OPINION – The Netherlands is sick and overweight

The figures speak for themselves. Nearly half of adults are overweight and over five million Dutch people have one or more chronic conditions. We all know how this happens. And it has also been clearly demonstrated scientifically. We eat the wrong things, we move too little and we have too much stress. And this makes us sick, or fat and then sick.

“We eat the wrong things, we move too little and we have too much stress.”

At present, 900,000 Dutch people have type 2 diabetes. Every year, the equivalent of a full Amsterdam Arena is added. A total of 55,000 men and women per year, 150 per day. People like you and me who will surrender their quality of life and are likely to die ten years earlier as a result of the disease.

The burden of disease is high, as are the costs. In the Netherlands, according to CBS, the Netherlands spent nearly 95 billion euros on health care in 2015. According to the CPB, an average family currently contributes nearly a quarter of its income to healthcare. This is estimated to be between 30 and 45 percent in 2040. A significant amount of money that could also be used for other fun and useful things.

But there is also good news. Many diseases and the associated costs are largely avoidable if we make other choices. As an individual, as a society and with our healthcare. Lifestyle-related disorders, such as type 2 diabetes, obesity, rheumatism and gastrointestinal disorders, cost less suffering and fewer euros when we work seriously on lifestyle as a drug.

A small but growing number of GPs and scientists are showing what is possible: peppers instead of pills. They are using lifestyle as a medicine in curative care. Certainly, fruit and vegetables but also cycling and walking or resting, on prescription.

“A small but growing number of GPs and scientists are showing what is possible: peppers instead of pills”

For example, the Leids University Medical Center and TNO have started a partnership. They are doing this because there is increasing evidence that a number of diseases can be prevented or even cured with targeted lifestyle changes.

In practice, GPs already have interesting examples. What about the type 2 diabetes patient who can stop the insulin that he has injected daily for ten years? The patient who was in bed with a migraine every week and now has a headache-free life? Not by complicated medical interventions, but simply by eating differently, moving and relaxing.

The Netherlands is ready. Lifestyle as a drug is in the best interest of care professionals, policy makers, health insurers and not least the patients. More and more people are taking control of their own health. They do not enjoy more disease, more pills or more syringes every year. They want to reverse their illness.

“Lifestyle as a drug is in the best interest of care professionals, policy makers, health insurers and not least the patients.”

A number of healthcare institutions are at the forefront. The Bernhoven hospital and the Radboud Medical Center, for example, use food as a medicine for faster and better recuperation after operations. Healthy food is also a spearhead of Reade, the center for rehabilitation and rheumatology in Amsterdam. No hassle with superfoods, but just fresh and unprocessed food.

And also for GPsthe shift is not too great. Patients being sent to the green grocer instead of the pharmacy may feel a bit uncomfortable, but it fits with the down-to-earth approach of Dutch GPs. Doctors who are internationally known for prescribing paracetamol and for limiting drug prescriptions. Lifestyle as a medicine also fits seamlessly within the professional protocols and guidelines. Nutrition, movement and relaxation are theoretically the first choice for many different conditions. However, daily implementation is harder.

“Lifestyle as medicine is the future”

Dutch health care is not yet organised for lifestyle as a medicine. In terms of training there is a lot to win. Most students of medicine do not yet have lessons on nutrition during their six-year education. They are taught how to increase medication, but the first drug-reducing protocol has yet to be invented.

“Most students of medicine do not yet have lessons on nutrition during their six-year program.”

The barriers are not only in healthcare but also in us, patients and consumers. At the Food Summit in February this year, four ministries and the food industry said in a final statement: “We want the Netherlands to be the undisputed leader in safe, healthy and sustainable nutrition and sustainable agriculture and horticulture worldwide in 5 to 10 years. A nice prospect for public health, at least if we eat that healthy diet. The Netherlands is eating too few vegetables, fruit and fish according to the RIVM. And we have never spent as little money, as a share of income, on food as now. We spend more on healthcare than on food. That is strange.

And it can be different. If we want it. The prospect is desirable, the willingness is there and the knowledge is enough to get started. The key is to get it done. In 5 to 10 years, we will find it absolutely normal that lifestyle as a medicine is the first choice in many chronic conditions. If lifestyle does not work sufficiently or not fast enough, medication is plan B. Let’s be the leader, as the Netherlands and benefit from it. For the individual and society, for our healthcare and our economy. Lifestyle as a medicine is the future.

Source: NRC (Dutch Newspaper). 28-04-2017