Why We're So Unhealthy

That America is in the throes of a systemic health crisis can no longer be denied. According to the U.S. Department of Health And Human Services, more than two-thirds (68.8 percent) of adults are overweight or obese.  (Overweight is typically defined as a body-mass index (BMI) of 25 or higher. A BMI of 24.9 is not exactly featherweight; I would have to add 30 pounds to reach a BMI of 24.9. )

The health risks of being overweight or obese include:

  • type 2 diabetes
  • heart disease
  • high blood pressure
  • nonalcoholic fatty liver disease (excess fat and inflammation in the liver of people who drink little or no alcohol)
  • osteoarthritis (a health problem causing pain, swelling, and stiffness in one or more joints)
  • some types of cancer: breast, colon, endometrial (related to the uterine lining), and kidney
  • stroke

Since the early 1960s, the prevalence of obesity among adults more than doubled, increasing from 13.4 to 35.7 percent in U.S. adults age 20 and older.  (Source)

The Journal of the American Medical Association (JAMA) reported in 2015 that roughly half of all adult Americans are diabetic or prediabetic (also called metabolic syndrome).

If we add up everyone in America who is either suffering from or at risk of lifestyle-related diseases such as heart disease, diabetes and lifestyle-related types of cancer, it’s clear this is an unprecedented national health crisis that has no easy or cheap medical fix.

Why have we become so unhealthy? The answers come thick and fast: we are more sedentary as most work is now white-collar; the foods low-income people can afford are unhealthy; children now spend time playing digital games rather than playing outside; serving sizes of sodas and other high-calorie/low nutrition beverages have ballooned; people buy more convenience and fast foods and prepare fewer meals at home, and so on.

Two things are clear: there is no one solution to the epidemic of lifestyle-related diseases. Limiting sodas in schools and demanding better labeling of food are examples of reforms that are well-intended, but have so far had little effect on the expanding waistlines of Americans or their ill-health.

The second is expressed by the Chinese proverb: “Diseases enter through the mouth,” i.e. disease is a result of what we eat and drink. Since what we eat has an enormous impact on our health, if we want to tackle our health crisis in a manner that get results, we must start with what we eat and how our food is grown, processed and prepared.

Once we start examining our diet, we have to examine where our food comes from, how it is grown/raised and how it is processed for consumers.

A second Chinese proverb explains why we must start with diet: “When you’re thirsty, it’s too late to dig a well.”  If we want to avoid lifestyle illnesses, we must start pursuing a new way of growing and preparing food now, not after we’re already ill.

The long lists of contributory factors to our growing ill-health distract us from the real source of our national health crisis: our food/illness/healthcare system is sick, and so it’s no wonder we’re sick, too.  The only possible result of our unhealthy food/illness/healthcare care system is ill-health.  

Understanding the Food / Illness / Healthcare System

To understand why this is so, we must start with the fact that we live in a highly centralized government/private-sector system that limits our choices to maximize the profits of corporate cartels: Big Agriculture, Big Oil/Ag Chemicals, Big GMO seeds (Monsanto et al.), Big Processed Foods, Big Supermarkets, Big Fast Food, Big Healthcare (what I have called sickcare for many years, because profits flow not from keeping us healthy via prevention but from keeping us alive when we’re suffering from chronic lifestyle illnesses) and last but not least Big Pharma, which is happy to provide medications that costs tens of thousands of dollars per patient per year to address the symptoms of lifestyle diseases rather than the causes, which trace back to what we eat and how we live.

Once you hear an alternative account of how we could be raising food and delivering it to consumers to prepare at home, you grasp the sickening stranglehold Corporate America and government agencies have on our food, diet and the resulting epidemic of ill-health.

I was fortunate to attend a permaculture conference, 'Better Soil, Better Food...A Better World' at Tara Firma Farms in Petaluma, California this past weekend that Adam Taggart (co-founder of Peak Prosperity) was responsible for producing. Joel Salatin (author of nine books, including Everything I Want To Do Is Illegal: War Stories from the Local Food Front and head farmer at Polyface Farms, Virginia), Paul Kaiser (Singing Frogs Farm, Sonoma, California), Toby Hemenway (author of Gaia's Garden: A Guide to Home-Scale Permaculture, 2nd Edition), and Robb Wolf (author of The Paleo Solution: The Original Human Diet) were on hand to explain the connections between the way our food is grown, processed and distributed and our ill-health.

Though these connections are common sense—we all know about garbage in, garbage out—the linkage between our extractive, monoculture agriculture and all the other subsystems of food and health remains opaque to most Americans.

Centralized Systems Are Hijacked By Those Who Profit Most From Them

Centralized systems are inevitably hijacked by vested interests in a way that is simply not possible in highly decentralized systems.  Powerful vested interests rig centralized systems to protect and extend their privileges and profits.  This dynamic is a positive (self-reinforcing) feedback loop: the greater the centralization, the greater the influence of vested interests, who increase the centralization that benefits them.

Though it is poorly understood by conventional economists and political scientists, centralization makes it inevitable that the interests that benefit most from centralization (corporations) will serve their self-interests by gaining control of centralized power via lobbying and political contributions.

Once entrenched interests have purchased influence over politicians and regulatory agencies, they use the power of centralized government to limit competition by erecting regulatory barriers.  The regulatory system is soon approving whatever reaps the most profit for the big corporations and restricting alternatives to corporate products.

Before centralized federal and state government agencies and big corporations became dominant, decentralized family-owned farms and grocery stores were the norm. Anyone seeking to control the entire sector faced an essentially impossible task.

Now, a handful of corporations control key sectors of the food/healthcare complex: seeds, chemical fertilizers, processing of food into consumer products, distribution to consumers via grocery chains and the fast-food industry, and the healthcare/pharmaceutical sectors.

This concentration of power over our food and health is presented as the lowest-cost and most efficient system possible: concentrated ownership and control, we’re told, enables vast economies of scale that lower the cost to consumers. While this might be true of grains, it is not true of healthcare.  And since food and health are causally connected, we have to consider the total system costs: not just the cost at the grocery store or fast-food outlet, but the eventual costs of low-quality food and an unhealthy diet.  

Once we consider total system costs, we have to include healthcare: the American healthcare system is the most expensive per capita on the planet, over-delivering costly (and often questionable or needless) tests, procedures and medications, and under-delivering affordable preventative care and well-being.

While it’s impossible to break out the eventual system costs of poor diet, the preponderance of lifestyle-related diseases that end up being treated suggest the percentage of healthcare related to diet and lifestyle (fitness, sufficient sleep, etc.) is substantial:

Though the mainstream media paints skyrocketing healthcare costs as the result of costly new technologies and drugs, the unspoken reality is that higher costs also reflect cartels being able to raise prices without fear of competition and the declining health of Americans.

The food/illness/healthcare system is not a conspiracy; it is a self-organizing system driven by the goal of maximizing profit and eliminating competition. The two are related, of course; the most effective way to maintain high prices and reap big profits is to eliminate competitors and consumer choice.

Big Pharma doesn’t ask the fast-food cartel to make its food unhealthy so its customers will need pricey medications to control the resulting lifestyle illnesses down the road; the fast-food cartel chooses the lowest-priced (and thus lowest quality) ingredients and processes to maximize its own profits.

The full consequences of the food/illness/healthcare system take decades to manifest. Humans respond to price (buy what’s cheapest) and what triggers the reward centers of the brain (consume sugar, fat, salt).  It’s remarkably easy to exploit these short-term factors to sell unhealthy food and meals whose lifetime costs are still years or decades in the future.

The same can be said of our extractive system of monoculture agriculture.  Though touted as the most efficient system for growing food in the world, monoculture depends heavily on cheap fuel, cheap chemical fertilizers and pesticides/herbicides, cheap transportation and ignoring the eventual cost of losses in soil and soil quality.

I’ll share one small example that illustrates the hidden costs of our corporate-dominated system.

Last summer we drove to a Central Valley (Calif.) farm county for the annual county fair, a staple of rural life we enjoy.  To reach the town, we took a two-lane county lane. On a sharp curve in the road, hundreds of ripe tomatoes lay on the pavement and shoulder. It didn’t take much to see what had happened; as heavily loaded harvest trucks made the turn, tomatoes had spilled onto the roadway.

We stopped and picked up some of the fallen tomatoes. They were red Roma tomatoes, and they were still firm, undamaged by the impact of cascading ten feet from the trucks.  The fields nearby were already plowed under, bare dirt as far as the eye could see.

Though the naked eye could not possibly discern the consequences of this monoculture mode of growing tomatoes, studies have found that each acre of tilled bare soil loses tons of topsoil to erosion of wind and rain every year.

As for the nutritional content of the tomatoes: as an experiment, we took some of the fallen tomatoes home to see if they ever ripened enough to become soft. They never did; they remained hard and tasteless, even in a bowl of fruit that naturally emitted ripening ethylene.

What was the nutritional content of this tasteless product of monoculture? Only a lab test could tell, but it was a good bet the nutritional content was as poor as the taste.

These indestructible tasteless tomatoes were undoubtedly bred to become tomato sauce in some distant processing plant, bound for wholesalers and retailers who end up taking most of the consumers’ dollar:

It Doesn’t Have To Be This Way

It doesn’t have to be this way. Regenerative agricultural practices actually build soils rather than strip-mining them. Consumer-supported agriculture (CSA) cuts out the corporate middlemen and delivers high-quality food directly to consumers.

If we consider that Americans throw away 40% of all food they purchase, it’s not hard to see another option: waste nothing and spend the savings on higher quality food.

High-quality vegetables can be grown in cities, lowering cost and raising access (see: A guerilla gardener in South Central L.A.)

My time this past weekend with Joel Salatin, Toby Hemenway and the folks from Singing Frogs Farm was filled with compelling yet practical steps each of us can and should take in our lives to take more control over our health -- in ways that are easy, enjoyable and result in big improvements to our quality of life

In Part 2: Take Control: If You Don't, Who Will? I share the most important of these takeaways and detail ways to opt out of our matrix of ill health and extractive systems. There's a lot of room for optimism here to make great improvements in our lives with steps that feel life-enhancing rather than sacrifices. The real question is not Why did we let the system get this bad?, it's rather Why shouldn't we start embracing these very accessible solutions immediately?

Click here to read Part 2 of this report (free executive summary, enrollment required for full access)

This is a companion discussion topic for the original entry at https://peakprosperity.com/why-were-so-unhealthy/

great posting chris… i have excellent health because i eat well and exercise. what i dont like is that my health insurance premiums are not super low because my healthy lifestyle makes me low risk.
i guess if the insurance companies based risk on behavior, they would have to admit the profit friendly, processed food industry is not healthy, and that is taboo.

so i pay my monthly insurance premium, knowing my real health insurance is in eating the organic food i produce here at home and the active lifestyle which makes that happen.


Two things are clear: there is no one solution to the epidemic of lifestyle-related diseases.
There is actually, one solution to this epidemic.  A sudden and violent collapse of society followed by a 12-18 month period without rule of law, followed by a dramatically lower standard of living for most.  That will fix alot of these health problems.  Not all aspects of the collapse are bad for society.


Says the USA is about the Money. 
Pertinent, I think that your medical profession is, well, Professional. They do it for the Money. 



Tragic,  I call it "afluenza".  We are too busy making money to look after ourselves.  ("We" as in we in general)
My advice to young people is don't aspire to get that expensive phone, car or home.  Minimize your debt unless there is a profit for you at the end.  If you must have a family, just have a small one.  Decide that learning,  exercise and eating well are the most important thing in life and plan accordingly.  Live within walk or cycling distance from work. Cost this all out and only work the minimum the hours necessary to achieve this.  I've done all of this and it's awesome. 

At the end of the day, we all have to make our own choices and reap the rewards or consequences.


Great post Charles, I agree with everything you say, but I think maybe you under-emphasize the role played by consumer / patient psychology in keeping us unhealthy. I've got a slightly different perspective on this because, as you and some readers may know, I'm a full time family physician in Canada. Canada is somewhat similar to the USA in many respects, I'm fully aware of the issues raised by yours and other blogs, and I have a website of my own promoting many of the same ideas, but in real life I go incognito, and I never talk to my patients or colleagues about these issues.

But back to psychology: what I see many times every day in my office is a trusting, childlike belief by patients that other people will keep them healthy; it's not their responsibility to make healthy choices for themselves. Overweight? I need to refer them to a dietician to tell them what do do. Extremely overweight? I need to refer them for bariatric surgery. High blood pressure and high cholesterol? The pharmaceutical industry can fix that. So overweight and arthritic they can barely walk? They need an electric wheelchair – not a manual one mind, which they could get some exercise pushing, but an electric one which can be moved by the slightest finger pressure, so they don't have to exert themselves. And so on. So who can blame the pharmaceutical industry, the medical industry and the food industry for stepping in and supplying the demand? It's just business.

Find a new doctor is the key to your health and the health of your loved ones. Do you want to do a good bit of research before settling on a specific person.

Followed the link and looks to me as another industrial food factory aiming at building muscle machines. Healthy? Hmmm… a grain of salt improves the critic taste…
Unfortunately this is exactly the opposite of what this article suggest: Take control of your food, grow yourself or buy fresh from known locally organic sources, take the time to cook at home, reduce meat content, etc…

Endoscopic surgery involves creating a small incision in the wrist or hand the device to the patient TV camera allows a view of the wrist. Nitin Engineer in Las Vegas

You mentioned Paul Kaiser (his wife's name is Elizabeth) of singingfrogsfarm.com    They say that bare soil, exposed to the sun, gives off as much as 17% of the CO2 that is in our air.  As a result of this knowledge,  they plant seedlings for a second (or third) crop as soon as something is harvested.  This is much to their credit, although I will say that I got a backache just reading about what must be a lot of work. :slight_smile:

Lisa, when you are interviewing a prospective new doctor you should tell him that you are preparing for TEOTWAWKI.  You will either find a kindred spirit or he will refer you to a psychiatrist (depending on his outlook).

I very much appreciate Charles' look at this topic and see LOTS of benefits in opting out of the dominant paradigm (which he emphasizes is a whole system).
There are emerging movements in medicine to do just this type of thing, though they are still "fringy."

One is called functional medicine where the focus is on culturing a healthy "terrain."  The idea is that many of the degenerative diseases of western culture are not present in people of similar genetic make up who live in other parts of the world.  The "diseases" develop when our lives are not lived in accordance to our genetic design.

I was working in an urgent care center in California a few years ago when the price of gas had risen dramatically.  Our minimum wage staff was being financially squeezed.  A receptionist said "If the price of gas goes up anymore I am just going to ride my bike!" (in a "there, take that you vulture oil company" type of voice.)

Knowing her medical history, I knew that riding her bike would have reversed her pre-diabetes, high cholesterol, deconditioning, chronic back ache and her extra pounds.  This would have saved her money spent on doctors visits to "monitor" these conditions, and medication purchased to permit a normal blood sugar despite a sedentary, high fructose corn syrup filled lifestyle.  And the exercise would have made her feel much better.




Great comments all, thank you for adding to the conversation. I heartily agree with Peter31's comments–this is something I hear from physicians again and again. Is the root of this denial of responsibility in the welfare state, or marketing, or both?  I don't have a pat answer, but the marketing magic (that there is an easy fix out there, just ask!) doesn't help…
here's a link published today in the Guardian (UK) on soil: http://www.theguardian.com/commentisfree/2015/mar/25/treating-soil-like-dirt-fatal-mistake-human-life

We’re treating soil like dirt. It’s a fatal mistake, as our lives depend on it

You've touched on some of the big problems. You left out insurance. Insurance actually makes things more expensive in the long term by reducing the impact of deleterious decisions. Does my insurance premium go down because I live a good lifestyle? Does it go up because I choose to smoke, drink, and eat twinkies all day? What financial incentive is there for anyone to live healthily? Insurance is one of the pillars that masks the true costs of unhealthy lifestyles.


I live in the US and am not familiar with Canadian practices. I'd appreciate your viewpoint. What I've seen here is that doctors are required to follow AMA guidelines. On the surface, that sounds great. Can a doctor prescribe a treatment that isn't sanctioned by the AMA? I suppose the doctor could, but only at great risk. Someone in the lawyer business would jump on that if the treatment didn't work and the patient wanted to sue.

As a result, doctors may be able to suggest positive changes to affect lifestyles, but they also need to prescribe some drug that is indicated by the symptoms - in order to avoid being sued. I simply can't trust my doctor to do the best for me when my doctor is worried about following sanctioned practices in order to stay out of court. What are your thoughts?


I am mostly seeing a private doctor now where office visits are out of pocket but any tests are covered under insurance.   He left regular medicine is disgust like another doctor I know.

Do you include the FED as part of the welfare state?   If so, lets banish it!

I think doctors in all jurisdictions - Canada, the USA, the UK or wherever - are increasingly in a straitjacket, bound by ever increasing quantities of regulations, guidelines and expectations.  When I first qualified in 1983, much was made of something called "clinical freedom" which basically meant a doctor could make his own decisions.  You could argue whether that was a good or a bad thing, and that maybe there should be common standards which everyone adheres to, but whatever view you take of "clinical freedom" it's ancient history now.  The guidelines are the thing, and if you depart from them you do so at your peril.  The guidelines pay lip service to patient education of course, but mostly they are about following a flow chart of different pharmaceuticals which you prescribe at different points in the patient's illness, lab tests which you do in order to follow what the pharmaceuticals are doing, and so on - in fact a computer could do it much better than I can.  If you depart from the guidelines you risk being sued, complained about or failing a random audit of your prescribing practices by your licensing body.  Increasingly, I am worried that if I comment adversely on a patient's weight, for example, this might be taken the wrong way and lead to a complaint that I was rude, or discriminating, or unsympathetic, and even a groundless complaint which is eventually dismissed results in months of grief while you are investigated for it.  So with so many cards stacked against you, the safest thing is to be a company man, do as you are told and don't make waves.

Grover, you're right about insurance–if I wrecked one car after another, I would pay sky-high insurance rates based on my behavior.  But if I wreck my health, it's my 'right" to pay the same as a healthy person.  Where is the incentive structure pointing? 
I've seen the nightmares created by 'standard of care," i.e. the defensive-medicine/ litigation avoidance strategy that's taken over medicine.  Treatments with very serious consequences such as chemotherapy are pushed down patients' throats because that is the "standard of care" established by attorneys and the state agencies via what they will pay for and how much they'll pay.

As I often say, if we set out to design a perverse, destructive, unfair, unaffordable and unsustainable system, we'd be hard-pressed to beat the current system.

Hi Peter,

Thanks for the response. You confirmed my thoughts about the medical profession. You shouldn't feel picked upon. The same issues are confronting all professions. I was an engineer before retiring. We didn't have the pharmaceutical companies pushing policies, but insurance and lawyers searching for deep pockets pushed us into another corner that smelled just as bad.

A friend's mother went in to get her knee replaced. The surgery went well (I suppose,) but she ended up with one of those bacterial infections that is resistant to all the available antibiotics. The doctors prescribed a cocktail of antibiotics/toxins with the hope of ridding the infection. She never recovered and died in the hospital. The doctors told my friend that they did everything they could … and that they were sorry.

I asked my friend if they tried colloidal silver to fight the infection. She said it wasn't considered. Apparently, there aren't any studies that prove its efficaciousness. Why would there be? Who would spend $millions to prove it works when it can't be patented? As you noted, to prescribe something "unproven" like this puts the doctor in peril. (If a patient requests it, does that remove the doctor's peril?) The ugly bottom line is that the doctor's professional needs supersede the patient's medical needs when push becomes shove.

I'm not making a judgment call here. I'm just stating the situation as I see it. It carries over to all professional services. Unfortunately, the buyer/patient/client needs to consider the provider's position before accepting the advice. Buyer beware.



Another from the medical side of things with frequently interactions with hospital acquired infections (MRSA) I once had a dream that was more like information on how to stay healthy if I or a love one (you) was to ever find myself needing IN patient care. Which by the hospitals definition and stastically shows, is a place of increased rate of infection (must not be clean enough?) I once asked why we organize the care of critical and non critical care patients in places that we know infection rates are increased? There was a few moments of awkward silence and the question was regarded as unhelpful and not serious.  
Here is my dreams recommendations.

  1. Using 5 gallons of soil/mud (mud is best but soil works as well) from home, the IN patient room is to be scrubbed and left for several hours. For inoculation, longer is better. 

  2. Then the mess is be wiped up with a light vinegar/water solution. As needed through out the time of occupation. No hospital chemicals or staff is allowed to clean while the room is occupied. This is done by loved ones.

  3. The nurse must also innoculate her hands with remaining mud followed by a rinse of water and towel dry during any nurse/patient interaction. mud should be left on for the count of 2 happy birthday songs, for comedic purposes mostly and request her hear the song for additional emphasis. 

  4. Minimize time spent in an IN patient setting, even pushing the limits of risk. And thank your sacrificial mud microbes, they won't be returning to the garden and should be treated accordingly.