Tuesday, March 29, 2011

Why are we sicker at a younger age?

As a community pharmacist, one of the things that you notice are trends in prescribing. Years ago, drug reps would ask the pharmacist which physicians are writing for their particular product. These days, the trends that pharmacists seem to pay attention to involve controlled substances. Which prescribers seem to write for them more often and in greater quantities. That's not what I'm going to discuss today.

Instead, I'm going to talk about something that I have observed over the last six or seven years. You see, right now I'm in my late thirties. I'm getting close to the age where chronic medical conditions have traditionally been diagnosed and people start treatment. I pay attention to what medications other people my age are taking. I compare my health with theirs. Right now, people my age are still in pretty good health.

But something that stands out to me is the medical condition of people who are younger than me. When I see the medications that people who are at least six years younger than me (we're talking the 32-and-under crowd), I am amazed.

The volume of people who are on blood pressure and cholesterol medications blows my mind. And the number of people on diabetes medications is even higher. I just saw a link to an article a couple days ago about using statins in children. ???

What is going on that has caused our younger generations to develop these chronic conditions at an early age? Well I have a theory or two about the causes. I have no data to back up these claims, it's just my observations and opinions.

Theory #1: Video games

I was in junior high when Nintendo brought out their gaming system. Super Mario and Duck Hunt were all the rage.

Ever since that system came out, video games have become the national past-time. Forget going outside to play baseball or football, we can stay inside and play it on the television and be a star. The activity level of our younger generations is virtually nothing compared to thirty years ago. Coincidentally, the 32-and-unders that I reference earlier would have just started elementary school when these systems were introduced. Our twenty-somethings have never known life without video games.

At least Mario is running around and jumping. Click here to see what would happen if Mario didn't do all of that running/jumping.

Theory #2: Fast food

I grew up in a small town in a rural area. When it was suppertime, we ate a full meal at home. McDonalds was a place that my family only saw when we were traveling on vacation. In my county, there were only a handful of fast food restaurants. For the longest time, there was only one McDonalds and one Burger King in the county that I grew up in. Both in the county seat which was 15 miles away.

During my high school years, Taco Bell moved in and another McDonalds opened up. Still, not a lot of fast food outlets. But Ronald McDonald had a trick up his sleeve. He started super-sizing the meals. What once were a large order of fries are now the small order. Sodas jumped from 21 ounces to 44 ounces. Fast forward to today. Can you drive through a town anywhere without passing at least one fast food outlet?

I stopped at a Wendy's with my daughter after preschool one day a year or so ago. There was a parent throwing a fit with the manager because her son didn't get the right toy with the kid's meal to complete the current promotion's collection. Just my opinion, but if your kid has had enough kids meals from a fast food joint to have the entire collection, you're eating fast food a bit too much. I wonder what the kid's lipid levels are.

Theory #3: Nutrient poor "food"

This ties in with the fast food a little bit, but I'm talking more about what people are buying at the grocery store. I worked at a regional grocery chain for four years. It was in an affluent community where the residents were concerned about their health. Best produce department in the county. The carts that passed in front of the pharmacy would have the produce in them, as well as a bag or two of chips, maybe some Ho-Ho's.

Contrast that to what I saw at another grocery in my county, one that has a higher proportion of customers utilizing food stamps. Do I even need to describe the items in the carts? Frozen pizzas, cases of soda (a "luxury" item), beef jerky, Doritos, Froot Loops... do I need to go on?

It was sad to see some of the younger (under 30) generation riding on the Mart-Karts because they are too fat to walk unassisted through the store. But you know what foods the carts were carrying.

I'm not going to blame Walmart for the low nutritional content of the food. It comes down to the FDA allowing food producers to distribute products with little to no nutritional content. Couple that with the food stamp programs that allow these foods to be included as covered items (luxury items) and you can see why we are getting fatter. This is just my opinion, but if the government is going to offer food assistance to people in need, let's not give them diabetes while doing so.

I went through the Express checkout at my local Giant Eagle a week or so ago in the middle of the morning. The person in front of me had three items: a bottle of Sprite, a single serving bag of Fritos, and a 24 ounce energy drink. Paid for by the Ohio Directions Card (aka food stamps). Check out the nutritional content of those items next time you are at the grocery store.

I read somewhere that your body will continue to crave food until the nutritional demands are met. That's why people can sit down and eat an entire bag of chips in a single sitting. Since the body is not getting enough nutrients, it tells you to eat more. And more. And more. Eventually the nutrient demand may be met, but it might be 3000 calories later.

I always get a kick out of this picture, but it does illustrate how your body is a reflection of the foods that you put into it.

Theory #4: Laziness/apathy

Ehhhh.... It will take too much effort to type my thoughts on this.

Besides, there's probably a medication that will take care of it. Why should I put in thirty minutes a day exercising to keep myself healthy if I can just pop a pill and chase it with a Mt Dew?

Heck, people are now to lazy to even walk their dogs.

It's sad to say, but those look like Ohio plates (my state) on that car.

Three weeks ago I put the following on Twitter:

I had a pt ask why they had to be on a med today. I wanted to say b/c you are fat, don't exercise, and won't watch what you eat.

Pretty much sums it up.


Anonymous said...

I had an attending physician say that verbatim to a patient not too long ago. It was priceless, the patient just stared like an idiot. She was fat, lazy, and stupid. All she knew was the government gives her money to eat, rent a place, go to hospital, and make babies.

The Ole' Apothecary said...

How about "convenience" appliances? DANG! I rented a car during a recent trip, and couldn't just grab a hold of my rear view mirror to switch it to nighttime view--the switch was electronic! Same with the seat adjustment. No lever to grab as in my old and trusty 2000-model car--electronic controls that I had to study up on in hte owner's manual. So much automaticity robs us of our ability to engage in activities of reasonable struggle that keep our spirits strong. Instinctively this morning, I tried to lick an envelope flap to seat a letter, only to be reminded of the "convenience" of self-sealing envelopes (stamps are mostly self-adhering now). The number of ways in which we have been softened in mind and body is growing steadily. What will be left for us to do in life for ourselves?

Ben S said...

I'm not so libertarian that I think the FDA shouldn't exist, but they're certainly not to blame for corporations giving consumers what they want to consume. No one put those Cheetos in their cart for them (unless they're getting personal shoppers as well).

Anonymous said...


"I had a pt ask why they had to be on a med today. I wanted to say b/c you are fat, don't exercise, and won't watch what you eat."

I am certainly glad you are NOT my pharmacist! You have no right to judge anyone who comes to your pharmacy with a prescription, seeking a professional to help them out. I guess you really don't care about your patients then do you? How very UNprofessional. I could go on, but really, there is no point...talk about ignorance and arrogance..