Sitting turns out to be dangerous not only to our weight-loss efforts, but to our health, so that’s another powerful argument for moving. An Australian study, based on twelve hundred participants, found that after age twenty-five, every hour of television you watch reduces your life expectancy by nearly twenty-two minutes.6 So if you watch six hours of TV a day, you’ll take about five years off your life. That’s actually worse than the impact of smoking cigarettes, according to the report. And it’s not the TV that hurts you, it’s the sitting.
Other studies have confirmed the correlation between sitting and premature death.7 The science is new here, and we’re still not sure exactly why sitting for long periods is so harmful. One theory is that surplus “fuel” builds up in the body when we don’t use the large muscles in our legs, because processes needed to break down fats and sugars slow down or shut off, and blood sugar levels rise as a result. We know that the average person burns 60 more calories an hour when standing than sitting. We need to do more research to really understand what’s going on, but I’m alarmed by the findings.
Personally, I can’t stand still, so this actually isn’t much of an issue for me, but if you spend most of your work day at your desk, think about a few ideas for mixing it up. Stand up while you’re making phone calls, keep the trash can on the opposite side of the office, walk around during your coffee breaks. Small changes add up and can make a big difference, both to your weight and to your lifespan.
Getting Americans moving again begins with the decisions each of us makes as an individual. But it doesn’t stop there. And that’s the topic we’ll discuss next.
CHAPTER TEN
LEADING THE CONVERSATION
MY STORY, WITH DR. NANCY SNYDERMAN, KATE WHITE,
DR. DAVID KATZ, REBECCA PUHL, DR. EZEKIEL EMANUEL,
REAR ADMIRAL JAMIE BARNETT (RETIRED), MAYOR MICK
CORNETT, DR. ROBERT LUSTIG, DONNY DEUTSCH,
SENATOR CLAIRE MCCASKILL, SENATOR KIRSTEN GILLIBRAND,
JOHN BANZHAF, CHEF LORENA GARCIA
The conversation that Diane and I have been having, and the ideas that experts have shared here about how you think, eat, and move, mirror the conversations I think we need to have as a nation.
Overweight people are in the majority in this country. We need to fix that, but we can’t do it unless we are prepared to have an open, honest, and caring discussion—not one that stereotypes, blames, or disdains overweight people. The problem belongs to all of us, and so does the responsibility to find solutions. We need to face this head-on.
Morning Joe is all about conversation. By talking with people on all sides of an issue, we often find a meeting place somewhere in the middle, someplace we can settle, agree, and move forward. I don’t think we are there yet on obesity, but there is a lot of constructive and public talk going on around the country. Many concerned people are trying to find ways to get us on the right track. I hope that hearing about their attitudes and policies can help us change.
If you’ll pardon the pun, what follows is some food for thought. As I said at the beginning of this book, you won’t agree with me on everything, and you may not agree with some of these folks either, but let’s consider what they have to say. Some of their prescriptions just might work.
A good place to launch a broader conversation about the national obesity crisis is to talk about the ideas we have about a healthy body. That begins with an honest look in the mirror. Although Hollywood stars may seem to be wasting away, most of us are not. “As the population becomes fatter, study after study shows that instead of feeling bad about ourselves, we have entered a collective state of denial about how big we’re actually getting,” writes health writer and blogger Tara Parker-Pope. “While researchers admit that some denial may have to do with personal embarrassment, the consistency of the findings suggests that neural processing and psychology probably both play a role.”1
NBC’s Nancy Snyderman thinks we need to get the word fat back into our vocabulary, and I agree with her. I know that Diane was very hurt when I first told her she was fat, but she now uses the term herself, and it is helping her face her own situation. We should talk about being fat, not to be pejorative, but because we have to tell the truth. By trying to be politically correct and socially sensitive, we end up skirting the whole issue instead.
Clothing manufacturers also help us do that, by allowing women to brag about wearing a size 0 or a size 2, according to Kate White, former Cosmo editor and author of I Shouldn’t Be Telling You This: Success Secrets Every Gutsy Girl Should Know. “There’s been all this downsizing in clothes. I ordered a pair of pants from a catalogue. I put them on and I was swimming in them. And I realized, what used to be my size has now been increased; it’s still the same size but they’ve really blown out the waistline.”
David Katz says that the tendency to tell ourselves little white lies is normal human behavior. “We tend to think we’re an inch taller than we are, and we tend to think we weigh a bit less than we do,” he observed. “We tend to think we eat fewer calories and we all tend to think we exercise a bit more than we do.” When each of us admits the truth about our own body weight, we begin to understand that we have a shared problem.
At the same time, a lot of us struggle to respond in a healthy way to all of the media images suggesting that women who are beautiful must be thin. The average woman in America weighs almost 163 pounds and wears a size 14. So when Ralph Lauren hires a gorgeous six-foot-two model who is a size 12 as the face of his “plus size” line of women’s clothing, he sends a message to every woman about what the fashion industry thinks.
“We have billion-dollar diet industries, billion-dollar fashion industries that communicate the message that women must try to conform to very unrealistic ideals of physical attractiveness,” complains Yale’s Rebecca Puhl. “Thinness has come to symbolize core values in our culture.”
We have billion-dollar diet industries, billion-dollar fashion industries that communicate the message that women must try to conform to very unrealistic ideals of physical attractiveness.
—Rebecca Puhl
What’s happening is that as American women are getting heavier, models and actresses are getting skinnier. Kate White recounts looking at older photographs of Christie Brinkley and Cindy Crawford and realizing that those models “were not skinny, skinny girls. They were very healthy looking, very feminine, and lush almost. When actresses became more of a fashion influence in Hollywood, they got skinnier, too. You look at Jennifer Aniston compared to how she was when she first started in Friends; there’s a big difference.”
Kate says that when she was at Cosmo, “I encouraged our team to use models that aren’t super skinny. I reject super-skinny models. I think it’s important for us in the media to show women who are natural looking, who are curvy, who are more like the Christie Brinkleys who have luscious, healthy bodies.”
I reject super-skinny models. I think it’s important for us in the media to show women who are natural looking, who are curvy . . . who have luscious, healthy bodies.—Kate White
For Kate, it was a matter of showcasing good health—she didn’t want to highlight a super-skinny body, but she was not keen on showing more plus-size models in Cosmo either. “I feel that we’ve run amok in this country with nutrition and food. And the way you deal with it isn’t to say, ‘Okay, well, we’ll start showing people who are putting themselves in health danger,’ just as I wouldn’t show people smoking.”
So how do we start championing bodies that are a healthy thin? For one thing, let’s act on the latest science and start early. Dr. Zeke Emanuel tells me we should get kids on the right path even before they are born.
“We might think of in utero effects,” he explains. “We know that a woman can have a big impact on the size of her baby and the amount of fat on the baby. We may need to think about pregnant women and the diversity and the nutritional content of what they’re eating. We do have some good evidence that once you create fat cell
s, you can’t really get rid of them, and therefore later in life it gets very hard—not impossible—but very hard to lose weight.”
We might think of in utero effects. We know that a woman can have a big impact on the size of her baby and the amount of fat on the baby.
—Dr. Ezekiel Emanuel
If the tendency to be overweight starts in the womb, so might the craving for certain foods. But people can change their desires, according to Yale Prevention Research Center’s David Katz.
“Taste buds are very malleable little fellers,” he says. “When they can’t be with a food they love, they very quickly learn to love a food they’re with. They like what they’re used to.”
Taste buds are very malleable little fellers. When they can’t be with a food they love, they very quickly learn to love a food they’re with.
—David Katz
So here’s the really good news: research shows that taste buds can be retrained to like better foods in as little as one or two weeks!
“Imagine if all that stands between us and one of the more massive opportunities in the modern history of public health is a hill only two weeks high?” asks Katz hopefully. “How do we help the public understand that they need a week or two to get used to it, and then they’ll spend the rest of their lives being perfectly satisfied with a food that’s much better for them?”
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.2
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 barg
ain,” 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.3 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.
Obsessed: America's Food Addiction Page 16
