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Can We Make American Healthy Again?

Can We Make American Healthy Again?

Imagine for a moment that a research expedition from another planet visited Earth. The aliens were studying what humans ate, how they got their food, and the health outcomes they experienced.

When they touched down in the more primitive societies, our imaginary aliens found simple methods of gathering, growing and preparing food. In these communities, people remained active and experienced little disease until their death.

When the aliens touched down in the more developed countries, the U.S. in particular, they found that almost no one was involved with gathering, growing and preparing their food. Instead, food came in boxes and cartons and bags, having been processed and distributed by companies that had no connection to the people buying it. And it had been like this for generations.  The health outcomes observed were decidedly dismal: more than 70% of the inhabitants were overweight or obese[1], and 60% had at least one chronic disease, with 40% having 2 or more[2].

This dire state of affairs, while alarming to those who work public health, was seen as normal to the inhabitants, for most of them alive today had never known another way. They had always gone to the supermarket, looked for the cheapest items, and filled their carts with what was convenient. Within two generations, the citizens had de-learned how to prepare their own food, and so now were dependent on whatever the companies making the packaged food were selling.

What had happened to create this situation? What had changed in the culture to make eating this way the norm? Is there anything to be done to reverse the trend of premature disease and death?

Let’s explore.

What happened to create this situation?

The years after World War II brought profound cultural shifts. First, women entered the work force in droves, which meant that family meals needed to be quick and easy. The packaged food industry obliged, ushering in a culture of convenience. Convenience became a value, and the diversity of heat-and-eat foods exploded. TV dinners. Microwave meals. Snack foods. Within a few short years, the novelty of near-instant food became the norm. The children of those working moms never learned how to cook for themselves, thereby becoming dependent on packaged food in all its forms.

At the same time, the government wanted to ramp-up food production and get more calories back into the food supply. It created legislation that subsidized the growing of certain staple foods, notably corn and wheat, that would make for cheap ingredients to feed the nation, as well as boost the economic outlook for farmers and foreign trade.

With a surplus of cheap ingredients, packaged food and beverage companies were able to make inexpensive foods for the masses.

One of those subsidized crops, corn, could also be processed into a cheap sugar, high fructose corn syrup (HFCS). With a sweeter taste than table sugar, it quickly became the ingredient of choice in all manner of sugar-sweetened beverages. HFCS enhanced the browning of baked goods, while also extending their shelf-life, so were added to almost every baked good on the shelves, including Today over 74% of packaged foods in the supermarket have added sugar.[3] Put another way, the odds are 3 to 1 that a random item you pick up in the packaged food aisles contains sugar.

In recent decades, as the consumption of sugar and refined carbohydrates have become the norm for most Americans, so have the amounts of disease: not only overweight, obesity and diabetes, but also every chronic disease, including heart disease (the number one killer in the U.S.), dementia, cancer and depression.[4]

How sugar became the norm

While riding the wave of demand for easy meals, the packaged food companies were learning how to sell the foods through the rise of advertising. Mass media was exploding, and radio, television and eventually cable TV became the primary vehicle for transmitting the value of convenience to the country. With the value of convenience foods being touted on television, eating packaged foods became the norm.

Through the modeling of behaviors on television, primarily through advertising, we learned that even picky kids would eat certain foods, that certain foods would make your husband happy, and certain foods could be whipped up quickly, winning the admiration of the family (and sometimes even jealousy of the neighbors). Through relentless exposure to these ideas – and the absence of other models in the media – convenience became the new normal.

How can we reverse the trend of premature disease and death?

There are many things that can be done simultaneously – both on the individual level and on the governmental level–though it may take a generation or two before profound results are seen.

On an individual level, we can all aim to minimize the amount of added sugar and simple carbohydrates we eat. Some actions include:

  • Read food labels and choose items with little or no added sugars in them.
  • Stop drinking your calories. Your body craves pure water, so choose it and unsweetened seltzer over soda, energy drinks, and sweetened teas. Avoid artificial sweeteners, as they may trigger cravings and have many other potential health risks.[5]
  • Learn to cook a few more things. With an abundance of free recipe resources on the internet, it is easy to try something new. The more you cook for yourself, the healthier you and your family will be.

But to move the greatest levers of change, we need to look to governmental policies:

  • Roll-back the market advantages of the packaged food industry by limiting their role in policy creation. As it is now, the big food conglomerates, including the packaged food industry, greatly influences how we subsidize crops and distribute food aid through programs such as SNAP (formerly food stamps), Women, Infants and Children program (WIC), and free and reduced school lunches. All of these programs approve foods that contain sugar and refined carbohydrates; SNAP even approves soda.
  • Support local food systems to enhance access to unprocessed, nutritious foods.
  • Apply a tax to sugar sweetened beverages to fund health education initiatives for the public.
  • Ensure school children are taught about nutrition and how to cook.
  • Limit the amount of junk food advertising to children.
  • Get sugar out of schools.

If the citizens of the United States and the developed world want to change their health trajectory, and thereby reduce the pain and suffering of avoidable chronic disease, as well as the enormous burden of the healthcare system to treat chronic disease, there needs to be a reckoning. We need to admit that the policies that initiated the great economic rebound of the post-war years (and that created great wealth) also had some very dire consequences for the wellbeing of the population. We can change the trajectory, but it will take educating the general public and a great deal of political will.

Let’s Make American Healthy Again.

 

 

[1] https://www.cdc.gov/nchs/fastats/obesity-overweight.htm

[2] https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm

[3] https://sugarscience.ucsf.edu/hidden-in-plain-sight/#.Xo9SEm57nOQ

[4] https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar

[5] https://www.health.harvard.edu/blog/artificial-sweeteners-sugar-free-but-at-what-cost-201207165030

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