By David Grotto, RD, LDN
I just finished watching the four-part HBO series called The Weight of the Nation and found it so compelling and frightening that I sat for four consecutive hours to watch it. My conclusion? Watching The Weight of the Nation can cause obesity!
Sounds silly, but one of the points made in this fairly well-balanced documentary about the plague of obesity in this country is that just about anything we do as Americans can be linked to our current obesity epidemic. Regardless of where we live, how educated we are, or how much money we have, obesity is an equal opportunity offender. The documentary shares many alarming facts, such as the cost of obesity, which is bankrupting our nation to the tune of $150 billion a year and that watching television or more “screen” time (of any type) has been linked to obesity.
Thinking about putting a television in the kid’s room? Think again. Children are much more likely to become obese by having a TV in their room than not having one. And it’s not just the mere act of watching a “screen” that blocks us from healthy behaviors, like moving more and engaging in physical activity, but that this low-calorie-burning “activity” is also compounded with titillating messages enticing us to eat more of the type of foods that fuel obesity. I think that’s what they call a “vicious cycle.”
Though there were inspiring stories of how individuals, companies, and entire communities made positive changes to improve health, the documentary in general was a little short on solutions, especially on the home front. So I thought it might be helpful to discuss two major themes of obesity and start a conversation about possible solutions. Sound good? Oh yeah, I’m expecting you to add your own ideas of what has worked for you, your community, or workplace!
Calories in. Problem?
Access to food. Not only are we bombarded with thousands of food choices every day, but we don’t have to travel far to fulfill any choice we want to act on. We have changed from hunter-gatherers to sloth-like seeker-orderers. We seek out food and place our order and the only hunting we do is for an open table. Thomas Farley, MD, MPH, Commissioner of the New York City Department of Health and Mental Hygiene points out in the documentary that we are not genetically programmed to turn down calories when they are presented to us. Apparently, part of our existing hard wiring that dates back from the early days of man has programmed us to seek out high-calorie foods that we could gorge ourselves on to tide us over until we bagged another unfortunate beast.
Sin Tax. Make foods that are associated with obesity have a higher price tag for the consumer while making nutrient-rich, lower-calorie foods more affordable. Ironically, in poorer neighborhoods, you can purchase more calorie-rich and nutrient-poor type foods for the dollar than you can healthy foods. And regardless of neighborhood, it costs more to buy a healthy salad and bottled water at a fast food restaurant than it does to purchase a burger and fries. This “sin tax” was instrumental in reducing cigarette smoking – it might be worth a try.
Make junk food harder to find. Redesign the layouts of grocery stores and cafeterias. Make good-for-you-foods easier to find and make sugar-sweetened beverages and fatty packaged pastries something you have to go on a treasure hunt for. Relegate obesity-promoting foods to bottom shelves and do not give them prime real estate.
Problem? Advertising of unhealthy foods, especially to children.
In part three of the series, called “Children in Crisis,” William Dietz, MD, PhD, Director of the Division of Nutrition, Physical activity and Obesity for the Center for Disease Control and Prevention stated that 1.5 billion dollars a year is spent on the marketing of food products to children. Seventeen leading food companies have formed the Children’s Food and Beverage Advertising Initiative (CFBA), which pledged to advertise only “better for you” foods to kids. In 2010, First Lady Michelle Obama encouraged not just a limit on advertising unhealthy foods but a simultaneous increase in the marketing of healthy foods to children. However, though improved, marketing of unhealthy foods to children remains a problem and warrants industry-adopted standards of what constitutes “healthy”. These industry-wide standards should also include stricter guidelines on label claims with hopes of eliminating confusion for the consumer.
No marketing of unhealthy foods, period! This sounds great at first glance, but what makes a food healthy or unhealthy? Do sugary sweetened cereals contribute to obesity? If so, how much do you have to eat to be concerned? What constitutes “sugary”? Many companies have already reduced sugar and increased whole grain in several of the cereals kids love and we need to encourage companies to continue to make products that are healthier for kids that they will still eat. Besides, cereal also brings along with it all the nutrition you get from milk. I would agree that sugar-sweetened beverages and treats with no redeeming health attributes should be banned from advertising.
Ban unhealthy portion size advertising. I think anything with the word “monster,” “jumbo,” “enormous,” “gut-buster,” or any such verbiage that describes huge portion sizes should not appear in advertising. I do think calorie, saturated fat, and sodium levels should be proudly displayed in all food and beverage advertisements. You want to promote a big gulp? Great. Also post what the cost of gastric bypass surgery is these days. You want to promote overeating on a food show? Great. Also post a Surgeon General’s warning that this type of behavior may also cause diabetes, contribute to heart disease, lead to erectile disorder…you get the idea.
Calories out: Problem?
Physical activity is not required in all schools! I was shocked to learn in the documentary that state and local governments, NOT federal government, mandates whether physical activity is offered in schools. What?
Make physical activity mandatory for all grade levels and provide adequate funding for equipment, organized sports, and facilities. Sounds simple here too, but this requires money and also a change in thinking. I was elated to see that one of the experts in the series made the connection between physical activity and improved learning. State of Texas Comptroller Susan Combs looks at the investment in physical activity in schools and the workplace as a method of controlling health care costs.
Problem? Many communities do not provide safe locations and facilities for physical activity.
Make federal funding of healthy communities a priority. The CDC gave 17 million dollars to the 2nd fattest city in America (Nashville) to improve city bike and walk ways among other projects to get citizens to move. They have also implemented exercise programs for their police and fire departments to help them get and stay in shape. Many communities do not have adequate sidewalks, ample lighting, or parks and recreational facilities to encourage their citizens to get moving. What wasn’t discussed was the cost of park district or health club memberships. Financial barriers need to be knocked down between those who want to be physically fit and the facilities that can help make that happen.
What was abundantly clear after watching this series is that obesity exists for many reasons, and there isn’t one solution. It will take the collective minds and souls of industry to put the health needs of consumers first as a vehicle for driving creative product development that is still profitable; policy makers, to do what’s best for its citizens instead of special interest groups; and adults, to model for their children by making healthier choices and choosing to move. I’d love to talk to you more but I think it’s about time to get up and move. Who’s with me?