An article in the August 13, 2009, issue of the Wall Street Journal has made the obvious very clear economically -- most health care costs come with increasing age, especially after age 65. Furthermore, most of these increasing health care costs are in the form of increased prescription drug usage. Good for the pharmaceutical industry; not so good for the growing government deficits that come with increased Medicare financing. So what does the ongoing health care debate say about the increasing poly-pharmacy used by our aging population? Basically nothing. Let me propose a relatively radical solution: To start a drug reduction program initiated by primary care physicians for those presently enrolled in any health care plan.
But what will replace the drugs that are being dumped? The answer is an anti-inflammatory diet. Two recent articles in the August 12 issue of the Journal of the American Medical Association give us an insight into what the future can hold. The first article indicates that by taking the cheapest drug known (aspirin), individuals with specific colon cancer that expresses pro-inflammatory hormones would have a 30 percent reduction in cancer deaths compared to those who took no aspirin. The reduction in cancer deaths rose to 60 percent if the colon tumor was one that produced excessive amounts of pro-inflammatory hormones. Perhaps not surprisingly, high-dose aspirin has a remarkable ability to reverse diabetes and remains the number one drug to prevent a heart attack even though it has no effect on cholesterol levels. The one thing that links all of these remarkable benefits is that aspirin reduces inflammation.
Of course, one problem with aspirin is that it can also increase death rates due to internal bleeding. On the other hand, an anti-inflammatory diet specifically reduces the production of the building block of those pro-inflammatory hormones inhibited by aspirin. Its great advantage is that such a diet has no known side effects. A common name for such an anti-inflammatory diet is the Mediterranean Diet. A more rigorous version of an anti-inflammatory diet is the Zone Diet, which can be considered the evolution of the Mediterranean diet to achieve even greater inflammatory control.
The other article in the same issue of the Journal of the American Medical Association indicates people who closely followed a Mediterranean Diet had a 40 percent reduction in the incidence of Alzheimer's compared to those who didn't. Follow a more rigorous version of the Mediterranean Diet (i.e. the Zone Diet), add extra fish oil rich in omega-3 fatty acids (which has additional anti-inflammatory properties) and you have the key for drug reduction of the poly-pharmacy that awaits aging Americans.
The bottom line is that increased inflammation is the reason why Americans are using greater amounts of health care resources. It's not that we don't offer the best health care in the world, but the simple fact that Americans are simply sicker at an earlier age that is driving our health-care costs out of control. By using diet as if it were a drug, you can not only reduce the mortality of some real nasty diseases, such as cancer or Alzheimer's, but also remove the driving force that forces Americans to fork over more and more of their income for prescription drugs.
Getting people to follow an anti-inflammatory diet is key to reducing inflammation without side effects. To make this happen means providing enough of a financial incentive to primary care physicians to work with their patients to reduce the drug load of the patient. A good pharmacological rule to remember is that every time you reduce the dose of a prescription drug by a factor of two, you reduce the associated side effects by a factor of four. That's real pharmaceutical leverage. To accomplish this means the physician has to spend time working with the patients to alter their diet while simultaneously eliminating various drugs and reducing the dosage of the remaining drugs. That's easy because this is what every patient wants, and it immediately saves out-of-pocket expenses. There will be far improved health care in this two-step approach compared to anything currently being discussed in health care reform debates.
For health care reform to be meaningful, it has to start in the kitchen. If that happens, then you can have basic insurance for everyone without breaking the bank.