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The Full Yield Blog

Reading the news

August 01, 2011 | Tags: Exercise , Featured , Food , Fruit , Health , Vegetables | Post comment

Reading the news

Mark Bittman and Jane Brody, two of my favorite journalists writing about food and health and policy, have pieces in the New York Times in the past few weeks which, along with the New York Times coverage of Michelle Obama’s announcement that big retailers will begin to serve food deserts are worth reading and talking about with family, friends, and anyone else you can engage in a topic so critical to the quality of our daily lives and our economy: our own health.

In a recent New York Times article, Jane Brody covers the research published in the June issue of the New England Journal of Medicine whose “fascinating results” indicate that when it comes to weight loss it’s not how many calories one eats but which calories one eats that matter. It is a tragedy long in the making that so many of the foods Americans innocently and earnestly eat are making them (that is, us) sick.  It is an equally insidiously created tragedy that we need research to tell us food quality is more important than a single unit of measurement.

Having been raised by a cultural anthropologist and having studied biology, anatomy, physiology, disease processes, recovery, and of course human relationships while training to be a midwife at Yale, it seems to me modern research has made public health worse (and isn’t making it better).  Nothing exists alone, not cells, not nutrients, not people, and human health—good, bad, and in between---is a constantly adjusting outcome of biology, society, and message and systems created by, for example, the healthcare and food industries.

Modern science, like all modern cultures, emphasizes the individual and the particulate over the inescapable unity of everything: decades of nutrient specific and calorie-based research has fueled everything from entirely health-depleting “functional” foods to 100 calorie packs of junk food; decades of disparate and often expensive attempts by the government, foundations, health plans, and healthcare providers to get people to eat better and move more has yielded only worse public health.   Well meaning reductionist research and well-funded disparate attempts to make people healthier will not solve our public health problem anytime soon—or maybe ever. 

But this is reliably and apolitically true: the quality of what we eat is fundamental to the quality of our health.  And not simply to particulate aspects of our health but to our health overall: our breathing, moving physical bodies and also our IQs, our inherent ability to regulate appetite and also mood, and our relationships to our groups and to the biggest context of all, the earth from which all things come.

Also writing in the New York Times, Mark Bittman proposes that we tax bad food and subsidize vegetables. He writes that the public health problem belongs not to the food industry, whose interest is exclusively profits, but instead to the federal government.  I agree but public health and profits, regardless of industry, are permanently entwined.  Our dire public health-- and the resulting productivity and healthcare costs which are paid by employers, government, and taxable citizens together-- has created one of the greatest challenges currently faced by the executive teams, directors, and stock holders of almost every company.  After all, the public in “public health” includes the employees of the food industry.

Taxing junk food is one potentially effective contribution to the public health solution and Mr. Bittman has done a great deal to inform his readership about the impact of farm policies on what shows up at the grocery store and at what price. Indeed, if we don’t simultaneously address the realities of the bigger landscape, the interplay between companies and their employees, between ag and health policies, between lack of regional perishable food distribution infrastructure and the already existing behemoth infrastructure of the packaged foods industry, and between fundamental human needs for social engagement and modern cultural dynamics, we won’t solve our public health problem anytime soon—or maybe ever.

The recent announcement at the White House by Michelle Obama, Wal-Mart, Walgreens and others that our biggest food retailers are committed to bringing produce to food deserts is a potent indicator of how much for-profit mindshare is now going toward public health, but of course just putting highly perishable foods in front of people exposed primarily to junk foods for most of their lives will not suddenly create new behaviors and good health.  I am reminded of the story an anthropologist I knew used to tell: in attempting to address disease being caused by contaminated water in an African township, well-intentioned Americans raised money to design a water system and to provide the villagers with shovels with which to install it.  Lo and behold, the shovels were unusable: the villagers lived their lives without shoes.  Giving them shoes, when they’d never worn them, did not make for a quick fix either.

Being told what to do and what to eat so that we can ward off scary diseases and lower the costs of our care is the shovel currently being offered by everyone from doctors and nurses to wellness experts to health plans to employers to Federal and state governments.  Every now and then we’re offered some shoes too, like those apple slices at McDonald’s and the carrot sticks on school lunch trays.

People the world over are suffering from, dying from, and paying in quality-of-life dollars and money for preventable diseases due to poor systems design.  Our compassion creates a genuine and urgent desire to mitigate human and economic suffering but we’ve been throwing culturally inappropriate and limited tools at everyone for years and now, with endless incentives and disincentives, we’ve taken to bribing people to use the tools and threatening them if they don’t.   

Until we recognize the role of food in every aspect of culture (society, economy, quality of life and health) and intentionally, collaboratively modify existing or design new policies, programs, treatments, production and distribution pathways, and relationships between patient, provider, employee, employer, consumer, manufacturer and retailer so that food can do what it has always done, which is to keep us well, make us feel alive and present, and link us to everyone and everything else, we won’t improve public health in any meaningful, lasting, and efficient way.