Obesity and Health
Many groups, like the Consumers International and the World Obesity Federation, argue food should be regulated as strictly as tobacco. Their claim (BBC News, May 18th) is that deaths from obesity are rising rapidly – about 30% globally from 2005-2010 – and that obesity promotes so many chronic diseases – from diabetes to heart disease to cancer – that the overall costs to the economy and health care system are so gigantic something must be done now.
Is Obesity Just About Diet?
Certainly not. But everyone eats. Food and water are parts of the health equation that people deeply care about – even if, for public health and politics, understanding is dim.
Obesity’s causes are complex. Complexity is not something present day media or politics do well.
Instead, their interests appear complicit – to make things as reductively simple and clear cut as possible.
As with much sloganeering, oversimplification, when allied with emotional appeals, can prove harmful. Witness the success of anti-vaccination forces, and the new epidemics, like whooping cough, they have helped produce.
Obesity is affected by hundreds of factors, including:
1. Level of physical activity
2. The amount of green space around residences
3. Food cultures and traditions
4. When and how people get up in the morning
5. Overall levels of light exposure – both awake and during the night
6. Body clocks and how they work
7. Work shifts
8. Urban design and levels of public transport
9. Societal conflict
10. National family planning policy – as in China’s one child families
There are many, many other elements. But people think they implicitly understand food and what it does.
Instead, food is an information system where social, physical, mental, and cultural factors come together with stunning effects on biology and society.
Why is Obesity So Important?
Obesity does far more than increase the costs of health care and shorten millions of lives. Obesity – through diabetes, heart disease and cancer – dramatically cuts people’s overall economic and social productivity – even when people are not ambulanced into hospitals. As American health care is now about one fifth of the national economy, its costs act as a giant tax on the American economic engine. The effects ripple everywhere – from airlines which complain about cargo weights and bigger seats, to larger schooldesks and bigger caskets. Invisible effects – as on people’s ability to think interestingly and creatively – are also present but hardly remarked upon.
What Are the Prospects of Regulating Food?
In the United States right now – dim. A polarized political system based on who pays the most effectively helps block changes to the status quo. When Mayor Bloomberg of New York proposed decreasing the “supersized” sugared soft drinks offered in the city – not exactly a severe public health measure – it was “cut down” in the courts. Processed food companies are in a good position to block legislative votes as well as deep six executive orders. Knowing that public anger is increasing but unfocused, they relentlessly trumpet the changes they are making for “healthier foods” – highly reminiscent of the tobacco companies publicity campaigns for “low tar” and “low nicotine.”
Progress remains slow. Witness how much trans-fats are prominently studded throughout the food chain. Public health has few champions – though it could save trillions of dollars and millions of lives.
What Can Be Done?
It may be best and most pragmatic to emphasize children. People care a lot about kids and what will happen to them. They don’t want their children to get sick.
Attempts to get soft drink dispensing machines out of schools are having some impact. Yet the biggest effect might come with advertising bans.
The Jesuits said “give us a child till the age of seven and we’ll have them for life.” As far as food is concerned, seven years may be way too long.
There is already evidence that what pregnant mothers eat affects their children’s future food preferences. The vastly increased amount of sugar in children’s diets also seems to convince many of them – perhaps for the rest of their lives – that high sugar content is a requirement of “tasty food.” Encoding such eating habits daily until the age of three or four may indeed impact people up to and including their entire adult lives.
Children who watch TV and videos see thousands of food commercials each year. Those ads are not mostly for oats, fruits, and vegetables, but for far more lucrative processed products, usually stuffed with sugar and fat.
That the US allows such unlimited advertising is often regarded as a scandal in other countries. They can’t believe we allow it.
Nor can they understand how agricultural subsidies are used to create cheap, easy to sell junk food. With palates shifted away from whole, natural ingredients to added industrial sugars and fats, poor mothers find that the foods their kids want to eat – the junk food they see on TV – is also the cheapest. More junk food means fatter kids who will be more prone to diabetes – and less able to compete cognitively and economically. So national food policies indirectly support increased economic inequality.
To an extent, we are what we eat. People need food to live; they don’t need tobacco. Regulating food products could arguably save the US economy trillions of dollars. Yet regulating it legislatively may take even longer than it took to regulate tobacco.
There is reason to hope. Looking at how food changes life can cause people to recognize how other health choices affect their homes, careers, and the nation. Health is not just about individual survival. It’s also about overall economic competitiveness and survival.
Emphasizing kids – particularly infants – may be the first place to go when trying to control an obesity epidemic that still rolls on.
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