Family doctor addresses link between nutrition, preventive health - January 18, 2020

Courtesy of The Times of Northwest Indiana

MERRILLVILLE — Dr. Mustafa Nakawa has a saying: “What we eat defines us.”

The problem today, he noted, is that definition is at critical condition.

“Food is more than an action. It affects our behavior,” Nakawa told the Northwest Indiana Health Disparities Council Friday at Innsbrook Country Club.

Obesity-related diseases, including heart disease, stroke and diabetes, resulted in 850,000 preventable deaths nationwide in 2017, Nakawa said.

“Clearly, we have a crisis,” said Nakawa, who specializes in family medicine at Methodist Hospitals. He added that malnutrition is an “epidemic” in the U.S.

Indiana is particularly at risk for obesity, the doctor noted. The 20% of obese Hoosiers in 2000 expanded to 34% in 2017.

Nationally, Nakawa said, two-thirds of Americans are overweight or obese. If that trend continues, he noted, by 2030 one-half of all Americans will be obese.

This health crisis is also reflected in the economy to the tune of $190 billion nationally annually, representing 21% of national medical costs. In Indiana, the doctor said, obesity costs $8.5 billion annually.

The doctor cited a lack of education and care. In 2017, he said, this country spent $3.5 trillion on health care, 3% of that on public health and less than 5 percent of primary care.

The council reviewed the findings of Methodist Hospitals’ community health needs assessment. Among the key needs is access to affordable food. During a Q&A session, audience members, including physicians, cited healthy diet challenges due to finances, transportation access, location, and work schedules.

Food can be a medicine, Nakawa said, as it can cause diabetes, hypertension, and obstructive sleep apnea. Food and exercise are key, he added, and the simpler — as in non-processed — food, the better.

There are also social determinants as to what people eat, Nakawa said, and that includes location.

“Weight is determined by the ZIP code, not genetic code,” he said. “Patterns of diet and physical activity are driven in large part by the environment in which we live, work, learn and play.”

Obesity is particularly an issue in the black and Hispanic communities, Nakawa said. Black women, he said, have the highest rate of obesity in the U.S. at nearly 59%.

To address this weighty problem, Nakawa suggested a multidisciplinary approach involving nutritionists, behavioralists, and psychologists. He also called for developing a role model for communities to follow regarding healthy food choices.

On a national level, Americans need to address federal policies that make “healthy choices easier choices.” That includes enabling those on federal programs, including Supplemental Nutritional Assistance Program recipients, to make healthy choices and opposing foods that are not healthy.