Stanley Feld M.D.,FACP,MACE
I said our population should not have to bear the exclusive blame for becoming more and more overweight by overeating. However, we have a choice and should bear the burden of blame for not saying “we are tired of this and are not going to take it anymore.” We must be responsible for our choice to overeat even though we realize we are being programmed to overeat daily.
The question is, why and how are we being programmed to overeat? Michael Pollan has written an excellent book “The Omnivore’s Dilemma”. The book describes the problem of obesity clearly. He is also a contributing writer to the New York Times and has written several articles in the past year outlining the causes of the obesity problem. His last article nails it.
He pointed out the research of an obesity researcher at the University of Washington Adam Drewnowski. Drewnowiski went to the supermarket to solve the mystery . “He wanted to figure out why it is that the most reliable predictor of obesity in America today is a person’s wealth. For most of history, after all, the poor have typically suffered from a shortage of calories, not a surfeit. So how is it that today the people with the least amount of money to spend on food are the ones most likely to be overweight?”
This is a powerful observation. However, the socioeconomic factor is fading rapidly as all socioeconomic groups are becoming obese today. He wanted to see how many calories a dollar could buy. “He discovered that he could buy the most calories per dollar in the middle aisles of the supermarket, among the towering canyons of processed food and soft drink. (In the typical American supermarket, the fresh foods — dairy, meat, fish and produce — line the perimeter walls, while the imperishable packaged goods dominate the center.)” He also found that “a dollar could buy 1,200 calories of cookies or potato chips but only 250 calories of carrots. Looking for something to wash down those chips, he discovered that his dollar bought 875 calories of soda but only 170 calories of orange juice.”
The supermarkets prime square footage and shelf space is devoted to processed foods that are considered junk food. What is junk food? Junk food typically contains high levels of fat, salt or sugar and numerous food additives such as monosodium glutamate and tartrazine; at the same time, it is lacking in proteins, vitamins and fiber, among others. It is popular with suppliers because it is relatively cheap to manufacture, has a long shelf life and may not require refrigeration. It is popular with consumers because it is easy to purchase, requires little or no preparation, is convenient to consume and has lots of flavor. Consumption of junk food is associated with obesity, heart disease, Type 2 diabetes and dental cavities. There is also concern about the targeting of marketing at children.
Pollan the states that “Drewnowski concluded that the rules of the food game in America are organized in such a way that if you are eating on a budget, the most rational economic strategy is to eat badly — and get fat”.
Pollan observes that “This perverse state of affairs is not, as you might think, the inevitable result of the free market. Compared with a bunch of carrots, a package of Twinkies, to take one iconic processed foodlike substance as an example, is a highly complicated, high-tech piece of manufacture, involving no fewer than 39 ingredients, many themselves elaborately manufactured, as well as the packaging and a hefty marketing budget.”
The Twinke is commonly regarded as the quintessential junk food. Each Twinkie contains about 145 Calories (607 kilojoules).A package of three Twinkies is one third of an average persons daily caloric intake. Five hundred million packages of Twinkies are produced each year.
Twinkie the Kid is the advertising mascot for Twinkies and can be found on packaging and related merchandise.
Are we being programmed and conditioned by the media? You bet we are.
So how can the supermarket possibly sell two or three of these synthetic cream-filled pseudocakes for less than a bunch of roots?” Michael Pollan points out the answer. It is in the farm bill. The farm bill subsidizes the Twinkie and not the carrot. “Like most processed foods, the Twinkie is basically a clever arrangement of carbohydrates and fats teased out of corn, soybeans and wheat — three of the five commodity crops that the farm bill supports, to the tune of some $25 billion a year. (Rice and cotton are the others.) For the last several decades — indeed, for about as long as the American waistline has been ballooning — U.S. agricultural policy has been designed in such a way as to promote the overproduction of these five commodities, especially corn and soy.”
The creative manufacture of increasing amounts of junk food has increased with each increasing farm subsidy.
The farm bill does nothing to support the farmers that grow fresh produce. Pollan points out that the real price of fruit and vegetables increased by 40% between 1985 and 2000 while soft drink (aka liquid corn) declined by 23 percent. The reason junk food is the cheapest food is the farm bill subsidizes these foods.
Shouldn’t we wonder why when faced with increasing obesity and the complications of chronic diseases precipitated by obesity leading to 90% of our healthcare costs, would our policy makers subsidizes businesses that promote obesity? Shouldn’t the government subsidize busnissess that promote wellness?
There are many perverse outcomes in our nation’s complex economic and political systems. The government permits energy companies to build “dirty coal plants” to generate electricity to solve our fossil fuel problem because we have an abundance of coal in America. The thinking is logical. However, the pollution from the particulate matter released by coal causes asthma, chronic obstructive lung disease and heart disease. Aside from the resulting morbidity to people affected by these diseases from the pollution, it costs the healthcare system $34 billion per year in avoidable recurring costs if the dirty coal plant pollution did not exist. It does not make sense when we are trying to solve healthcare costs if less harmful alternatives exist.
Another perverse example is osteoporosis. The complications of osteoporosis cost the healthcare system 20 billion dollars annually. You can decrease the fracture rate by at least 50% with current treatment. However, you have to discover this silent disease by measuring a patient’s bone mineral density. In order to save money Medicare is reducing reimbursement of bone density measurements by 70% in the next two years. The reimbursement will be below the cost of the test for most clinics. This is certainly not a way to promote early detection and treatment to prevent complications of this chronic disease. Faulty, perverse policy decisions occur frequently. I believe it is a result of an obsolete policy making process. We assume our elected representatives represent our interests but they seem to represent the vested interest of other powerful stakeholders. The result often is an expression of a lack of common sense.
The only way to stop it is if we the people express our opinions to our politicians and force our political system to respond and represent our needs and not the needs of other vested interests. Our well being is the only need they should be considering. With the internet, blogs, and instant communication we are capable of making our needs known. We must exercise our people power.