Combating the obesity crisis

[Sun Fin]

I hated it when Jamie Oliver ruined school dinners. All the nice things got taken off the menu and it didn't get replaced by anything else for a couple of years as schools tried to keep up with the pressure. I suspect it is better now!

How did Jamie Oliver ruin school dinners?

Long term he probably changed things for the better really.

I don't know if everyone would know who he is (I don't know if his a big figure across the pond?) but Jamie Oliver is a celebrity chef. About 10 years ago he started a campaign about how unhealthy schools dinners were in the UK and they needed to be changed. He won a lot of support and managed to make schools (I'm not sure if the government passed any laws or whether it was just the external pressure being put on the on the schools that made them act) cut out some of the worst foods. As Dong said however the schools didn't plan properly and almost overnight took out lots of food but didn't replace them with anything. Personally I was devastated that I couldn't eat 3 x sausage rolls every day anymore .

[James]

One of the problems may be that people don't listen to their doctors enough - who (in my experience) on dieting are usually liable to give the usual sound common-sensical advice: don't overeat, don't eat junk, exercise regularly, sleep regularly, drink water, and so on. But there's a kind of anti-intellectualism in our culture which advertisers of all sorts tend to prey on. The most extreme and mockable examples - I'm sure you've seen them - are of the type that go 'He lost 30 pounds in two weeks with this one crazy trick! [Insert interest group here] hates him!' But most fad diets deploy more subtle variations on the same kind of advertising and rhetoric.

But yes, I generally agree that people need to eat healthily and in proportion - and meals, rather than snacking throughout the day. (I'm personally really bad about this one.)

Some of the weight-loss professionals I read have attempted to address that problem with fairly consistent arguments, though I've not saved the links. They might point out, here, that while general care doctors typically do give the fundamentals in advice they typically do not go to greater lengths to explain (or even necessarily understand) what is involved in following through with that advice, and additionally that there's no ongoing followup. And there's usually no stones cast here: in many areas—more so in poor regions which typically correlate with greater food health concerns—there's a shortage of general care doctors, and even if they wanted to, they couldn't provide the sort of dedicated, ongoing health intervention needed in these cases. It's also a problem some regions are trying to address by founding dedicated weight-loss clinics where an overweight individual could receive the kind of ongoing advice, intervention, and education that appears to be necessary.

Similarly, a doctor can run down the list of excellent advice you've mentioned, and stress that a person's health or certain problems may improve or be eliminated with weight-loss, and that person can even believe them and wish to apply themselves, but turned loose to sort out the details and act upon that desire, they would typically fail. The system's stacked against them. What should be accessible information is muddied and vague—a concern contributed to by a range of factors including awful advertisements and claims such as the example you gave above.

I thought the CrossFit types were a different cult. Probably I just haven't spent enough time with them, though.

My thought on this one is purely subjective. It just happens to be the same sort of groups that get really caught up in fitness (and fitness fads) that tend to promote paleo, and it frequently leeches into their families. It also seems to relate to health trends here which have actually resulted in healthcare professionals and governing bodies cautioning against diets and claims which call for an excess of protein in the diet.

I'm not a fan of Whole Paycheck for several other reasons which are somewhat tangentially-related. And you're right that the 'organic' label Whole Foods uses is completely overblown. The environmental benefits of organic farming are real, but the real kicker as far as climate change is concerned is burning fossil fuels, and a good percentage of that happens in distribution - transportation being the 'largest end-use contributor' to carbon emissions in developed countries like ours. If you're trying to eat conscientiously with regard to the environment, it's often really better to eat conventionally-farmed foods grown and sold locally. TL;DR: fully agreed with you on this point.

Hmm... interesting information from the FAO. It does seem to slightly overstate the case for organic foods, though, but this impression may be colored by lobbying which has impacted regulation here in the United States and Canada. I expect some of those factors are global concerns, however, because the practices of 'big agriculture' are not limited to these Western countries. Here the sort of 'organic' you might pick up from a smaller local production can vary wildly from the same sort of 'organic' that can supply food at a volume, where land can be similarly dedicated to monoculture, managed with the same massive machines, somewhat similar scaled back in terms of forage for pollinators (hard to match the potential of GM crops to allow for application of glyphosate to crop and weed alike), and transported with similar concern and consequence. And for little health benefit.

But I don't want to rail on that—the sort of 'organic' which privileged individuals can source from local, seasonal suppliers can in fact be *much* healthier for the environment. It's just become a problem because the organic industry uses similar techniques and at the high production scale also overlaps significantly with the same players in traditional agriculture. Some related reading in Food Politics by Marion Nestle or The Omnivore's Dilemma by the colorful and outspoken Michael Pollan.

Had no idea the CEO of Whole Foods had his head in the sand about climate change...
Sure doesn't stop Whole Foods from playing to every left-leaning health fad under the sun.

On the GMO thing. GM food may be perfectly safe for consumption; that's not my main beef (er, so to speak). However, giants like Monsanto and DuPont have a hideous corporate record when it comes to farmers' rights and welfare. GMO lobbyists are slimy, and GMO researchers have been caught behaving unethically in several contexts (of which the Tufts Golden Rice study is the one I'm most familiar with). So I'm very much a proponent of GM labelling, not because I think GMOs are dangerous, but because I think the purveyors of GMOs have a lot to answer for, and consumers have a right to the information they need if they want to punish them through boycott. My wife is a big advocate for GM labelling for precisely this reason; she feels that GMO researchers take unethical advantage of lax regulations in non-Western countries to do their research.

(My mom's a botanist and plant biologist, by the way - don't know if I mentioned that. Her take is a bit more pro-GMO than mine, but she's still concerned about corporate misbehaviour on the part of the big GM firms.)

You're... stepping into a bit of a minefield here. DuPont, Bayer, and especially Monsanto—there is heaps upon heaps of exaggeration, misrepresentation, and lies surrounding what these companies do, the safety of their products, and the entire GM-crop industry. Which is not to say these companies have definite negatives and problems with ethical practice—they certainly do—just that you'll need to temper what you read with some level-headed scientifically supported voices in the same discussion. GMWATCH, for example, can be depended upon for misrepresentation and misinformation—or simply general activism. But on the other hand, Marion Nestle, who you linked to for discussion of the Tufts Golden Rice Study—she's a gem.

Or as a more defined example, should Patrick Moore drink 'glyphosate' presented by an activist? Or should he drink RoundUp, which is more than glyphosate alone? The fundamentals of the claim he made are not wrong, however. Kevin Folta has been willing to present a similar demonstration. Also, not a Monsanto lobbyist. Of note glyphosate has an LD50 of 5600 (compare to water at 90000, sucrose at 30000, ethanol at 7000, sodium chloride at 3000, caffeine at 192, nicotine at 50—and consider relative dose).

Would I drink glyphosate at the dare of an activist even having written this?

I think the key here is to make sure there's a clear separation between industry practices and science when discussing the subject. And even on the topic of science, to be sure we don't poison our interpretation of a very large body of research by being caught up on concerns with individual studies. There's a great deal we ought to be concerned with when it comes to Monsanto, but here too we need to look at the industry as a whole. For example, conventional foods can also be patented.

(I do recall that your mom is a plant biologist! I certainly am not.)

Agreed. We also have to consider costs in time and lack of amenities that a lot of poor people face (I believe this is what you meant by 'time investments and knowledge which may be less accessible'?) when doing these kinds of calculations. Take Barbara Ehrenreich's article here (bold mine):

I was also dismayed to find that in some ways, it is actually more expensive to be poor than not poor. If you can’t afford the first month’s rent and security deposit you need in order to rent an apartment, you may get stuck in an overpriced residential motel. If you don’t have a kitchen or even a refrigerator and microwave, you will find yourself falling back on convenience store food, which—in addition to its nutritional deficits—is also alarmingly overpriced. If you need a loan, as most poor people eventually do, you will end up paying an interest rate many times more than what a more affluent borrower would be charged. To be poor—especially with children to support and care for—is a perpetual high-wire act.

I've been a grad student and a poor English teacher without a working kitchen before, and I've done the whole relying-on-7/11-food thing before. Not an experience I'd care much to repeat... But adding a consumer-end sin tax to junk food, in such cases, would be something akin to an act of cruelty. On the other hand, if raw foods suddenly became cheaper than processed ones, we might find that the costs don't get passed on so much to the end consumer. (Convenience stores might find it more economical, for example, to stock ready-made sandwiches and microwave meals from local rather than national commercial surplus. On the other hand, though, their standing franchise agreements with big food corporations might prevent them from doing precisely this - that might be something to look into.)

No argument at all about the plight of being poor, or the manners in which it can inflate costs. And it ties in directly to very serious unintended consequences that can follow ill-conceived or poorly executed public health policy (hence it must be considered very carefully because the poor are frequently at the heart of individuals these policies aim to help). And yes, it's part of what I intended by use of that language. Also, if you're poor, you have less resources to search for and gather information; less time to do so; less time to act upon information and recommendations you gather. Although on the flip-side owning no fridge or microwave is rare here—America's 'poverty' tends to be in the least better off than that. A pretty good example I can think of, though, are the refugees attending schools here in Salt Lake City. In many cases they have no computer and it's something the school district needs to consider carefully in education.

The sin tax, though: if we were to have a properly formed 'sin tax' on junk food it might target processed foods like the Snickers bar, or those Cheetos. I'm having a hard time imagining a scenario where the government should act on any level to sustain a diet on these foods—especially given these foods do a poor job of addressing hunger (if not promoting it through the expert application of food science). The packed sandwich or even the hotdog is a far, far better choice for 1) being full (even relative to cost) and 2) health, and 3) ongoing financial and health concerns associated with the consequences of adapting to a diet accepting of these foods. A more likely sin-tax is one on added-sugar beverages (we should drink water—cheaper and healthier, and positive results form the Mexico case linked earlier) or a small general tax on added sugars (which probably wouldn't be damning enough to impact behavior).

Yup! Agreed completely.

Again, I think pricing of junk food would be a lot better-accounted if we got rid of the damn subsidies.

Sadly, it probably wouldn't do much to reduce prices of healthier alternatives.

There are some pretty stringent and punitive regulations on milk production in the US. This is one example of a recent story I've read on the matter. Raw or green-top milk is used in certain artisanal cheeses which I would hate to see banned, and which we really shouldn't be forced to import from France or England. Besides (and yes, I hear you that facts and laws don't always correspond), the EU food regulator has ruled green-top milk and raw-milk products as safe for human consumption, but requires that they be labelled. As with GM foods, this strikes me as a safe and desirable middle ground.

I think the cheese example would be a case of misapplied law (or lawmaking). It's not the same thing as drinking raw milk, though this sort of unintended consequence does happen. And it's not raw milk that's unsafe; it's what can be living inside it that can be very dangerous. Here, I think, politics also come into play: most wealthy countries seem to do a better job than the United States of making sure safety concerns are properly addressed at the source; here we allow or have allowed some serious safety concerns (see salmonella, E. coli) to reach restaurants and the customer through sympathetic response to food industry lobbying (and, perhaps, other factors such as the USDA serving two contradictory missions in both promoting and regulating their industry). The FDA does a slightly better job, but it's not without it's own noteworthy shortcomings (intentional or forced through lawmakers and legal challenges).

[James]

I don't know if everyone would know who he is (I don't know if his a big figure across the pond?) but Jamie Oliver is a celebrity chef. About 10 years ago he started a campaign about how unhealthy schools dinners were in the UK and they needed to be changed. He won a lot of support and managed to make schools (I'm not sure if the government passed any laws or whether it was just the external pressure being put on the on the schools that made them act) cut out some of the worst foods. As Dong said however the schools didn't plan properly and almost overnight took out lots of food but didn't replace them with anything. Personally I was devastated that I couldn't eat 3 x sausage rolls every day anymore .

Sounds like some healthy changes were made, with no proper effort to replace some of the foods lost with a range of enjoyable alternatives? Thinking back to my time in school I would have been heartbroken to see my chocolate milk (nutritionally just slightly better for you than soda), pizza, burritos, fries taken away. But if my parents had taught me to make better health choices (in addition to making them at home) and better health decisions had been enforced at school, I probably would have had a much, much better relationship with food as a young adult.

My my estimation, if a parent objects to their kiddo eating unhealthy food at schools, they can always ensure they're loaded up with everything they need to foster diabetes in a packed lunch.

[Dong Zhou]

James

Your mention of 'sin tax' is the particularly interesting element, for me at least. And I also think this is a tricky one. A major problem here is that it tends to be the poor who are most vulnerable to the health drawbacks of cheap (can be read 'processed' in many cases) foods—or also applies to fast food and sodas. And sin taxes do indeed increase the costs of these foods in an economic reality where they are frequently some of the cheapest options available to these families (if only because some alternatives require time investments and knowledge which may be less accessible). But in weighing costs, though, we also need to consider the economic impact of disease and obesity, which ties in directly to the foods we'd hope to target with a 'sin tax'. And in some of these cases a 'sin tax' can be more reasonable—such as soda—where there are more healthful alternatives available at similar or less price. It can be tricker in other circumstances, such as applied to a school lunch.

Alcohol gets more stamp duty=that nice glass of cider for a treat is that bit more expensive. For "health reasons" things get smaller and risks being less filling or less easy to share out among the family. Eat such treats responsibly=gets shafted becuase too many can't behave. Such taxes may indeed be needed but it speaks ill of the wider culture.

Would also be surprised if good things suddenly got cheaper in response

What's somewhat saddening here is that a healthful diet really is not all that complicated to learn. And we don't need to cut out or slash down any food groups (though those deserts are definitely going to need to become treats and we'll probably need to cut down on caloric beverages). It's just so hard for the layman to sort out what the truth is when interests at every angle are tugging them away with beliefs such as a convenient, nicely packaged solution (diet), or noise intended to dissuade from health concerns from health professionals.

Yep. I mean that chocolate tart with cream might not be a good idea while your really trying to get weight down and afterwards, only as a treat but your meals, day in day out, should be enjoyable. Share a nice curry with rice, a chocolate bar afterwards? You can have that. Crisps? Can have that with the right meal. Everything in moderation

I think one challenge is social life. Watch a film? Don't take snacks and drinks with it, you can enjoy a film without popcorn and a soda. Going down to the pub? That is going to become a problem. Workmate brings in doughnuts? Avoid. Going out to a restaurant or grabbing a takeway? Going to really shaft your weight.

Also when someone buys something they aren't keen on, becuase it is healthy then they stick it in the fridge, eat the yummier stuff first and when it comes to eating the healthy sounding thing, they grab a takeaway rather then face it. That is an old trap which is why people should buy things they like within the calory range.

Well, you probably have nothing to fear as someone who has successfully kept your weight down, nor anyone who is already at a healthful weight, as any foods targeted would be the sort that facilitate obesity. Heck, cutting those foods more might actually help those who are at a healthful weight to enjoy more health in general, as outward appearance is not necessarily an indication of internal health.

It hits soda? That isn't going to hit me and does seem a good idea. Where else will it hit though? Ice-cream's, chips, puddings?

My argument, though, is that at this point we're not 'trusting' people to keep their weight down. These people do want to keep their weight down, and frequently try to do so. The trust we've misplaced is in all the interests which have been making it so difficult for this goal to be accomplished, and in my opinion a big part of this is industry having run away with profits at the expense of health (e.g. foods engineered to maximize eating based on combinations of sugars, fats, salts with health not even entering the radar relative to consumption)—or even restaurants which don't care one bit about caloric content relative to taste. Here in the United States it is not unusual at all for restaurants to have meals that clear 2,000 calories.

Some are indeed trying so hard and need help. Others more treat it like a gym membership in January, they sort of mean to but never quite get round to it. Others don't care about it at all.

Yes we need to tackle business but we need to tackle the consumer. We need to change culture, some of the things leading to this have been going on awhile, others is adapting to way technology has changed, stopping a short term culture and helping people become more organized and disciplined.

My my estimation, if a parent objects to their kiddo eating unhealthy food at schools, they can always ensure they're loaded up with everything they need to foster diabetes in a packed lunch.

That, or alternatives like handing takeaways through the railings, actually happened.

WWD

One of the problems may be that people don't listen to their doctors enough - who (in my experience) on dieting are usually liable to give the usual sound common-sensical advice: don't overeat, don't eat junk, exercise regularly, sleep regularly, drink water, and so on. But there's a kind of anti-intellectualism in our culture which advertisers of all sorts tend to prey on. The most extreme and mockable examples - I'm sure you've seen them - are of the type that go 'He lost 30 pounds in two weeks with this one crazy trick! [Insert interest group here] hates him!' But most fad diets deploy more subtle variations on the same kind of advertising and rhetoric.

But yes, I generally agree that people need to eat healthily and in proportion - and meals, rather than snacking throughout the day. (I'm personally really bad about this one.)

I don't think it is anything new. What the doctors suggest is hard, takes more effort then some are willing to give and slow (I would suggest also far easier to stick to and yummier but people don't see that), they want to get the weight off quickly or feel that they must do something.

I thought your Barbara Ehrenreich passage was intresting

My mistake of late was my body tends to tell me I'm hungry after seal so I would add a few waterbiscuts... I'm also bad at exercise.

[James]

Yep. I mean that chocolate tart with cream might not be a good idea while your really trying to get weight down and afterwards, only as a treat but your meals, day in day out, should be enjoyable. Share a nice curry with rice, a chocolate bar afterwards? You can have that. Crisps? Can have that with the right meal. Everything in moderation

I think one challenge is social life. Watch a film? Don't take snacks and drinks with it, you can enjoy a film without popcorn and a soda. Going down to the pub? That is going to become a problem. Workmate brings in doughnuts? Avoid. Going out to a restaurant or grabbing a takeway? Going to really shaft your weight.

Also when someone buys something they aren't keen on, becuase it is healthy then they stick it in the fridge, eat the yummier stuff first and when it comes to eating the healthy sounding thing, they grab a takeaway rather then face it. That is an old trap which is why people should buy things they like within the calory range.

Social concerns seems spot on. I think that's a huge part of the challenge for many of us. I think this 'calorie clump' theory line of reasoning from Yoni Freedhoff is pretty spot on. It doesn't take many irresponsible nights a week to completely sabotage even an excellent diet and progress five other nights, and the notion of a 'cheat meal', which seems common to many diets, sure doesn't help. Here in the United States portion sizes are also a large (hue) problem. At many restaurants a typical entree might be big enough for two or three people; a desert plenty enough for four. I eat enough to be happy and satisfied, but sometimes that involves ordering foods which will refrigerate and reheat well and portioning my meal before I start. Or when I eat with my wife, we'll share an entree and perhaps order side salads at these restaurants.

One important key for weightloss and a healthy relationship with food, at least in the Western diet, seems to be cooking at home. The food is just so much healthier. And as you say, stocking the proper sort of foods in your refrigerator or, continuing the line of thought, bringing such foods to lunch at a regular job.

It hits soda? That isn't going to hit me and does seem a good idea. Where else will it hit though? Ice-cream's, chips, puddings?

The trick is that 'it' doesn't necessary have a form. What sort of legislation can be passed in the first place? Here in the United States a 'sin tax' is almost a lost cause at the federal level, and typically a lost cause at the state level. Between numerous (typically Republican) lawmakers opposing such legislation on grounds that it is federal overreach (often in concert with special interest groups across both parties) measures are typically defeated and if one does make it through it may well be so hampered that it fails to produce material statistical change and is later revoked.

A sin tax on soda is an easy one. It would hit beverages with added sugars in the least. Legislation on labeling added sugars in foods would certainly be a good step to take and a tax could theoretically be tied to that as well, but I'm not aware of anywhere where such a tax has been realized.

Whatever the case, it becomes pretty tricky. As WWD suggested above, you wouldn't want the tax to start hitting the healthier options available to people who are already struggling.

Some are indeed trying so hard and need help. Others more treat it like a gym membership in January, they sort of mean to but never quite get round to it. Others don't care about it at all.

Yes we need to tackle business but we need to tackle the consumer. We need to change culture, some of the things leading to this have been going on awhile, others is adapting to way technology has changed, stopping a short term culture and helping people become more organized and disciplined.

To what extent is this possible when culture is informed by the advice given by government, the efforts of the diet industry, the voices of countless 'professionals' who seek to sell products and services? America definitely does need a cultural shift in terms of food, but I wonder if, in the present environment, it is even remotely feasible for such a shift to take place—if culture can shift in a direction which isn't defined or recognizable. And even if we do experience a cultural shift, it needs to be strong enough to change the nature of restaurants and processed foods—a part of which is certain to involve addressing profound economic issues in the process. I expect there are plenty who go to McDonald's not because they love the food, but because it's one of the realistic options within the realm of not knowing how to cook, not being able to afford it, or not having the time to care one way or the other.

I wonder how much of this will change when lawmakers serve the interests who are not concerned with public health over the public.

[Dong Zhou]

Social concerns seems spot on. I think that's a huge part of the challenge for many of us. I think this 'calorie clump' theory line of reasoning from Yoni Freedhoff is pretty spot on. It doesn't take many irresponsible nights a week to completely sabotage even an excellent diet and progress five other nights, and the notion of a 'cheat meal', which seems common to many diets, sure doesn't help. Here in the United States portion sizes are also a large (hue) problem. At many restaurants a typical entree might be big enough for two or three people; a desert plenty enough for four. I eat enough to be happy and satisfied, but sometimes that involves ordering foods which will refrigerate and reheat well and portioning my meal before I start. Or when I eat with my wife, we'll share an entree and perhaps order side salads at these restaurants.

I think people mentally never quite count the meals out or that little half down the pub or that takeaway when they got home late or so on. If I eat properly for six nights a week then went out to a restaurant/pub/Mc Donalds, I'm going to gain weight. Fine if a one-off and I take that into account but easy to have too many one off's.

I think a good rule is doing things like the way you and your wife suggested once your weight is down. Only go out for a meal on real special occasion when dieting.

Portion sizes are indeed a big problem. Plates are bigger and I think people need to accept that if your meal doesn't fill a large plate, that is ok.

One important key for weightloss and a healthy relationship with food, at least in the Western diet, seems to be cooking at home. The food is just so much healthier. And as you say, stocking the proper sort of foods in your refrigerator or, continuing the line of thought, bringing such foods to lunch at a regular job.

It does help. Most food we have takes half an hour at most but one does need helpful working hours for that sort of time.

My father pops out and eats a cheap sandwich (not Subway type sandwich) when at work which seems to work.

To what extent is this possible when culture is informed by the advice given by government, the efforts of the diet industry, the voices of countless 'professionals' who seek to sell products and services? America definitely does need a cultural shift in terms of food, but I wonder if, in the present environment, it is even remotely feasible for such a shift to take place—if culture can shift in a direction which isn't defined or recognizable. And even if we do experience a cultural shift, it needs to be strong enough to change the nature of restaurants and processed foods—a part of which is certain to involve addressing profound economic issues in the process. I expect there are plenty who go to McDonald's not because they love the food, but because it's one of the realistic options within the realm of not knowing how to cook, not being able to afford it, or not having the time to care one way or the other.

I wonder how much of this will change when lawmakers serve the interests who are not concerned with public health over the public.

But in the UK, we have the same problems with both parties rather more keen on public health issues then US ones. The only people trying to sell people onto smoking, when everyone knows it is a stupid idea, are those selling at and yet we still smoke (though government changes do seem to have had some effect). Drinking only came down becuase youngsters seem to have seen my generation or just above getting wasted and decided to be sensible.

Affordability is a problem. Is it that hard to put on a microwave or learn to cook? Time is a factor.

If we can get wages up and personalised debt down (but our treasury relies on a consumer debt culture so fat chance and would need cultural change as well) that would help. If we can get more free time or better hours then that would help but not going to happen. Dieiting? Unless government goes after the internet and magazines (they have enough trouble with Leveson), hard to see what they can do. The British though need to be more organized and willing to plan rather then our usual haphazard style, to stop repeating the same mistakes again and again, to stop abusing food. Even with the best corporations and government in the world, we would still have a lot of problems in UK around food

[Dong Zhou]

I wonder if one thing to tackle would be daily going to coffee shops. Nothing wrong with enjoying such a drink if you know what your drinking and it's content then make it a treat but going to one every work day as part of a routine? That is going to risk adding the pounds.