Look at "The Questionable Contribution of Medical Measures to the Decline of Mortality in the United States in the Twentieth Century", by Mckinlay and McKinley (1977). I know it's an old paper, but it has some fascinating and, to me, very persuasive time series. Those plots show mortality from various infectious diseases over the 20th century.

Example: death rates (per 1000) from scarlet fever dropped from 0.1 in 1900 to effectively 0 in 1940. There is NO VACCINE for scarlet fever.

Example: death rates from measles (lately very much in the news) dropped from 0.12 in 1900 to 0 in 1960 (a vaccine for measles was introduced in 1960).

A similar trend exists for many other infectious diseases: huge drops in mortality PRECEDE the introduction of vaccines or antibiotics for the disease. Surely we can't credit vaccines with such a drop in death rates. I don't see how anybody could come to such a conclusion.

Yes, measles death rates had dropped precipitously (fortunately), however incidence (new cases) had only dropped a little. It wasn't until the vaccine was introduced that incidence dropped to nearly zero[1]. Yours is a common anti-vaxx talking point, and one that seems to neglect that death is not the only negative outcome from measles. It's understandable to take the talking point at face value when it appears to be scientifically-supported, though this is a good example of how a talking point uses a cherry-picked fact and reframes the issue for a presupposed conclusion (that vaccines are unsafe or ineffective), because the origin of that talking point had no interest in comprehensively informing people but converting them to believers.

[1] https://ourworldindata.org/grapher/measles-cases-and-death-r...

For me the paper shows not just that good sanitation and nutrition help reduce deaths from many infections diseases, but that they are the primary agent in that reduction. I thought it was a very cool paper, although you don’t seem moved in the same way as me.

When I was a child, my parents weren’t upset when I got measles (I was, because it meant missing a trip to the seashore). It meant that you were going to be miserable for a week, but would be immune afterwards. So I became one more case, but not one more death.

And nobody really knows why this is, though there are plentiful hypotheses. And exercise is just one aspect of living healthy, though a very important one. You find similar strong associations between 'clean' eating and all other sorts of aspects of a living a healthy life.

Not only does it have effects but rather dramatic ones. I'd think most people would probably see this in their daily lives as healthfulness has dramatic effects on both physical and psychological wellbeing.

[1] - https://www.cancer.gov/about-cancer/causes-prevention/risk/o...

[2] - https://www.bbc.com/news/health-11664660

Other things would be to offer a 100% tax credit for things like gym memberships. If this actually incentivized people, then it'd probably pay for itself through better health outcomes for society. It could also be paid for by adding a health tax, such as already exists on cigarettes, to e.g. highly processed foods, candy, and cola.

Similarly, the FDA should have some sort of an accreditation that restaurants and other food services can apply for that confirms some standard of minimal healthfulness of their food. This accreditation would be extremely critical since, in general, just dumping salt and sugar into food makes it more addictive, which increases margins, so when you go for health - you do so at profit loss. Such an accreditation could help combat this by giving people something to look for.

I didn't contest the relationship between regular exercise and health. The questions I raised were: what evidence is there that [malnutrition] is a significant contributor to infectious disease in countries like the US? What evidence is there that an otherwise healthy immune system could be "boosted" with proper nutrition and elimination of environmental toxins to the point that it would have a meaningful impact on infectious disease?

I agree with all of these solutions for encouraging regular exercise, and I'm open to the solutions for encouraging healthier nutrition.

Solutions are not difficult to find for this specific manifestation of malnutrition. The primary issue is crap foods and cola which enable one to consume far more calories than you'd even be able to if eating a comparable amount of healthy food. For instance 2400 calories is 15 100g (cooked size) chicken breast servings. Or it's less than 2 McDonalds Big Breakfasts.

Another thing is to remove the ability to purchase junk foods and cola with government food assistance. There's an extreme inverse correlation between obesity and income (hah.. imagine people of a couple hundred years ago hearing that) and so steps like this could actually have a tremendously positive overall impact on overall social health and wellbeing. This is even more true when you consider that twinkies and cokes are being bought on strictly limited budgets which means that much less money (and now more) for healthy foods.

There's merit to the government food assistance (SNAP in the US) idea, though if you're trying to ban "junk food" from SNAP you're going to run into definition issues. Banning things like Twinkies and cola from SNAP is one thing, but "junk food" may also include ready-made ultra-processed food depending on your definition, and that may be the only type of food typical SNAP recipients can use (e.g. homeless who do not have access to cooking, people who live in food deserts). There is also a valid concern about micromanaging the food people eat, because SNAP recipients are normal humans and we tend to give normal humans leeway to indulge in a treat every now and then.

Food deserts are largely irrelevant. Things like rice, beans, canned goods, and other such products are widely available and provide sufficient nutrition. There is also online food ordering (from Amazon etc) that allows payment with things like SNAP. And the sort of products we're talking about are not "treats", and should not be seen that way. They are highly addictive and harmful trash that, in the future will almost certainly be completely banned, certainly in anything like their current formulations.

Rather than have the stores and restaurants pay for changes they can be required and tax funded. Do it gradually.

The economy will thank you later.