that articleI had been planning to post today about the myth and legend of the healthfulness of vegetable oils (I know – how much more compelling a subject could there possibly be?!? I figure if you’re reading these Food Friday posts, though, you might have some interest in understanding food/health myths, too). However, when I write about things like this, I want my points to actually have a basis in fact. I therefore began doing additional research, and I ended up going off on a fascinating, if sometimes blood-boiling tangent.

My vegetable oil research last weekend led me to a book I’m now reading that was published a few years ago, with a title I utterly love: “The Big Fat Surprise.” It’s written by Nina Teicholz, an investigative journalist whose credits include reporting for National Public Radio and writing for numerous publications including Gourmet magazine and The Economist. If you’re interested in the links between food and health, this book is a must-read, and despite the fact that she’s sifting through a virtual mountain of research and historical records, it’s written in such a way that it’s hard to put down – rare, in my experience, for non-fiction. It’s screwed up my entire sleep pattern this week, and this post is later than usual today because I spent far more time lost in reading over the past several days than in writing!

The author, who is decidedly not someone with any proverbial skin in the game of either the food or the healthcare industry, spent 9 years meticulously researching the nutrition science and research behind the “known” links between saturated fat and poor health  (cholesterol, heart disease, obesity, cancer), which was prompted by an article on trans fats her editor at Gourmet asked her to write (that article was published in June of 2004). The article was written about a year after the FDA announced that, starting in 2006, food manufacturers would be required to print information about trans fats on their labels. The book was published in 2014.

As she was researching and writing the Gourmet article, the question she was attempting to answer was “why.” Why, when research for more than 30 years had been indicating that trans fats were possibly far worse for health than saturated fats (which were the demon-children of the diet and nutrition world from the 1960s onward, and still are, according to many doctors), was further study not aggressively pursued? She was able to scratch the surface of an answer in the article, but the matter required a lot more digging –  in essence, meta-research (research on the research – especially about the methods that were followed in the various studies that were supposedly the foundation of what became incontrovertible dietary recommendations for the U.S. for several decades). It’s that meta-research which underlies The Big Fat Surprise.

I’m only about 1/3 of the way through the book as I’m writing this post, but what I’m reading certainly has my hackles up so far, as one might expect upon becoming enlightened about being lied to for most of one’s life, regarding genuinely life-altering things. I’m going to try to finish reading it before next Friday, by which point I should have enough rant-worthy material to keep us all going for quite some time.

Happy Food Friday!

A while ago I came across a whitepaper that decimated a notion I’d harbored for a long time: that farm subsidies were a key enabler behind our national problem with obesity, and, therefore, many chronic, preventable health conditions. It seemed to be a logical (if factually flawed and highly simplified) flow: subsidies encourage overproduction of certain commodities, especially corn and soy, which, because they’re so abundantly over-produced, end up as meaningless livestock feed and unhealthy fillers in processed foods; processed foods, made mostly from these unhealthy ingredients, end up being significantly cheaper than healthier whole foods, encouraging over-consumption.

It turns out that the very first part of that flow – the part where subsidies encourage overproduction –presented the surprising (to me anyway) flaw in my logic. This whitepaper isn’t new – it came out in 2011. I’m sure it was widely discussed in food policy advocacy circles at the time. Sadly, from what I have seen, the policy changes advocated in the paper (which appear to be based in quite a deep and sound body of evidence) have yet to take root.

I haven’t been able to do further research (yet) into why it is that we haven’t made any significant strides on the food policy front, but I have a few hypotheses: 1) Disengagement. As I’ve surmised in prior posts, the long-term negative health impacts of poor eating habits simply aren’t particularly evident, usually until it’s too late, so most people just aren’t paying attention – they have bigger fish to fry (so to speak!) in their lives, or so they think. It’s a little like engaging with our democracy – we take it for granted until things get too painful for us, then we start writing our Congressmen. Maybe. 2) Food policy is a double-whammy. Not only is its importance not evident enough to enough people, it also does get into politics. Changing policy requires changing minds at the legislative level, a challenge for even the most fired-up consumers, especially in light of the lobbying power of 3) “Big Food.” The whitepaper makes a clear point in its third finding: “The food industry has been the main driver of commodity policy, not farmers.” The evidence shows that “the deregulation of commodity markets – not subsidies – has had a significant impact on the price of commodities. Deregulation also has provided benefits and incentives to the food industry, including processors, marketers and retailers, and is one of a number of contributing factors impacting the availability of high-calorie processed foods in the marketplace.”

The paper is very much worth the read if you’re even remotely interested in addressing public health issues and the cost of healthcare. If you don’t have the time for the full 13 pages of content, there’s also this issue brief that distills it all down to 3 pages.

The impact of blaming subsidies also tends to demonize farmers, which I suspect most of us don’t want to do. There’s been a definite resurgence of small, local farms in various places around the country in the past decade, but it’s incredibly difficult for them to make a consistent living from growing things we can actually eat (as opposed to mass production of the commodity crops noted above), and it’s especially difficult for them to price their products at levels that lower-income households (who are disproportionately impacted by those pesky preventable chronic diseases) can justify spending. What if there were a way we could incentivize farmers to go back to growing actual food, in places that are relatively local to most of us, and make real, fresh, healthy food accessible and affordable to everyone?? The paper concludes with a short list of recommendations for policy solutions:

• Engaging in the long-term campaign to reform commodity policies;
• Increasing consumption of fruits and vegetables, whole grains and other healthy foods;
• Expanding the supply of healthy foods by helping farmers diversify their production and supply local and regional markets with healthy food;
• Building the infrastructure needed to better link farmers and consumers and aid in the delivery of healthy foods.

We can keep burying our heads in the sand and ignoring this problem, arguing over “healthcare reform” that’s focused only on treating symptoms, or we can focus on things that will make us, our children, and our grandchildren truly healthier.

There are many organizations out there who are doing this work at national, state, and local levels, and they are always delighted to have extra voices and resources to help. The two who collaborated on the whitepaper, Food and Water Watch (www.foodandwaterwatch.org) and The Public Health Institute (www.phi.org) are great places to start, but nearly every state and major city also have food policy organizations addressing things at more local levels if you’re so inclined. (There’s a wonderful one in the Hartford, CT area for which I served as a board member for 6 years, Hartford Food System (www.hartfordfood.org)). Their work and the work of their counterparts around the country will make you smile. Check them out.

Happy Food Friday!

Why is it that we can so easily recognize the importance of understanding and structuring policy regarding the dangerous addictive properties of opioids, but we have such a hard time recognizing the importance of understanding and structuring policy regarding food, which, in many cases, plays along the same addictive pathways in the brain?

There are numerous studies showing that certain foods (sugar, for example), can be at least as addictive, if not more so, than cocaine or heroin, activating the same receptors in our brains as the drugs. (This article is a great read, and provides links to a few such studies if you’re so inclined. There’s also this study regarding highly processed foods and “food addiction”). Some studies suggest that the impact of sugar on those receptors could be even *stronger* than the impact of cocaine.

We’re enraged to the point of proverbial torches and pitchforks at the pharmaceutical companies who produced and marketed opioids literally to death. (According to the latest figures – January 2019 – from the National Institute on Drug Abuse, approximately 130 people die from opioid overdoses each day – over 47,000 per year).

Yet, with the clear links between poor diet and chronic preventable disease (mentioned in my Food Friday blog last week) and related deaths, which number approximately 1.4 *million* annually in the US (I had to go to a few different sources on the CDC website to compile this number, but roughly, it’s comprised of 600,000 deaths per year each from heart disease and cancer; 140,000 from stroke, and 80,000 from diabetes), up to 40% of which are preventable (much higher, actually, for Type 2 diabetes), where’s the outrage? Where are the lawsuits?? What are we thinking???

I find it fascinating how we humans (especially we freedom-loving Americans) rationalize things like this, and how outraged many people become at the suggestion of policy (such as consumption-based taxes) that can begin to shape longer-term, truly beneficial changes in our food and beverage habits. We cling to them like a tattered blankie from childhood, assigning all sorts of mythic autonomy to our “rights” about our choices for what we eat and drink, and, in the process, choose a clear path to disease, premature death, and billions and billions of dollars in healthcare spending that are truly avoidable. We *all* then pay the price in higher costs of “delivery” and upward-spiraling insurance premiums. And then we punish the providers by continuing to squeeze them to deliver an ever-increasing volume and quality of services at lower and lower cost. It really pisses me off.

As it stands, in 2017, $3.5 *trillion* was spent on healthcare in the U.S., representing 17.9% of GDP. In 1970, in inflation-adjusted dollars, we spent $400 billion, which represented 6.9% of that year’s GDP. The rate of healthcare spending has been increasing at a considerably steeper rate since the late 1990s, and even though it’s slowed down somewhat in the past couple of years (as of the date of the latest Peterson-Kaiser Health System Tracker), the links between preventable chronic disease, death, and dietary choices remain.

We need to get more aware of what’s influencing our “decisions” (our own brains’ pleasure receptors gone wild; willful and active ignorance by food manufacturers as they continue to produce and heavily market products with addictive ingredients – remember the tobacco industry 40 and 50 years ago? Yeah, that. But with your FOOD.) We need to stop acting like petulant children, stamping our feet and declaring in effect, “it’s my body and I’ll eat what I want to.” We need grow up and instead, plant our feet firmly in the soil of true self-worth (as opposed to misguided notions of self-determination masquerading as “choices” we think we want to make) and start taking seriously our own roles in our individual and collective health.

Rant over. Happy (Food) Friday!

Call me (still) crazy, but back about 10 years ago when people were fighting like cats and dogs over the  Affordable Care Act and political liberals and conservatives largely fell into nice, neat lines on either “side” of the debate, I, who consider myself to be largely a social liberal and a fiscal moderate, was trying to invent a completely different line whenever the issue came up in conversation. That line invoked my deep and pretty much unrelenting conviction that when you’re dealing with any significant, systemic issue, you do yourself (and any impacted constituents – in the case of healthcare, that’s more or less all of us who aren’t super-wealthy) a huge disservice by only addressing symptoms. Rather, analysis of, and solutions for, the root cause(s) of an issue are the path to a longer-term, more effective answer.

In this case, the “symptom” was (is) the skyrocketing costs of healthcare (duh!), which, per the main focus of the ACA, would be addressed by a turning of the regulatory screws, mostly on providers and payers. My point (then, and still) was that we already knew at the time, and we have an even greater body of evidence now, that there are a few *significant* drivers behind healthcare costs in this country. One of those drivers is spending on chronic preventable diseases (which also impacts some of the other major levers of spending, including “service price and intensity,” a significant proportion of which is driven by increasing costs of pharmaceuticals and acute interventions to *treat* the chronic preventable diseases).

My essential argument is this: we’ll *never* rein in the costs of healthcare if all we focus on is the cost of delivery of healthcare. We need to get serious (as serious as a heart attack, maybe?) about making the deeper changes we need to make as individuals, a country, and as a culture that will influence our collective health. And I’ll be the first to admit that diet isn’t the only issue, but it’s my soapbox, and I’ll focus on food if I want to, because it’s a big one.

Here are some sobering statistics from the Centers for Disease Control and Prevention (a.k.a. the CDC – though this language is quoted from “The Nutrition Source” on the website of Harvard’s T.H. Chan School of Public Health):

• Chronic diseases are the leading causes of death and disability.
• 70% of annual deaths are due to chronic diseases.
• These *preventable* (emphasis added) conditions not only compromise quality of life, they add to rising health care costs—*75% of our health care dollars are devoted to treat these diseases* (emphasis added, again).
• Among adults ages 20 to 74, diabetes remains the leading cause of kidney failure, blindness, and non-traumatic lower-extremity amputations.

“Chronic diseases —*including heart disease, stroke, diabetes, and cancer* (emphasis added)— account for some of the most common health problems in the United States . . . yet many of these chronic diseases are preventable, as they’re linked to poor diet and lifestyle choices including tobacco use, excessive alcohol consumption, and inadequate physical activity.” Let me repeat: 75% of our health care dollars are devoted to treat these diseases.

This isn’t simply about making changes to our diets, though. There’s an entire undercurrent (more like a riptide) of culture that needs to evolve as well, and I’ll be talking more about that in future entries, but allow me close this post with one simple example, as this particular policy is certain to whip up controversy wherever it’s proposed: a tax on beverages with added sugar. People invariably FREAK. OUT. over this (though I think it’s a freak-out that in large part is manufactured by political action/interest groups representing beverage manufacturers, whose “ads” on the horror of the idea are intended to sow discontent). But this is what I mean when I talk about the riptide of culture, and I’ll come back to that next time.

Cheers for now, and happy (Food) Friday!