Thursday, May 14, 2015

Public Action for Public Health

Whether or not it is accepted by the public in general, most of those in the health industry would agree that our Country faces an obesity epidemic that is increasing incidences of preventable diseases, shortening the lives of our children, and increasing public health costs.  Similar to many other societal ills, the popular cognizance of this issue has been condensed to a morality play: If you are overweight, you lack the moral constitution to be thin.  If you are thin, you are a fundamentally superior individual.

I have to acknowledge that as someone who has lost a fair amount of weight myself and run in a few endurance events, I bought into a lot of that.  Not openly, but quietly and within my own thoughts.  But as with any other easy idea, it did not stand up to additional research.  Watch this trailer about a recent documentary called "Fed Up":

Now also watch this short clip about how our body digests sugar:

If you can't watch, here's a summary - a calorie is not a calorie.  Different foods are digested different ways by our bodies, meaning that two people who eat the same amount of food, but of two different types, will have vastly different outcomes in terms of how their body accepts those foods, regardless of whether they exercise or not.

Now we should put this in the context of capitalism.  Food companies want us to buy more of their food in greater quantities.  Full stop.  One way they can do that is by putting more sugar into their foods, regardless of whether sugar is integral to the taste they are trying to create.  Sugar tricks our bodies into thinking we are still hungry when we are not and makes our periods of satisfaction after eating shorter, prompting us to eat more often.  Once upon a time, we received most of our sugar from fruit, but this sugar was paired with fiber, which helped us digest the sugar and prevent the harmful consequences described in the videos above.  Now that sugar is served without the fiber that made it useful, we are getting fat, developing diabetes, and living shorter lives.

We ultimately pay for each other's choices in public health costs.  And in far less abstract terms, we certainly pay for the health costs of our public employees.  Officials at every level of government have advocated for addressing this public health concern based on public health imperatives, but also the most base concern of "this is costing us money".  At just about every turn, the food industry has turned up the "nanny state" dog whistle, which casts any effort at promoting healthy choices as "telling you what you can eat."

Understanding that our reptile brain is on the side of sugar (i.e., it wants it and will make us [temporarily] feel good for eating it), it makes sense to prompt our cognitive brain to make better choices.  And I will certainly concede that the manner in which we do that is up for debate, prone to overreach, and paternalistic.  We can agree there.  But only if we also agree that there are more silent forces exerting powerful pressure on our choices with a profit motive.  They tap into our subconscious with notions of nostalgia or wholesome fun.  They put influence on our government to sell inside our schools, libraries, and public buildings.  These aren't villains.  They are private actors operating within the space we allow for the "free market".  The only difference is that their influence does not stop with purchase.  It has a legacy that follows through to the doctor's office, pharmacy counter, and hospital bed.

So should our government act on this issue?  It is a matter for public debate.  The louder we are in discussing it, the more likely someone who sees a "calorie as a calorie" may be educated on the difference.  And this is one issue where knowing really is half the battle.

Have a great Thursday doing what you love!