than self-discipline and physical effort, to relieve the consequences of their idleness. This extends to a mental laziness whereunder any initiative to alter behavior is dismissed as "Nanny State" meddling.

It's a curious combination of cynicism toward facts (climate change, or one's own ill-health) that might disturb the mind-set, and gullibility to reassurances from those with a clear interest in promoting unbridled consumption and squandering of resources. And no accident that push-button devices have replaced books, newspapers and thoughtful exchange of ideas as sources of information and decision-making.
The Op Ed cited this book:

So, I bought it and read it in one day. Very interesting. Examines two concurrent, statistically correlated adverse trends: overconsumption of both food and (predominantly dirty, extractive non-renewable) energy. For one thing, it brought to mind my May 1st post "Upstream, downstream; what happens to health when there IS no more stream?" and my post about the worsening U.S. drought.

Robert Paarlberg:
I am ordinarily suspicious of those who single out America for having fundamental flaws. In my own work, I freely criticize my country’s policy failings, but denigrating the nation itself is something I try to avoid. America’s reflexive critics too often have suspect motives or credentials. Some are Europeans, jealous of America’s wealth and influence, and resentful that their own historical moment has passed. Others are smug bicoastals who have never visited what they dismiss as “flyover country.” Still others are shallow utopians for whom all of reality is a disappointment.
My own motive for writing this book about America’s excess food and fuel consumption is more explanatory than judgmental, yet a sad judgment does emerge in the end. America’s inability to contain its overconsumption of food and fuel is not simply a policy failing; it is deeply rooted in the nation’s distinct material circumstances, its unique political institutions, and also its singular national culture. America’s overconsumption is overdetermined by national flaws that are in fact quite fundamental...

...In this book I stick to the...task of explaining why things are as they are...
The Origins of Excess 
Excessive food consumption has given the United States the highest obesity prevalence in the industrial world. At the same time, excessive consumption of fossil fuel makes America a global leader, by an equally wide margin, in per capita carbon dioxide (CO2) emissions. Other rich countries today are also prone to overconsume food and fuel, but why is America’s excess so extreme? Vaclav Smil, a distinguished Canadian geographer, has pointed out the “inescapable” parallels between these two dimensions of America’s excess, yet they have never been examined side by side (Smil 2011). In this book, I correct that omission.

Excess consumption on a society-wide basis first became possible during the second half of the twentieth century, thanks to a revolutionary decline in the cost of all consumable goods relative to income. Throughout most of human history, the use of food and fuel had been disciplined out of necessity because of high costs, so self-control did not have to be exercised. Then, during the second half of the twentieth century, personal incomes grew throughout the industrial world while the cost of securing both food and fuel dropped sharply, so overconsumption became a widespread social option. Our long-standing human struggle to obtain enough food and fuel was suddenly replaced by an unfamiliar new challenge: to avoid consuming too much.

In preindustrial societies today, the traditional struggle to secure enough food and fuel remains as challenging as before. In the African countryside today, one out of three adults is chronically undernourished. Purchasing enough food remains difficult because incomes are typically less than two dollars a day, and producing food is difficult because the prevailing agricultural techniques are primitive and unimproved. Fields are still cleared by hand, crops are still planted by hand, and weed control remains a time-consuming chore throughout the growing season. Then comes the labor of harvesting, winnowing, pounding, and drying the grain, followed by a daily trek on foot to fetch wood and water, and finally cooking the grain over a hand-built fire.

In traditional settings of this kind, the sustained overconsumption of either food or fuel is for most people a physical impossibility, and intentional waste is essentially unknown. Some grain is lost in the field to insect damage, and some is spoiled by rain or eaten by rodents in storage, but at the consumption stage almost nothing goes to waste. According to the World Bank, only 5 percent of food loss takes place at the consumption stage in sub-Saharan Africa, and the non-essential burning of scarce firewood is almost unheard of.

In today’s rich countries, by contrast, food and fuel are no longer scarce relative to income, so both are routinely wasted or consumed to excess. Fuel ceased being scarce when modern societies learned how to access the carbon and hydrocarbon energy supplies stored below ground in the form of coal, oil, and natural gas. These “fossil” supplies of fuel are the remains of plant and animal matter that incompletely decomposed over a period of 500 million years before humans. Once people began to access these fossil fuels and leverage them to power an industrial revolution, techniques for recovering still more fuel, and for growing more food, underwent spectacular improvement. Personal incomes increased across the board, so excess consumption of energy and food eventually became affordable for nearly all...

Paarlberg, Robert (2015-01-06). The United States of Excess: Gluttony and the Dark Side of American Exceptionalism (Kindle Locations 51-134). Oxford University Press. Kindle Edition.

With regard to our unsustainable energy overutilization, I observed on another blog in 2009,
We can choose to continue to drill, mine, cut down, and grind up the planet in pursuit of short-term business-as-usual, unevenly distributed consumerist comforts, but the day of tragically harsh mass reckoning draws ever closer. The lessons to be drawn from Jared Diamond's "Collapse" are compelling in this regard. There is no shortage whatsoever of constructive and remediative work to be done in support of a sustainable and broadly prosperous future for all of humanity. But, let's not kid ourselves that an unregulated "invisible hand free market" alone will suffice to insure its emergence. Recent economic history alone refutes that assertion.

To be sure, the U.S. comprises only ~5% of world population, and the responsibility of our federal government is constitutionally bound as a priority to address the "general welfare" of our own citizenry. However, we consume about 25% of the world's resources in the aggregate, and, given that our politicians never pass up an opportunity to extol the U.S. as "the greatest nation on earth," perhaps we might start acting like it in the area of sustainability leadership, for, in the end, humanity will survive or perish as a planet-wide species.
See also my 2008 post "0.0143"

More Robert Paarlberg:
Waste, in fact, is not the real issue. More serious are the physical harms we impose on ourselves by consuming too much. Excessive consumption of fossil fuel is now destabilizing the Earth’s climate. A National Climate Assessment in the United States in 2014 found that a number of events linked to higher greenhouse gas concentrations were already imposing costs such as increased heat and drought in the Southwest, more punishing rains and coastal flooding in the East, and shrinking glaciers in Alaska (USGC Research Program 2014). In 2014, the Intergovernmental Panel on Climate Change (IPCC) warned that a continued increase in atmospheric concentrations of greenhouse gases such as CO2 would lead to “severe and widespread impacts on unique and threatened systems, substantial species extinction, [and] large risks to global and regional food security….” A tipping point might eventually be reached, resulting in “abrupt and irreversible change” (IPCC 2014).

In parallel fashion, the excessive consumption of food has destabilized energy balances within the human body, bringing on a “metabolic syndrome” consisting of increased blood pressure, high blood sugar levels, excess body fat around the waist, and abnormal cholesterol levels. These factors increase personal risks of heart disease, stroke, and diabetes (Mayo Clinic 2013). America’s Centers for Disease Control and Prevention (CDC) report that when an individual becomes obese (clinically defined as a body mass index greater than 30) risks also increase for cancers, liver and gallbladder disease, sleep apnea and respiratory problems, osteoarthritis, and gynecological problems including infertility for women (CDC 2012a).

Because food and fuel no longer ration themselves, unprecedented self-disciplines must now be constructed, at both the social and individual level. This is extremely difficult with both food and fuel, yet for completely different reasons. For climate change, disciplines are difficult to enforce because the payoffs will not be noticed immediately by those making the consumption sacrifice. Climate change is driven by an accumulated stock of greenhouse gases in the atmosphere, not by small changes in annual emissions flows. Even if annual flows are cut sharply, the accumulated stock changes very little at first, so current trends in temperature increase can remain essentially unaltered for decades (IPCC 2014, p. 10). Also, when the payoffs do finally come, they will take the form of bad things that did not happen, which are always hard to notice, measure, and document. In addition, the payoff will only come if all of the largest industrial countries agree to share in the sacrifice, a global cooperation problem that has yet to be solved.

For food consumption, constructing self-imposed disciplines will be hard for entirely different reasons. At an individual level, the health benefits derived from more disciplined eating can be noticed and measured almost immediately, and they can be secured without global cooperation. By reducing calorie intake by 500– 1,000 calories per day while maintaining a constant level of physical activity, an individual will immediately begin to lose about 1 to 2 pounds of body weight every week, and even a modest weight loss of 5– 10 percent of total body weight usually brings measurable improvements in blood pressure, blood cholesterol, and blood sugars (CDC 2011). Individuals can experience these gains even if their friends and neighbors are continuing to overconsume. [op cit, Kindle Locations 157-184]
190 pages of elegantly written prose buttressed by mountains of data from around the world. The end note citations and index alone run another 138 pages.

Paarlberg posits two remedial action categories:
  • Mitigation, vs
  • Adaptation
On the energy side, mitigation goes to proactive policies and measures such as limits on greenhouse gas emissions, along with measures to incentivize non-CO2 renewables (interestingly, no discussion given to nuclear options; only a few references to nuke plant shutdowns appear in the book). On the food overconsumption side, mitigation goes largely to things like tax/regulatory policies and "voluntary" initiatives that discourage junk food and beverage consumption, along with exercise (e.g., think Michelle Obama).

As to "adaptation," well, we can build more levees, harden our shelters, and ramp up emergency response infrastructure capacity to combat the effects of anthropomorphic-driven climate change, and we can expand clinical capacity to deal with the increasing prevalence of lifestyle-correlated maladies wrought in significant measure by excess consumption of food (concomitant with decreased levels of routine, sustained individual exercise regimens).

Paarlberg unhappily concludes that, in the U.S., "adaptive" tactics will likely hold sway, particularly on the energy side of things, owing to our political system and cultural evolution constraints, and given the skewed distributions (and relative immediacy) of risks and benefits. On the health"upstream" side, "mitigation" goes more (albeit not exclusively) toward "prevention," whereas "adaptation" goes to post-dx "treatment."

How much of our currently deployed Health IT can even contribute materially to the public health "big data" we'll need to have to know where we stand across time?

Asked and answered.

I find this an important book. Highly recommended.
America’s inability to reduce excessive food and fuel consumption at home will therefore generate divergent outcomes for the rest of the world. In the difficult area of climate change, America’s policy drift toward self-protective adaptation will undercut its already weak efforts to reduce CO2 emissions, thus significantly increasing climate risks for others who lack self-protection options. In the area of obesity, however, lax mitigation efforts in America will not diminish mitigation options for governments abroad, and the new treatments that American researchers are likely to develop will be available for export, ensuring an international benefit.

This may seem to be a Janus-faced outcome, but America has in fact failed equally and in the same way on both fronts. The impact on others is divergent only because America’s performance remains critical to the global outcome for climate change, but not for obesity. The manner in which America has been falling short on both fronts is not only identical, but identically unattractive. In each case, America’s approach is a form of sauve qui peut. In response to climate change, America pivots toward adaptation to protect itself, and itself alone. With obesity, America’s embrace of personal rather than government responsibility works well enough for the nation’s more fortunate citizens, those better educated to avoid the condition and better able to afford medical treatments. For Americans with less education and fewer resources, particularly disadvantaged minorities, personal responsibility without stronger public policy action will remain inadequate. Conclusions such as these, which point to flaws in national character, are painful to reach but impossible to avoid. [ibid, Kindle Locations 3082-3095]


From The Incidental Economist.



Your Daily Donald

More to come...

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