Have you seen the Red Robin commercial for the "bottomless" helping of french fries? Just what a nation in the midst of an obesity epidemic needs, right? Then there was the recent decision by Burger King to eliminate its "lower fat" fries in two-thirds of its outlets because of weak sales.
Some say these and other fast-food purveyors are simply responding to market demand. Others argue they have a responsibility to help change the bad habits they promote and that lead to billions of dollars a year in health care spending for ailments associated with overweight and poor nutrition.
For now, the bulk of the war on obesity is being waged by health care professionals. H&HN has profiled many hospitals that offer everything from more nutritious cafeteria choices to public cooking classes to space for community gardens.
Sometimes, it's as simple as a "mindful eating" workshop like the one coming up later this week at Humility of Mary Health Partners in Youngstown, Ohio. A nutritionist will discuss how eating in front of the TV, while driving or at a desk can lead to significant weight gain, and how people can become more aware of what they eat and why they eat it.
In a community needs assessment conducted by WellSpan Community Health and Wellness in Pennsylvania, only 3 percent of respondents had eaten the recommended servings of fruits and vegetables the day before, and among adults living in poverty, none had done so. Since June, and continuing through this month, four WellSpan physician practices have been issuing Fruit and Veggie RX prescriptions to encourage patients to meet those recommendations. The prescriptions include links to online recipes and local farmers' markets. And the patients receive vouchers worth $20 for buying fruits and vegetables at local markets.
Among the anti-obesity efforts at Cincinnati Children's Hospital Medical Center is a taste test program at local schools. As senior director of community relations Monica Mitchell said in H&HN's July issue, "One of the barriers to healthy eating is that many children are hesitant to eat healthy foods because they literally haven't tasted the food. It can be a powerful tool to not only recalibrate kids' palates for healthy eating, but also to create a culture in which healthy eating is fun and popular."
On another front, efforts are underway to improve physicians' understanding of nutrition — a topic that is not covered nearly adequately enough in medical schools, according to David Seres, M.D. In a blog for The Hill last month, Seres wrote that only 25 percent of doctors in a recent survey felt competent to discuss diet and exercise, and fewer than one in eight patient visits included nutritional counseling. Another survey found that only 25 percent of medical schools provide a required nutrition course — down from 30 percent in 2006 — and that med students on average receive 19.6 hours of nutrition instruction — down from 22.3 hours in 2004.
Seres cited two bills now before Congress that he says would improve on that. The Education and Training (EAT) for Health Act would require six hours of annual continuing education in nutrition for primary care providers employed by the federal government. The Expanding Nutrition's Roles in Curriculums and Healthcare (ENRICH) Act would establish a grant program for medical schools to incorporate nutritition into the curriculum.
Reactions to Seres' blog, posted at the end of it, are interesting and varied. They include the usual claims that you can't legislate behavioral change and that government shouldn't spend money trying to. Of course, as with seatbelt laws and restrictions on smoking, public policy has, in fact, proven to be extremely effective at saving lives, as well as money. Recent findings in New York even indicate that nutrition education and improved offerings in cafeterias are contributing to a reduction in obesity among schoolchildren.
Seres is, among other things, associate professor of medicine in the Institute of Human Nutrition at Columbia University and this year's recipient of the Excellence in Nutrition Education Award from the American Society for Nutrition.