Monday, October 3, 2011

Of Course Not

When I first started reading this blog, I thought the posts were nice but boring.  But these folks are right on target - fabulous work, searing insight.
I used to work in some of these neighborhoods that are considered "food deserts"- the term that has been assigned by advocacy groups to areas where there is a lack of supermarkets and access to fresh food. Most of the programs designed to improve nutrition in these areas focus on bringing more fruits and vegetables to these families, either through increased vegetable markets and produce stands, food stamp programs that can be used at farmers markets, and education programs (teaching families to eat more fruits and vegetables). Ten years in and it doesn't seem like these food programs are really working since morbidity rates keep going up. This leads me to believe that simply providing more fruits and vegetables may not be the answer.

Obesity, diabetes, and other associated chronic diseases are associated with poverty. In the past, poor Americans suffered from being underweight due to malnutrition and food insecurity. Today, poor Americans suffer from being overweight due to malnutrition and food insecurity. Cheap, processed nutritionally poor foods (or food stuff) are more ubiquitous and abundant in the US then they ever have been in the history of this country. So are poor people eating more junk food? Probably, but bad choices are not the only reason and are only part of the picture. Poverty is associated with many determinants of bad health - it's not just about eating fast food. Other significant factors are stress (social, financial, work), lack of health care, lack of education, depression, disrupted routines because of familial or employment insecurity, cultural norms (i.e. - fear of food insecurity can cause parents to over feed children), lack of outdoor space for physical activity, lack of resources for any activity, and reliance on poor quality food either in “food desert” neighborhoods or in the form of food aid, to name just a few.

So while these programs are well-meaning, and I do think that increasing good supermarkets, farmers markets, and fruit and vegetable stands in food deserts are positive steps in the right direction, I think new approaches to food access and nutrition must address these other problems with multi-pronged strategies at different policy levels for improvement - not just teaching people "how to..."

First, I think it's paternalistic, elitist, and irresponsible for government or non-profit organizations to think they should "teach" people how to eat, and that lesson being: eat like a vegan. This is not to say that we, especially those of us with chronic diseases, shouldn't be provided with nutritional information and guidelines on what we should and shouldn't be eating (obviously no sugar and carbs for diabetics). But most of you already know where I stand on carb and protein intake - so you know where I'm going with this. Of course, convincing people to cut back on processed fast food and getting them to cook fresh food at home would be ideal. But trying to convince people to eat expensive organic fruits and vegetables to fill bellies that have been used to calorie-dense starchy, sugary carbs is not exactly the most satisfying alternative or realistic approach.

Along with plenty of vegetables and some fruits (but not for diabetics), part of these guidelines should also include healthy animal proteins and fats - which are both energy and nutritionally dense foods. They fill you up, give you energy, and won't cause insulin resistance or diabetes. Our
present nutritional guidelines that are promoted both by government and non-government agencies are created from junk science, ideological trends, and advertising. They distract us from our traditional diets that have kept our ancestors healthy for generations. Until we start promoting REAL food again and stop believing there is a magic bullet (like non-fat, soy, spelt, gluten-free, whole grain, organic cane juice, agave sweetened, nugget/food/stuff), we will continue to get fat and sick. And until we approach the root causes of poverty and tackle the different problems associated with bad health outcomes, we will continue to see a rise in these chronic diseases and mortalities.
http://youarewhatieat.blogspot.com/2011/09/more-fruits-and-vegetables-is-not.html

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