I was pleased to join NYU's Samantha Heller this past Friday on the Doctor Radio channel on SiriusXM Radio (Channel 81). Samantha and I had previously shared airtime on CureTalks web radio, discussing Making Good Food Choices in an Urban Environment. This past Friday, we talked more generally about overcoming obstacles to healthy eating.
As one topic, we covered how food need not be expensive to be healthy, a point I also make (with references) in a recent co-authored paper on Nutrition Myths. Making that same point at-a-glance--comparing prices of healthier vs. less-healthy food -- is a powerful infographic from years ago in the The New York Times. There is also a case to be made for not wasting money elsewhere (e.g., smoking) so that more money can be available for healthier food.
But beyond prices paid at the register, when you consider true cost accounting (factoring the value of social, environmental, and health impacts of food production), there is no comparison between healthier and less-healthy food: healthier food invariably wins, hands down.
Admittedly, healthier food generally takes more time to prepare, and the time cost of food needs to be considered. But a one-time investment in select kitchen equipment -- e.g., a pressure cooker for dried beans and grains, or a blender for whole fruits and vegetables -- can pay huge returns and result in savings not only with regard to time but with regard to energy costs and food waste.
Even with useful kitchen aids though, some extra prep time may be inevitable when choosing real whole foods. This extra time may not be a bad ting. Time spent preparing a meal can have benefits beyond the food. For instance, there may be stress reduction and psychological escapism in the "joy of cooking." And cooking may offer opportunities to spend meaningful time with family, and promote family meals, as the World's most progressive -- and in my estimation, best -- dietary guidelines encourage.
Not knowing how to procure or prepare real food is a real obstacle to healthy eating. Adults need to practice food-shopping and cooking skills and teach these skills to children less everyone become helplessly reliant on industry for all our food preparation. Atrophy of cooking skills and loss of cooking throughout the generations leads to dependence on, preference for, and habituation to less-healthy processed foods.
Some processed foods -- minimally processed foods --have their place in busy modern life (e.g., pre-soaked and softened canned beans, pre-washed and chopped salad, or pre-cut frozen vegetables). But food should always be recognizable as food and not be artificial formulations of refined components mixed with hard-to-pronounce additives.
Some individuals and some communities will have greater access to real, whole, minimally-processed foods -- access in terms of physical proximity, financial affordability, and cultural appropriateness. When it comes to difficulties with access, adding supermarkets might not be the answer. Introducing famers' markets might not be the answer either. Street vendors (i.e., mobile food vendors) hold promise, but may not currently be meeting community needs. Other possibilities include innovative growing strategies for urban agriculture, or even urban foraging.
Importantly though, obstacles to healthy eating are individual, and solutions need to be individualized. Clinical advice like "avoid sodium" or "eat less" is not helpful for anyone (and may be harmful). It is important that clinicians take a boarder view beyond food constituents and food components and consider fundamental causes of dietary intake. Clinicians can provide useful nutritional advice, but should also be involved in improving food environments -- partnering with patients/families -- to remove contextual obstacles and to make healthier eating the default.