Feet, forks, and fingers

Sonnie Bailey

5 March 2016

Although I tend to focus on wealth and financial outcomes on this blog, many of the biggest risks to which we’re exposed are not financial in nature.

That’s part of the reason I define “wealth” broadly. It’s one thing to be wealthy in a material sense, and quite another thing to be wealthy in a broader sense. There might be a relationship between the two, but the latter is in my view more important. It’s why I’ve written in the past about personal relationships being central to the themes of wealth, risk, and succession

More specifically, I think there’s truth to the notion that “your health is your wealth”. And that’s what I want to address in this post.

I’m currently enjoying the book Disease-Proof by David L. Katz M.D. As a doctor, a nutritionist, and founding director of Yale University’s Prevention Research Centre, he brings an informed view to preventative medicine.

Discussing a 1993 paper entitled “Actual Causes of Death in the United States”, Katz explains:

the diseases we had long listed as the leading causes of death – heart disease, cancer, stroke, pulmonary illness, and diabetes – are not truly causes. These disease are the results or effects of how people live. When someone dies of, say, a heart attack, it is not very illuminating to blame the cause of death on disease of the cardiovascular system, is it? What we all really want to know is what caused the cardiovascular disease.

(This mirrors the content of an earlier post of mine: What is the leading cause of death? An interesting perspective.) 

He then explains that the authors of the paper, Drs Michael McGinnis and William Foege, “found that, overwhelmingly, premature death and chronic disease were attributable to just ten behaviours”. Namely:

  1. Tobacco use
  2. Dietary pattern
  3. Physical activity level
  4. Alcohol consumption
  5. Exposure to germs
  6. Exposure to toxins
  7. Use of firearms
  8. Sexual behaviour
  9. Motor vehicle crashes
  10. Use of illicit drugs

I’ve highlighted the top three items, because Katz explains that this list “was dominated by the top three: tobacco use, dietary pattern, and physical activity level, which accounted for… about 80 percent of the total [premature deaths in the US in 1990]!”.

In his book, Katz spends a lot of time discussing the importance of “feet, forks, and fingers”. Namely, physical activity level (=feet), dietary pattern (=forks), and smoking (=fingers).

Feet, forks, and fingers. It’s an elegant way of referring to three important sets of behaviours that are within our power to change, that can significantly impact our long-term health outcomes.

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