Health Care Reform: The Doctor Questions His Assumptions
Since you’re reading this newsletter, I can safely assume we agree that changes in individual eating behaviors are key to improving the health of Americans. Personal responsibility is the basis of my Midwestern, Roman Catholic upbringing. And taking personal responsibility for one’s success and failure has always been a fundamental characteristic of the prototypical American. But after reading this quote from HartBeat, a free online newsletter from the Hartman Group, I rethought the obstacles to, and have a better appreciation for, the difficulty of change:
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We all want to believe that given the right information, consumers, as rational human beings, will make better decisions. So what is going on here?
HartBeat goes on:
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During World War II, when much of the domestically produced beef and pork was being purchased by the government for our troops and the allied war effort, the federal government attempted to persuade U.S. consumers to return to eating more organ meat (such as beef hearts, kidneys and liver), cuts that had been abandoned as the prices of “better” beef and other meats became more affordable. Since no other meat was available during the war, this effort to change eating culture met with only very short-term success. When the war ended, people went back to their old, but now new, eating habits.
Some of the detrimental elements of our “eating culture” today include:
- Snacking on foods high in sugars and fats instead of eating balanced meals
- Eating prepared foods rather than cooking meals at home
- The huge portions customarily served in restaurants
- Fast food as a frequent choice
- Diets that emphasize high protein/low-carb (such as Atkins), rather than veggies and whole grains
These trends enable obesity, give us heart disease, and in general make us unwell. Shift happens; the questions are how, when, and why?
Snacking
I don’t see us as a culture abandoning snacking any time soon. And while it’s true that more and more whole grain snacks are available today, many of them depend on excessive salt or fat for flavor, which virtually negates their health benefits. (We’re doing our part to offer a wholly healthy whole grain snack with the Dr. Kracker Snacker Kracker). If parents bought more whole grain products that don’t contain these added fats and salt, and accustomed their kids to prefer whole grain to refined white flour, coming generations will be part of a whole grain culture.
Lest you think creating a whole grain culture is not possible, consider this: in Denmark more than 80 percent of the citizenry eat the heavy black rye bread that so intrigues me as a baker. This whole grain rye is an iconic food of their culture. In Mexico, the segment of the population for whom beans and whole grain corn tortillas are the heart of the diet are lean. So it’s possible for families to raise children who crave and continue to eat whole grain foods. Interestingly, I can’t think of a single iconic health food (like Danish black bread or whole grain corn tortillas) that is a staple of our culture. (Sliced bread, hot dogs and apple pie don’t exactly qualify.) Why did each ethnic group who brought these iconic foods to our country abandon them in favor of the standard American fare of sugar, refined flour and fat? I don’t know, but I do know this: the taste we have developed for unhealthy foods and the way we snack on them with abandon is the single biggest obstacle to tackling dietary disease in our culture. And correcting that taste is something best done by every child’s mom and dad, by offering these foods when their kids are young, keeping them in the house, and making them part of the fond food memories that become cornerstones of our food culture.
Eating Prepared Foods Instead of Cooking
While snacking leads to excess caloric intake, our new dependence on foods prepared outside the kitchen makes healthy eating more challenging. Prepared foods offer more variety than the typical fast food, but they don’t always offer less fat and sodium, or more fiber and whole grains. Perhaps our current economic recession will lead people to switch to shopping for ingredients instead of paying extra money for the convenience of having someone else prepare their meals.
Why don’t more people cook at home? We seem to esteem the activity. Cooking shows are drawing record audiences, and oodles of tapes and photos are available on YouTube, Squidoo and foodie blogs and websites. Cooking is empowering. We can choose ingredients and recipes that we prepare, make exactly what we want to eat exactly the way we like it.
When the information on better food choices is combined with skills to cook better food, some shift will happen. In Austin, we need to look no further than our hometown favorite Whole Foods Market. Whole Foods is adapting its food message to emphasize more vegetables, legumes and whole grains; it’s promoting a plant strong diet as one of its new “healthy eating” programs which will offer corresponding classes in the stores, along with designated Healthy Eating information areas within the store. But again, the best opportunity to shift a cultural attitude is to teach and expose young children to cooking at home and freshly prepared meals become collectively woven into fond childhood memories.
Restaurant Portions
Large portions in restaurants promote obesity. It’s gotten to the point where people expect to stuff themselves to capacity for the money they pay. Some restaurant chains tried serving smaller portions in response to health criticisms, but customers accustomed to large portions criticized the value of the meal and the restaurants had to go back to super sizes to compete. So it’s up to consumers to modify how much they eat in one sitting. When my wife and I go out to eat, we often split an entrée, since neither of us can finish an oversized portion. It took some thought on our parts to make this change, and some discipline, but we quickly enjoyed the feeling of satiation over bloating.
Fast Food
Fast food is a major source of refined calories, excessive sodium and fats in the American diet. It distinguishes the American diet from all other World Cuisines. Genuinely unhealthy, yes, but fast food’s convenience and price are impossible to ignore, and they keep consumers coming back for more. Though these cheap calories may fill our bellies, long-term, they’re ruining our health (and our environment, too, which is a whole other topic). To add to the insidious nature of this market segment, in the lowest income neighborhoods in our larger urban areas, there are often no conveniently located supermarkets or corner stores where fresh produce can be purchased, yet fast food restaurants abound. When we consider that food cost has gone from 20 percent of the average household budget 40 years ago to less than 10 percent of that budget today, whereas health care has gone from about 4 percent up to a current 17 percent, we shouldn’t be surprised at the relationship between inexpensive calories and poor health. But perhaps we should be angry.
High Protein Diets
High protein diets work short term. People lose weight, and get the results they want quickly. Moreover, the beef, pork and chicken trade groups and the Dairy Council all make their living by convincing Americans to consume more concentrated proteins. Not to mention the fact that television viewers, especially of sports events, are bombarded relentlessly with tantalizing commercials featuring sizzling meats and cheesy dishes. A return to low protein eating may not happen until the link between concentrated protein and debilitating disease is further established. The fear of death can change how we act very quickly.
There’s no easy answer to rethinking our eating so that we make more time to prepare and to eat better food. Changes in choices like this are dependent on each individual, as well as an overall cultural acceptance of the benefits of eating fresh, authentic foods.
So what can we do to make shift happen? It would seem that learning to cook new foods and putting the knowledge that we have into the food on our dinner plates will be an important first step to changing our eating culture and with it our health. (Popular culture may be able to play a role too, Who knows, maybe the new movie Julie and Julia will inspire a new generation of cooks!)
But beyond food as art, food as fun, and food as comfort, we need, as a culture, to develop a respect and awareness for food that reverses our current disconnect between what we eat and how fat and unhealthy we are becoming. When we make associations between what we eat and our wellness, when we learn, as a society to recognize how the different vitamins, minerals, proteins and fibers contained in natural amounts in natural foods are necessary to good health and interdependent in their efficacy, we cannot help but shift our attitude, habits, and behavior around eating. Many writers describe the multiple ways that a meal shared together with friends and family fosters physical, mental and spiritual health. We need to foster health on all levels!
We can hope books such as the China Study by T. Collin Campbell reach larger readership. I can’t recommend this one highly enough. Much of Whole Foods’s new emphasis on vegan eating is based on the conclusions of China Study.
My October hero is one of our brokers, Gerald, who has lost 30 lbs since May. He and his wife joined Weight Watchers, and Gerald stopped eating fast food. Congrats, Gerald!
