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<div class=""> </div></div><div id="opinionator"><div align="left"><span class="" title="2012-12-18T20:15:35+00:00">December 18, 2012, <span>8:15 pm</span></span><h3 class="">Dietary Seat Belts</h3><address class="">By <a href="http://opinionator.blogs.nytimes.com/author/mark-bittman/" class="" title="See all posts by MARK BITTMAN">MARK BITTMAN</a></address><div class="">
<p>Here's some good news: Seat belts save lives<a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#1">[1]</a> . So do vaccinations. <a href="http://www.nytimes.com/2012/12/14/health/worlds-population-living-longer-new-report-suggests.html">The world's population is living longer.</a> The <a href="http://www.rwjf.org/content/dam/farm/reports/issue_briefs/2012/rwjf401163">childhood obesity rate has declined</a><a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#2">[2]</a> in parts of the United States.</p>
<p>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."</p><p>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 <a href="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">33 people die violent, painful deaths</a>
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.</p><p>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.<br><br>And guns are just the bloodiest public health menace to go virtually unregulated. <a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#3">[3]</a>
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.</p><p>When we hear about extended life expectancy on a global scale<a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#4">[4]</a>
, 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.</p><p>And we're hearing about the failure of policy to address the leading public health challenge of the 21<sup>st</sup> century: not finding a "cure" for our leading killers - coronary artery and related disease, cancer, diabetes (<a href="http://www.nytimes.com/interactive/2012/12/14/world/causes-of-death.html?ref=health">which jumped from the world's 15<sup>th</sup> rated killer to its 9<sup>th</sup></a> in 20 years) - but taking easily defined action to prevent them<a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#5">[5]</a> .</p>
<p>The <a href="http://www.thelancet.com/themed/global-burden-of-disease">global burden of disease report</a>
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.</p><p>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<a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#6">[6]</a>.</p><p>Preventing chronic diseases - <a href="http://www.cdc.gov/chronicdisease/overview/index.htm">for the first time in history responsible for the majority of deaths</a>
- 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<a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#7">[7]</a>
. 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.</p><p>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.</p><p>In 2007, Mississippi's <a href="http://www.healthyschoolsms.org/ohs_main/MShealthystudentsact.htm">Healthy Students Act</a>
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 <a href="http://www.kpbs.org/news/2009/jul/01/california-bans-soda-schools/">in 2009</a> and limited unhealthy snacks in 2007.<a href="http://opinionator.blogs.nytimes.com/2012/12/18/dietary-seat-belts/?nl=todaysheadlines&emc=edit_th_20121219&pagewanted=print#8">[8]</a></p>
<p>Philadelphia hasn't allowed soda or sugary drinks in vending machines in schools <a href="http://news1.iwon.com/odd/article/id/379547%7Coddlyenough%7C01-16-2004::09:14%7Creuters.html">since 2004</a>, and its schools no longer have deep-fryers; the Food Trust (<a href="http://opinionator.blogs.nytimes.com/2011/04/05/go-philly/">as I wrote in 2011</a>)
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 href="http://bigmethod.com/bmp/new-york-city-department-of-health/big-sugar/10242011.html">a highly visible ad campaign</a> that tells subway riders, for example, the number of miles they'd have to walk to account for that sugary drink.</p>
<p>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 <a href="http://www.cnn.com/2012/09/13/health/new-york-soda-ban/index.html">Big Gulp Ban</a>
(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.</p><p>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!"</p><p>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?</p>Footnotes:<br clear="all"></div><div class=""><p>1. Something like 20,000 per year in the United States alone.</p><p>2. These numbers are slight but nevertheless encouraging.</p><p>
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 <a href="http://www.nytimes.com/2012/12/16/opinion/sunday/kristof-do-we-have-the-courage-to-stop-this.html?partner=rss&emc=rss">by Nick Kristof this past Sunday</a>.</p>
<p>4. Might be worth noting that the country with the world's biggest economy - the U.S. - has the <a href="https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html">51st highest life expectancy</a>, just ahead of Taiwan and Chile, and roughly 20 places behind Jordan and Greece.</p>
<p>5. More and more people are talking about <a href="http://cpr.sagepub.com/content/11/1/3.short">this</a>, of course.</p><p>6. Perhaps this becomes most apparent by considering that about <a href="http://feedingamerica.org/hunger-in-america/hunger-facts/usda-hunger-numbers.aspx">one in six Americans</a>
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.</p><p>7. I recognize that at this point smart public health policy may feel like it will take a miracle.</p><p>8. At least in part as a result, the state has a student body that consumes <a href="http://www.rwjf.org/content/rwjf/en/about-rwjf/newsroom/newsroom-content/2012/05/california-high-school-students-consuming-fewer-calories-at-scho.html">upwards of 150 fewer calories per day</a> than those of states without such programs.</p>
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