Junk food and obesity: Taking a cue from tobacco control

What to do about the obesity epidemic? Here’s a thought: Substitute “tobacco” for “junk food.” That provides a pretty clear road junk foodmap about what government authorities should be doing to safeguard public health.

Unfortunately, officials are instead just reheating the same old leftovers.

Dietary guidelines issued recently by the U.S. Department of Agriculture basically say Americans need to ease up on the salt, sugar and saturated fats, and instead eat more fruits and veggies.

This is the same advice given by the department three decades ago. The difference is that the obesity rate for adults was 15% in 1980. Now it is almost twice that number, according to the Centers for Disease Control and Prevention.

In fact, more than two-thirds of adults over 20 are either overweight or obese, the CDC says. About a third of all American kids fall into that category.

“It’s not that we’re morons and have no idea what’s good for us,” said Harold Goldstein, executive director of the California Center for Public Health Advocacy, a nonprofit organization. “It’s the world around us. We’re influenced to eat by our environment.”

In other words, we might know in our heads that a Twinkie or a chocolate shake is a heart attack waiting to happen. But our gut just can’t resist the siren call of all that tasty sugar or fat. And so we eat.

And eat.

Food and beverage companies have long argued that if their products are used in moderation, they don’t pose a danger to public health. They also say it’s unfair to blame them for causing the obesity epidemic.

“If we really want to solve this national public health challenge, we must focus on educating Americans through comprehensive approaches that include nutrition education based in fact and focusing on total diet and exercise,” Susan Neely, head of the American Beverage Assn., said in a statement.

Personal responsibility is certainly a factor — no one forces us to stuff our faces. But Goldstein and other health advocates say consumers are brazenly manipulated by an industry that spends billions of dollars annually getting us to consume what it knows is bad for us.

“Up to now, it’s been a complete free-for-all, with the food industry convincing us to eat more and more of their high-fat, high-salt, high-sugar products,” Goldstein said. “It’s time that this was addressed through public policy.”

And tobacco regulation shows the way.

The rate of adults who smoke peaked at 45% in 1954, according to Gallup. It remained around 40% through the early 1970s and then started dropping as awareness about the dangers of nicotine grew, and as state and federal officials enacted anti-smoking programs.

Today, the adult smoking rate is about 20%. The same percentage applies to older teens, while about 6% of younger teens are smokers, according to the CDC.

The answer seems obvious: If we want to protect ourselves from a deadly epidemic of heart disease, diabetes and other ailments, just as we’ve taken steps to protect ourselves from an epidemic of lung cancer, we need to act.

And that means strict — some might say draconian — measures to reduce consumption of what’s bad for us, and aggressive campaigns to get us to eat and behave in a healthier fashion.

“It doesn’t seem at all draconian to me,” said Toni Yancey, a professor of health sciences at the UCLA School of Public Health. “We need to change social norms to make certain foods less appealing, just as we made it less appealing to smoke.”

We’re already removing sugary sodas and junk food from schools, and we’re doing it to help kids be healthier. Surely the same rationale applies to the rest of society.

I’m not saying we close down all McDonald’s and Burger King outlets. I’m saying we significantly limit advertising and sponsorship by companies selling, as Goldstein put it, high-fat, high-salt, high-sugar products.

This has worked for tobacco. It’s worked (on a largely volunteer basis) for alcohol. It can work for junk food.

Yancey said a good place to start would be government buildings — eliminate all bad-for-you foods and beverages. Instead, make healthful alternatives available. Gradually, if the political will can be found, expand the junk food ban to all workplaces, just as smoking bans spread from the public to the private sector.

Meanwhile, we need to step up wellness efforts to get people to make healthier choices and exercise more. These programs should be funded by levies on the foods that contribute most to obesity, and the obvious place to start is soda.

The beverage industry fiercely opposes such ideas. The chief financial officer of Coca-Cola Co., Gary Fayard, said at an industry conference this month that soda makers need to band together to fight any new taxes on their products.

Researchers at Harvard University say soft drinks are a “major driver” of obesity in the United States, and that raising the price of a can of soda by about a third could cut consumption by as much as 26%.

Tax money could also be put to better use.

“Because we subsidize corn, it ends up as high-fructose corn syrup,” Yancey said. “Why not subsidize healthy foods instead?”

I asked her what she thinks the obesity rate will be 30 years from now.

“I think it will be even higher,” Yancey replied. “Adults will be fatter.”

But if we act now, she said, future generations of kids won’t be exposed to all the cues and temptations that contribute to runaway waistlines.

“Hopefully they’ll be less fat,” Yancey said. “That’s where we’ll turn the tide.”

By David Lazarus
Latimes, June 29, 2010

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