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How bad can America’s health actually get? And what shall we do?
All kinds of ill health are steadily increasing, from age-adjusted obesity to autism and depression. Anxiety in young adults nearly doubled in the decade pre-pandemic. Type 1 and type 2 diabetes has risen dramatically. Deaths of despair have also risen. There seems to be no actionable plan, ready for implementation, to halt the rising tide of ill health. The numbers are steadily increasing adjusted for age, with some numbers rising faster in the young than in the old.
I find the willpower discussions to be missing the point. Unless there is a plan that we can implement in schools to significantly increase or teach willpower, then it hardly matters whether the will is relevant. The diseased from poor choices and the diseased from poor environment equally hurt the security of the nation, costing trillions from decreased productivity, decreased fertility, and healthcare expenditure. It is curious how much discourse in America is spent quibbling on issues that are so much less important than the health question. Health is something that directly impacts every aspect of the country, not the least of which is the plain happiness and fertility of citizens.
What I would like to see is a harm tax put in place that adds onto every unhealthy item the cost per item of its societal harm: the projected healthcare costs, the loss from intelligent citizens working for corporations that poison us, the projected loss of productivity. Now, this will always be an estimate, but so are many taxes. I think this would largely make sodas prohibitively expensive.
I suspect the purpose of a tax on unhealthy food is not to defray the harm unhealthy food causes but instead to stop people consuming that food. I believe this because that's exactly what has happened with the similar cigarette taxes. They have escalated constantly and are now being replaced with bans on cigarettes in some countries.
I believe once the hard work of getting this tax in place has been done, it will be raised until it achieves the goal of reducing or eliminating consumption of unhealthy food.
I am against banning or restricting unhealthy food and your post does little to convince me that this is not the end point of the suggested tax. Until you have a concrete amount for these taxes and until you can signal credibly that the tax will remain at that level, I am against taxing unhealthy foods to pay for health costs.
Why are you against banning or restricting unhealthy food?
In no particular order:
A life lived well is measured by how filled it was with things you enjoy, not by the number of years you existed on earth. Banning unhealthy food is a step away from the former and towards the latter. Banning unhealthy food would make people's lives less worth living, to a degree not made up for by the extended lifespan they'd see.
These are adults and ostensibly ones we trust enough to vote on the direction of our country. A democratic state shouldn't be micromanaging their decisions about their own health.
Freedom is generally good and we should need a extremely strong reason and lack of alternative options to resort to having the state restrict it, especially to the degree that banning a category as wide as "unhealthy food" would entail.
What diets are considered good and bad for you has changed immensely just in my living memory. Trying to mandate healthy eating on such a shaky foundation is foolishness and could easily make things worse. Imagine if we mandated high-carb diets based on the food pyramid. Would this have been a sensible decision or a disaster?
In this particular case, I would also object to the dishonesty of arguing for a tax under grounds that it will be used to pay for the harm of unhealthy food if your goal is actually to use it as a slippery slope towards restricting or banning consumption.
There is no evidence that unhealthy food increases life satisfaction apart from its craving->satisfaction downward spiral feedback loop. Those who quit sugar often find themselves having no cravings after a couple months. No study suggests that sugar consumption is important for life satisfaction, but many studies suggest that health is important for life satisfaction. On your deathbed you will not wish you ate more cake, unless you are hungry, and then when you have the cake you will surely wish you had less cake, because the dissipation of the craving will allow you to see clearly how worthless it is. Also, there is no positive correlation between sugar intake and life satisfaction either on an individual level or a society level. There is instead a strong negative association between sugar consumption and levels of life satisfaction.
If you want to increase sum total happiness, banning sugar should be as obvious as banning heroin.
The obvious explanation for sugar consumption being negatively correlated with happiness is that your causation is backward; people whose lives suck eat more sugary food because it's a cheap and easy way to be happier. Eating ice cream to feel better after a breakup is a trope for a reason.
Okay, maybe not entirely backward. It's clearly possible for sugar consumption to reduce your life satisfaction by making you fat. But given the myriad confounding factors it's a big leap to go from correlation to "sugar caused this!"
The comparison to heroin is weird, since the main issue with heroin is that it reduces your baseline happiness and leaves you needing more and more of it to get to normal. Most people keep a stable level of sugar consumption over long periods of time rather than spiraling out of control and eating increasing amounts of it, so sugar doesn't seem to have the same problem that leads to heroin ruining lives.
There have been dietary interventions with controls that have shown mood increase from reducing refined carbs. Here’s one: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0222768
https://gut.bmj.com/content/69/7/1218.abstract
Even after just 10 days: https://www.sciencedirect.com/science/article/pii/S0195666310006963
I dispute this given the age-related increases in obesity that are higher in sugar-filled diers
I've had a look at the studies and I'm not impressed.
I'm not sure how the second study links to life satisfaction, since it appears to be talking about gut microbes and measurements of being in good health. A quick skim of the paper body didn't show any measurement of life satisfaction either so I've ignored it.
The first and third studies cover very short timeframes. It seems obvious that health is an area where bad diet could induce unhappiness that could be resolved by a good diet, but none of these studies cover the kind of timeframe that would be required for a dietary change to result in significant health changes. Neither even covers the "couple months" you said it takes for sugar cravings to go away - shouldn't these people still be craving sugar (and therefore be unhappier than usual) on the timeframes these studies cover?
Given it can't be a major turnaround in health, what changes are being caused by the new diet that would explain substantially improved mood over such a short timeframe? The studies don't seem to have any idea what specific changes they're looking for, since they've thrown a variety of tests that mostly just return insignificant results.
Doing this scattershot approach, especially on small study sizes, is a good way to get meaningless but "statistically significant" results.
I'm asking you to just look at the people around you. Unless you're in a particularly strong bubble then most of them will be eating sugar at least some of the time. Are they constantly eating more and more sugar? Do children brought up occasionally eating cookies eventually graduate to eating whole packets of cookies by adulthood? An addictiveness even a tenth of heroin's should be readily apparent.
If you need to apply statistical tools to populations over years to find see the effect then that already puts its addictiveness leagues away from heroin.
healthy microbiome is associated w well-being, the reason short time frames are used is that these are intervention studies and it’s difficult to tell a person to eat a new diet for years. We know from correlation studies that refined carb intake is associated with poor well being. A short time frame can induce changes in inflammatory markers and some gut changes. For instance iirc there are profound mood changes from 10 days of very low caloric fasting
Yes? Look at the obesity epidemic. Addiction is not linear. Maybe only 10% of those who take opioids become addicted. But opioids are addicting. There’s a study on heroin users in Vietnam which show only a minority continued their addiction on returning home
https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.64.12_Suppl.38
Yes, statistically, given the rise in obesity
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