Facebook, cell phones, Starbucks: a lot has changed for the better over the past 30 years. But among all the welcome advances in caffination and connectivity, there’s been one wholly unsought proliferation: the US has nearly doubled in its rate of obesity.
Why should you care? For starters, it’s going to cost you—a lot. Associated with an increased risk of dozens of chronic diseases, obesity accounts for nearly 10 per cent of the annual US health care budget. And if current trends continue, these costs will more than double every decade by 2030.
It’s a complicated problem that needs multi-faceted solutions—including changes in federal guidelines, the workplace, school, and home environments, and yes, our individual habits—says Marlene Schwartz, PhD, Deputy Director for the Rudd centre for Food Policy and Obesity at Yale University. Schwartz discussed with us why today’s society is hazardous to our health and how policy—and you—can transform our future.
PYP: The percentage of obese Americans has dramatically increased over the last 30 years. Why is this?
MS: The consensus among researchers is that it has to be today’s environment, which is substantially different than the one in which we were living prior to the 1970s. It used to be that people ate breakfast, lunch, and dinner, with few snacks. There weren’t a lot of pre-packaged processed foods, and most meals were made at home from raw ingredients.
Now, people are eating a lot between meals, and the calorie density and the portion sizes of meals have increased. People are regularly eating at restaurants or on the go, where, as research shows, they are likely to eat more calories and unhealthy meals.
At the same time our intake is going up, our physical activity has gone down because of the automation of so many of our tasks and the fact that people spend most of their time in a chair looking at a computer screen. For children in particular, there’s a lot of incentive for them to be sedentary: watching TV, playing video games, sitting at a computer, sitting in school. When you put these things together, it’s really no surprise that there’s been such an increase in obesity.
PYP: How, as adults, can we re-learn these positive habits and fight the environmental factors that have been in place since childhood?
MS: One of the first things people can do is look at their eating behaviours. By keeping track of what you eat, when you eat, and how many calories you’re eating for a few days, you can learn a lot. For example, one of the ways that people take in a lot of calories is by drinking them. Regular soda, sports drinks, energy drinks, and fancy coffee drinks have an astonishing number of calories, typically from sugar, that don’t provide any nutrition or make you feel full.
Your body doesn’t compensate as well for calories that you consume in liquid form compared to those you eat. So if you eat a big lunch, you will probably compensate by eating less at dinner. But if you eat lunch and drink a lot of soda, you may take in just as many calories, but you’re not going to feel full. Try to limit your consumption of sugar in liquid form and basically switch to water, skim milk, and maybe seltzer with some juice. If you have coffee, have it with skim milk and one teaspoon of sugar.
Another thing that people will notice is the frequency with which they eat. Snacking is becoming normative and there’s an entire industry that has created highly palatable, inexpensive snacks that can sit in a vending machine for a long time, but that are also high in sugar, salt, and fat. Keeping a healthy snack with you and avoiding the habit of going to the vending machine at your office can make a big difference. I try to bring a piece of fruit and yogurt to work every day so when I get hungry, I have something healthy close at hand.
PYP: There are a lot of factors in the typical workplace that prevent us from eating well. What should employers do to help overcome them?
MS: At the Rudd centre, we talk about improving the food environment a lot, so we’ve never had the problem of people bringing in doughnuts or leftover Halloween candy. But, a while back, we were slipping into the habit of bringing dessert to celebrate birthdays. We have grown to about 30 employees, so I knew if I didn’t stop this, we would end up with too much dessert at work. I had to make the sort of Grinch-like decision and say: we need to practice what we preach and stop doing this. One solution we came up with was having people draw a name from a hat at the beginning of the year, and when that person’s birthday came, you purchased an inexpensive gift or brought them fresh flowers. The idea is to keep the fun, but lose the empty calories.
I know that having food around is en grained in a lot of office cultures, but you can make changes gradually. Instead of eliminating all food, bring in fruit salad or healthier snacks for birthdays. When you have workplace lunches, make sure that all options are healthy.
The second thing workplaces can do is build physical activity into the day. A lot of newer buildings have stairs that are accessible, attractive, and well-lit to encourage walking. Some buildings slow down the elevators, making it faster to take the stairs, which really encourages people to do so if they’re physically able.
PYP: What can employees—particularly young professional women—do?
MS: I think it’s going to be the young female professionals who will change the workplace culture. Older males who have been around for a long time may be used to having doughnuts and coffee at every morning meeting. But if young women come into the workplace wanting a health-conscious environment where the food in the office is healthy, they’re not tempted to eat junk food, and there are places to walk around the building, they can really make a difference. Young women should feel empowered, not intimidated, to make changes. They’re the ones who can do it.
PYP: Your work at the Rudd centre strives to improve practices and policy related to nutrition and obesity. Why is it so important for our government to step in?
MS: Some people say that we don’t need regulations and that we just need to educate people. My response is that we’ve done that and it hasn’t worked. People know what’s healthy and what is not healthy; lack of knowledge is not the problem. The problem is that unhealthy food is more convenient, accessible, and affordable than healthy food. We need to turn this around and it will take a lot of different policies to transform the environment to one where the healthy foods are the default options.
PYP: What has the current administration has done well so far in terms of health policy?
MS: From the beginning, Obama made it clear that he wanted government agencies to look at all policies from a health perspective and do everything within their power to promote health in the workplace and schools. Michelle Obama’s “Let’s Move” initiative has also raised a lot of awareness. Another huge change is menu labelling, which will soon be required as part of health care reform. People are going to be extremely surprised when they see how many calories are in restaurants’ menu options. I think this will not only help consumers make different choices, but it will also force restaurants to change their offerings. They’re going to be too embarrassed to have a 3,000 calorie appetizer on their menu. And that’s going to be good for public health.
PYP: How did you get started in this field?
MS: I’m a clinical psychologist, and for many years I directed a Yale clinic for eating disorders and obesity. I really liked helping people manage their behaviours and shift their self-confidence to focus on what’s really important, rather than judging themselves on what they look like. But I felt like my patients would go out into the world, and the world would undo all of our progress. That’s when I decided to focus on policy. I thought that my energy would be better spent trying to change the world rather than trying to change people one at a time.
PYP: How can young professionals pursue a career in influencing policy?
MS: Most people who do this type of work have either a master’s or a doctorate degree in Public Health. With a public health degree you can work for a government agency or a non-profit organisation. If you work for an agency that is allowed to lobby, you can really have big influence on policy. We have a number of academic disciplines at the Rudd centre, including psychology, economics, and law. We are focused on doing the research that will inform policy. Another avenue for a young professional is to work for a foundation that funds public health projects. There a lot of opportunities in the health field for passionate people to find work that is meaningful.
The Rudd centre for Food Policy and Obesity at Yale University strives to improve the world’s diet and reduce the stigma of obesity through creative connections between research and policy. Marlene Schwartz, PhD, Deputy Director of the Rudd centre, focuses her research and community service on how home environments, school landscapes, neighborhoods, and the media shape children’s eating attitudes and behaviours