We're No. 1, We're No. 1!!

In terms of our country's (ever-increasing) girth, that is:

The United States is the fattest nation among 33 countries with advanced economies, according to a report out today from an international think tank.

 

Two-thirds of people in this country are overweight or obese; about a third of adults — more than 72 million — are obese, which is roughly 30 pounds over a healthy weight.

If, like me, you're spatially-relations challenged, this may take a few seconds to wrap your head around, but it illustrates the alarming obesity trend/epidemic nicely.

Bring on the Junk Food Taxes!

Bring on the junk food taxes (combined with more subsidies to help lower the price of healthy food!). Yeah, that's right, pure, unadulterated "nanny state," baby.

This is a good follow up to a study I mentioned the other day. That study found that increasing the price of junk food was a more effective means of improving people's food choices than bringing down the price of healthy food. Now a new study -- this time, not a virtual study, but a 20-year study of actual human behavior -- shows that higher prices for soda and pizza decreased consumption of those items. The bottom line, 124 calories less a day, 2.3 pounds a year.

This has got to be the most persuasive study to date showing that a sin tax on soda or junk food would actually have the desired effect -- and not just aggravate people who care to indulge in an occasional root beer (or threaten their sense of personal freedom). Soda tax advocates may embrace it as proof that their policy goals are justified.

One need only look to the "comments" section of blogs or newspapers to see whining about "nanny state" when taxes on soda or Pringles are suggested. Would they say the same thing about seat belt laws? How about warning labels and PSAs on the health consequences of smoking?

Yes, this not as simple as taxing every bag of Doritos. It's well documented that many people in low-income areas are heavy consumers of soda and junk food. That kind of thing happens when you don't have a real grocery store in your vicinity, don't have reliable transportation, or the cash to buy fresh fruits and vegetables. So there have to be concurrent changes in policies to lower the price of healthy food and make it more accessible. And that is a huge hurdle to overcome.

But the argument can be made that obesity is the #1 public health issue of our time. In that light, taking these policy measures should be a no brainer.

Diet, Obesity, Cancer

I try to keep my professional life separate from my (poorly read) blogging activities. But I recently wrote something as part of my work that was really really interesting, to me at least, and has to do with food... well, at least potentially it does.

For some background, obesity has now been pretty strongly linked to cancer, with the upper estimate put at 100,000 cases of cancer annually linked to a significant excess of body weight. So, remembering that...

What I wrote about was a study in which researchers, using both cancer cells in a dish and mouse "models" of cancer, showed that cancer cells could use this lone enzyme to make themselves more aggressive. That is, makes them more likely to keep growing and potentially spread to other parts of the body.

The enzyme, when it's present in high levels in cancer cells, appears to help produce lots of specific kinds of fatty acids, little bits that make up fat molecules, and these fatty acids, in turn, jump start communications within the cells that allow them to engage in a hallmark of cancer, uncontrolled cell growth and proliferation. That in and of itself is pretty interesting.

But, what was even more intriguing -- and here is where the food comes in -- was this: they took mice with these specific aggressive cancers and they reduced the levels of that naughty enzyme that's causing all of the problems, and that slowed down tumor growth. They then fed some of the mice a high-fat diet and others a normal diet. And don't you know that tumor growth in the mice given the high-fat diet just took off.

As the researchers wrote, the findings may have

"provocative implications for the crosstalk between obesity and tumorigenesis.”

These are only cells in a dish and mice that did not develop cancer naturally. But at the very least, it's enough to really make you think about the connection between what we eat and cancer risk.

A Scrapin' Addendum... An Important One

Two things that should have made it into the previous "digest" posting. Both somewhat sciencey. The latter probably more pressing than the former. The latter has also convinced me to stop eating bluefin tuna.

First, scientists from the Scripps Research Institute perform a cool animal model study -- that is, they did some experiments in rats -- and showed that their brains responded to a steady diet of junk food much the same way that heroin addicts' brains respond to heroin.

Pleasure centers in the brains of rats addicted to high-fat, high-calorie diets became less responsive as the binging wore on, making the rats consume more and more food. The results, presented October 20 at the Society for Neuroscience’s annual meeting, may help explain the changes in the brain that lead people to overeat.

“This is the most complete evidence to date that suggests obesity and drug addiction have common neurobiological underpinnings,” says study coauthor Paul Johnson of the Scripps Research Institute in Jupiter, Fla.

Are humans rats? No, but we're not that different.

Second is, to me at least, more disturbing because experts have been warning about this for some time. This sentence sort of says it all.

A recent analysis of the Mediterranean bluefin tuna population by the WWF shows that the breeding population of the species will disappear by 2012 if the fisheries continue with business as usual...

What I find most disturbing about this are the parallels with global warming. I don't claim to understand the science behind global warming. I do understand the basic concept and that the vast majority of scientists who study the subject agree that the earth is warming and that humans are a big reason for that.

And it seems to me that at some time there will be a tipping point, much like there is with tuna now, when the potentially catastrophic consequences of the collective unwillingness to act -- because of politics or greed -- will become clear. And at that point, much like with the bluefin tuna, there won't be much to do about it.

The obesity rescue berry?

Maybe you've heard of miraculin. I haven't. It's this little berry, resembles a cranberry apparently. You chew it up, get all of the pulp and seeds out, swirl around in your mouth, and dispense. Now put a lemon in your mouth. It will taste sweet. Miraculin makes anything acidic taste sweet. It's used for "flavor tripping parties" in the Big Apple and elsewhere.

Mr. Aliquo greeted new arrivals and took their $15 entrance fees. In return, he handed each one a single berry from his jacket pocket. ... He ushered his guests to a table piled with citrus wedges, cheeses, Brussels sprouts, mustard, vinegars, pickles, dark beers, strawberries and cheap tequila, which Mr. Aliquo promised would now taste like top-shelf Patrón.

But could it be used to combat obesity? Hmmm....

But with miraculin, would anyone be able to tell the difference between tofu pudding and creme brulee? Since it's nearly impossible to change someone's taste, perhaps what's needed to get Americans to eat better is literally to change their perception of taste.

Could miraculin really do that? Perhaps?

At the very least, some folks see a business opportunity.

Some companies have been attempting to create flavor-modulating compounds that mimic what miraculin does naturally. Two of those are Senomyx and RedPoint Bio, which are also developing bitterness blockers and exploring the pathways that translate to salty.

Both have partnered with or are in talks with food companies who are trying to reduce calories in their products by adding taste enhancers instead of sugars or sweeteners.

If these products reach a wider market, more and more patients might be eating foods with the same taste but just a fraction of the calories -- and they likely won't be able to tell the difference.

As this blog post points out, perhaps it could lead people to eat lower-calorie foods, but would it fill them up, or just lead to them still taking in as many calories as before by consuming more?

Paint me intrigued, but extremely skeptical.

A taxing situation

Sooooo... you've got this fairly disturbing report showing that obesity-related health care costs run about $147 billion annually.

"These results reveal that obesity continues to impose an economic burden on both public and private payers," writes Dr. Eric Finkelstein, director of the Public Health Economics Program at the North Carolina-based RTI International, which produced the national study.

"The connection between rising obesity rates and rising medical spending is undeniable."

Part of the solution to the obesity problem, it's been argued, is to slap a tax on junk food. Make it more expensive to eat bag after bag of potato chips and drink 24 oz. Mountain Dews, and you produce an easy incentive to alter people's behaviors. On its face, it seems like a no-brainer (h/t Serious Eats):

About one-third of Americans are obese, up from 15% in 1980. Fat people are more prone to heart disease, diabetes, bone disorders and cancer. An obese person’s annual medical costs are more than $700 greater than those of a comparable thin person. The total medical costs of obesity surpass $200 billion a year in America, which is higher than the bill for smoking.

Of course, the folks who make some of these products don't like this idea one darn bit. Perhaps you've seen the ads from Americans Against Food Taxes? You know, the one which argues that, during these tough economic times, those meanies in Congress should not be adding to the cost of "the simple pleasures that we all enjoy, like juice drinks and soda" by slapping a big 'ol fat tax (no pun intended) on them.

[On a side note, does anybody actually believe that "Americans Against Food Taxes" is actually a grassroots organization, and not an astroturf campaign funded by the American Beverage Association?]

As others have pointed out, I think it would be difficult to define just what should and should not be taxed. What about the juice drinks we buy, made by the folks at Honest Tea (which is partially owned by Coke, I know, I know), that are organic, have just a little (real) sugar and only have 40 calories? I would hardly say that qualifies as a fattening food.

But generally I think it's a good idea. The revenue could be used to pay for health care reform and, as has been shown with cigarettes, may actually help ween people off of the stuff. At the same time, it's a regressive tax, because it would hit lower-income people (who are at increased risk for becoming obese) harder, since they often live in neighborhoods that lack grocery stores and decent restaurants and, as a result, buy more food items at convenience stores and fast-food restaurants (which are in abundance in many low-income areas) meaning their diets are replete with the fattening foods that would become more expensive.

To be workable, in my view, taxing junk food has to be coupled with a serious effort to make healthier foods more affordable, by taking away those billions in corn subsidies and using them instead to help more farmers return to growing a diverse array of crops, and to promote a more regionalized food system, so those said farmers can't more easily get their products to willing customers.

In the end, I doubt either will occur. But stranger things have happened.

Scrapin’ Up the Bits… Heavy Reading Style

A whole host of stuff worthy of noting.

To begin with, and on a completely self-serving note, my food obsession intersects just slightly with my day job. The writing’s a bit heavier than you might get in USA Today or the Post-Gazette. But it’s still neat stuff.

Want to get an up-close look at some local farms? PASA is sponsoring a local farm tour this Saturday!

And it’s been a while for this, but there is a new entry in the Fast Food Abomination of the Week. And it’s a returning champ this time, Quiznos, for its $5 “large deli favorite subs,” the commercials for which proudly proclaim that these subs come with one pound of meat.

Speaking of way too much food – or, perhaps more accurately, calories – Americans continue to get bigger.

From 2005 to 2007, the proportion of adults who were obese (based on self-reported height and weight) increased by 7% to a nationwide average of 25.6%, Deborah Galuska, Ph.D., of the Centers for Disease Control and Prevention, and colleagues reported in the July 18 issue of MMWR: Morbidity and Mortality Weekly Report.

In three states -- Alabama, Mississippi, and Tennessee -- almost a third of adults were obese.

But it appears that Burger King has gotten part of the message. After close to a year of test marketing, Burger King is taking its apple fries – red delicious apples cut to look like French fries – nationwide.

The nationwide launch coincides with its new BK Positive Steps Nutrition Program and nutritionally balanced kids meal.

The apples are available a la carte for $1.49, said Burger King spokeswoman Heather Krasnow.

The kids’ meal offers a serving of macaroni and cheese, fresh apple fries with a low-fat caramel dipping sauce and a low-fat milk. The meal has a total of 350 calories and less than 25% of calories from fat. It carries a suggested retail price of $3.49.

I’m still not taking my kids there.

And those tainted tomatoes? Psych. But look out for the Ja-Lop-A-Nose!

Federal officials investigating a three-month-old salmonella outbreak have isolated the bacteria in a jalapeño pepper from a small distribution facility in McAllen, Tex., and yesterday warned consumers nationwide to avoid eating raw jalapeños or products that contain them until more is known.

It’s a good thing the jalapenos in our garden, and like four other pepper varieties, are finally starting to appear.

And this takes home gardening to a whole other, kind of snobby, level

That is where Trevor Paque comes in. For a fee, Mr. Paque, who lives in San Francisco, will build an organic garden in your backyard, weed it weekly and even harvest the bounty, gently placing a box of vegetables on the back porch when he leaves. …

As a result of interest in local food and rising grocery bills, backyard gardens have been enjoying a renaissance across the country, but what might be called the remote-control backyard garden — no planting, no weeding, no dirt under the fingernails — is a twist. “They want to have a garden, they don’t want to garden,” said the cookbook author Deborah Madison, who lives in Santa Fe, N.M.

I guess if you don’t gain any satisfaction from growing a little of your own food and have the cash to spend on a personal gardener, why not, eh?

The Sentences and the Fury

ALERT! ALERT! This is a serious post that will discuss important social issues and reference scientific research. You’ve been warned.

Maybe I’m overreacting. But darn if this didn’t set me off when I read this last week:

A nation in which the poor are defined by an income level that in most countries would make them prosperous is a nation that has all but forgotten the true meaning of poverty. A nation in which obesity is largely a problem of the poor (and anorexia of the upper-middle class) does not understand the word "hunger."

The offending two sentences came early on in an op-ed by Bret Stephens, a member of the Wall Street Journal editorial board, in the Journal’s online “Opinion Journal.” In the context of the larger commentary -- a backhanded slap at anybody who dare complain about “divisions” in America or about the progress, or lack thereof, in Iraq -- these two sentences were nothing more than punditry detritus.

But those two sentences say a heck of a lot to me about how a good portion of people in this country view the socioeconomics of food and, more specifically, nutrition.

It’s true, of course, that the obesity epidemic is concentrated in less-affluent populations (how’s that for medico-journalese!). And there’s a very good reason for that: cheap, calorie-laden food is what many low-income people can afford.

Just last month, researchers from the University of Washington reported something that might surprise Mr. Stephens, but not anybody who’s been paying attention:

They found that the foods which are less energy-dense -- generally fresh fruits and vegetables -- are much more expensive per calorie than energy-dense foods -- such as those high in refined grains, added sugars, and added fats.

[snip]

Lower-calorie foods jumped in price by about 19.5 percent in that two-year period, while the prices of very calorie-rich foods stayed stable or even dropped slightly, the researchers found.

And this isn’t some short-term phenomenon:

Since 1985, the actual price of fruits and vegetables has increased 40 percent, while the price of sugar and fats has declined by 14 percent.

The bottom line is that more fattening foods are far cheaper than healthful foods. This is due in very large part, of course, to the federal subsidies paid to support the growth of corn, soy, and several other “commodity crops” that are the backbone of those calorie-laden foods (e.g., the gazillion tons of corn used to feed all those cows needed to produce those flimsy little meat patties at McDonalds).

In the same McClatchy article, a beautiful chart shows that of the $70.2 billion in subsidies – that’s right, BILLION – given to agriculture interests between 1995 and 2004, only $1.55 billion went to support fruits and veggies.

So is it any wonder that, when a mom of two making, say, $16,000 a year, sees what it will cost her to buy four or five oranges, and then realizes she can get a case of generic orange soda for the same price, she chooses the case of soda?

This whole diatribe thus far brings me round to another recent study, published just this month and covered by the New York Times’ Tara Parker-Pope, which demonstrated that giving poor people vouchers to purchase fruits and veggies actually… wait for it… increased the amount of fruits and veggies they ate.

Who would have thunk it? Certainly not Mr. Stephens, who I have little doubt would decry such a program proposal as a government “handout” -- unlike those billions of dollars in federal subsidies for growing the corn so desperately needed to produce Cherry Pepsi.

In the study, women were given $10 vouchers weekly for use at a farm market or supermarket.

After six months, women who shopped at the farmers’ markets were eating about three additional servings of fruits and vegetables a day, compared to the control group. Supermarket shoppers consumed 1.5 extra servings.

The study results, Ms. Pope reported, coincide with a decision by the USDA -- after apparently a bit of pressure from public health groups -- to start giving participants in the federal W.I.C. program (Women, Infants, and Children) subsidies for purchasing fruits and vegetables.

“Wonderful!” you might think. “Fantastic, even!”

Think again:

The W.I.C. program will provide monthly vouchers worth $8 to each recipient and $6 to each child. Breastfeeding women will receive just $10 a month toward fruits and vegetables.

So here you have a study that demonstrates quite clearly that the eating habits of poor women with children can be significantly improved through nominal weekly vouchers for fruits and veggies. In contrast, you see an action by the USDA intended merely to provide a talking point, something along the lines of, “We are helping poor women and their children eat healthier with vouchers for fruits and vegetables…”

The well-documented socioeconomic disparities in deaths from diseases like cancer and heart disease are not due to happenstance. There are directly attributed to environmental and economic factors, such as whether somebody can afford to buy a bunch of grapes or a bag of carrots at the grocery store. And, meanwhile, you have the government subsidizing the production of the most fattening and cheap foods on the planet, while doing almost nothing to help those in most need of getting an apple a day.

And what are the costs of this?

A new study shows that the nation's unchecked diabetes epidemic exacts a heavy financial toll as well: $174 billion a year. That's about as much as the conflicts in Iraq, Afghanistan and the global war on terrorism combined.

[snip]

The incidence of diabetes has ballooned — there are 1 million new cases a year — as more Americans become overweight or obese, according to the study, released Wednesday by the American Diabetes Association. The cost of diabetes — both in direct medical care and lost productivity — has swelled 32% since 2002, the report shows. (emphasis added)

So, contrary to Mr. Stephens’ assertion, I would argue that, as a country, we definitely understand what “hunger” means. There are many kids and adults who go to bed -- or heck, spend a good portion of their day – hungry, and there are many others who have enough money to eat, but only the cheapest foods, the stuff that leads to things like obesity and diabetes.

I don’t know how much any one individual can do about any of this. But aside from the superior taste and quality of everything I get from local providers, buying as much as I can from local farms is one way I see to help further develop a local food infrastructure that can, in its own way, be part of the solution to these problems.

I know that our CSA, Harvest Valley Farms, participates in WIC, and hopefully as people start to demand more sustainably raised produce and meat, more of it will become available, the price will begin to inch down, and something good can begin to take hold well beyond what’s in my CSA basket each Tuesday from May to November.