A crisis, it's said, is a dangerous opportunity. But among the dangers is that this adage is just wishful thinking. The danger in a crisis asserts itself with no help from anybody; the opportunity must be recognized, seized, and cultivated -- or it just sails by.
The newly released White House Task Force on Childhood Obesity Report to the President does a fine job of characterizing the relevant danger, and highlighting opportunity. The panel, which convened under the banner of the First Lady's "Let's Move" campaign, generated recommendations to reduce childhood obesity rates from the current level of roughly 20 percent to five percent by 2030. The 120 page report addresses actions in every setting from living rooms to cafeterias, and broaches topics from breast feeding to re-engineering the built environment.
While welcome, and fundamentally solid, I see some important limitations to the report. It is focused on what to do, but offers very little guidance on how the proposed actions actually get done; in its defense, it promises a sequel on this topic.
I think, as noted parenthetically above, that the prevalence of childhood obesity is underestimated in the report, as it is underestimated in national statistics that rely on exclusive, rather than inclusive, criteria for the diagnosis. Thus, the goals of the task force may be unrealistically optimistic.
A work of the government, the report routinely invokes government standards for such matters as the quality of school lunches, that in my view often fail to go far enough. Perfect should not be made the enemy of good, but "just adequate" should not be made the enemy of genuinely good, either.
And finally, the report is too true to its stated focus on "childhood" obesity. No man, woman, or child is an island, and children don't live on one off by themselves. They live in families. Better diet, more activity and better health will take hold of all members of a household, or they won't take hold at all.
But these reservations notwithstanding, the report is a valuable guide and an even more valuable indication of commitment to this vital cause. The quick summary of its 120 pages is this: everything is broken, and everything needs to be fixed. The slightly embellished version is that what we do each day with our feet and our forks represents the proximal cause of epidemic obesity. The root cause is modern living -- and our solutions must be comprehensive and directed there.
My personal fear is that among the dangers in this particular crisis is the peril of rejecting its opportunities. While better use of feet and forks may be a matter of personal responsibility, the environment that dictates our daily options, that empowers or disempowers our personal pursuit of health, is a matter of public policy. Much of the most crucial defense of the human body resides with the body politic.
And so, working against the goals of the First Lady's task force, which depend greatly on collective action, is the currently prevailing societal sentiment against just such cohesion. Threats to the opportunities before us abound, from parents who defend cupcakes in classrooms or oppose soda taxes on principle, to school systems that oppose raising nutrition standards or carving out some time for daily physical activity, to restaurants that still lure customers with the false bargain of an "all you can eat" buffet. The "what I do with my feet and my fork is up to me, so bud out" response will reliably cause the agenda in this report to fail.
So, perhaps the dangers intrinsic to a different crisis may serve to illuminate the evasive opportunities in this one.
Imagine that you and I, and our children, are on the Titanic on the fateful night of April 14, 1912.
Anticipating the calamity that looms, what comfort would you derive from knowing how to swim, or having dutifully taught your children? What reassurance would be imparted by your judicious packing of warm clothes?
Or in the aftermath of the disaster, how satisfied would you be with a plan that called for the addition of one or two lifeboats to the "next" Titanic, or a reduction in its top speed by one knot per hour? If the ship still crashes and sinks, and countless people needlessly die, we might as well have added window treatments.
Prevailing diets of highly processed foods and prevailing levels of physical inactivity -- and the forces that conspire to make such patterns prevail -- are the ship we now sail. Obesity, diabetes, heart disease, stroke and cancer are the icebergs that loom. The most salient of differences between our crisis now and that of the Titanic is that this ship sails us toward doom in relative slow motion. And ... there are a great many more of us aboard.
If the only adequate response to the Titanic disaster is a response that prevents the ship from hitting the iceberg, prevents it from sinking when it hits, or prevents people from dying if the ship sinks, why should half measures do for the current, larger menace?
The new Task Force report tells us more about where to go than how to get there; I eagerly await the sequel. And, if anything, I think the report should go further, push us harder, and ask us all to go faster. That said, I certainly support the full scope of actions it espouses, and hope you will, too.
The dangers of childhood obesity are clear, and omnipresent. The opportunities will require our collective effort. As we contemplate that, we may do well to reflect on past crises. For now, as then, we are all -- men, women, and children alike -- in the same boat.
-fin
Dr. David L. Katz: www.davidkatzmd.com
www.turnthetidefoundation.org/
Follow David Katz, M.D. on Twitter: www.twitter.com/DrDavidKatz
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I am convinced that HFCS and other hidden ingredients (MSG, sugar, and other toxins from processed food) absolutely wreck little developing taste buds. It is absolutely about health (not obesity) and I want to give my kids the best chance at a healthful life. But, if it's this hard for me, a professional working mom who loves to cook, how hard must it be for other parents and caregivers? Where are the free cooking classes? Where are the subsidies for organic produce? I'm sorry, but I'm facing another long day of trying to feed my kids nutritious food. And, giving kids a complex about the label of "childhood obesity" is not helpful either and will result in obese adults.
We need a Food Revolution and we needed it yesterday. We have to stop being slaves to the corporate food masters. We have to start giving kids whole foods prepared by people, not machines. That is actually much harder than it sounds and a little help on that front would be a nice start. Instead of telling me to feed them less and make them move more, how about some actual education on how to prepare whole foods well.
We need to eat better, but we also just need to be eating a whole lot less and teaching our kids to stop before they are "stuffed." Kids don't necessarily need to be counting calories, but at the same time there has got to be some awareness that the food industry is out of whack, and if you "go with the flow" in America and don't watch what you eat, you will end up being obese. Being a healthy weight in this country takes a lot of work, and that's really a shame. It wasn't always like this, and it shouldn't have to be. With things the way they are it's no wonder the kids are getting fat too. We just need to have a societal wake-up call and realize that we can't eat like we all do physical jobs all day. When we finally adjust this, we'll get both childhood obesity and adulthood obesity under control. Until then, unfortunately I think all fixes will be mostly band-aids.
Our minds are set, full throttle, and don't bother me with sign that says "Beware Cliff Ahead".
Reminds me of something I read from a medical doctor who said that 90% of patients told that they faced death from some chronic disease unless they changed behavior, decided not to do so. They rather die. So where's the leverage?
In the face of such empiricism on the matter, I'm not sanguine about the future of mankind. But please someone change my mind!
Alexa Fleckenstein M.D., physician, author.
http://members.authorsguild.net/fleckenstein/blog.htm
Peace,
Shannon
Atchka.com
FierceFatties.com
Fact 1: the number one predictor of obesity is being poor. Now why would this be?
Fact 2: The cheapest food in the US happens to be the unhealthy garbage.
Fact 3: If you look at the ingredients in the "unhealthy garbage" food, it is mostly made from heavily subsidized foods, like corn (corn syrup, cornstarch, etc.) Meat and dairy comes indirectly from these foods as well because we have found ways to feed it to cows (even though this is not their natural diet and results in higher saturated fat content)
I know no one wants to hear it, but a cheeseburger should not cost a dollar. If you are paying a dollar for a cheeseburger you are eating 20% burger and 80% garbage. If unhealthy food were priced correctly, we would be forced to *gasp* actually prepare our own meals now and then and perhaps even buy fresh produce. I know it's a difficult concept for most people to wrap their heads around, but just try.
Sure you don't want to use the Black Plague or the crucifixion of Jesus?
Peace,
Shannon
Atchka.com
FierceFatties.com
We have a health issue, but obesity is not the focus. Obesity is a symptom of the health issue. Dr. Katz routinely focuses in on obesity because it is the cause celebre. But everything he says could be directed at lifestyle and NOT weight.
Because, guess what... there are thin kids who are sedentary and eating crap and the message they hear with the obesity brou ha ha is that so long as they aren't fat, then they are healthy. In fact, that's the message grownups are getting right now too... if you're fat, you're a walking timebomb. If you're thin, go about your business.
Finally, all of the analogies mention fail because the presumption is that all fat people are on a collision course with disaster. But there are, indeed, fat people who are physically active and eat well, and are subsequently just as healthy as their thin counterparts; and much healthier than thin people who are sedentary and eat crap.
I take exception with Dr. Katz's repeated focus on a symptom, rather than the cause, of health issue.
Peace,
Shannon
And a detour around the drive-thru.
http://mamasoncall.com
I urge all parents who are concerned about their child's weight to look into the books of Ellyn Satter, heck, I recommend the books for everyone concerned about what they eat.
I agree that as a nation we need to eat fewer processed foods and exercise more, but we also need to embrace body diversity and accept that some of us will be larger than normal and some smaller, otherwise normal would have no meaning.
I think the First Lady's plan is dangerous. When you are a kid that keeps being told that you are unacceptable because of your weight, nothing else matters, not your grades, not your talents, nothing. You are so vunerable and desperate for acceptance from anyone that you might make decisions that you are not nearly old enough to understand.
You're the first person I've seen on here who has read Ellyn Satter. I just finished "Your Child's Weight" and will be arranging an interview with her soon.
I'm going to ask her about this national plan and whether all of these obesity prevention efforts are going to turn your experience of obesity prevention (as well as my wife's and countless other women) writ large and have exactly the OPPOSITE effect on children.
Consider yourself fanned.
Peace,
Shannon
Atchka.com
FierceFatties.com
I was looking at pictures of my dad's family from around the time of Great Depression, and he was telling me that my grandfather's cousins, all girls, worked on the family farm sun up to sun down and I'm looking at their pictures and they were all fat. Oklahoma during the Great Depression doing outside farm work 12 hours a day, and still fat, it made me mad all over again at how much my mother restricted my food.