Obsessed: America's Food Addiction--And My Own (27 page)

It’s probably not quite that simple, as my own experience with eating mostly healthy foods and occasionally going on a binge suggests. But educating people at every opportunity can certainly help. The messages about food, weight, and health should be coming from lots of different places so that we hear them over and over again.

People who have learned how to eat well, enjoy their food, and maintain a healthy weight can share some of their secrets with people who still struggle. Supermarkets can help by installing interactive screens and other technology so that people know what’s in the food they are buying. Some of the nation’s leading grocery stores are already doing this, and others can
follow. One innovation to adopt is the NuVal System, created by David Katz and his team, which scores food from 1 to 100 based on how nutritious it is. NuVal scores are placed right next to the price tags on store shelves, making comparisons easy.

Doctors also need to take more responsibility to educate their patients. Unfortunately, many of them don’t even know where to begin, since only 30 percent of US medical schools require a nutrition course. Most graduating medical students say their nutrition education was inadequate, which tells us we need to do a much better job incorporating it into the medical school curriculum.
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Talking to parents about their kid’s weight makes many doctors particularly uncomfortable, either because they don’t know how, or because they realize it’s going to anger some parents. “I can’t tell you the number of parents who hate the doctor for initiating the conversation, like it’s the doctor’s problem,” Dr. Snyderman says. “But it’s the doctor’s responsibility to be a child’s advocate and call it as you see it. That means getting a kid help.”

If an obese child or adult has a checkup, it should be the first topic the doctor raises. Instead, we have fat people walking into the doctor’s office all the time and it never even gets mentioned. How is that possible? You don’t walk in there with cancer and not have a doctor mention it. They take your blood pressure, check your temperature, check everything else, and weigh you. Then they should sit down and have a talk and explain how you can lose some dangerous weight.

That’s more likely to happen when the businesses that pay for health insurance start insisting on it. A lot of companies are already experimenting with payment plans that reward doctors
for
preventing
illness, instead of paying them for every health service they provide. Some are negotiating insurance contracts that encourage medical practices to improve the way they treat complex chronic illnesses. I’d like to see doctors make more money if they successfully manage interrelated health problems, such as overweight, high blood pressure, and diabetes, as a single package. I’m also in favor of reimbursing employees for seeking out nutritional counseling, and providing discounts on insurance premiums when a worker reaches certain health targets.

All of these are great ways to get people committed to improving their own health, while reducing the cost to employers. Put the right incentives together, and we can create a win-win.

Obviously schools, where our children get 40 to 50 percent of their daily calories, have a big role to play in educating the next generation about food, health, and weight, and in making smart choices available.

It may surprise you, but the military is taking a lead role in pushing for better food in the schools, and I applaud that. “When we have somebody show up at our doorstep who wants to get into the armed forces and they’re overweight, we have to overcome eighteen years or more of lifestyle habits,” says Rear Admiral Jamie Barnett (retired) of Mission: Readiness, the organization of retired military officers that promotes investments in youth. “It’s pretty difficult. We really need to be able to start in early childhood with the right nutrition, the right fitness, and the right development in order to ensure that they
have the best shot not only in the military but in the workforce in general.”

When we have somebody show up at our doorstep who wants to get into the armed forces and they’re overweight, we have to overcome eighteen years or more of lifestyle habits.

—
Rear Admiral Jamie Barnett (retired)

It’s not the first time military officers have stepped forward with their concerns for our young people. Barnett points out that after World War II, the military helped convince Congress to pass the National School Lunch Act. Back then, too many Americans were unable to serve in the military because they were underweight and malnourished. Now, too many young people can’t serve because they are too fat, so the military is trying to get junk food out of the schools and exercise back in.

“This is a longitudinal problem with a longitudinal solution,” Barnett says. “What we really need to do is start with the kids who are in preschool, kindergarten, and elementary school.”

Retired top brass from all branches of the military are visiting schools across the country, and they tell me they are shocked by what they have seen. One school district in Kentucky didn’t even have an oven in the cafeteria. “All they had were deep-fat fryers. Guess what they were fixing for their kids?” asks Barnett.

That’s pretty basic. I could not have imagined a school district without a stove and other tools to make healthy food.

Along with equipping our schools properly, we also need to make sure that school nutritionists have proper training and
authority. I’m not entirely sure what they are doing right now, but I think nutritionists should be holding seminars with students, cafeteria workers, teachers, principals, and school boards to talk about how to make the right food available.

I’m particularly enthusiastic about the kind of work that Venezuelan-born chef, restaurateur, author and television host Lorena Garcia is doing. Lorena goes into the schools to train the staff that actually prepares the food, encouraging them to be creative in making the small changes that can put a lot more nutrients into meals. “We’re really giving them a reason, and motivating them to start cooking a little more with ingredients that they already have, just stepping away from processed foods,” she says.

Everybody should have nutrition, weight, and health in mind when they make food-related decisions for their cafeterias. To me, allowing schools to sell soda, candy, and high-fat snacks in vending machines, or à la carte on the lunch line, defeats other efforts to serve healthier meals in schools. I’d like to see all of that prohibited.

And we have got to put exercise back into the curriculum. So many schools have cut way back on gym classes and recess, and some aren’t offering them at all. “We take normally rambunctious children, send them to school, bolt them to chairs all day long so they can grow up to become adults we can’t get off couches without crowbars, and we medicate them in the bargain,” complains David Katz.

With all the emphasis on test scores, it’s not always easy to sell schools on the need to make time for kids to exercise. But what if kids actually perform better when they have a chance to get some physical exercise during the school day? We should
fund research to find out more about that. “Kids need to get up periodically and run around, period, end of story,” says Katz, who is the father of five children.

Katz has developed a novel approach, called ABC for Fitness, which gets kids moving in class. “We developed a program where classroom teachers could dole out activity bursts right there in the classroom for three minutes at a time, five minutes at a time, eight minutes at a time, at their discretion, throughout the day, whenever the kids needed it,” he explained. “We matched the activity bursts to grade level and subject matter, and pointed out to teachers how they could teach during the activity burst.”

To see whether ABC for Fitness made a difference, researchers conducted a study of over a thousand schoolchildren, and sure enough, the ones offered activity bursts improved their fitness, were less disruptive in the classroom, and needed less medication for asthma and attention deficit disorder.
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The program, which is free, is distributed in schools throughout the United States and can be used at home, too.

I love this idea. Kids need to move. They need to sweat. We should be insisting that our schools make that happen.

I’m also really interested in some of the ideas being discussed in urban-planning circles about designing communities for health. We should be thinking more about getting sidewalks throughout our towns and cities, providing safe parks that are easy to get to, and locating schools and businesses within an easy bike ride from residential neighborhoods.

Oklahoma City mayor Mick Cornett emphasized those kinds of strategies at the same time he put his entire city on a diet.

Cornett began his effort in 2005, truly the best of times and the worst of times for his city. Back then, Oklahoma City was getting some attention and respect, showing up on lists like “Best Places to Get a Job” and “Best Places to Start a Business.” But that same year,
Men’s Fitness
magazine published a list of America’s fattest cities, and Oklahoma City was right near the top.

“It embarrassed me,” recalls Cornett. He was even more embarrassed when he went to a health information website, typed in his height and weight, and discovered that he qualified as obese. “It took that website to point out that I was a part of the problem,” he admits.

The mayor’s first step toward solving it was to put himself on a diet. Then he persuaded a private donor to fund a health initiative, beginning with a website,
thiscityisgoingonadiet.com
, which offered everything from diet tips and shared journals to corporate challenges and exercise opportunities. Cornett called a news conference at the zoo, stood in front of the elephants and declared to residents, “We’re going to lose a million pounds.”

We’re going to lose a million pounds.

—
Oklahoma City mayor Mick Cornett

Forty-seven thousand people signed up, and five years later the city had reached its goal of one million pounds. It was a remarkable accomplishment. What made it work?

For starters, Cornett took a leading role in the conversation and talked about his own story first. If he was going to put his
city on a diet, he knew he would have to be honest about himself in the process. “I had to become comfortable talking about weight loss, how personal it is, how sensitive it is, how difficult it is, and my own lifelong struggles to keep my weight off.”

Once Cornett went public with his story, it was as if a light had been flicked on across Oklahoma City. Suddenly, obesity was “okay to talk about at the dinner table and okay to talk about over the backyard fence and at the water cooler at work and at church,” he says. “Seemingly overnight, people were willing to talk about obesity for the very first time in this community.”

The mayor did a lot more than talk. Cornett realized that like much of America, his city was ruled by the automobile. So he gathered city planners and asked them to reinvent the city; instead of catering to cars, he wanted to focus on people. As a result, he says, “We’re putting brand-new gymnasiums in all forty-five of the inner-city grade schools; we’re building health and wellness centers throughout the community for seniors; we’re completing our bicycle trail master plan; we’re putting in new sidewalks throughout the community; we’re putting in a downtown streetcar system to get a head start on mass transit. We are designing a city that revolves around people and pedestrians.”

The restaurant industry has embraced the cause, too. Chefs began offering low-fat options on their menus, and the fast-food industry now advertises its healthier meals and tells consumers how to make better choices.

Even with such a comprehensive approach, the mayor estimates it will take ten years to completely change the city’s culture from one that fosters obesity to one that fosters health and
wellness. But the payoff has already started. Oklahoma City is now on the
Men’s Fitness
list of fittest cities in America, and the mayor says the changes in the environment have attracted an influx of highly educated twenty-somethings. Jobs have followed. A recent study named Oklahoma City the most entrepreneurial city in the country, with the most start-ups per capita, the lowest unemployment in the United States, and what Cornett calls “a boom economy.”
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