As many of you know, I work in healthcare IT. Most recently, I've spent several months configuring a prototype of our software that would work in an average outpatient family practice or pediatrics clinic.
Last week, I presented my project to my team. When I got to the Growth Charts, several team members spoke up. I had normal girls and normal boys growth charts. They wanted overweight growth charts.
"All the kids are obese these days," someone said. "Yeah," said someone else. "And the parents won't believe the doctors - their kids are off the growth charts. They want overweight growth charts."
It seemed almost like fate that the very next day, I saw an article titled Food Companies a Target in Obesity Fight (I highly recommend reading this).
So, let's talk. Whose fault is it? Can you sue Starbucks for marketing the Chantico? Can you sue Oreos for putting trans-fat in cookies? Should we pass a law banning trans-fats? Or perhaps the Republicans really have something when they talk about "personal responsibility." If you think this diary is worthy, please recommend it.
First, I want to share with you a "fat map" from
Ban Trans Fat (for the interim years, go to the website to take a look).
Just so you have a better definition of obese than "fat" or "really fat" - it is defined as a BMI (Body Mass Index) greater than 30.0. A BMI greater than 25.0 is "overweight." (You can calculate your own BMI here)
Looking at these maps, I don't think there's any dispute over whether obesity is a growing problem (no pun intended).
What changed in the 16 years the maps span?
My first VMD diary discusses school lunches as a subsidy to the meat and dairy industries and the influx of high fructose corn syrup into our foods (again, courtesy of government subsidies).
Clever Marketing
Another trend I've seen creep up in the past few decades is the dominance of the almighty frappucino. I'm a latte girl myself - no syrup, no sugar. When I worked in DC, there was a Starbucks in the bottom of my building (Farragut North metro station to those of you who live there) and I used to watch grown ups walk out of there at 8:30a.m. with caramel chocolate chip frappucinos, topped with whipped cream.
A grande caramel frappucino with whipped cream has 430 calories, 16g fat, and 52g sugar. In contrast, the same size McDonald's Triple Thick Vanilla Milkshake has 550 calories, 13g fat, and 72g sugar. How many of those responsible business professionals would treat themselves to a McDonald's milkshake for breakfast?
In marketing class, we talked about framing. If you market a PDA as a little computer, you're getting nowhere with it. It would be a shitty computer. But what if you market it as a glorified calendar. Then, wow! Look how powerful they are. Starbucks wouldn't have the line out the door if they called their frappucinos what they are - MILKSHAKES. But call them coffees and then it's okay to have them for breakfast - and they are darn yummy for coffees.
I think the restaurants and brands that permeate all aspects of our lives justify unhealthy eating for us. We learn about Coca-Cola, McDonalds, and Hershey as young children. As a preschooler, I had a tape of Christmas specials that I watched all year round (and I was raised Jewish!) with the commercials taped too. I remember those commercials. M&Ms melt in your mouth, not in your hand. How many licks does it take to get to the center of a Tootsie Pop? And remember the Tootsie Roll jingle? I actually know the girl who sang it. I can rattle off decades of McDonald's slogans as well: Do you believe in magic; I'm lovin' it; Food, folks, and fun, etc.
Restaurants and major agribusiness corporations dictate what is available to you and then they bombard you with billboards, TV ads, magazine ads, special deals, and huge signs visible from any road you are driving on. It's okay to eat crap because Coca-cola and McDonald's tell you it's okay. And it's pretty fun to believe it. You don't need too much encouragement to just go along with it.
Additionally, non-fast-food isn't always better for you. I dare you to look at the nutrition info on the Panera website or the Starbucks website (in particular, check out the Chantico... for that matter, check out the "low fat" breads and cakes). My health conscious family ate at Panera several times a week for YEARS - until Mom got online and found out that my favorite sandwich (the tuna) had 40g fat. I was devastated.
(Side-note here - I know you know this, but I want to recognize: if you do the work and pay attention to what you buy and eat, the alternatives ARE there. Buy transfat-free Newman-O's instead of Oreos for example. Mix 1 c. plain yogurt with 1 tbsp. dijon mustard and 1 tsp. rice vinegar and use that instead of mayo. Shop in the bulk section of the grocery store. And always, fresh fruit and vegetables. But when was the last time you saw a commercial for a carrot?)
Personal Responsibility
When it comes to personal responsibility - I have many ideas. I swear by the book Superfoods Rx. I have a healthy easy vegetarian recipes website. I admit to a smug satisfaction when I saw an article a few weeks back titled Switching to Vegetarian Keeps Weight Down.
I'm not sure I think you can sue a food company unless they falsely advertise (like McDonald's using beef tallow in "vegetarian" fries). From everything I've read, fast food places can offer healthier fare and no matter what, people flock there to buy the greasy stuff. For all of their rhetoric, Americans like their junk food.
The article I linked to at the top sums it up well:
"You don't have the collusion or the cover-up you had in smoking," says James Tillotson, a business and food policy professor at Tufts' Friedman School of Nutrition. "We want to blame somebody, but the thing is, we're all a part of it."
Sure, companies set the stage with cheap, calorie-dense foods.
But government also has propped up agribusiness, the medical community was slow to take on obesity and good nutrition, and consumers seem determined to move less and eat more, says Tillotson, a former food industry executive.
How much of that burden of blame belongs to the food industry can be difficult to answer.
Where it becomes the food company's fault is lobbying campaigns like this. Last April they took out full page ads in Newsweek and the NYT and tons of ads around the DC Metro. I don't have the text of the ad, but it said something like "Obesity:epidemic problem HYPE."
The ads were sponsored by the "Center for Consumer Freedom" (Swift Boat Veterans for Consumer Freedom is more like it). It's a front group for National Steak & Poultry Association, Phillip Morris, Cargill Processed Meat Products, Perkins Family Restaurants, Outback Steakhouse, Armor (as in ham), and I think the group that owns Applebees and Olive Garden, and more. They oppose MADD, PETA, organic foods, trial lawyers, and anyone else who might tell you to eat less, drink less, and smoke less (science, healthcare workers...).
Hype? Fuck you! I work around the "hype." I go into exam rooms and listen to doctors telling their hyperlipidemia patients that they can prescribe a med or two but the real solution is a lifestyle change. I watch nurses discharge patients from the Cardiac ICU and send them out the door with a four-page printout of the "Healthy Heart Diet." I set up computer software to track out of control diabetic patients and to use decision support that alerts docs that their diabetics need A1c tests, foot exams, eye exams, and LDL cholesterol tests. I listen to residents discussing with attending physicians that one med will bring down only the LDLs and one will bring down only the triglycerides, trying to decide which one is the priority.
And several family members of mine have weight problems. Several are diabetics (type 1 and type 2). Several have heart conditions. Most, myself included, have high cholesterol. I take a certain amount of pride in the fact that neither of my children are overweight - until I remember that they are both cats and in fact they do not carry any of my genes because I got them from the Humane Society.
Government Responsibility
Here's what I think our government's role should be in combatting obesity. The government has a stake in the issue because of the impending healthcare crisis. To use a cliche, an ounce of prevention is worth a pound of cure. Any money they spend on healthy lifestyles, they will make back many times over in healthcare costs saved.
- No more soda machines in public schools.
- A renewed effort to create a healthy school lunch program - not a dumping ground for low quality meat and dairy.
- Laws requiring gym class in public schools. (I grew up in IL where we had gym every year through grade 12, with the exception of one semester during which we took Health)
- Healthy cooking classes in public schools.
- Get rid of Ronald McDonald - regulate fast food advertising that targets children.
- Ban trans fats in packaged foods and at restaurants. (Although this creates a new issue if you read Melvin's diary from yesterday)
- Strengthen federal food labelling laws (I know they just sort of did this this year... I think it was to add allergens and trans fats to the labels).
- Require increased availability of nutritional info at restaurants. (I'm thinking in the menu or a menu supplement that is handed out like a wine list)
- Regulate definitions of certain foods (How about "coffee" and "milkshake" for a start - Germany has laws regulating ingredients for "beer," "milk chocolate," and more. If you don't meet certain requirements for the percentages of milk, cocoa, sugar, etc, in your chocolate, you can't call it milk chocolate in Germany).
- CMS can review and strengthen their standards for interventions for overweight children or children with high blood pressure or cholesterol (and set standards for testing cholesterol).
Those are just a few of my ideas. What are yours?
And now... the recipes.
Lemon Bulgur Garbanzo Pilaf
Just a little secret: My brother calls this one "Colon Blow" (after the SNL commercial). It's not a shock to your system if you are used to eating healthy, but if you eat crap and then you have this for dinner, it sends you running to the toilet. I think it's good for him. Serves him right for all the McDonalds and the slurpees.
Don't let my brother's toilet humor deter you. My whole family loves eating this, and I'm the only vegetarian among us. They add meat to it when I'm not looking.
Also, you can make it in a crock pot. Instructions are on the crock pot page of my site.
Ingredients
- 1 c bulgar
- 1 can chickpeas
- 1 can black beans
- 1/2 tsp salt
- 2 c vegetable stock
- 1/2 c water
- 1 small onion, chopped
- 2 carrots, chopped
- 3 cloves garlic, minced
- 1 tbsp olive oil
- 1-2 tsp cumin (to taste)
- 1/3 c fresh lemon juice
- 1 c fresh parsley, chopped
- Cayenne pepper, to taste (optional)
Start by microwaving bulgur and broth for about 15 minutes.
While the bulgur cooks, saute the onion, carrot, and garlic in the oil until onions are translucent. Then, rinse and drain the beans and chickpeas, and add them to the vegetables.
Once the bulgur has thoroughly cooked, add it to the saucepan with the beans. Stir the bulgur in with the beans. Taste a spoonful and add extra cumin, salt, or cayenne if necessary.
Add the lemon juice and parsley. Mix. Serve immediately.
Serves: 6
Per Serving: 347 Calories, 8.5g fat, 17g protein, 16g fiber, 10.5% RDA calcium, 28% RDA iron
Superfoods Black Bean Burrito
Prep time: 5 min; Total time: 5 min
Ingredients
- 1 whole wheat tortilla per person
- 1/2 c. fat free refried black beans per person
- 1-2 tomatoes
- 1/8 avocado per person
- Broccoli sprouts
- Baby spinach (optional)
- Grated cheese (optional)
Take a tortilla and fill it with about 1/2 c. of beans. Dice your tomato and add as much as you want. Add about 1/8 of the avocado. Then add some broccoli sprouts. If you want, wash the spinach and add some. Last add the grated cheese. Fold up the tortilla, microwave it for 1 min, and enjoy.