Two Men With Heart Disease

I tabled with RAVS at a health fair today.  We talked to about 25 people.  I’m really impressed with PCRM‘s handout nutrition booklet “Vegetarian Starter Kit.”  It is very appealing with nice graphics, and made it easy to discuss a lot of issues and send people home with something easy to understand.

This morning I thought up the idea for “Two men with heart disease,” composed a poster, printed it out and had it on the table with the handouts.  The other staffer laughed at my photo of Cheney; I could have been much more cruel, but I had held back.  All the photos I saw of Clinton were calm and happy, but at least half the photos of Cheney he was angry with his mouth open.  So I figure my poster was just reflecting the truth.  Anyway, as little as I like Dick Cheney, I’m not blaming him for his condition, just asking people to reflect on why one treatment is considered normal and the other is not.

The idea was based on a Compassionate Cooks podcast where Colleen first described open heart surgery and then compared that with the alternative by reading a recipe for split pea soup.

Boiling my Garbage

My husband once told me that he and his friends used to make fun of one of their moms who would freeze her garbage.  This sounded ridiculous until he explained that she was freezing food scraps in a bag so they wouldn’t stink up the trash can, and then would throw them away on trash day.

But I can’t help thinking of this story since I have begun boiling my garbage.  The short story is that I’m making never-ending soup stock.  I’ve just started keeping my smallest pot in the fridge, lid on, and any vegetable trimmings that aren’t spoiled go into it right off the cutting board.  It gets peelings, ends, and even the pulpy centers of peppers, and don’t forget the onion skins.  I typically fill this little pot every day.  When it’s filled, I cover the trimmings with water, simmer an hour, and then let it cool.  I drain it into a plastic container with whatever stock I already had.  The soggy trimmings then complete their detour into the compost bin.  If you’re going to keep adding stock to an existing container, of course you’ll want to make sure to use it all up frequently so you don’t have a mix that’s getting older and older.

The long story: I’m not only doing this to reduce waste and save on purchasing stock, since after all the cooking gas isn’t free.  I’m also doing it to try to cut down on salt.  The bouillon paste I use, Better Than Bouillon, is awfully salty.  Despite my pretty healthy lifestyle, my blood pressure has been climbing for a few years, and I’m consistently in prehypertension now, in the 120′s over whatever.  The word prehypertension sounds like something you don’t need to worry about yet, but a Dummies book I read said it would be better called “lower risk hypertension.”  It’s still hypertension, it still does damage, it still increases risk of heart attack and stroke, just not as much.

After reading the book, I bought an automatic blood pressure monitor and have started tracking some things I think might affect my bp: sleep (snoring husband), exercise, meditation, alcohol/caffeine, and salt.  Too little data to comment yet.  I read that vitamin D deficiency may affect bp, so after several years of failing to bring my D up with vegan D2, I did a 45-day trial with some vegetarian D3.  It certainly brought up my D3 levels, but it didn’t make any difference in my bp, so I’ve returned to the D2.  There are other things that affect bp, such as obesity or lack of fruits/vegetables, but they don’t apply to my situation.

I eliminated most prepared foods, a huge source of sodium, from my diet years ago.  This past few weeks I’ve been able to cut way back on the salt I use in cooking, and while my family often adds salt at the table, I don’t miss it.  I made Lentil Soup last night without salt; I used my stock instead of water and some diced tomatoes instead of tomato sauce; I thought it was great.  I’m not planning on being an anti-salt fanatic, especially if it doesn’t turn out to affect my bp readings; but why not adjust my taste buds to a healthier habit?

Stretch-Sensor Malfunction

I want to tell you about a strange lung issue I have, because not many doctors seem to know what it is, I’ve never been able to find it online, and I am running across more people lately who have it and are as perplexed as I was.

Since at least third grade I have occasionally, every couple of weeks, had difficulty with breathing.  At the time (late ’70s), asthma was uncommon, but nowadays the moment I mention a breathing difficulty, people nod and say, “Asthma, right?”

I don’t think I have asthma.  I don’t have congestion in my lungs.  I don’t feel constricted, either breathing in or out, I don’t feel light-headed, and I’ve never been afraid during an “attack.”  I can’t feel any physical difference in my airways, and I know that I’m getting sufficient air, but I feel as though I can’t take a deep enough breath.  It’s a neurological urge, just like feeling that you need to use the toilet.  Normally, when I take a deep satisfying breath, at the top of the breath I feel a virtual switch flip over, and it is very pleasurable.  But during an “attack,” no matter how deeply I breathe, that switch won’t flip.  I’ve always visualized that I can’t quite jump over a stone wall, and I keep falling back on the wrong side.  It’s frustrating and distracting, but never frightening the way a real breathing constriction would be.

What this sounds like to other people is deep sighs, repeatedly.  I remember having an episode as a kid while watching TV with my family, and my Dad saying, “Will you knock it off?  If you don’t like what we’re watching, go away.”  Others I’ve spoken to lately have had the same sort of thing happen; people ask them, “Are you upset?  Why do you keep sighing?”

I remember having episodes at all different ages, in all different situations, in different states and environments: at school, at home, at work, at a Tai Chi class.

I would mention it to doctors and they never knew what to make of it.  I looked it up online, but really had no idea what to enter.  The moment you search on anything like “breathing problem” or “deep breath,”  you are inundated with asthma links.  I asked my brother, a pulmonologist, about 15 years ago and he said he hadn’t heard of anything like that.  I started to think it was all in my head.  But after my daughter started having the same issues at Thanksgiving, I asked him again at Christmas and now he knew just what it was, so the reason for this posting is to share his explanation.

He started out mentioning that there are some nerves whose function is just to tell you the location or position of parts of your body.  So for instance there’s a nerve that tells you whether your finger is extended even if you’re not looking at it.  He said there’s one that runs around the chest, and it’s called a stretch sensor.  He said that when we’re at rest, reading or the like, we are only using about 10% of our lung capacity.  The problem with this is that the tips of the lung cavities could collapse due to body pressure, and without oxygen coming there, blood stops flowing there and bacteria can form.  So the body has a way to prevent that, and that is to have you take a deep breath, what they call a sigh breath every so often.  The brain triggers the sigh breath, and the stretch sensor verifies that you did it.  But sometimes, the stretch sensor fails to report back, and so your brain keeps urging you to take a sigh breath.

My brother said he’s never seen this written up, it’s just based on 13 years of patients coming to him with it.  It isn’t a disease, and it doesn’t progress, but he believes it’s a real feeling.  His example was that if you clench your fist for five minutes, it will truly hurt, but there is nothing for him to measure.  His patients come to him and tell him they can’t take a deep breath, but he measures them and they are fully breathing, I think he said 110%.  Also their blood oxygen is fine.  When he sees his patients later and asks them about it, they say, “Yeah, it still happens, but now that I know it’s not serious, it doesn’t seem so bad.”

I can relate.

In the last few years, especially I think since beginning meditation, it bothers me even less.  I can just be with it without giving in to the urge to sigh.  I think it goes away more quickly when I do that, in a matter of a few breaths.

I hope somehow the search engines help people find this post and it can be helpful.

[Extra Tags: can't breathe deeply enough, lungs, not asthma]

Goodbye, Ella

Ella

Our cat died two weeks ago.  Ella had just turned 17 and had had cancer for a year and a half and kidney failure for two and a half years.  She was healthy and happy up until her last week, when she stopped eating and drinking.  The same thing happened two years ago and it turned out to be a urinary tract infection making her feel ill.  We nearly lost her that time but with a few days at the vets and a few weeks of antibiotics she went on to have two more quality years.

This time the vet could feel her tumor, her blood tests indicated the cancer was causing havoc, and when we got the test results that she did not have a UTI, we knew that she was not going to get better.  We had had years to get used to the idea, thought of it as a long goodbye, and were ready to let her go, but nothing you do can make that day easier.

You can learn at this post, Vegan Cats, my thoughts on the subject and what I did when I learned she had liver cancer.  That site tells what proportions of vegan to prescription food I was giving, though starting this year I had to cut her back to one to one (only half vegan).  I never held too tightly onto the idea that this would be a cure, and, at least as I implemented it, it seems clear that it was not.   Beyond being sad about my cat, it was personally discouraging that a tumor continued to grow on a diet I hoped would stop it.

I couldn’t feed her all-vegan food because there is no vegan kidney-failure prescription food, but I thought it would be enough, <10% animal protein – would her cancer have grown on 0% animal protein?  Did her cancer grow more slowly on her mostly vegan diet?  Her vet had given her 3-12 months, saying it was a toss-up whether her kidneys or cancer would take her, and yet she lived 18 months; the vet was amazed at how well she was doing, both in lab tests and in appearance, but it’s my understanding that prognosis are difficult to make and notoriously inaccurate, so maybe the diet had no effect at all; we just can’t know from this case.

We were able to keep her kidney numbers in the good range until earlier this year, but even to the end the vet said the kidney numbers were not that bad, and that didn’t seem to be what was making her ill.  Everything indicated it was the cancer.

So while we have a lot of questions, we did learn that: 1. a cat with serious health problems can be healthy and happy on the diet I fed her for quite some time.  2. It does not stop kidney failure or liver cancer.  3. It doesn’t seem to accelerate them, either.  4. It seems to have delayed them.

I would have loved to have fed her a 100% kidney-friendly vegan diet.  What could we accomplish, what could we try, if we thought rationally about the issue of vegan cats, and explored it as an option, instead of just dismissing it as crazy?  I’m grateful my vet was willing to work with me, but it would have been even better if there had been a food I could turn to.

Why I care what other people eat

I was commenting at a blog the other day in favor of recent proposed legislation meant to nudge people into making better food choices.  A reply to my reply asked me why I care what other people eat.  I had to think this over a bit, but I have an answer, and prefer to give it its own space here on my own blog.

I care what other people eat because of compassion, the food environment my family faces, and concerns about costs and sustainability.

First the background.  People are not making food choices in a vacuum.  They are making those decisions in an environment which is slanted in such a way that they are encouraged to make unhealthy choices.  Unhealthy food is subsidized by the government (through grain which is converted into meat, sugar, and fat) and is more profitable for food companies and retailers.  Unhealthy quantities are pushed on us through ubiquitous placement and marketing by a food system that needs us to buy more, more, more, in order to remain competitive.  The fact that we can only eat so much has been ignored and, actually, disproved; turns out we can eat more calories than we used to, and than we should.

What this means is that the status quo, expecting people to suddenly make better choices, regardless of whether they are children, whether they can afford it, whether it is available in their neighborhood, and whether they are relentlessly marketed unhealthy food, is unrealistic, as has been proven by decades of rising obesity.  Thirty-four percent of the U.S. population is now obese, and an additional 34% are overweight.  Yes, that’s 68% of adults over a healthy weight.   Almost 17% of U.S. children ages 2-19 are obese.  How is a two-year-old responsible for being obese?  How will blaming the child’s parents help the child?  Scroll down at this page from the CDC to see an amazing map showing the population relentlessly getting heavier, state by state, through the years.  Blaming individuals hasn’t worked for the past 30 years, as obesity rates have risen, so what makes us think that it’s going to work in the future?

The U.S. Center for Disease Control introduces their entire obesity section not with an urge to “put down the fries, fatty,” but with this:

American society has become ‘obesogenic,’ characterized by environments that promote increased food intake, nonhealthful foods, and physical inactivity. Policy and environmental change initiatives that make healthy choices in nutrition and physical activity available, affordable, and easy will likely prove most effective in combating obesity.

But to return to the question, so what?  I provide good food for my family and we are healthy.  Why don’t I mind my own business?  Why should I care what my proverbial neighbor eats?

I care because I have compassion.  The same compassion that leads me to forgo eating animal products leads me to support legislation that tries to undo the unfair food environment in which we are immersed, an environment I have been lucky to resist not because I’m a superior human being with stronger character (I’m not) but probably because of a combination of good genes, good socioeconomic status, a mother who ate well during pregnancy and nursing and cared about nutrition and family suppers, and a leaflet someone handed me that led me to become vegan.  I have compassion for the 68% of overweight adults and the real suffering that ensues; the risks for these diseases increases:

• Coronary heart disease
• Type 2 diabetes
• Cancers (endometrial, breast, and colon)
• Hypertension (high blood pressure)
• Dyslipidemia (for example, high total cholesterol or high levels of triglycerides)
• Stroke
• Liver and Gallbladder disease
• Sleep apnea and respiratory problems
• Osteoarthritis (a degeneration of cartilage and its underlying bone within a joint)
• Gynecological problems (abnormal menses, infertility)

People who are overweight also suffer social stigma, employment bias, and low self-esteem, often along with a continual struggle with the unhealthy food that surrounds them.  Overweight people often report that they never stop thinking about food – it controls their lives much like an addictive drug.  For this I have compassion, and if I can speak up to encourage laws to prevent overweight and obesity, I will.  I care.

I have compassion for the 925 million hungry of this world who would like to eat the grain wasted when it is fed to animals.  Thirty-six million people died of malnutrition in 2006.  Of course this is not all our fault, and this is a complex issue, but our country’s food policies, including subsidies which not only encourage our inefficient consumption but also unfair trade, absolutely play a strong role.  I support domestic and international policies and encouragement of personal diets that take world malnutrition into account.  I care.

I also have compassion for the animals suffering in this food system under government-skewed economics that encourage us to eat more of them because their feed is subsidized and their negative environmental and health impacts are not paid for at the checkout counter.  If I can encourage legislation that brings the price of meat in line with the real costs, I will.  If I can lift the veil of secrecy that hides the horrible things done to farm animals in our name, I will.  I care.

My children eat well at home, and I pack lunches for them because the school lunches are not healthy.  Did you know there is currently no limit to the amount of sugar that can be in a USDA-approved school lunch?  And yet there are minimum calorie requirements, and insufficient funding.  Hmm, how can schools put in enough calories with hardly any money?  Sugar and fat are the cheapest calories (remember corn oil and high fructose corn syrup are subsidized by the government?), but the fat actually is restricted to 35% of calories (still a lot), so now you know why school lunches are loaded with fat and sugar.  So I support legislation to improve school lunch standards for other kids, even though I side-step them myself.  Here are some other ways I mentioned in an earlier blog about how the food environment impacts my kids despite my best efforts.  We seldom eat out or watch TV, but my kids have personally encountered these:

Restaurant kids meals are always horrible, commercials on TV encourage kids to eat unhealthy food, teachers have kids visit web sites from candy companies in school, unhealthy snacks are often given to kids in preschool programs, lollypops are handed out on the way out of restaurants, fast food restaurants line the streets near schools, candy and sugary drinks are sold at gas stations and drug stores on the way home from school, schools have vending machines selling sports drinks and candy, weekly birthday or holiday parties include cupcakes with 4″ of icing, classes that behave well earn pizza or doughnut parties; chips, cookies, ice cream, and Little Debbie snack bars are sold daily in the lunchrooms, and on the first day of school my son’s teacher handed out taffy to kids who raised their hands.  Every one of these situations makes parents’ job, to raise healthy kids, harder.

Someday soon my kids will be on their own.  I hope that I, like my mother, can inoculate them against the toxic food environment they will face 24/7.  But if I can speak out to help improve that environment to make healthy decisions easier, I will.  I care.

I’m concerned about our nation’s diet’s effect on health care costs.  The Physician’s Committee for Responsible Medicine makes the connection between this issue and our hair-tearing about the high costs of medical care:

“Even if the steak and cheese produced on American farms foster health problems, our government rallies behind agribusiness all the way to the emergency room.  Sadly, every administration in recent decades has been caught up in a system that not only tolerates ill health, but encourages it.” – Barnard

Almost 10% of total U.S. medical expenditures are attributed to overweight and obesity.  The Congressional Budget Office calculates that if obesity rates continue to rise from 2007′s 28% to 37% in 2020, health care spending will be 7% higher than it would be if obesity rates were to be reversed and drop to 20%.  I support legislation that will lead to a reversal in obesity rates because I care about health care costs that our family pays through insurance premiums and taxes.

I’m very concerned about the environmental unsustainability of Americans’ current eating patterns, and trends in the developing world.  We eat more meat per capita than any other country except Uruguay, so we can hardly ask others to cut back, but the planet cannot, cannot support even the current worldwide population eating like Americans do.  I’m not talking about causing some pollution somewhere, maybe a few frogs die, I mean it’s physically impossible, but on the way to the impossible we will irreparably harm our planet.  Our choice of diet is having an enormous and unsustainable impact on water usage and pollution, acid rain, soil erosion and pollution, air pollution, global warming, wildlife, oceans, antibiotics, and non-renewable energy.  I don’t mean that our unavoidable need to eat causes these problems, I mean we make them magnitudes worse than they need to be because of the discretionary foods we choose to put in our mouths.  The example we set, the culture we export, and our inability to ask others to do what we cannot is setting the stage for a disaster.  The U.N. knows this and is urging the world to adopt a plant-based diet.  One of the suggestions to reduce energy use from a University of Wisconsin researcher who calculated energy use of foods is to “decrease consumption of beef, sugar, and highly processed foods.”  But right now our government is subsidizing exactly these foods through grain subsidies, making them cheaper and therefore increasing sales.  I support ending those subsidies, or if that is politically impractical, counterbalancing them with taxes on unhealthy foods or subsidies on healthy foods.  I care what people eat because our diet is ruining our planet.

All legislation is not equal.  We can debate the merits of particular bills, their costs and effectiveness.  But first we need to care.

Killer at Large

I just watched the movie Killer at Large – Why Obesity is America’s Greatest Threat.  This documentary is a collection of interviews and clips from journalists, researchers, doctors, and public health figures regarding the obesity epidemic.  I must warn you that it inexplicably opens with graphic footage of an obese 12-year-old girl getting lipsuction.  I made the mistake of sitting down with my lunch to watch, and I don’t recommend that.  I think this scene would have been better later on in the movie, or perhaps not at all – I’m not sure what function it served.

However, once past that the movie was very good.  It returned frequently to the point first made in the film by Surgeon General Richard Carmona: people are frantic about terrorism, but obesity is much more dangerous.

The movie covers schools, and I enjoyed hearing what the vending machine rep said to a gym teacher who was trying to get vending machines out of his school.  The dire consequences of this act would be that 1. kids would get in their cars to drive to a store to buy the item they could no longer get in school.  On the way they would be killed in a car accident, and that would be on the gym teacher’s head.  Dire consequence number 2. was that instead of soda bottles with bottlecaps, the kids would have soda cups with lids, and the soda would spill all over the carpets.  I guess the gym teacher would have to live with that, too.  So, every kid in school would die and they’d have a whopper of a carpet cleaning bill.  Ultimately, money won out and the school would not give up the $1,000 that the kids were feeding into the machines.

Absolutely astonishing was footage of parents outraged that junk food was being removed from schools.  They staged demonstrations where they passed junk food in through the schoolyard fence to kids who were being deprived.

Other parents demonstrated against Sesame Street when Cookie Monster told kids that cookies were a sometimes treat and they should eat their veggies.  Parents and children marched with placards showing “C is for cookie, not carrots!”  More signs said “No carrots!” or showed carrots with the circle and line X-ing them out.  Of course, parents were handing out cookies to the kids as they all marched around.  ????

I loved the segment regarding the Shrek “Get out and play an hour a day” public service ad.  The documentary shows representatives from 8-10 processed food companies together with George Bush and the head of Human Services meeting to try to take some action on this obesity thing.  Did the representatives have any suggestions regarding improving the nutrition of their products?  Not that I could discern.  The outcome of the meeting was apparently the Shrek public service announcement, the industry’s typical shunting of blame to the exercise side of the obesity equation, to avoid any embarrassing scrutiny of the diet side.  Steven Colbert takes over from there, and I’ll leave you with him: Clip

Well, it may cause cancer, but it’s so good!

OK, I just had to pass this wisdom from the breastcancer.org: “Dairy Products and Risk of Breast Cancer.”

QUESTION: What information do you have regarding Jane Plant’s book [Understanding, Preventing, and Overcoming Breast Cancer]? Is dairy-free really a miracle cure?

ANSWER: The dairy-free diet is intriguing, but it’s certainly not a miracle cure. It’s true that cows are sometimes fed lots of hormones to increase their milk production, as well as antibiotics, and that the grass or hay they eat may contain some pesticides. Toxins do tend to be stored in fats or “hang out” in fat. Dairy products tend to be full of fats. Cheese, for example, is basically concentrated animal (cow) fat (and very delicious! — I can’t live without blue cheese myself). So if it’s true that fat isn’t good for you because of the possible toxins in them, and because they can increase blood cholesterol, etc., then a diet that limits dairy fats is probably a good idea. Having said that, it’s important to keep things in perspective. Non-fat organic dairy products can be very healthy and tasty. Keep in mind that life is meant to be enjoyed. Organic regular cheese can be an occasional special treat. And a nice bowl of ice cream every once in a while is a great way to celebrate a good day or a wonderful moment.

—Marisa Weiss, M.D.

You don’t have to be a doctor or know anything about this book to break down this Q&A:

Q: Will eating less dairy prevent or stop breast cancer?

A: I don’t actually know but I’m going to begin by stating that it won’t.    The idea makes a lot of sense because hormones and antibiotics are normally stored in fat and dairy tends to have a lot of fat, which also can raise your cholesterol.  But it tastes good.

Dr. Weiss, tasting good does not change its effect on cancer and is irrelevant to the question.

King Corn

I just finished watching King Corn, a fascinating documentary about how cheap corn powers a cheap food economy.  This film is very well done, with engaging graphics and music and good camera work.

I was dubious at first of  Ian Cheney and Curt Ellis’ idea.  Driving to Iowa in January to plant an acre of corn seemed like a pointless exercise in literally watching grass grow.  But they seem to have spent their time well, interviewing the locals and experts including Michael Pollan, whose The Omnivore’s Dilemma inspired the movie.  There was no way for them to follow their own corn, which is mixed in with everyone else’s, so they took a journey before the harvest to see where their corn might go.  They even made their own high fructose corn syrup when  no manufacturers would let them in to see it done.

This is a quiet film.  I like how these understated, good-natured guys just let their subjects talk, allowing the viewers to come to their own conclusions.  This approach sometimes caught the interviewees in some bizarre statements, such as the feedlot owner who said he got a warm fuzzy feeling looking out at the cattle and knowing he was feeding a lot of Americans.   I was most surprised that many of the people involved expressed their reservations that this is a very good system.

One of the more interesting parts for me was their visit to Earl Butz, who set up these subsidies under Nixon.  Unapologetic, he said Americans pay less for their food than ever before, so we can spend more on other things.   He’s very proud of that.  Cheney and Ellis show great understanding when they say it’s easy to see how someone like Butz who grew up with a hard farm life where food was expensive would see this system as a great success.

Nevertheless, they go from there to a store that is filled with cookies, crackers, and soda.  They look at the shelves, and you know this can’t be a good system.

Watch the movie to find out what they do with the corn they grew and the land they grew it on.

Obesity: How about Supporting Personal Responsibilty?

I just watched the 18th lecture in the Yale Psych 123 class I’m auditing, “The Psychology, Biology, and Politics of Food.”  This lecture was about conflicting ways of thinking about the obesity issue, and I found his approach to a messy topic to be very organized and well-considered, so I thought I’d sum it up here.

He begins by posing the rhetorical question, Should government play a role, and if so, what should be done?

He asked the class what was a threshold for government action – what would or did convince us that government should get involved in what was often viewed as a personal issue?   I thought about it and decided there were two reasons I thought the government should be involved: First, it is already involved through farm subsidies, such that people are faced with a regressively unfair food environment – government needs to undo this or at a minimum patch together supports for healthier eating to balance the situation.  Secondly, we’ve been playing the personal responsibility card for decades and the problem is getting worse.

One student answered his question as I did, that government is involved, and Professor Brownell pointed out that it is involved in more than subsidies, and many of these programs encourage unhealthy diets:

• USDA nutrition guidelines
• FDA and food labeling
• WIC, Food stamps, etc
• National School Lunch Program

Brownell next talked about the two main competing frames (points of view, ways of talking about obesity) which define the issues, and had this great chart:

Issue	Corporate/Government	Public Health / Non-Gov’t Org.
Cause?	Personal misbehavior	Environment
Who is afflicted?	Those at fault	Those in need
Impact?	Costs others $	Suffering
What should change?	Individual	Social drivers
Default priority?	Treatment	Systemic change
Main approach?	Education	Prevention

He then discusses the American view of Personal Responsibility, which is not a worldwide view.  He says personal responsibility can be debated as matters of morality and life philosophy (is what we’re asking of people moral and just?), science (e.g. food deserts, or biology working against us – asking if what we expect of people is defended by research), and pragmatism (how is that working so far, or what would be the impact of what we ask of people?).  He goes into details for each:

American morality/philosophy is a convergence of the Protestant/Puritan work ethic, a “just world” bias, and American values.  He teases those apart:

The Protestant/Puritan work ethic says:

• hard work and determination = success
• self-determination is the key to happiness
• hard work and success are moral imperatives
• pull yourself up by your bootstraps

Basically, if you’re not succeeding, there’s something wrong with you.  Can you see how this ethic would affect our views of the obese?  Is it just?

The “just world” bias is when people believe:

• Good and bad things happen for just reasons, so…
• …people get what they deserve.
• …people deserve what they get.
• …bad conditions (diabetes or poverty) are deserved.
• …only bad people deserve bad conditions.

If you believe in the first statement, the rest of the conclusions follow.  When it’s written out like this, they look indefensible, but this bias is a common psychological phenomenon.  If you don’t see how wrong it is, click on the above link to read about some experiments that should convince you, or consider little kids with cancer.  Related to “just world” is the “fundamental attribution” error: when bad things happen to us we blame conditions (I was tired, bad luck, bad situation) but when bad things happen to other people we blame them.

The above ethics and errors translate into American values:

1. Freedom is coupled with personal responsibility.
2. Individuals determine what happens to them.
3. People must prevail over poor conditions.
4. Everyone can succeed.
5. Lack of success = personal failure.
6. Only defective people fail.

Can you recognize these statements as typical American views?  Are they fair?

Next he talked about the second way of discussing personal responsibility, using science.  Some examples for the obesity discussion would be:

1. influence of biology (animal and genetics studies)
2. world change in diet (do the trends suggest personal responsibility or environment?)
3. migration studies (what happens when people move from one environment to another?)

Then he discussed the third way of approaching the personal responsibility argument, pragmatism, saying personal responsibility has been the default since the 1960′s.  Has it been effective?  Does it lead anywhere constructive?

Professor Brownell then suggests a way to reconcile those two frames, environment vs. personal responsibility.  Most people would agree that poor diet is a personal issue, but for some time it has also been recognized as a medical issue.  People are starting to see it also as a public health issue, and some people include social, economic, and political factors.  The key is that those who accept all the factors still understand that personal responsibility is important, too.

This next point he said was the most important point of the whole class.  He showed a diagram which presented the old way of approaching obesity: educate and implore people to eat better, in the hopes they will have a better diet.  This has not worked.  Our diets are worse.  He suggests a better way, backing upstream and using economics, legislation, an improved environment and regulation to affect optimal defaults, and those optimal defaults would then encourage individuals to choose a better diet.

He discusses a new understanding of “food safety” which includes not just the sanitation, contamination and toxins, for instance, that we usually think of causing immediate diseases, but also factors that cause long-term disease.  Is a food “safe” if it kills us in 20 years instead of 20 minutes?

His proposed new view of the obesity issue is:

1. Personal responsibility is critically important.
2. What undermines it?
3. How can we enhance it?

The “blame the environment” camp is often framed as wanting to curtail Americans’ freedoms, the freedoms to eat what we want, in the quantity we want, as often as we want: people like Professor Brownell want to infringe on your right to eat deadly trans-fats.  But the issue can also be framed with other freedoms in mind, freedoms that support personal responsibility:

• the freedom to be informed (e.g. restaurant labels)
• the freedom to have safe food (e.g. trans fats)
• the freedom to be free of commercial exploitation in schools

Supporting personal responsibility.  An idea to think about.

An overview of obesity’s causes and solutions

I have been reading a LOT about obesity and nutrition lately, and this 3-page article from the Journal of the American Medical Society, “Food Safety for the 21st Century,” seems like a good overview of the issue.