Never before has the human race been threatened by a profound overabundance of food.
—Nancy Snyderman
We can’t allow it. The problem threatens our health, our wealth, and our national security, and I’m convinced that together we can make the commitment to solve it. It will take education, government regulations, legal action, and commitment at every level of society, but tobacco showed us how much is possible. At one time, half of all American adults smoked; now fewer than 18 percent of them do. Turning that around took a combination of things.
“It wasn’t just doctors talking to patients, it wasn’t just getting rid of the advertising, it wasn’t just raising the prices, and it wasn’t just changing social attitudes and driving smokers off campuses,” says Zeke Emanuel. It was all of that and more.
So it has to be with food, he says. “We have to get smaller plates, we have to get better labeling, we have to get the price differential reduced so that the healthy thing is not the more expensive thing. All of these things are going to be important in getting our arms around the obesity epidemic.”
TEN WAYS TO CHANGE OUR APPROACH TO WEIGHT
•Start talking honestly about what needs to change. Hold constructive and public conversations about weight, body image, and how we produce, distribute, market, and eat food in America. Put the word fat back into our vocabulary and start using other blunt and forceful language. It’s not enough to say “eat more fruits and vegetables.” We also need to say “here are the foods that are killing us.”
•Publicize the costs of obesity. The idea is not to stigmatize plus-size Americans, but to allow government officials and employers to break out their calculators and see whether programs to prevent or reverse obesity are worth the investment.
•Insist that our leaders lead. People with influence and authority at every level—in federal, state, and local government, in the workplace, in the health care system, and in the schools—should help promote the broad changes that will get us on a healthier path.
•Establish a federal obesity commission. I’d like to see smart recommendations, based on science, coming from the top about how to build healthier communities, incorporate incentives for weight loss into our health care system, make healthier foods more affordable, promote behavior change, and much more.
•Fund more scientific research. Losing and regaining weight involves complicated biology, and we need to learn more about that. We also need to understand whether food really can become addictive and what messages will get people to act.
•Overhaul the food climate in this country. There are a million public policy opportunities to make a difference. For starters, we should change the crops we subsidize, eliminate food deserts, revise the food label, and levy taxes on soda and other unhealthy food.
•Educate the public at every opportunity. Our health care professionals should talk about weight with their patients, our markets should install touch screens to provide more information about what’s in the food they sell, and people who have succeeded should share their secrets with those who have not.
•Make our kids the first priority. There is lots more we can do to improve the quality of school lunches, teach kids more about food, and get them moving. Teachers should talk to parents about their kids’ weight. And there is no excuse for selling sugary drinks and snacks in school vending machines.
•Forge a healthful vision in small towns and big cities. Let’s make communities that work—with sidewalks, bike paths, easy-to-access and safe recreational activities, farmers’ markets, and stores that have an incentive to sell fresh and healthy food.
•Celebrate a healthy thin in the media. Enough with the ultraskinny models. Let’s show photographs of what real and healthy bodies look like.
CHAPTER ELEVEN
TEACH YOUR CHILDREN WELL
MY STORY, WITH DR. DAVID KATZ, LISA POWELL,
DR. EMILY SENAY, DR. DAVID LUDWIG,
DR. MARGO MAINE, DR. NANCY SNYDERMAN,
MAGGIE MURPHY, SENATOR KIRSTEN GILLIBRAND,
CHEF LORENA GARCIA
Let’s go back into our homes now and talk about what else we have to do to get our children on the right path and keep them there. Nothing is more important to me, because I am passionate about preventing my daughters from struggling with food the way Diane and I have. It just takes up too much brain space, and it’s too risky for their health.
I’ll keep arguing for creating an environment that promotes a healthy thin for our kids. As I’ve said, schools, businesses, health care providers, and government can and should do a lot more.
But we can’t hand off all the responsibility. We have to fight back together against a food industry that targets kids with billions of dollars in marketing, a media industry that tries to impose its own notions of healthy bodies on the rest of us, and a diet industry that says weight loss is easy if you just buy this or that product.
Teaching our children how to resist all that has to begin at home. That’s where we can control the conversation.
We’ve got to take food back. We need to be in charge, to take ownership over what we buy and what we cook, and make it a priority, because it is going into our children’s bodies and we have to make it healthy for them. As parents, we have an obligation to provide a firm grounding in smart eating so that when we send our kids into the world, they are as prepared as possible for the assault they will face. That’s what it takes if they are not to become that generation of overweight and obese kids whose life span is shorter than that of their parents.
So how do we get our kids to eat well and to develop a healthy body image? What’s the right way to talk about this with them? What do we say? What do we not say?
Talking about weight with your children is like threading your way through a minefield. Too much, and you worry that your child loses self-esteem or latches on to disordered eating. Too little, and you risk a child whose weight makes her a target of bullying and sets her up for a lifetime of health problems.
I turned again to the experts for their thoughts and guidance.
Everyone agrees on two things: good eating habits matter, and parents need to model good behavior. “We use the term junk food as if it’s an innocuous thing,” says Dr. David Katz, “but it is the construction material for the body and the brain of that growing child of yours. We would not countenance building a house out of junk. We would not sanction driving a car built out of junk, and yet we look around every day at children being built out of junk and everybody’s okay with it. There’s something profoundly wrong with that.”
We use the term junk food as if it’s an innocuous thing, but it is the construction material for the body and the brain of that growing child of yours.
—David Katz
Changing that begins with parents, says Canyon Ranch’s Lisa Powell. Their role “is to choose and prepare a healthy menu, and to model healthy eating behavior that’s neither restrictive nor overeating.”
Lisa gets frustrated by parents who bring their children in to see her and say, essentially, “Fix my kid” without looking at their own eating patterns. “Sometimes I want to shake them and say, ‘You brought this food into the house!’ That’s the mother and father’s responsibility: to decide what is going to be available in the house and how meals are going to be structured.”
Dr. Emily Senay agrees. “Take them to the store, shop in the vegetable aisle, let them help you prepare food, get them involved in the process. You can’t stop them from eating junk food outside the home, but if you give them information and continue to model healthy eating behavior at home, eventually kids will eat more like their parents.”
Take them to the store, shop in the vegetable aisle, let them help you prepare food, get them involved in the process.—Dr. Emily Senay
It has to be a family affair. I think Jim and I are doing a pretty good job exposing our girls to healthy eating. We are certainly trying to shape their attitudes toward food and expand the horizons of their
taste buds by training them to enjoy fruits and vegetables.
The girls are more aware of good and bad food than I ever was. We discuss it a lot in our household, and they generally lead the discussion. I tend to hang back, because I don’t want to add to the pressure already imposed on them from my job and my issues with body image. I’m sure they think that is just as well—teenage girls don’t need to hear their mother tell them how to eat every second of the day!
But they do need guidance, and I am grateful that Jim takes an active part in these discussions and does a lot of our grocery shopping. He’ll buy organic peanut butter for Amelia because she runs track, and we give the girls a steak once a week because they are still developing and need protein and iron. Jim and I don’t eat red meat so we’ll have a different meal, but that’s part of the conversation, too. And we get tons of broccoli rabe and Brussels sprouts, which all of us share.
When I was their age, I was like a runaway beer truck around food. One of my issues growing up was that I wanted to eat American food, and I wonder if that made me feel like I was missing out on something. In my household now, we have an all-American diet, but it’s a healthy one. And I don’t think my children feel the kind of lack that I did.
I don’t think they feel denied. Ours is not a “Food Nazi’s” household, but we do shop carefully and we don’t buy food that we don’t want them to eat. We don’t keep commercial cupcakes or sugary cereal around, but we do have granola without a lot of extra sugar, we have almonds, we have whole-wheat crackers. We even have windmill cookies, which have a certain amount of fat in them, but they’re just not over the top. We don’t buy potato chips and dip, but we do eat baked corn and whole-grain chips, and we enjoy salsa with them. We have all sorts of juices, but none of them are the processed sugar-filled ones in boxes. They don’t have added sugar and they are organic.
One place we are strict is with soda. There is absolutely none of it in my house. None. As far as I’m concerned, if you wipe all soda off the face of the earth, this would be a better place. I don’t see any reason why anyone should serve soda to their kids. It’s like letting them drink candy. It’s nothing more than liquid sugar, and as we’ve seen, sugar is poison.
Guess what I get out of that attitude? One kid who never drinks soda, and one who always orders it at the restaurant. I can live with that, for now. It shows that parents can’t influence all of their kids’ behavior (as if we didn’t know that), but without soda in our home, I know they are drinking a lot less of it.
Two studies back up my strong feelings here. In a Boston study, 224 overweight or obese high school students were given either the sugary beverages they usually drank or sugar-free drinks, including bottled water.1 That was the only difference between them; they got no nutritional advice, and they did not change their exercise habits. After a year, the kids in the sugar-free group weighed an average of four pounds less than the soda drinkers.
“I know of no other single food product whose elimination can produce this degree of weight change,” said Dr. David Ludwig of Boston Children’s Hospital and the Harvard School of Public Health, who led the study.
Similar results came in from a study in the Netherlands that involved more than 650 children, ages four through twelve. During their morning break at school, some kept drinking their usual sweet beverage and others were given sugar-free drinks instead. Eighteen months later, the children drinking the sugary drink weighed an average of two pounds more.2
Even with our crazy schedules, Jim and I try to have a sit-down family dinner with the girls at least a few times a week. It’s not always easy to do, especially since I really want the meals to be home cooked as often as possible, but the research I’ve examined is too strong to ignore: eating dinner together is a good tool for helping kids avoid obesity and eating disorders.3 Family dinners don’t happen often enough in many homes, says Margo Maine. “Sometimes when a family comes into my office and I ask them about family mealtime, they say, ‘We don’t eat together’ or ‘The last time we ate together was the last holiday.’” That’s especially troubling given the research that’s out there to suggest that kids whose families ate dinner together three to four times a week may be more resilient against substance abuse.
“When you’re not sitting down, parents aren’t really feeding their kids. Everybody has to fend for themselves,” says Margo. In that situation kids aren’t likely to get a well-balanced meal, especially if they come home late after a game or another activity. “They’re just going to eat something high in fat and sugar. That’s what we’re drawn to when we’re really, really hungry.”
Dr. Nancy Snyderman says it is not only a matter of what we eat, but how we eat it. “All of those subtle things about how we learn to eat—manners, conversation, portion control, cooking together—those things have been lost in our generation because we no longer sit down and have dinner,” she says. “Even if you do drive through and pick up the food, please take it home and put it on a plate. You eat slower, you eat better, and you’re more cognizant about what you put in your mouth.”
Even if you do drive through and pick up the food, please take it home and put it on a plate. You eat slower, you eat better, and you’re more cognizant about what you put in your mouth.
—Nancy Snyderman
But I want to see families cooking together again, instead of relying mostly on takeout and prepared foods. That’s the only way to have personal quality control. Our kids ought to see us cook and help us cook, because we all learn so much when we buy food, handle food, and cook food together. That whole transaction has been lost for many families. Kids should learn how much oil goes into a recipe, and what good healthy ingredients are.
That’s the idea behind Big Chef, Little Chef, a program created by chef Lorena Garcia. I’m a big fan because it gets parents and kids together to learn how to cook healthy foods and take back control over what they eat. “They end up loving being in the kitchen,” says Lorena.
I know it saves time to let someone else do the cooking, and it’s hard to make different choices with both parents working. But as Dr. Senay says, it can be done. “You’ve got to think carefully, you’ve got to plan, and you’ve got to continually push out the toxic stuff.” I just don’t think we should be passing on responsibility for what goes into our kids’ bodies to someone else. To someone who doesn’t care. To someone who will add tons of butter and fat and salt and sugar to a dish to make it taste good so that you’ll buy it.
Maggie Murphy, who edits Parade magazine and Dash, a food magazine, agrees with us. She is on a campaign to get more kids and parents making meals together, and her magazines provide simple and healthy recipes to help. “I think there’s some connection between childhood obesity and the fact that people have become very disconnected from cooking,” she says. “My mother was too busy working to teach me to cook, and I think our generation has lost something. We’d have more family dinners if we could simplify cooking so we could fit it into our busy, busy lives.”
If someone as busy as Senator Kirsten Gillibrand can do her own food shopping and find ways to interest her two young boys in nutrition, I don’t think the rest of us have a good excuse not to do the same.
The senator talks a lot to them about what their bodies need to grow. “When I ask them what they want to drink, I always say, ‘Well, milk helps you grow, would you like some milk?’ Henry always says, ‘Yes, Mommy, I’d like milk because it helps me grow.’”
The senator also gets four-year-old Henry to see how many colors he can put on his plate, giving him blueberries, red and green apples, and other colorful produce. “It really helps the kids understand that the more colors they have on their plate, the more vitamins and minerals they have on their plate.”
Senator Gillibrand also invented a point system that has helped her older son, Theo, understand the quality of different food choices. “We’d rate foods from zero to ten based on their quality. So candy would be a zero, and chicken broth and brocco
li would be a ten,” she explains. “When he would ask me for foods that had very little nutritional value, I would often tell him, ‘Well, you can have those potato chips, if you pick something that’s a ten to eat before you eat the chips.’”
I think she’s on the right track, because both her kids adore fruits and veggies.
Senator Gillibrand also looks for teaching moments. On Theo’s birthday, she allowed the boys to choose whatever they wanted for breakfast. Theo had cereal and fruit, and then took a cookie on his way out. Four-year-old Henry decided to just have sugar for breakfast: cookies, cake, and candy.
En route to school, Henry fell asleep on her shoulder, and couldn’t even walk into day care. “When he said, ‘Mommy, I’m so tired!’ I said, ‘Well, what did you have for breakfast?’” That gave her a chance to explain that he needed protein, not sugar at breakfast, and that he would feel tired without it. Now, “when Henry asks for anything other than a healthy breakfast, I say, ‘How did that sugar make you feel, Henry?’ And he says, ‘It made me feel tired.’”
Although I try hard to model a healthy attitude toward food, there is no hiding the truth about my own challenges from my kids, and I do worry about imposing an eating disorder on them.
I know that’s a real risk. “We do see a lot of families with multigenerational eating disorders,” says Margo. “That doesn’t mean genes. It means the shared heritable environment. That would include how the family related to food, weight, body image, and appearance. How did they tolerate or encourage emotions? What did they teach about perfectionism? And was that child ever allowed to feel ‘good enough’?”
Obsessed: America's Food Addiction Page 18