Bonnie Modugno, MS, RD - SURVIVING ABUNDANCE: We need to broaden the discussion
In a commentary published in the Journal of the American Medical Association on Oct 6, 2010. (JAMA. 2010;304(13):1487-1488. doi:10.1001/jama.2010.1436), Drs. Kelly Brownell and Jeffrey Koplan charge the food and beverage industry with questionable practices that significantly contribute to the incidence of an over weight and obese population. There is no question that food companies are complicit in the food issues of the day. But the problems are bigger than what the food and beverage industry is stocking on supermarket shelves.
Certainly, food and beverage companies have to step up and do what they can. I am encouraged by decreasing trans fat content in food, and current efforts to reduce sodium, sugar, and especially high fructose corn sweetener. But reformulating food is only one piece of the puzzle. Harder questions need to be answered regarding our food supply.
I’d like to see a more honest discussion. This discussion should be less preoccupied with assigning blame and begin to address the broader challenges of eating well in an environment of abundance. This is the challenge today, surviving abundance–whether we have enough to eat or not.
BETTER AT SURVIVING SCARCITY
Obesity, overweight and the resulting consequences on health is not a junk food issue, a fast food issue, or even a tightly targeted SoFAS (solid fat and added sugar) issue despite the public health community’s preoccupation with these factors. The challenge is bigger than these easy targets. There is a disconnect between the entire food supply and our physiology. The basic truth is that we are much better at surviving scarcity than navigating abundance.
Ironically the core challenge we have is not an overweight and obesity issue. If body weight was the perfect metric, we could assume every thin person eats an ideal diet and is in perfect health. They don’t and they aren’t. A preoccupation with body size obscures the truth.
THIN CHILDREN ARE NOT NECESSARILY BETTER EATERS
My sense is that thin children mostly just get away with it. Studies have shown heavy and thin children eat the same foods, approximately the same calories, with basically the same food composition (relative calories from carbohydrate, protein and fat), and drink about the same amount of soda. Shining the spotlight only on overweight children completely misses this truth.
As we age more people stop “getting away with it”. There are a few outliers, but they definitely are in the minority. Most people I talk to know someone who eats whatever they want, whenever they want and as much as they want—and they don’t gain weight. But they do get cardiovascular disease, hypertension, diabetes, and cancer. Being thin isn’t an antidote for disease.
You wouldn’t know that by reading medical literature. Most of the angst regarding nutrition and health is directed to our increasing girth. This is inherently dishonest and distorts the discussion.
Using body size and weight as a litmus test for health is inherently disingenuous. The sooner scientists and health care practitioners learn to disassociate the two, the better. Good nutrition is important for everyone regardless of body size. Once everyone is charged with eating well, then a meaningful discussion can commence. When that happens, it will be important to address the far more significant nutrition challenges of the day.
1. Empower FDA to truly determine what is “generally regarded as safe (GRAS), and take ingredients out of the food supply when we find out they are not. The data regarding trans fats and high fructose corn syrup illustrates the problem with assuming ingredients are safe if they have been around for awhile or seem to resemble what we already eat.
Conclusive studies on food safety need to be done first. We need to be willing to pay for them. It is not cheaper to have millions of people with more cardiovascular disease, diabetes, hypertension and the like because scientists are not cautious enough. Disease is definitely more expensive–just not for the manufacturers of these ingredients and the corporations that sell products made with them.
2. Address our farm policy that makes highly refined and adulterated food far cheaper than fresh fruits, vegetables and and other foods “close to the earth.” In a recent assessment at my local grocery store, about 80 calories of cheap white bread cost $0.16; the same calories from an apple or orange cost $0.62.
2. Honestly assess how much money we spend on food served to kids and every other marginalized population. We don’t value nutrition very much when dietitians are charged to plan menus and feed the masses with pennies. USDA wants more fresh fruits and vegetables on that menu? They’re offering an additional $ 0.06 a serving to make that happen.
3. Be honest about food shopping. Too many supermarkets, convenience stores, liquor stores, and food marts stock excessive amounts of highly processed and adulterated foods with added sugar, starch and fat. There are many more aisles of cookies, chips, snacks, candy, sodas, meal replacement bars, and the like compared to the fresh produce, meats and dairy. Assuming that access to a full service supermarket will inherently improve food choices is naive at best.
4. Investigate all food eaten away from home. It is simplistic and stereotypical to talk about super-sized burgers and fast food meals. It is disingenuous to ignore the portions at sit down restaurants. Many entrees from neighborhood bistros, national chains and even exclusive dining establishments offer 1000, 2000, and more calories per entree while typical large hamburgers range between 600-800 calories.
5. Critique food everywhere. Most entertainment venues preferentially sell excessively processed, adulterated foods and beverages in enormous portions to justify outrageous prices. All this points to businesses preoccupied with profit over people. We can no longer afford an indulgent posture, rationalizing something “just this once.” Treats are not occasionally. Most people are offered multiple opportunities to indulge every day.
6. Charge every person involved with food and food policy to ask themselves, “Are you part of the problem or part of the solution?”
7. Lastly, intensely critique our national values. As long as productivity and monetary wealth is valued more than health and well being we will continue to see people make food choices based on convenience and taste.
There is little incentive to improve food choices when there is little value for the time and energy needed to purchase, prepare and eat healthy food. Eating well takes time, skill and effort. It will not happen just because it should.