An overweight character tells his doctor, “I try to eat healthy. I never sprinkle salt on ice cream, I only eat decaffeinated pizza and my beer is 100% fat free.” The plight of the preposterous patient was penned by the famous American cartoonist, the late Randy Glasbergen.
Noted for his honed and humorous handling of health issues, the talented Glasbergen liked to say that he lived, worked and dieted in a creaky old Victorian house in rural upstate New York. Best known for three decades of widespread newspaper syndication of his precise pieces, and a successful freelance career, he produced from 1982, the seasoned strip of the still sparring couple, “The Better Half” which ended in 2014, after a 58-year run. Glasbergen, also aged 58, ironically died from cardiac arrest the next year, following admission to a hospital for an infection.
Among my best-loved Glasbergen illustrations, is the scathing advice to a patient, from the much-featured medical practitioner, “With this diet you don’t count calories, fats or carbs. You count people who suffer from heart disease, diabetes and high blood pressure.” Glasbergen’s compositions are admired and accessible including across the worldwide web because of the enduring international appeal of the comic but crafty messages, be it in Chenago County, Charity or Chaguanas.
One condition is bad enough, as I am fast losing count of the people who suffer from two or all three. Within my own extended family and friends, close cases have not stayed alive long enough for me to hope for proper accuracy, urgent public policy overhaul or a scientific reprieve, much less to contemplate cultural and cuisine changes.
My pun-mad Trini partner with whom I spar, especially over chicken curry and curried chicken, frequently offers loud laughter and lurid lines such as the gourmet who avoids unfashionable restaurants because he does not want to gain weight in the wrong places, or the Dr. DoLittle Diet where you do little in terms of real exercise while choosing to talk to junk food instead of eating or better still ignoring it. He argues it is not the minutes spent at the table that prompt weight gain, it is the seconds, and insists the biggest drawback to fasting for seven days is that it makes one weak.
But the state of our world and national health is no joke. Last week, the British medical journal, the Lancet revealed that one in five deaths globally is associated with poor diets. In 2017 alone, 11M such deaths were linked to people eating too little good foods and taking in too many poor ones high in sugar, salt and bad fats, a threat worse than fatalities from tobacco. Tobacco was linked to 8M deaths and high blood pressure was associated with 10.4M, according to estimates. Too much salt amplifies blood pressure, raising the chance of heart attacks and strokes.
Meanwhile, we ponder the puzzling preference for factory packaged imports over fresh and organic produce, and the killer advertising power of foreign franchises over delicious local home-cooked meals. With unused lands and scarce foreign currency, the Caribbean spends a massive US$4B importing food mostly from North America.
A whopping 255M so termed DALYs were attributable to dietary risk factor worldwide. DALY is the abbreviation for Disability-Adjusted Life-Years, a modern measure of overall disease burden, expressed as the number of potential years of healthy life lost to sickness, disability or early death.
It was developed by Harvard University for the World Bank in 1990, and the World Health Organization subsequently adopted the method as a way of comparing the overall health and life expectancy of different countries. The DALY value is becoming common in the field of public health and health impact assessment.
However, it is not so much what we are eating as what we are not. In the latest comprehensive Global Burden of Disease (GBD) assessment tracking international trends in consumption given 15 dietary risk factors, from 1990 to 2017, the Lancet maintained that people in 195 countries including land-rich Guyana would benefit from rebalancing their daily diets to take in greater natural edibles like cardio-protective vegetables, fruits, whole grains, legumes, nuts and seeds. Other factors considered the harmful effects of diets low in milk, fibre, calcium, seafood omega-3 fatty acids, polyunsaturated fats, and diets high in red meat, processed meat, sugar-sweetened beverages, trans fatty acids, and sodium.
In fact, Guyana now has among the world’s highest rate of deaths caused by such awful choices. Guyana and Haiti are the only two countries in the Caribbean and the entire Americas coloured an alarming red for recording frightening figures greater than or equal to the scale 8,740 DALY deaths per 100,000 of the population over the 27 year-period.
In Guyana’s case about one in 11 persons pass away from causes directly due to their poor-quality diet. While the country’s age-standardised mortality rate per 100,000 population ranged from 249 to less than 313 behind Haiti’s peak in the region of more than or equal to 397 persons sent to early graves, Guyana’s DALY rate per 100,000 population blamed on diet was high at a calculated estimate of nearly 10,500.
For 1990, Guyana came in at 12,603 cases in the age-standardized rates of DALYs attributable to dietary risks among adults at the national level as against 9,000 in 2017, while the related death rates remained cause for considerable concern given our small population, at 386 per 100,000 residents, down from 553 in 1990, in comparison to Haiti’s 2017 DALYs of 9,426 and death rate of 425.
The main killer in this country continues to be cardiovascular diseases resulting from impaired dietary choices, with some 337 deaths in 2017 as against 514 on 1990, while those of DALYs slid to 7 199 from 1990’s 11,173. Type two diabetes follows with DALYs climbing from 1,134 to 1,529 in 2017.
In 2017, there was a ten-fold difference between the country with the highest rate of diet-related deaths (Uzbekistan) and the country with the lowest (Israel) or 89 deaths per 100,000 people while the United Kingdom ranked 23rd (127 deaths per 100,000) above Ireland (24th) and Sweden (25th), and the United States measured 43rd (171 deaths per 100,000) after Rwanda and Nigeria (41st and 42nd). China was named the 140th (350 deaths per 100,000 people), and India 118th (310 deaths per 100,000 people). The countries with the top rates of diet-related deaths were Uzbekistan (892 deaths per 100,000 people), Afghanistan, Marshall Islands, Papua New Guinea, and Vanuatu.
Globally, in 2017, cardiovascular disease was the leading cause of diet-related deaths (10M deaths and DALYs 207M), followed by cancers (913 090 deaths and 20M DALYs) and type 2 diabetes (338,714 deaths and 24M DALYs). More than 5M diet related deaths and 177M diet-related DALYs occurred among adults under 70 years old.
In 2017, the intake of all healthy foods was lower than the optimal grade in all 21 GBD regions. “The only exceptions were the intake of vegetables in Central Asia, seafood omega-3 fatty acids in high-income Asia Pacific, and legumes in the Caribbean, tropical Latin America, south Asia, western sub-Saharan Africa, and eastern sub-Saharan Africa. Among unhealthy food groups, consumption of sodium and sugar-sweetened beverages were higher than the optimal level in nearly every region. Red meat consumption was highest in Australasia, southern Latin America, and tropical Latin America. High-income North America had the highest processed meat intake followed by high-income Asia Pacific and western Europe. The highest intake of trans fats was observed in high-income North America, central Latin America, and Andean Latin America, “ the report revealed.
Stressing the need for sensible and prompt interventions to promote the production, distribution, and consumption of healthy foods, the authors urged coordinated global and national efforts to improve diets everywhere, as a matter of life and death. The Father of Medicine, the ancient Greek physician, Hippocrates counselled, “Let food be thy medicine and medicine be thy food.”
ID worries about the fading of farms, fruits and fine foods. She believes the Arabian proverb, “He who has health has hope; and he who has hope has everything.”
