BLOG

Over the past several years, I have often drawn attention in my books and communications to the unfolding global chronic non-contagious disease (CND) epidemic, manifesting as steadily increasing rates of seemingly unrelated diseases, from colon cancer to Parkinson’s disease, from heart disease to cognitive decline, and from autism spectrum disorders to chronic liver and inflammatory bowel diseases.

At the center of the CND epidemic are the rising rates of obesity and the associated metabolic dysregulation. As of 2021, 15.1 million children (5–14 years), 21.4 million adolescents (15–24 years), and 172 million adults in the U.S. are overweight or obese. This amounts to a 75% rate of overweight and obesity in the adult US population. Forecasts suggest these numbers will further rise, with obesity affecting one-third of adolescents and two-thirds of adults by 2050.

Even though the worldwide obesity epidemic, a major driver of the CND epidemic, continues to grow unabated, it has received much less attention in the public eye than the HIV or the COVID-19 epidemics in the past, while the number of deaths from the CND epidemic, and the cost to our healthcare system are staggering.

However, the stealth mode of this latest epidemic is about to be disrupted by very different forces: On the one side of the spectrum is the environmentalist turned health expert and populist, Robert F. Kennedy Jr, on the other side is the pharmaceutical industry riding on an unprecedented success of the new “miracle” anti-obesity drugs, the GLP-1 and GIP agonists.

Regardless of the winners in this contest, the ensuing debates will finally raise the awareness of the seriousness of the CND epidemic to a level required to find an effective solution, different from the current approach of the medical industrial complex to benefit from keeping affected patients alive (reduced mortality) without dealing with the prevalence of disease (morbidity) or underlying cause of it.

The MAHA (Make America Healthy Again) movement has many supporters across the political spectrum (including myself) but it will take a tectonic shift in the way the federal government does business with the thousands of lobbyists and their financial means of the agricultural, medical, pharmaceutical and food industrial complex, to make a noticeable course correction that ultimately benefits the health and well-being of the average American. After all, the CND epidemic is extremely profitable for all involved parties, including the medical system and it is hard to believe that our future government with its track record will be inclined to implement such a dramatic course correction affecting many of its key financial supporters.

The Kennedy approach.

As part of a promise to address the high rates of chronic disease in the United States, Robert F. Kennedy Jr. — who was recently tapped by President-elect Donald Trump to lead the Department of Health and Human Services — has said that he would “fix our broken food system.”

In interviews and on social media, Mr. Kennedy has made a number of claims about the country’s food supply and eating habits and proposed solutions based on these claims.

Amid a number of valid statements, Kennedy has predominantly made unsupported claims and statements about our food supply and public health measures that raise serious questions about his qualifications for the job as US health czar. Nobody in the world of science would be able to make such totally unsubstantiated statements based on pseudoscience and populist myth and not be ostracized by their peers, lose research funding and ultimately be fired from their jobs. The list of his claims is long, but the following stand out:

His criticism of childhood vaccinations, including the totally unsupported implications of such vaccinations in the pathophysiology of autism spectrum disorders, his promotion of the health benefits of raw milk consumption, of ivermectin and hydroxychloroquine as effective COVID-19 treatments, his criticism of the clear health benefits of fluoride in drinking water, his claim that antidepressants are a cause of mass shootings, and his accusation of Dr. Anthony Fauci as an architect of public harm.

Kennedy has suggested that Americans are being “unknowingly poisoned” by seed oils like canola, soybean and sunflower, and it would be healthier for restaurants to fry food in beef tallow instead. However, according to the majority of food scientists and health experts, the claim that seed oils are harmful to health is false. Decades of research have shown that seed oils are not only safe, but the heart-healthy unsaturated fats they contain have been linked with reduced risks for cardiovascular disease, Type 2 diabetes, cancer and earlier death. Seed oils are a far better choice for health than solid fat alternatives, like beef tallow, butter or lard, which are high in saturated fats.

On the other hand, there is general agreement on the following assessments by Kennedy of our compromised food system and its role in the current disease epidemic:

Many public health and nutrition experts agree that ultra-processed foods — which make up an estimated 73 percent of the U.S. food supply — are probably contributing to the obesity epidemic in the United States, and it would be beneficial to cut back on them. However, the definition of ultra-processed foods is under heavy criticism and it’s not clear if beyond the excess consumption of sugar, salt, unhealthy fats and excess calories associated with many of these foods there is an important role they play in the chronic disease epidemic as a distinct category.

Kennedy has suggested that consuming too many added and hidden sugars, especially from high fructose corn syrup (heavily subsidized by the US government), contributes to childhood obesity and cardiovascular disease. There is solid evidence that consuming too many added sugars, including from high fructose corn syrup, can drive up the risk for a number of health problems, including cardiovascular disease, Type 2 diabetes, fatty liver disease, obesity and cavities. Americans consume, on average, about twice the American Heart Association’s recommended limit for added sugars, with sweetened beverages, particularly soda, being a top source.

The Pharmaceutical Approach

The new class of anti-obesity drugs like Ozempic, Wegovy, Zepbound remain the most popular modern drugs which continue to receive great attention on social media and have been celebrated as the “drugs of the century”. These long sought after “miracle” drugs have been shown in large, randomized placebo controlled studies to reduce up to 20% of excessive body weight and – as long as you take them – maintain their effectiveness.

Further flaming the public interest, recent preclinical and clinical research is suggesting that the same drugs which were originally developed as diabetes medications, may even be effective in the treatment of substance use disorders and may lower the risk of cognitive decline, heart disease, stroke and kidney disease. While the mechanism(s) underlying these wider health benefits are currently unknown, one may hypothesize that it is the effective treatment of one of the main causes of the CND epidemic, namely obesity and metabolic disorder which underlies the unexpected benefit of this class of drugs.

What will be the outcome of the two approaches to our chronic disease epidemic?

While I support several of Kennedy’s assessment of the key role that our food supply plays in our current chronic disease epidemic, I have serious doubts that his plans for a major course correction will be successful, given the gigantic economic forces keeping the current system intact. Given many of his statements over the past several years, and given Trump’s implicit endorsement of unhealthy eating habits, and resistance to previous Democratic attempts to reducing sugary drink consumption or promoting healthier school lunches, it is hard to imagine that his efforts will be successful.

I must admit that I’m worried that the likely failure of his campaign will further fuel the success of the pharmaceutical solution to our healthcare crisis, as more and more data will emerge to support the Ozempic approach to deal with the fallout of our unhealthy lifestyle and associated food consumption. However, in the chance that this movement succeeds, we might be able to see both approaches synergize, creating a significant change in our food production as well as more effective medications which would significantly reduce the fallout of the obesity epidemic.