Sunday, October 26, 2008

Eating pumpkin ice cream reading obesity research

After a lunch of lightly grilled, prepackaged organic vegetables (broccoli, carrots, red cabbage), I had a dish of pumpkin ice cream with some peanut butter on top. While eating the dessert I was reading "Transforming Research Strategies for Understanding and Preventing Obesity" by Huang and Glass in JAMA, Oct 15, p. 1881. Before I go into detail, let me ask you a few questions, and please don't argue or go off topic, just answer about you and you only; no one else:
  • Has the federal government made you fat?
  • Has your state or local government made you fat?
  • Did your educational institutions--high school, college, grad school--make you fat?
  • Has your income, whether high or low, made you fat?
  • Has your peer group made you fat?
  • Did your mother's diet before you were born make you fat?
  • Has the location of your super market or grocery store made you fat?
  • Has the lack of fresh fruits and vegetables where you shop made you fat?
  • Has the lack of a farmer's market in your neighborhood made you fat?
  • Has lack of exercise opportunities made you fat?
  • Has the zoning where you live made you fat?
  • Did the farm, town or city where your great, great grandparents lived and worked make you fat?
  • Have USDA policies affecting land use made you fat?
  • Has building design of your home or work place made you fat?
  • Has the elevator in your building or the parking lot for your car made you fat?
  • Has food labeling or lack of it on restaurant menus made you fat?
I've been up the scale and down the scale, and no one but me can determine whether I'll be obese or not. But there's a whole bunch of government money out there just waiting to call me a liar.

Using the tobacco taxes as an example of how top down punishment by the federal government can stem the obesity tide of the predicted $860 billion in health care costs, the writers of this article (both NIH employees), are pointing the way for Uncle Sam to join you at the dinner table, the restaurant, the grocery store, the snack bar and the tailgate party before the OSU football game. And he won't be a fun or an invited guest.

Clearly, education about personal responsibility for health and weight has failed, the authors report. We have evolved, but not enough. Our bodies are not equipped for an obesogenic environment. After working their way through maternal feeding patterns, lack of P.E. in schools, public snack machines and sedentary behavior, the authors pounce on the real problem. You'll be glad to find out it's not your genes, your taste buds, your cravings, or your lack of will power. It's the government--all levels from cradle to grave, from bike path to freeway, from safety to quantity.
    At the governmental level, policies regarding food, agriculture, education, transportation, urban design, marketing, and trade all play a role in increasing the accessibility and availability of high-fat and high-sugar foods vs fresh fruits and vegetables and in decreasing opportunities for physical activity. The lack of access to preventive care is also a major concern. Historical U.S. policies that led to social inequality and segregation have, in turn, resulted in inequalities in the built environment, leading to disproportionate rates of obesity among the poor and minorities.
"Trust me, I'm from the government." These are the same guys from the government who don't require country of origin on your canned goods, and have no way to check the quality or adulteration of foodstuffs imported from Mexico and China, the most recent culprits that sent people to the hospital. But we're supposed to hand them billions in government grants for "cross-disciplinary hypotheses to research on upstream (trendy word = bad capitalists) policy interventions and their downstream effects on food and physical activity behaviors, investment in capacity building and rigorous training of a new generation of multilevel scientists, and global perspective on obesity research." What does cross disiplinary look like?
    medical geography
    advanced neuroimaging tools
    socioenvironmental factors
    spatial data
    expression of genes
    population patterns
    food marketing
    taxes on unhealthy food
    public transportation
    crime free neighborhoods
    behavorial economics
      and of course
    the United Nations World Health Organization
Please note you free market and capitalist morons, your government knows best: "Neoclassical economic theory promised that allowing individuals to pursue their individual passions and desires with a minimum of constraint would lead to aggregate prosperity. However, this theory may be flawed in the case of food and activity preferences. If humans have built-in biological propensities at odds with their environment, top-down approaches may be needed to achieve population obesity prevention goals."

And here comes Obama rama dom dom.


Mmatters said...

This is a great post.

Food and obesity is the next tobacco if Obama wins.

Norma said...

Except this has been coming on for years, "peace and justice medicine" and it didn't even need Obama. These are probably his "classmates" of the 80s, but they were MDs instead of lawyers.