Seth Barham Design
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Being Healthy in America is Hard

In America, 68% of adults are either overweight or obese, nearly 10% of the population have diabetes, and 610,000 people die from heart disease every year. Look no further for a perfect example of a first-world problem. Actually, an American problem would be far more accurate. The United States has been falling behind its peers in the developed world since 1980 in almost all things health. In addition to the obesity-related illnesses above, we also have some of the highest rates of adverse birth outcomes, homicides, chronic lung disease, and drug-related illnesses in the developed world.

All of these problems are made worse by having the highest percentage of people who are either uninsured or without access to primary care. However, I’m not writing this post to start a healthcare debate. After traveling through a baker’s dozen of different countries and observing my British wife’s reactions to the South’s emporium of fried foods over the last month, we’ve developed a shortlist of problems, small and big, that contribute to all of these dire numbers.

This post isn’t intended to scold my fellow Americans - it’s more of a warning to those who either want to visit or live here: being healthy can be a challenge in the United States. We are not known for running a health resort with our cuisine over here, but that's not the only issue. There are other forces at work that are driving these statistics up, such as infrastructure, income inequality, and poor education when it comes to living a healthy lifestyle. We'll discuss the obvious as well as the sinister forces of Ronald McDonald's invisible hand down below. 

1. Americans drive almost everywhere.

If you live in America, owning a car is almost a necessity. If I decided to go car-free, I would need to walk or cycle about 5 miles to the nearest gas station to get even the most basic of necessities. The nearest grocery store is over 10 miles away. Most small townships don’t even have proper infrastructure for pedestrians. In cities that don’t quite have the same resources (or have them but don’t spend them as wisely) as New York or Chicago, public transport can be very lackluster. So, naturally, a nation of people that drive everywhere instead of walking are going to burn less calories - not good when the US consumes more empty calories than almost anyone else. I will say that my city of Greensboro has been trying to improve this problem with a very ambitious greenway project, but it has been met with opposition every step of the way because it's "wasteful". I think that a lot of Americans don't really appreciate the value of being able to walk instead of drive, mostly because many have never had a chance to experience it in their daily lives. Hopefully we'll continue to see more pedestrian infrastructure projects like Greensboro's increase across the country. 

2. Income inequality can limit your options.

In addition to being the unhealthiest developed nation, we also have the largest income gaps between the rich and the poor, and this discrepancy is mirrored in the diets of the rich and the poor. A study by the The Journal of the American Medical Association Internal Medicine analyzed the diets of both poor and wealthy Americans from 1999 to 2010 and found that "socioeconomic status was associated strongly with dietary quality, and the gaps in dietary quality between higher and lower socioeconomic status widened over time." Unfortunately, the simple fact is that more healthy foods here are more expensive than their cheaper and often more processed counterparts. If you're a single mother working two minimum wage jobs to make ends meet, you're likely not going to be able to do your weekly shopping at Whole Foods or Earth Fare. One possible alternative to expensive health food stores are farmers markets, but they are not always open year round and not every town or city is so lucky to have one. I don't think it's impossible to have a balanced diet on a lower income, but it sure is a hell of a lot more difficult. 

3. Empty calories are lurking behind every corner. 

One of the first happy discoveries that tourists in America will make is the glorious free refill. It’s also why so many of us are fat. Most soft drinks have little, if any nutritional value at all. Sodas, candy, and junk food all contain empty calories - calories that count toward your daily 2,000 limit while not providing any actual nutritional value. However, there are some empty calorie culprits that are not as obvious as a super-sized Mountain Dew. Have you ever taken a look at how many calories are in your salad dressings? What about your over-sweetened coffee drink from Starbucks? Some ranch dressings can have as many as 200 calories per 2 tablespoons, and there are just as many calories in a Starbucks latte. That's already a quarter of your daily allowance gone with little of what your body actually needs to show for it. If you're visiting from abroad, keep this in mind: America loves its sauces. If you're trying to keep a balanced diet, ask for them on the side. 

4. Junk food masquerading as health food. 

This is a major annoyance to both myself and my wife, although she's got a much better eye for catching it than I do. Despite me seemingly shitting all over America in this post, it has definitely had a positive trend toward more healthy foods in recent years. Where there is a trend, there is a businessman in smokey back room trying to figure out how to exploit it. A great example is the huge campaign (marketing ploy) against saturated fats. At one time, there was very weak, untested evidence that saturated fat maybe, might possibly be linked to higher bad cholesterol. This has since been thoroughly debunked. But, the marketing campaign continues. The big problem is that food doesn't taste very good at all if you remove all of its naturally occurring fats. Manufacturers instead add a shitload of sugar and/or sodium to make up for this. The end result is a product marketed as healthy but in reality is probably less healthy than its full-fat counterpart. For more examples of this that will drive your logical, skeptical, and cynical mind crazy, check out this article

5. Restaurant chains have an empire throughout the country.

One of my favorite things about both China and Europe is that you can find a little café, pub, or noodle shop around every corner.  It’s very easy to eat or drink locally. In America, however, drive down any major drag and you’ll see the usual suspects: Chili’s, Olive Garden, Cheesecake Factory…you get the point. These are the chains that exist on a tier above fast food, but are they really better for you? Not in the slightest. First off, the very nature of being chain prevents these places from using fresh ingredients. Everything is frozen, pumped full of preservatives, and sent from the closest distribution center to a franchise near you. This is a minor worry when you consider that many of the meals at these places are routinely 1,500+ calories (the recommended daily allowance is 2,000). Farm-to-table is starting to make a comeback in America, but these homegrown eateries simply can’t compete with a chain’s prices and marketing budget. 

6. Sugar.

There’s a little white powder in circulation here that kills at least 25,000 people every year. You would think I’m talking about the opiate epidemic, but this stuff is considered safe for small children by the FDA. Sugar is everywhere. It’s in almost everything. Even foods that are marketed as healthy, such as yoghurt, are full of it. Sugary drinks are one of the biggest contributors to the scourge that are empty calories and America - along with most of the world in this respect - are completely addicted. Unfortunately, the stigma of drug addiction overshadows the fact that you can actually become addicted to sugar and that it can be just as deadly, even though the effects aren't immediately observable to the outside viewer. Sugar stimulates the reward center of our brains by releasing dopamine and even naturally-occurring opioids. Most are completely ignorant to the fact that they have an addiction, and sugar is so ingrained throughout the industry that there's little we can do to stop it. 

What are we to do?

Unlike most existential problems in the world today that I don't really have a good answer for, overcoming these obstacles in the path of a healthy American lifestyle is possible for almost anyone, even for those on the wrong side of the economic chasm. Reading is your friend. Education and motivation are going to be your two biggest tools here. Be aware of what you need for a balanced diet and know exactly what you're going to be buying before you venture into the supermarket, and don't make the mistake I always make of going in on an empty stomach. Don't be fooled by junk food in disguise. Avoid sugar at all costs and get it from natural sources like fruit. Research menus before going to a restaurant as most will have a calorie count these days. Oh, and exercise is pretty important, too. People seem to forget that it doesn't matter what you eat if you're going to be sitting on your ass all day. All of this said, I'm the first one to tell you I'm not perfect. Hell, I've been enjoying a delicious Starbucks drink while I've been writing this. Do what mom says: try your best. 

Seth Barham