Smelling Health

"Fat people are fat because they are more comfortable that way. The day is easier being obese than suffering from the discomforts of not eating." - Steadism #28, p19

The medical student association sponsored a community event this weekend. Students took blood pressures and stabbed finger to assess glucose (sugar) levels. About 15 folks, out of about 3200, from the community came to have this free service performed and most of them were from the surrounding area (around school) or directly associated with the school. Sad really. A free, healthcare event, with very few active "takers" to come out from the community. I wasn't really surprised. I've been involved with these types of events before.

A member of the local medical community was also in attendance and shared some local demographic information that is truly phenomenal. Over 50% of this community has hypertension (high blood pressure) and/or acquired diabetes. Whoa! 1/2 of the population had disease processes that are known to be genetically and or environmentally induced related to insulin resistance, and vascular damage. Our understanding of metabolic syndrome...induced insulin resistance...is increasing daily.

I have no NIH grant and didn't do a study that would be approved by my peers, but I could have predicted that level of disease. I'll call this "COA", community observational assessment. And what do we see? Obesity, lousy food choices, alcohol abuse, and the smell. The smell.

As I walk to school each day, and walk home for lunch, and walk home after school, it is the smell that is most telling of the health of this community. On an island, each day, the Caribe breezes blow away the tell tale signs of lingering smells, so what I smell each day is what is happening at that moment in time. It is, a olfactory snapshot of the community. And what do I smell? Cooking grease...the heavy, permeating smell of grease. The smell of a McDonald's uniform after a full shift of cooking french fries.  It's almost as diagnostic as the smell of cigarette smoke on a patients person as they emphatically tell you that they don't smoke.  You can almost feel the fat caking the lining of the arteries, making them thick, non-compliant, and causing intimal (wall) inflammation. I can hear the screams of the pancreas islet cells as they labor to produce enough insulin to overcome the fatty tissue deposited around organs and various appendages.

The food choices on this island, and the food preparation techniques, are not atypical of many communities around the world.  And the rampant insulin resistance, peripheral vascular disease and associated sign, symptoms and health (or lack thereof) is not shocking at all.

Oh, I won one of the raffles at the health event. What did I win? An order of fries from the local eatery. I wish I was making this stuff up. I'm not. Life is more entertaining than fiction.

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American diet seen as key factor driving up U.S. healthcare costs. - In an essay in the the NY Times, 10/12,..."one of the biggest, and perhaps most tractable," reasons for increasing healthcare costs "is the cost to the system of preventable chronic diseases. Four of the top 10 killers in America today are chronic diseases linked to diet: heart disease, stroke, type 2 diabetes, and cancer.