When Americans are surveyed regarding the US health care system, many concerns and complaints are heard. One of the most common is our reliance on pharmaceuticals. Apparently, it is a frequent experience, whereby someone goes to their doctor with some sort of complaint, pretty much any kind of problem, and the physician’s response will be to pull out their prescription pad and write for some kind of drug. Not for a moment am I intimating that this is always an inappropriate response. For many medical conditions, this is a necessity and a critical means of treatment for many disease entities.

Many of our fellow citizens believe this has become a “knee-jerk” response of health care providers. Lifestyle changes are of benefit for so many of the more prevalent chronic diseases but how often are these recommended or even discussed? Many Americans think it is not often enough. Due to the changing economics of health care in this country, medicine has become much more of a business than a service. This transition is one that most doctors can attest to if they aren’t new to the practice of medicine.

More doctors are employed by large corporations than ever before. These multi-national, large-scale enterprises are not generally known for their level of human interest, their “touchy-feely” attitudes, or concern for the average consumer. Consequently, many physicians feel pressured to meet the various quotas, specified levels of production, which are in no way, tied to good medical care. This is one facet of the complex question as to why nutrition and lifestyle changes are not more often considered.

Although highly debatable, many well-informed individuals would posit our medical education systems have historically been weak in teaching about nutrition. How much do our allopathic medical schools teach their students about this topic, the nutrients required for health and well-being, and the consequences of inadequate intake of nutrients? What about the question of how our dietary intake can affect various disease states? Because there has been insufficient research into these and associated subjects, little is taught about these questions, and the use of diet as a form of therapy. In essence, we simply don’t know enough about this tremendously important topic.

Data obtained from U.S. government reports suggest a relationship between increases in many diseases of lifestyle (with this list including cardiovascular problems, asthma, bronchitis and some orthopedic conditions), with declining levels of magnesium in the US diet, especially in tomato, lettuce, cabbage and spinach. Is it possible mineral depletion is a significant contributor to our current health care crisis?

A common theory, although unaccepted by some, claims modern horticultural methods have led to a reduction in the levels of critical nutrients in your average grocer’s food. How has this occurred? A number of factors seem to be at play. Newer methods of farming, such as hydroponics (growing fruits and vegetables in irrigated systems rather than soil) and chemical fertilizers, together with new varieties of crop, longer storage times and long-distance transport, may all have led to these changes in the nutritional value of the foods we eat.

Is this an accurate conclusion? If, indeed, the quantity of minerals in the vegetables we consume is lessening, is this truly important in the long run? There are many sources for minerals in our diet, but what about vitamin content? A recent Canadian study reported that most of the fruit and vegetables purchased in supermarkets of the provinces have shown marked declines over a 50-year period. Analyzing US government studies reveals that potatoes have lost 100 percent of their vitamin A and 57 per cent of their vitamin C. Both of these substances are recognized as being critical to health and well-being.

In fact, one would have to eat eight oranges to get the same amount of vitamin A as a single orange eaten by your grandparents. You would need to have eaten 10 tomatoes in 1991 to have obtained the same copper intake as from one tomato in 1940. Some would argue that the reduction in potassium levels in leafy vegetables is irrelevant, since people get this from other sources. Many eat bananas and those are well known to be rich in potassium. Another example offered as evidence is the reduction of iron content in carrots over the last half century. They may have lost 46 per cent of their iron but they were never considered a good source of iron anyway. Eat some liver, some might counter.

One frequent response to the concerns of reduced nutrients states we have greater access to fresh vegetables and fruits nowadays. One problem I have with this concept is that a person can only consume so much. Do you eat enough vegetables and fruits to make up for any deficiencies that may exist in our foodstuffs? A large percentage of the US adult population do not eat sufficient quantities of vegetables regardless of their vitamin and mineral content. Obviously, an essential part of this is most meals of the technologically-advanced nations are meat-based.

Another question that remains a source of contention is the contributions of a poor diet on the development of disease. Can a food plan which provides inadequate levels of some essential nutrients lead to various disease states? Although it would seem logical that this is the case, medical research has found it difficult to make definitive recommendations about diet and disease. And if one were to assume nutrients are important to health, what type of diet is best? A subsequent question should be “can people in modern society obtain all the beneficial elements from a traditional dietary plan, utilizing the usual food sources?

For the first time in man’s history, the number of over-nourished people outnumbers that of undernourished. One result: obesity has become a disease of epic proportions. But health is not merely the absence of disease. The symptoms of ill health should not be medicated away and consequently ignored. Unfortunately, chronic disease management has become the norm, the accepted method of health care.

If we want to be happier and healthier, we have to understand we are part of the environment and not separate from it. Our diet is a significant part of a health-promoting environment. It would seem this component, the nutrients and vitamins required for health, is declining. What is the answer to this complex, multi-faceted question? Take supplements, aka vitamins, or eat only organic food? Both of these are billion-dollar industries, so clearly some people think so. I would say the answer is more research, but this kind of research is time-consuming and very expensive. I would venture to say the topic is important enough to warrant federal funding in nutritional research. But changes are hard to make, especially when it comes to feeding the planet. Yet, to some degree, our lives may depend on it.

Editor’s note: Dr. Conway McLean is a physician practicing foot and ankle medicine in the Upper Peninsula, with a move of his Marquette office to the downtown area. McLean has lectured internationally on wound care and surgery, being double board certified in surgery, and also in wound care. He has a sub-specialty in foot-ankle orthotics. Dr. McLean welcomes questions or comments atdrcmclean@outlook.com.