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Archive for the ‘Public health’ Category

Quote of the day

Okay, this HuffPo blog post by journalist/author Venetia Thompson on “the culture of obesity” is going to make wendyrg‘s head explode! But I thought this bit of interest:

I would argue that our addiction to fast food, corruption of the food chain, lack of interest in physical activity and resulting obesity epidemic is a symptom of a far more serious problem: the collective misery caused by our increasingly solipsistic, alienating societies.

This resonates with me. And I really must stop procrastinating and read Bruce Alexander’s Globalization of Addiction, since he makes essentially a very similar point.

Alexander argues that we aren’t really seeing a massive failure in personal responsibility so much as we are “being torn from the close ties to family, culture, and traditional spirituality that constituted the normal fabric of life in pre-modern times” … and the result is that people “adapt to this dislocation by concocting the best substitutes that they can for a sustaining social, cultural and spiritual wholeness.”

Yes, for some this is addiction, but for many others, it’s not as far along on the continuum of problematic behaviors.

Alas, I think Thompson has her finger more on the problem than the solution, which according to her starts with “we have to take responsibility for our bodies again” and “aspiring to be a healthy member of society is what gives us dignity.” Oy.

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Dr. Walter Willett, nutrition chair at Harvard (among other things), has a new book — Thinfluence — coming out next month. In a promotional interview with The Atlantic, he talks about the “powerful and surprising effect” the environment and our social networks play (emphasis mine):

If you look around the world at wealthy countries like the United States, you see very different rates of obesity. In Japanese women, prevalence of obesity is under 5 percent; in Swedish women it’s about 6 or 7 percent. In the U.S., it’s between 35 and 40 percent—and we know that when people come from these countries to live in the United States, they fatten up. That’s a clue that there is something pretty important going on that’s related to where we live, and that there are very important factors operating [outside of us as individuals].

We’ve started to understand some of these; they’re often complex but it’s a clue that Americans aren’t simply completely irresponsible people. And looking at kids, too, their obesity rates have about tripled over the last four years, or quadrupled among some groups. It’s not that kids have become massively irresponsible in such a short time, but that there are obviously factors outside the kids’ inner-selves that are operating here.

So much of what people have been told is that weight is just about individual change. We’re not saying that there is no such thing as individual responsibility, but sometimes even very responsible people can have a hard time making the choice that’s in their best interest if there are a lot of barriers in their daily life and environment.

I might quibble with characterizing this as “surprising” … but I suppose it’s helpful when someone like Willett proclaims it so.

In the book, Willett talks about a very interesting program in Kentucky that leverages “contagious health” as a wellness tactic. The idea behind this program (see “microclinics“) is very, very compelling IMO!

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Quote of the day

In an article for Bitch, chef/writer Soleil Ho wonders “how can we fetishize the act of eating so much while also making food more inaccessible to the people who need it the most?”

I don’t mean to minimize the important question/concern of food accessibility, but this snippet of Ho’s related to the act of eating (or at least shopping for food) struck me:

Though it can be said that the acrid odor of snake oil marketing has always been a hallmark of American laissez faire capitalism, we’ve entered an age where consumer choice and moralizing have combined to turn grocery shopping into an incredibly neurotic experience. If you want to be cosmopolitan, you’ll buy star anise, kimchi, and coconut oil. If you want to prevent cancer, buy collard greens, blueberries, and omega-3 eggs. If you want to eat food free of pesticides and high fructose corn syrup, buy organic meat, flour, and dairy. Compound all of these seemingly innocuous exercises in American Dreaming with diet fads like “clean” eating, Westernized veganism, or the paleo diet, and you’ll get a supermarket full of people staring at labels, searching the copy for proof of ideological and medical purity. I need to buy this if I want to be good, if I really want to take care of myself and my family. As it turns out, this moralistic way of framing choice is extremely profitable for food processors, restaurants, and produce retailers: we’ve been effectively held captive by our own consciences.

As this #Breaking Black post on “food gentrification” suggests, there “are no easy answers, but we have to start asking the questions before food becomes a privilege instead of a necessity.”

And while we’re at it, perhaps we should look more at if/how much this “fetishization” of eating leads to analysis paralysis and “what the hell” decisions around folks’ diets.

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Quote of the day

Dr. David Katz is a busy guy! One of his many roles is Editor-in-chief of the journal Childhood Obesity. In an editorial in the February issue, he asserts that obesity is like drowning: “medically legitimate,” but not a disease. For him, this is not just semantics:

The importance of considering obesity a variety of drowning lies with the implied remediations. Whereas we do treat drowning when it occurs, our principal approach is directed at prevention. … We recognize the problem of drowning as a mismatch between our bodies and the environment, and direct our efforts at the interface. Diseases, in contrast, bespeak a problem within us, rather than all around us, and direct our efforts accordingly.

Obesity as disease implies that a large population of our sons and daughters are not just heavy, but diseased. I object to this, for the fault lies not with the bodies of our children, but with the body politic. The fault lies with a culture that sanctions junk as a food group, jettisons physical activity from the school day despite evidence of its myriad benefits, and, in general, leaves health to languish on a road not taken while neglecting much that might be done to put it on a path of lesser resistance. If ever more effort is directed at obesity as a disease, treated in the customary ways, none of these fundamental problems will garner the attention each deserves.

Obesity need not be a disease to be legitimate. If it is a disease, it is a social disease.

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label

Current label on left, proposed label on right

I think the proposed changes to food labels and portion sizes are generally pretty good. Certainly from an info design perspective it makes sense to create at least a little contrast (e.g., by emphasizing the calories) as well as some proximity (putting the percent daily values closer to their respective nutrients. From a public health perspective, it should be much better for portions to be more realistic, as well as to have added sugars called out on the labels (though not sure why they didn’t go ahead and create an “Added Fat” call-out too).

All of this said, it’s not clear that kids are going to care that their sugar-sweetened beverage now explicitly says how much of both (calories & sugar) they are getting. And of course, the more food you eat without labels, the better. But perhaps it will cause business to respond with healthier options … either in the foods that would be re-labeled or as additional offerings.

NPR has a good write-up here. Not surprisingly, Marion Nestle approves.

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Quote of the day

Disease Proof author Dr. David Katz revisited a post from late last year, wondering: Should choosing a meal really require choosing a Messiah?

Couldn’t the proponents of low-carb eating acknowledge that jellybeans were part of the problem, but pinto beans- not so much? The vegans have important arguments about the treatment of our planetary cohabitants, sustainable eating for a population of 7 billion, and planetary stewardship- but if anything, these get lost when they fail to allow for the fact that game and fish figure in the diets of some of the world’s longest-lived, most vital peoples. We could have been right about reducing saturated fat intake, and wrong about what we ate instead. We could agree that eating real food, close to nature, rich in nutrients, and mostly whether or not exclusively plants would be far better than the typical American diet, and would occupy ground common to the disparate theologies of food. …

Whether about wheat or meat, sugar or starch, calories or carbohydrates, this fat or that fat, we seem to have an insatiable appetite for mere grains of truth about diet and health, rather than the complete recipe. Planting such seeds, we are reaping just what we are sowing: more heat than light, unending opportunities for food industry abuses, stunning lack of public health progress, and the very kind of trees that make the forest impossible to see.

Maybe Chris Masterjohn has the right idea:

yum

Yum!

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Food Politics’ Marion Nestle has written today about new food-based dietary guidelines Brazil has issued for public comment. [If you can read Portuguese, here’s the original.] The guidelines are:

  1. Prepare meals from staple and fresh foods.
  2. Use oils, fats, sugar and salt in moderation.
  3. Limit consumption of ready-to-consume food and drink products.
  4. Eat regular meals, paying attention, and in appropriate environments.
  5. Eat in company whenever possible.
  6. Buy food at places that offer varieties of fresh foods. Avoid those that mainly sell products ready for consumption.
  7. Develop, practice, share and enjoy your skills in food preparation and cooking.
  8. Plan your time to give meals and eating proper time and space.
  9. When you eat out, choose restaurants that serve freshly made dishes and meals. Avoid fast food chains.
  10. Be critical of the commercial advertisement of food products.

What I find fascinating is how many of the guidelines have to do with something aside from what foods to eat, such as the guidelines about eating meals with others (4 & 5) and the guidelines about cooking & planning (7 & 8).

Nestle is a fan:

The guidelines are remarkable in that they are based on foods that Brazilians of all social classes eat every day, and consider the social, cultural, economic and environmental implications of food choices.

It will be interesting to see if/how the guidelines change as a result of the open comment period, as well as the reaction to them from the US dietary establishment.

Side note: Nestle got a translation of the guidelines from University of Sao Paulo’s Carlos A. Monteiro, author of a study defining the concept of “ultra-processing” and contributor to these draft guidelines.

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