[Vision2020] Dietary Seat Belts

Wed Dec 19 04:32:54 PST 2012

[image: Opinionator - A Gathering of Opinion From Around the
Web]<http://opinionator.blogs.nytimes.com/>
December 18, 2012, 8:15 pmDietary Seat BeltsBy MARK
BITTMAN<http://opinionator.blogs.nytimes.com/author/mark-bittman/>

Here's some good news: Seat belts save
lives[1]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#1>.
So do vaccinations. The
world's population is living
longer.<http://www.nytimes.com/2012/12/14/health/worlds-population-living-longer-new-report-suggests.html>The
childhood
obesity rate has
declined<http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2012/rwjf401163>
[2]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#2>in
parts of the United States.

That's miraculous, because the policies for food, energy, climate change
and health care are, effectively, "let's help big producers make as much
money as they can regardless of the consequences."

Except for just after the most visible tragedies, public health and welfare
are barely part of the daily conversation. When New York is flooded,
climate change dominates TV news - for a week. When innocents are
slaughtered with weapons designed for combat, gun control is a critical
topic - for a week. When 33 people die violent, painful
deaths<http://www.marlerblog.com/legal-cases/my-listeria-cantaloupe-client-and-king-sooper-freshpack-frontera-jensen-farms-and-primus-customer-jim-weatherred-is-dying/#.UNBksnPjlkA>from
eating cantaloupe, food safety is in the headlines - for a week. When
nearly 70,000 people die a year, from mostly preventable diabetes, most
media ignore it.

Forget the fiscal cliff: we've long since fallen off the public health
cliff. We need consistent policies that benefit a majority of our citizens,
even if it costs corporations money.

And guns are just the bloodiest public health menace to go virtually
unregulated. [3]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#3>Preventable,
chronic disease - to a large extent brought about by diet - is
now the biggest killer on the planet. Soda kills more people than guns -
more people than car wrecks - only less dramatically. What we need is the
equivalent of a dietary seat belt.

When we hear about extended life expectancy on a global
scale[4]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#4>,
we're hearing about the triumph of public health policies - from
municipal water treatment and delivery to sewer systems and immunizations.
We're also hearing about health care that extends lives despite chronic
disease, a triumph of expensive technology over thoughtful, less expensive
planning.

And we're hearing about the failure of policy to address the leading public
health challenge of the 21st century: not finding a "cure" for our leading
killers - coronary artery and related disease, cancer, diabetes (which
jumped from the world's 15th rated killer to its
9th<http://www.nytimes.com/interactive/2012/12/14/world/causes-of-death.html?ref=health>in
20 years) - but taking easily defined action to prevent them
[5]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#5>.

The global burden of disease
report<http://www.thelancet.com/themed/global-burden-of-disease>found
an impressive decrease in childhood mortality and deaths from
malnutrition but also found a doubling of deaths from diabetes since 1990.
Stroke and heart disease - not exclusively the result of obesity, but tied
to it - are together responsible for a quarter of all deaths worldwide.

Malnutrition in the form of overeating is now a bigger problem than
starvation, and both are preventable by sane policy measures that could
make decent and real food available to all. Contrary to the hysterical
preaching of techno-agriculturalists, there already is enough real food to
feed everyone on the planet; there simply isn't
access[6]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#6>
.

Preventing chronic diseases - for the first time in history responsible for
the majority of
deaths<http://www.cdc.gov/chronicdisease/overview/index.htm>- would
not require massive public works programs like building water
delivery or sewer systems but simply regulating the quality of our food and
the quantity of the nonfood we allow ourselves to ingest. It is not a
matter of technology or of miracles, but of
policy[7]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#7>.
Minor inconveniences and infringements that benefit everyone - like
seat
belts, gun control and limiting our "right" to smoke or drink - should take
precedence over our "right" to kill ourselves and one another.

There is evidence not only in studies but also in the real world that
public health policy measures can be successful. Why did the childhood
obesity rate decline in such disparate places as New York City,
Philadelphia, Mississippi and California? It's simple: These places
aggressively tackled dietary issues in schools and elsewhere.

In 2007, Mississippi's Healthy Students
Act<http://www.healthyschoolsms.org/ohs_main/MShealthystudentsact.htm>mandated
45 minutes per week of health education (home ec, anyone?) and
limited the kinds of food and beverages sold in school vending machines.
California banned sugary drinks in schools in
2009<http://www.kpbs.org/news/2009/jul/01/california-bans-soda-schools/>and
limited unhealthy snacks in 2007.
[8]<http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#8>

Philadelphia hasn't allowed soda or sugary drinks in vending machines in
schools since 2004<http://news1.iwon.com/odd/article/id/379547%7Coddlyenough%7C01-16-2004::09:14%7Creuters.html>,
and its schools no longer have deep-fryers; the Food Trust (as I wrote in
2011 <http://opinionator.blogs.nytimes.com/2011/04/05/go-philly/>) has
pushed healthier food in corner stores. And New York has, among other
things, banned trans fats from restaurants, made it easier for low-income
people to shop at farmers' markets and run a highly visible ad
campaign<http://bigmethod.com/bmp/new-york-city-department-of-health/big-sugar/10242011.html>that
tells subway riders, for example, the number of miles they'd have to
walk to account for that sugary drink.

Like Philadelphia, New York has come close to passing a soda tax, which has
raised consciousness about the dangers of sugary drinks. The so-called Big
Gulp Ban <http://www.cnn.com/2012/09/13/health/new-york-soda-ban/index.html>(which
will not, sadly, affect actual Big Gulps) will be implemented in
March; if it hangs around, New York's obesity statistics may slide even
further below the national average before too long.

These are dietary seat belts, and seat belts save lives. And only a jerk
would say: "It's a slippery slope toward telling me what to do. If I want
to ride without a seat belt, it's my right!"

When we see something, we should do something. The something we can all see
is this: Eating badly - consuming unprecedented amounts of nonfood, like
soda - causes obesity. Obesity brings about chronic disease. Chronic
disease kills, wrecks lives and wreaks havoc on our health care system and
our economy. We have the power, collectively, to further reduce disease and
improve longevity. Who's against that?
Footnotes:

1.  Something like 20,000 per year in the United States alone.

2. These numbers are slight but nevertheless encouraging.

3.   That gun control is a public health issue as well as a political issue
is obvious, and the case could not be made better than it was by Nick
Kristof this past
Sunday<http://www.nytimes.com/2012/12/16/opinion/sunday/kristof-do-we-have-the-courage-to-stop-this.html?partner=rss&emc=rss>
.

4. Might be worth noting that the country with the world's biggest economy
- the U.S. - has the 51st highest life
expectancy<https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html>,
just ahead of Taiwan and Chile, and roughly 20 places behind Jordan and
Greece.

5. More and more people are talking about
this<http://cpr.sagepub.com/content/11/1/3.short>,
of course.

6. Perhaps this becomes most apparent by considering that about one in six
Americans<http://feedingamerica.org/hunger-in-america/hunger-facts/usda-hunger-numbers.aspx>is
undernourished at least some of the time, in this, the country which
Big
Food would have us believe provides us with the "safest, cheapest and most
abundant" food supply. A food supply that has resulted in two-thirds of us
being overweight or obese. Allowing for some overlap - you can be
overweight and still be undernourished, even truly hungry - it's still safe
to say that about three-quarters of us have nutritional issues.

7. I recognize that at this point smart public health policy may feel like
it will take a miracle.

8. At least in part as a result, the state has a student body that
consumes upwards
of 150 fewer calories per
day<http://www.rwjf.org/content/rwjf/en/about-rwjf/newsroom/newsroom-content/2012/05/california-high-school-students-consuming-fewer-calories-at-scho.html>than
those of states without such programs.

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