Looking Out, Looking Up

When it comes to health outcomes related to nutrition and physical activity, I recognize that I harbor what may be a deep-seated cultural bias which can be summarized in three words: sole personal responsibility. After all, adults are ultimately responsible for what they put into their mouths. Adults are responsible for choosing to move or choosing to lay on the couch “binge-watching” serialized entertainment. On the surface it appears obvious that the shape we’re in is a product of our own volition.

But.

Do we assign illness responsibility to people who are affected by consuming contaminated drinking water discharged from petrochemical companies? How about blaming people for having asthma in densely populated urban areas?

Neglecting the influence of the external environment on our health blinds us to the reality that we are creatures of both nature and nurture. These two forces are in constant dynamic interplay, continuously influencing one another and all of us. If you are interested in exploring the emerging scientific exploration of the obesigenic environment in which we are immersed, check out this 2011 Obesity Review article. If you are inspired to collaborate with others in bucking the system, the Centers for Disease Control and Prevention have a web page which can point you to action plans for developing physically active communities.

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We Are What We Eat

Science relies on empirical data in order to assess what is “true” or “correct”. So what happens when it turns out that previous examinations of evidence led to erroneous conclusions? Widespread confusion, usually. For example, studies conducted in the latter half of the last century led researchers to proclaim that consumption of cholesterol and fats of animal origin increased the risk of cardiovascular disease. This encouraged an entire generation or two of folks to replace butter with margarine, lard with cooking oil or vegetable shortening, and to attempt to eat a “low-fat” diet, often by substituting simple carbohydrates in their meal plans. Later research provided evidence that trans-fats in margarine and shortening were even more damaging than either cholesterol or saturated fat to the cardiovascular system, and diets high in simple carbohydrates have been a major factor in the skyrocketing rates of overweight and obesity world-wide. The Annals of Internal Medicine published a report on March 17th, 2014 on a meta-analysis of information regarding the consumption of saturated fat and heart disease: this analysis of 72 studies including more than half a million people found found NO association between the two (Reuters has published a good summary of the findings).

Before you roll your eyes, groan and order a double cheeseburger with mayo, consider this: we eat primarily to fuel our bodies and to reinforce social bonds. While minimizing the risk of cardiovascular disease is important, other aspects of our physical health such as our risk of developing cancer and diabetes are impacted by our diets as well. Health is also much broader than just our raw physiology; it encompasses both mental and social aspects of well-being. Finally, what we choose to eat and to feed our families has a direct impact on the health of the planet through the effects of farming on the natural resources all beings need in order to survive and thrive on our little blue planet. 

Eat saturated fat? Sure. In moderation. Eat sugar and other carbohydrates? Yes. In moderation. Eat protein? Yep, in moderation. I think you get my point. For further information, I encourage you to read “In Defense of Food” by Michael Pollan. Although he is a journalist and not a scientist, his work is sound, engaging, and refreshingly easy to understand. You can find a summary of his 8 words to guide your food habits here

Musing Over The Details

In my Facebook feed this morning a professor of nursing commented on a post by George Will, opinion writer for the Washington Post. The title of Will’s piece, “Better health through good choices”, echoes a strong sentiment felt by many: that our overall health is under our direct control. Buried, however, in his text is a simple phrase about our capacity to make those choices: “Certainly one lesson of the past 50 years is that one of the most cost-effective things government does is disseminate public health information concerning behaviors as disparate as smoking and using seat belts.”

Where does that “public health information” come from? Take a moment to think about the huge amount of human investment which goes into researching these fundamental issues which affect all of us. Think further about the forces aligned against dissemination of that research (if you haven’t yet watched “Thank You For Smoking” I strongly encourage you to do so). And think about the time, energy and money that goes into attempting to educate us about factors which directly impact the health and well-being of ourselves and our families. Of the 2.6 TRILLION dollars spent on health care in the US in 2010, 3.1% went to public health efforts. If Mr. Will is right, and our ability to “make good choices” is both a major factor in our health AND a direct consequence of public health outreach, imagine what we could achieve if we chose to invest more of our dollars in basic research and effective education. 

40 Days

A month of modified fasting is a feature of a few religious traditions around the world. While I don’t advocate extreme fasts, choosing to abstain from consuming non-nutritive or downright harmful substances for a set period of time may provide the impetus for longer-term positive health change. After all, if you can live without it for 40 days, you can probably live without it for a lifetime! I’ve jokingly told folks that I’m giving up preconceived notions for Lent, and this includes my knee-jerk response to anti-sugar fanatics. It turns out that they really might be on to something I ought to be paying attention to: check out this hot-off-the-presses World Health Organization report.