Some considerations on obesity
Well, the problem of obesity had to come up sooner or later. It’s a subject that puzzles me. I don’t find most of the standard answers for the surge in overweight people particularly compelling.
But I do know that I am not a bit happy with many of the food activists who advocate that the government get in there and legislate certain diets. I tend to libertarian views (or better liberal as understood by John Stuart Mill, not contemporary liberal) and that means I don’t want the state legislating our personal habits.
But instead of getting into all that now, here are a few links I’ve been collecting.
The first few, sent by Kay, have to do with the increase in portion size in ready-to-eat and restaurant foods. This is background to the post about the increase in portion size in cookbooks.
Compare year introduced:
http://www.eatright.org/cps/rde/xchg/ada/hs.xsl/media_3073_ENU_HTML.htm
Compare 1970’s (with pix):
http://www.divinecaroline.com/article/22178/49492-portion-size–now
Compare 20 years:
http://healthyamericans.org/pages/?id=246
Then there are US and German studies in the Journal of Internal Medicine that suggest that obesity (as currently defined) does not necessarily bring with it the health risks we are often told. Here a link to a report with references to the articles.
A slightly bizarre study on the cost effectiveness of surgeries for obesity.
And the Onion suggests a sure fire way to deal with obesity. Sad to say, this probably happens far too much.
Rachel, given the written conversation we were having on the entry about “De-Fatting the British Food Industry”, I was going to suggest you wrote a piece about obesity, and you beat me to it!
Here is another link to an article about obesity, from a very different perspective
http://www.realitysandwich.com/reuniting_self_autoimmunity_obesity_and_ecology_health_part_2
I note that you said that you found the subject of obesity puzzling but I would be interested in your thoughts on obesity, as addition to offering the links above, given that you clearly have a lot of interest and experience in food issues.
When you say that “I don’t want the state legislating our personal habits”, I wonder how you see anti-smoking legislation or legislation forcing people to wear seat belts? Clearly there are some differences with food, as whilst smoking effects others health, I don’t think overeating does. But it does seem to me there is some role for the state in food regulation, tricky and delicate as it will be, as I wrote in a comment on the other post.
PS I see that the link to the report about the German and US study on health and obesity comes from the same site as the article about “Defatting the British Food Industry”. I think it suffers from some of the same problems as the other article in that it takes a particular view on the theme, in this case obesity, and uses two studies to support this view without taking into account, and intelligently arguing against, the many other studies that are showing a very different perspective.
It can be argued that smoking directly affects people that are not actually smoking (much of the ban on smoking in various countries has concentrated on passive smoking and the effects on staff etc), ditto drugs and alcohol. Somebody that chooses to eat 3000 kcal in a sitting doesn’t directly effect anybody else in an immediate sense, although there could be an eventual cost to the society in terms of health bills etc.
Another issue is a changing attitude towards appearance. When only the wealthiest 5% of the population were as fat as pigs it was a good thing, now being fat is seen as reflecting a lack or self restraint. Even word usage has changed to reflect this to some extant. It wasn’t that long ago that “sleek” was used to mean smooth and plump, now it is more likely to refer to something smooth and thin.
OK, obesity.
As a nutritionist, with a degree in the stuff, I know that the powers-that-be in the field tend to wonder, “What is happening here? Why is everyone so, well, um, large?”
The sheer mathematics of the issue testify to the truth: calories in = calories out. Unfortunately, these days “calories in” do NOT equal “calories out.”
The portion-size thingy is the big eye-opener. Or should be. But not just that. The TYPE of food eaten plays a huge part in this terrible epidemic, for the lack of a better word.
I’m going to go off the scientific message here and point out a couple of things. First of all, chips, sodas, ice cream, and other such culprits contribute to the problem. But one can eat all of these things and not be fat, much less obese. It’s how much goes in and down the hatch.
But that’s just to start with. If a person eats the equivalent of three servings of potato chips, but only gets up to open the fridge and check on what’s to eat for supper, well, pretty soon those chips will give new meaning to the old joke, “I look at food and it just jumps onto my hips,” or however it goes.
Chips are easy to eat. Eating mindlessly is one of the major issues in obesity, as Karen alludes to in the piece to which Rachel links.
Most adults of a certain age recall days when cookies, cake, chips, soda, and ice cream only appeared for parties a few times a year, if at all even then. In the meantime, most people ate food cooked at home, made with ingredients that hadn’t meandered too far from nature. In other words, lightly processed.
And, truth be told, kids played outside, sometimes for hours, while adults let them be and didn’t worry too much about what the kids did. Dinner was on the table, usually, at 5:30 or 6 PM and everybody ate together AND everybody ate the same thing.
The fat kids in school were the exception, not the rule.
So getting back to the whole question, the equation has become unbalanced. Studies show that people in social networks tend to mirror each other even in body size.
Obesity is complex in one way, but the very real and measurable “calories” = “calories out” cannot be ignored.
And obesity is not just a poverty-level issue, either.
Cindy, couldn’t agree more about the calories in, calories out. What puzzles me is why obesity has suddenly become so much more prominent in the last decade. Like you I grew up in an era where a teeny packet of potato chips was a weekly treat from an uncle and then each chip was counted and shared between three siblings. Where there was never anything but water to drink. Where raiding the fridge was unheard of because there went tomorrow’s dinner.
But has the whole complex really changed so rapidly in the last ten years? Or has it been creeping up on us?
At the end of my last comment, I meant to say “calories in ” = “calories out” cannot be ignored.
One theme that I pick up here and in the other discussion on “Defatting the British Food Industry” about both obesity, and what is a healthy diet, is that there is no broad consensus on these issues, (as eventually developed with making the link between cigarette smoking and lung cancer) and a lot of conflicting evidence and studies.
In addition to Cynthia’s equation “calories in” equals “calories out”, which makes a lot of sense, I think that the subject is more complex than just looking at the nutritional content or otherwise of food and its general effect on the human body. The effect seems to be to be mediated first by the particular individual (their personality, history, mood at the time, physiology etc) and also by the cultural context in which the food is consumed.
For example, in a different but related subject area, that of exercise, someone told me of an interesting study that showed that the positive effects of exercise on the human immune system were stronger when the exercise was carried out in the context of a spiritual faith. This was told me to me in relation to Mexican dancers at religious fiestas who spend many hours dancing in the street. It seems that is not just the exercise that is good for them but that its positive effects are amplified because they do it in this specific social and religious context. Likewise, I think the effect of eating is mediated by the cultural context in which it occurs.
One final personal reflection about food and obesity, I have noticed that if food is tasty and satisfying, then I do not want to eat large quantities of it. I think people (well at least me) consume large quantities of fast food because it is inherently not satisfying and the only way to go is to continue until you feel stuffed.
Paul, I’ve said this to you in an email but I’ll repeat it here. I’ll get to all these issues as soon as I can. So please hang in there. And thanks for the long and thoughtful comments and the links by email.
Thought provoking post and comments.
I think you are all describing a perfect storm of sorts where many factors have all come in to play. The portion size issue is mind boggling and a testimony to our ability to make foods cheaper; in the U.S. supermarket the food presentation and placement is astoundingly weighted toward prepared foods; prepared foods don’t offer as much in the way of satisfaction; kids can’t go out to play etc. Mothers line up in their SUV’s to pick up their kids and drive them home from the bus stop. Let them walk. To start to untangle the obesity web, we need to pick apart all the different threads and realize there is no QUICK, EASY, FAST solution.
P.S. God bless The Onion! Click-Click the Magic Stapler!
Do you share my shock at American supermarkets when you return from elsewhere? there is so little food food in them. And I agree about no quick, fast. easy solution.
Over the past few decades it’s become easier and easier to eat more and move less. I think it has been creeping up on us.
Most Americans my age can remember when happy meals or kids meals at fast food restaurants were an occasional to rare treat and when gas stations didn’t have convenience stores attached to them. There were free sports programs after school and when we got home we played outside for hours on end. And every kid had a bike, skate board or roller skates or all three.
I just transferred my kids from a private school (that I had to drive them to) to their resident school that’s .7 miles away. The vast majority of the students at their resident school are locals who can walk to school, yet the majority of them are driven to and from school. It can’t be to save time. The elementary, middle and senior high schools are adjacent to each other, serving a few thousand students total. The traffic is a nightmare and it takes us twice as long to drive and find parking then it does for us to walk.
This is in a very safe, middle class suburb of Los Angeles. One of the safest cities in America with a population over 100,000.
When my kids attended private school I was shocked that most of their friends did not like walking when we had play dates. Some refused to walk. One little girl in Pre-K was still pushed around in a stroller!
So far, in both schools I’m talking about mostly middle class to affluent kids from diverse cultural backgrounds. The rate of overweight in elementary is pretty low, much lower than what I see when I visit lower income schools. But the weight starts creeping up on these kids in middle and senior high school. Very few that are in the obese category but certainly chubbier and fatter than kids in the same age group were a couple of decades earlier.
Why? They have the kind of access to cheap, overly processed foods that my friends and I did not when we were the same age (same income group that I noted above, the kind of kids that were the first to get home computers and department store charge cards for teens). Calorically dense, nutritionally empty food is almost EVERYWHERE. And it’s gotten cheaper and cheaper and faster to get.
Now, I’m not opposed to much of anything when it comes to food, in moderation. It’s not just marketing, it’s physical access to this kind of food. The architecture of our environment makes it extremely easy to eat more and move less.
I like the architecture point. And lack of access. I was a bit shocked to hear over Christmas that water is not available as a lunch time drink in some schools. The kids were complaining about the sugary juices and the milk, so I asked, why not a glass of water? No glasses, no water!
Easy availability of food with high sugar and salt content, ‘snacks’, yes.
Rarely anyone in the kitchen as designated full-time cook of healthy things.
Lots of neighborhoods with no parents home when the kids get home from school – and the kids told to *not* go out because of perceived dangers.
I’ve read more than once that the jump in obesity levels started climbing here in the US in noticeable fashion sometime in the 1970’s.
Supermarkets overflowing, with marketing geniuses nipping at the minds of the consumer in every way possible (and there are many many ways). There often is a marked difference in supermarkets in poor rural areas and in middle-class suburban areas, though – just as then again, there is a marked difference in the marketing style/level/options between middle-class suburban and urban.
The driving-kids-around is an interesting thing. Yes, it’s done more and more. I actually think it may possibly be the dinner-table replacement in terms of ‘bonding time’ – the time spent in the car. With all the above shifts affecting family life (women in the workplace, nobody at home as full-time caregiver, fast food easy to get, time crunches due to hours of work demanded of the non-salaried worker, on and on) instead of gathering around the table we may be gathering around the engine as we move along.
The car as bonding time is another very interesting point. I’m going to do a follow up post soon, including some links that Paul sent. And American supermarkets blow my mind. I go into temporary shock every time I return until I learn to filter out the junk. A Wal-Mart or HEB in Mexico is not the same as a Wal-Mart or an HEB in the US.
I’m not sure what it is that “food activists” really do. And why???
At my children’s school, cafeteria lunches are $2 for an entree, salad, fruit, and juice or milk (choice of chocolate, strawberry, or plain). Bottled water is available for an additional $1. So, free milk or juice or pay extra for cold water.
Of course they have water fountains at the school, but no cups.
Outrageous. Charge 50 c for a plastic glass if they want. But no way to drink water except from the water fountain. My goodness.
I’ve never seen water in cups available to students at any Los Angeles school I’ve attended or visited. So go back to the mid 70s, fast forward to now. I’m talking about private and public elementary, middle and secondary schools. I think it’s a lot of schools, not just some. Over the years I’ve seen lots of vending machines with water bottles, sodas, juice, sugary drinks, etc.. in schools.
I remember when fast food places or concession stands didn’t even offer water. Or if they did, they made you pay for the cup, which was usually a few nickels or dimes less than the cost of a soda. They explained that the soda barely cost them anything, the bulk of the cost was the cup or container. (I know this stuff because my father would always ask for water when I was a kid).
I don’t remember exactly when fast food places started offering water and cups for the water at no charge. Maybe it was when they started offering free do it yourself soda refills.
School lunches here are $1.85 full price. There is a reduced-price program and a no-cost program in place also, for families who qualify based on their income.
Lunch is an entree (the ones I hear about the most are pizza, chicken patties (ha ha silly sounding), tacos (the kids claim they are filled with dog food) and cheeseburgers – all ready-to-serve re-heats by the cafeteria ladies – and two sides which are usually something like canned corn or frozen green beans or ‘fruit cocktail’. The only salad dressing available when salad is served (‘salad’ meaning chopped iceberg lettuce with a few dreary clips of tired carrot in it) is Ranch. Which of course should be named our National Salad Dressing.
A lot of food goes into the garbage.
The drink is milk or chocolate milk. No water except the fountain, as Ji-Young mentioned – and the fountain is outside in the hallway somewhere so naturally the teachers are loathe to allow students to leave the cafeteria to go to it (even if there were cups to use). There is also the particular circumstance in one of our schools where the janitor who has worked there for a number of years is now handicapped and does not move around very well and there is nobody extra brought in to help – so basically, things are not kept clean. Not the floors, not . . . well let me stop before I start. A good act, a kind act done in keeping him on. But.
The car-as-bonding thing came to mind from the reading of many things bewailing the loss of the ‘family dinner’ (admittedly I have reservations about how perfect those ‘family dinners’ were in many cases but for a few lucky ones and for a concept developed in fertile imaginary soil) and on why that is the reason why we as a society and as families are falling apart at the seams.
Even Felipe Fernandez-Armesto got quite emotional about this in one of the closing chapters of ‘Near a Thousand Tables’.
I don’t see it. Though I’m sure there is adequate data to support it.
My family is nontraditional (not by choice, mind you – but seriously in today’s world no woman needs to stay married to a lying philanderer unless she really wants to for some bizarre reason) and we often do not sit around the dinner table together. Yet (knock on wood) my children and I are close, and some of the best conversations we have are while we are driving around here and there (as we must do – errands, classes, etc.)
The dinner table was the outshoot of the hearth. We needed the hearth to survive. Then we needed the dinner table, during periods of time when survival depended on family and family ties. Now we need the car, the engine, which takes us to the places we now need to survive: the institutions that have supplanted hearth and family – ‘jobs’, and the schools that will open the doors to those jobs.
Well. That’s just my theory, anyway.