Sunday, December 14, 2008

Nutrition and Malnutrition

From being Indian, the only malnutrition I knew is protein-caloric under-nourishment with kwashiorkor, protruding bellies and skinny, sickly limbs. But from living in America, the only malnutrition you need to know is protein and caloric overloading, protruding bellies and oversized hips and thighs. It is omnipresent, almost taken for granted. Less known is the fact that obesity has the potency to kill like cancer from smoking does. The current generation will be the first in history to NOT outlive their parents.
Last week, a 44 year-old male patient in the Intensive Care Unit succumbed to death after suffering from a fever of 101-103F for 15 days. He had an abscess on his buttock that was being treated with multiple antibiotics. There were 6-8 specialists on the team who were trying to decipher the source of his fever, day after day, week after week. He was on the lung ventilator, heart monitor, urinary catheter, feeding tube, peripheral intravenous and central venous lines and several cooling blankets. His 'numbers' kept creeping downward, with his kidneys, heart and liver also showing signs of deterioration. We could have sent him to a University or tertiary center for multi-disciplinary care. Why were we all so helpless? It was his weight: 520 lbs. He wouldn't fit inside any CT scanner in the area. Not in our hospital, not in our city or the state. Perhaps only 2 machines are available to accommodate such a size in the entire US: Mayo clinic, MN and some South Carolina university hospital. We even called the Philadelphia Zoo to find out if they had a scanner they used for large animals. Finally, due to our inability to determine the cause of his fever, we had to let him go. Each of his last days was a mixture of hope for a miracle and despair and frustration, for the family and the medical team.
You probably know that 66% of US is overweight (defined at Body Mass Index >25) and almost half of those overweight can be classified as obese (BMI>30). Here are some startling facts about obesity you might not know:
In 1963, the average 10-year-old American boy weighed 74 lbs; girls 77 lbs. Today, the same boy weighs 85 lbs and the same girl weighs 88 lbs.
Obesity is linked to the top 10 causes of death, depression, absenteeism (school and work), lower marriage rate and lower income potential.
Only 2% of children consume a “healthy” diet (as defined by the US Department of Agriculture) on a daily basis.
25% of American teens drink 4 colas a day!
20% of all ‘vegetables’ consumed in the United States are french fries and/or potato chips.


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