June 2011 Archives

Everyone remembers the battle over healthcare reform legislation - a struggle that continues today. While all of us may not agree on the specifics of each component of the plan, we do share the conviction that something must be done to decrease healthcare costs at every stage of life.

Obesity, which affects one-third of all children, and conditions related to obesity cost families and our country dearly. According to the Children's Defense Fund:

•        Annual medical costs for a child diagnosed with obesity are on average three times higher than those for a child who is not overweight or obese.

•        Nationwide, it is estimated that annual costs for prescription drugs, emergency room treatment and outpatient services related to childhood obesity total more than $14 billion, with an additional $238 million in inpatient hospital costs.

•        If the childhood obesity trend continues, experts predict it could cut two to five years off the lifespan of the average child in America - making this the first generation to have a shorter life expectancy than its parents. 

Sound health practices that help prevent disease must begin in early childhood, but even among children, it's very hard to change unhealthy behavior. The good news is that obesity can be prevented and that disease prevention is poised to assume greater urgency with the June release of The Public Health Institute's National Prevention and Health Promotion Strategy. This blueprint for realigning the nation's healthcare system details the role that all sectors must play in containing costs and reducing disease. Surgeon General Regina Benjamin described this strategy as the "Americas Plan for Health and Wellness."

Many communities already have good health promotion programs in place, but now we must unite behind a master plan by connecting and collaborating. Granted, it can be challenging to change our mindset from disease treatment to disease prevention, but it's the only way we can reverse trends that are undermining our country's well being - including our health, economy and even national security.

Start by reading the National Prevention and Health Promotion Strategy. Use a wide net to identify and connect with all the health-related programs in your community. Focus on areas where you can have an impact. And be sure to put healthy eating and physical activity at the top of your list.

What is the number one nutrition and health issue in the news today? Without a doubt, it's obesity. But there's another issue just as high on the national agenda, one that may not receive the same attention but nevertheless presents an equal degree of risk to our country's current and future health and well being. This issue is hunger - or, as it is called in today's policy-making circles, food insecurity.

Earlier this year, television's 60 Minutes alerted the nation about hunger in our nation's families. This news was shocking to many Americans. We have been relentlessly focused on helping our children make healthy choices and eat fewer calories. School lunch and breakfast programs have lowered sugar and fat content and reduced portion sizes. And now we're told many of our children are not getting enough to eat? How can these two problems - obesity and hunger - exist side-by-side in the same community, in the same school, in the same family and, most confusing of all, in the same person?

The fact is that more than 12 million children under age 18 are not assured of the availability of nutritious food. Under-employment, unemployment and even poverty have crept into families where they never existed before. People who needed no assistance now frequent food banks and other catch-as-catch-can resources. These people are the definition of "food insecure."

We all know that hungry children get sick more often and hunger can compromise long-term health, growth and development. When compared to children who are not worried about if and when they will eat, poorly nourished children have lower academic achievement, are unable to concentrate, and display social and behavioral problems.

Low income is one factor behind this situation, but food insecurity - that is lack of access not only to food but also to healthy food - isn't exclusive to communities where incomes are traditionally  below the poverty level. A child need not appear malnourished to be food insecure - and that is the key to how obesity and hunger can exist side by side.

The obesity-hunger dichotomy reminds us of the impact of lack of resources, lack of access to healthy food, cycles of food deprivation and overeating, and stressful lives. Because our children's ability  to learn is critical to the future of every sector of society, we must be strong advocates for the expansion of  child nutrition programs. A meal at school may be the only meal and/or the only healthy meal that many of today's children receive.

We also must be aware of all the resources already available to combat food insecurity in our communities. Kudos, for example, to the state of Virginia - and actor Jeff Bridges and Gov. Bob McDonnell - for the No Kid Hungry Campaign, which seeks to raise awareness of the availability of state and federal food programs. This kind of advocacy is exactly what we need to ensure hungry people take full advantage of every opportunity available for nutritious food.

My view on the debate over high fructose corn syrup (HFCS) is in line with those of The American Dietetic Association and other medical societies: HFCS is no different from table sugar.

This perspective was reinforced last week in a discussion with one of my former professors, an esteemed biochemist now retired from The Ohio State University (where I earned my doctoral degree). He gave me a refresher course on the metabolism of sugar.

HFCS is manufactured form corn syrup, which undergoes an enzymatic process to increase its fructose component, making it about half glucose and half fructose - just like sucrose (table sugar). Thus, the label "high fructose" is somewhat confusing: HFCS has more fructose than regular corn syrup but also has an equal amount of glucose. Some critics claim that this process alters metabolism, thus causing diabetes, obesity and metabolic syndrome; however, there is little evidence to support this theory.

And now, the controversy over HFCS has brought another issue into play - the role of fructose, the sugar found in fruit. Enough already!

The really important issue here is consumer confidence - confidence in what we as nutrition professionals recommend. The news isn't good. For example, the International Food and Information Council's latest survey reveals a disturbing trend: Consumers are less concerned about their weight and do not count calories.   

I am concerned that by delving so deeply into food ingredient/ processing and by making pronouncements based on so little real proof, we are creating unnecessary fear in the minds of consumers and undercutting our voice of authority in food and nutrition. I am concerned that debates like the HFCS skirmish push consumers to disregard our recommendations. Think about it: Lately, even newscasters and talk shows roll their eyes over the "next round" of nutrition advice."

Yes, it is important to have a conversation - and a debate when necessary - about the ingredients in our food, but let's not create so much fear that we destroy Americans' confidence in their food supply. Behind all the noise is a simple fact: Products containing HFCS can be part of a well-balanced diet of smaller portions and fewer calories. That's what we should be teaching.