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A dollar of prevention is worth $5.60 in cure
By Sarah E. White for CalorieLab Calorie Counter News
If $10 were invested for every American each year into proven health programs, we could save up to $16 billion in health costs annually within five years, making the payoff for each dollar spent $5.60.
That’s according to a report from the Trust for America’s Health, which reports that Medicare would see $5 billion in savings, while private insurers would save more than $9 billion and Medicaid almost $2 billion.
How to use the money
The report says that the money could be used for non-medical interventions, such as:
- Building sidewalks and parks
- Making affordable, healthy food more available
- Helping people to quit smoking or raising tobacco taxes
The report says that many programs are effective at helping people lose weight or preventing chronic diseases even when less than $10 per person is spent.
Where the savings come from
The report says that communities that implemented changes would see a 5 percent reduction in diabetes cases and high blood pressure within two years, a 5 percent drop in heart disease, kidney disease and stroke within five years, and a 2.5 percent reduction in some forms of cancer, as well as arthritis and chronic obstructive pulmonary disease, over 10 to 20 years.
These reductions in health problems would decrease health costs across the board, the report says, but the return on investment would be greater in some states and regions than others.
For example, the report suggests the return on investment for such a program in Washington, D.C., would be 9.9 to 1, or almost $10 in savings for every dollar spent. Utah would see a benefit of only 3.7 to 1, according to the report.
Clearly these numbers are not related to a decrease in obesity levels, since Colorado, the leanest state, would see a 5 to 1 return on investment, while Mississippi, the fattest state, increases its ROI only to 5.2 to 1.
Still, this kind of investment is worth making no matter the level of return, says Jeff Levi, executive director of the trust.
“This study shows that with a strategic investment in effective, evidence-based disease prevention programs, we could see tremendous returns in less than five years — sparing millions of people from serious diseases and saving billions of dollars,” he said in a press release.
In 2007, the Big Fat companies (after the Big Tobacco) decided, after intense marketing sessions, to publicly limit their advertising to children. The move was so bold that New York Times reported on it. That same year, Ad Council, the Government and the Big Fat teamed up for an awareness campaign on obesity - their solution - Shrek. Now Which? comes out with their latest report on how the Big Fat is only playing with numbers, taking from one place and adding to another. Their marketing budgets are not decreasing, far from it. They are just being re-allocated to new mediums, more modern and as deadly as TV.
The seriousness of all this makes me laugh. I keep picturing their meetings when they talk about how to keep selling and at the same time appeal to the public’s concern. If you want to have an idea of how it must be, check DirecTV’s new line up of commercial.
On Ad Council’s obesity awareness campaign website, there is a page listing all the partners. Among them are Coca Cola, PepsiCo, Kellogs, Kraft, McDonald, Del Monte, General Mills, Hershey, and Cartoon Network - who survives only because of those companies. Children for them are Billions and Billions in revenue. They will not only do everything to look like they are listening and care for children, but they will also do everything to make sure they maintain and expand that market. They will not lower their marketing budget, only re-allocate it. And increase it.
The first sign of a problem is denial. Deny there is a problem. Am I fat? Of course not, look around. I look like everyone else. Stores sell XXXL shirts because it is normal. Restaurants serve portions that big because it is normal. Fast Food stands are everywhere because they are so convenient and so tasty. I don’t have a problem. The rest of the world wants me to have a problem, but I don’t!
This is pretty much the level of conversation I have when talking about our food and health system.
In 1999, BBC wrote about people’s denial. Then Forbes wrote about it in 2006. This month, the Chicago Tribune talks about the perceptions of obesity are changing.
With larger people everywhere, individuals who are slightly overweight may now think of themselves as average and those who are heavier may think of themselves as having only a minor weight problem, the study’s authors suggest.
This year, we started to talk about Airlines charging by weight. People went nuts, saying that it was inhuman. I say we should do it. Or at least put a surcharge.
We keep talking about obesity and overweight with white gloves, making sure to crop out the faces of people on those fat images. I say put them on. Lets start to face what we have become. How much more disconnected from our body, from our health can we be?
On Good Food this morning, Catherine Friend talks about raising sheeps and here latest book, The Compassionate Carnivore
WE Play! Trainings Coming to a City Near You
Just received this email from Kaboom.
Kids Need Playgrounds! Learn how to make it happen at WE Play!
Learn how to fundraise, build and advocate for great places to play in your community! Thanks to the generous support of our partners KOOL-AID and The Home Depot and led by KaBOOM! presenters, KaBOOM! Workshops Entirely on Play are one-day, FREE regional trainings packed with interactive sessions, including:
- Guidance on how to build a playground in a day with volunteers from your community
- Research to build your case for play
- Proven fundraising techniques and planning strategies to get the job done
- Tried-and-true ways to engage the community
- The opportunity to meet other local and national activists who share your commitment to kids
Click here for the official flyer.
The fun doesn’t stop there! On the following day at most of the WE Play! workshops, allWE Play! participants have an opportunity to take part in a KaBOOM! Build Day. During this event, you’ll witness how 150 volunteers can transform an empty lot into a dream playground in six hours! Learn these important Build Day execution strategies firsthand:
- Site layout and logistics
- Volunteer management and youth engagement
- Flow of the day
- Equipment installer relations
- Celebration and appreciation
I grew up going to summer camp every year. Most of my best memories as a child are from those camps: a two week canoe trip, a week on the isle verte , and countless others. An idea, have your children spend some time on a farm, a sustainable farm. Worldwide Opportunities on Organic Farms, USA (WWOOF - USA) is part of a world-wide effort to link volunteers with organic farmers, promote an educational exchange, and build a global community conscious of ecological farming practices. Our organization produces a quarterly directory of more than 500 organic farmers in the United States who would like to host volunteers on their farm.
LOCAVORE is the 2007 Word of the Year for the Oxford American Dictionary!
For more information or for a great reading, check out The 100 Mile Diet or Plenty, written by Alisa Smith and James MacKinnon.
About the book:
Like many great adventures, the 100-mile diet began with a memorable feast. Stranded in their off-the-grid summer cottage in the Canadian wilderness, Alisa Smith and J.B. MacKinnon turned to the land around them. They caught a trout, picked mushrooms in the forest, and mulled apples from an abandoned orchard with rose hips in wine. The meal was truly satisfying; every ingredient had a story, a direct line they could trace from the soil to their forks. The experience raised a question: Was it possible to eat this way in their everyday lives?
Back in the city, they began to research the origins of the items that stocked the shelves of their local super market. They were shocked to discover that a typical ingredient in a North American meal travels roughly the distance between Boulder, Colorado, and New York City before it reaches the plate. Like so many people, Smith and MacKinnon were trying to live more lightly on the planet; meanwhile, their “SUV diet? was producing greenhouse gases and smog at an unparalleled rate. So they decided on an experiment. For one year they would eat only food produced within 100 miles of their Vancouver home.
It wouldn’t be easy. Stepping outside the industrial food system, Smith and MacKinnon found themselves relying on World War II-era cookbooks and maverick farmers who refuse to play by the rules of a global economy. They bargained for sacred squash at a suburban Buddhist temple, discovered the true sweetness of honey, and learned the lost history of dozens of varieties of local wheat. What began as a struggle slowly transformed into one of the deepest pleasures of their lives. For the first time they felt connected to the people and the places that sustain them.
For Smith and MacKinnon the 100-mile diet became a journey whose destination was, simply, home. From the satisfaction of pulling their own crop of garlic out of the earth to pitched battles over canning tomatoes, Plenty is about eating locally and thinking globally.
The authors’ food-focused experiment questions globalization, monoculture, the oil economy, environmental collapse, and the tattering threads of community. Thought-provoking and inspiring, Plenty offers more than a way of eating. In the end, it’s a new way of looking at the world
On the Today Show this morning. Richard Louv and the importance of spending time in the wild.
In my mailbox today is the newsletter from the My Wonderful World, an initiative from National Geographic. The campaign—backed by a coalition of national business and non-profit organizations— wants to expand geographic learning in school, at home, and in communities. “We want to give kids the power of global knowledge”.
Although focused on Geography, the theme of this month’s newsletter is Food.
Prepare for your backyard barbecue with geography. From eating local foods to beating rising gas prices to learning more about how and what Americans eat, My Wonderful World is out to give you geo-news you can use. Have a great summer—all 75,000 of you! Christopher Shearer, Director, My Wonderful World
The following are excerpts from the newsletter.
The Time Is Ripe
Nothing says “summer” more than sunshine, lazy days at the pool (or beach), and barbecue. Sweet corn on the cob, juicy watermelon, and hearty burgers are staples of the season. But this year more than ever, people are thinking critically about the choices they make when it comes to buying groceries. Attitudes are changing in response to increased fuel prices, recent natural disasters, disease outbreaks, and environmental concerns. These factors contributed to the thriving local-food movement, with farmers’ markets popping up across the country, organic-grocery chains like Whole Foods Market offering local fare, and even the most haute-cuisine restaurants committing themselves to local sourcing. This month, MWW challenges you to learn about the food system and consider the impacts of your family’s purchasing decisions. Start by visiting Local Harvest, a resource for finding local-minded businesses and farmers’ markets near you.
Worldwide Opportunities on Organic Farms (WWOOF)
offers unique, hands-on immersion experiences at organic farms around the world. Volunteers help farmers in their daily duties, learn about organic growing methods, and receive their stay and meals free of charge. Opportunities range from fruit orchards in England to olive groves in Argentina.
Foodie Dictionary
Feeling lost in the lingo of food issues? Here are a few key definitions to help demystify foodie jargon:
Slow Food—A countermovement to fast food, created in 1989 and that seeks to raise awareness of where our food is grown and how our food choices affect the rest of the world.
100-mile Diet—Challenges participants to eat only foods grown within a 100-mile radius of where they live. That’s right—if the salt and pepper in those shakers came from outside that distance, they aren’t going on your food.
Locavore—Someone who commits himself or herself to buying and eating locally, often using the 100-mile-diet guidelines. Locavores believe that less processing and shipping leads to more nutritious, eco-friendly, and tasty food.
This Wednesday, July 16, the “Today” show is scheduled to air a special segment on family nature clubs with an in-studio appearance by Richard Louv, live from New York. The segment also features a filmed interview with Chip Donahue and his family-oriented nature club, “Kids in the Valley, Adventuring!” (KIVA). Started in Roanoke, Va., in January 2008, KIVA has already grown to include more than 170 families.
Out of the Kitchen, Into the Field
Some great Feminine inspiration.
“There is much work women can do on a farm with perfect propriety,” Laura Clay, a bluegrass farmer and veteran suffragist was quoted as saying in The New York Times on Nov. 18, 1917. Nearly a century later, Clay’s statement rings vibrantly true. There are 80 percent more women who are farmers than there were 20 years ago in the United States, even as the number of farms has decreased, according to the Department of Agriculture. In the Northeast alone, nearly 20,000 farms are run by women, some of whom are shown on the following pages. Whether raising heritage livestock, combing the woods for exotic morsels or coaxing delicacies from the ground, these women forge new bonds between field and table, strengthening the connection between things we love to eat and the stewardship that makes them possible.
Diane St. Clair Animal Farm, Orwell, Vt.
In 1999, St. Clair (previous page) left her job in public health to live on a farm in Vermont. First came the draft horses and then the family cow. Next, homemade butter. After investing in custom small-scale creamery equipment, St. Clair, 52, began selling to the local food co-op, aiming for the best butter she could produce — handmade and infused with Vermont terroir. To this day, St. Clair is involved in the entire process: the milk is hand-separated; the butter, hand-kneaded and washed. The renowned product of her labor — about 80 to 100 pounds a week — makes it only to Per Se, the French Laundry and No. 9 Park in Boston. St. Clair is clearly enchanted by the craft of food, although she is attentive to her seven Jersey cows as well. They eat only forage from the pastures, imparting a distinct flavor and color to the butter that is as changeable as the seasons of Vermont.
Barbara Shinn Shinn Estate Vineyards, Mattituck, N.Y.
Shinn (above) flits effortlessly between trimming vines and fixing the tractor, a farmer at heart. When she moved from California to Manhattan in 1990, it was a detour to the farming life she had long envisioned. Along the way, she and her husband, the chef David Page, opened the Greenwich Village restaurant Home and found themselves celebrating farm life and comfort food amid the concrete hills of the city. In 1998, they bought 22 acres of wheat fields and established Shinn Estate Vineyards. Shinn, 45, works in the field, conducts vineyard tours, talks wine in the tasting room and, along with her husband, runs the property’s bed and breakfast and delivers their critically acclaimed wine to the 50 restaurants and 20 shops that sell it. Coursing through all of this is her mission to blaze a trail of sustainability in the small farm community. A pioneer of organic practices on the North Fork, Shinn never stops fine-tuning biodynamic and low-impact agricultural methods and sharing the lessons of their success with local growers.
Nova Kim Wild Gourmet Food, Randolph, Vt.
When Kim (opposite) moved to upstate New York in 1978, she started a garden. Or perhaps more accurately, she started a plot of weeds. Determined not to waste what was growing, she began working with the plants that thrived naturally. The result? A lifelong obsession with wild edibles. Kim, 65, and her partner, Les Hook, moved to Vermont, and by 1992 they had shifted from a successful wild ginseng herbal tea business to full-time “wildcrafting” (ethical collecting). They have collected more than 150 varieties of wild mushrooms and just as many greens, roots, nuts, barks and berries. Their yield is destined for seven adventurous chefs and 10 members of one of the country’s most distinctive community-supported agriculture groups. During mushroom season, Kim and Hook collect 65 pounds of mushrooms a day from the woods and deliver the haul of the wild.
Caroline Pam The Kitchen Garden, Sunderland, Mass.
Pam (right) was drawn to farming by her love of food. She left a career in journalism for culinary school and a succession of farm-related jobs, eventually settling down on a farm of her own. The inspiration? To eat well and grow the things she wanted to cook. Pam, 31, works the farm with her husband, Tim Wilcox, often with their 5-month-old daughter, Lily, in tow. They each worked on farms in Italy, and their European training shines through in specialty crops like blanched frisée, Treviso radicchio and zucchini blossoms. Asia and the American South are represented in the guise of Thai eggplants and Shanghai bok choy, okra and crowder peas. This culinary approach to growing has led to a synergy with Pam’s green-market customers and chefs, in which grower and eater work back and forth, trying this, requesting that, nurturing community and that most basic relationship between the soil and the things that find their way to our plates.
Betsy Fink and Annie Farrell Millstone Farm, Wilton, Conn.
Rare-heritage chicken breeds like mop-topped Golden Polish, feather-footed Sultans and Cuckoo Marans with their cocoa-brown eggs are the flashiest evidence of the diversified farming project at Millstone Farm (Page 60). Shetland sheep, Devon cattle and Tamworth pigs round out Farrell and Fink’s vision to help preserve genetic diversity — albeit in well-heeled Fairfield County. The 50-something Farrell was one of the first growers of organic specialty produce to supply Manhattan’s restaurants. Eventually she moved from hand-picking mesclun to helping other farmers create sustainable systems. She arrived at Millstone Farm to work with Betsy Fink in 2006. Fink, who is 52 and grew up in farm-forward Ithaca, N.Y., bought the 75-acre residential property with her husband, Jesse, in 2005 to establish a sustainable farm. What they have accomplished so far is nothing short of astonishing. Beyond the educational program and community events they sponsor, Millstone is challenging how we think about food and the self-sufficiency criteria that go hand in glove with anyone who grows food — and they’re doing it a dozen extraordinary eggs at a time.
Melissa Breyer is a writer who lives in Brooklyn.
As you all know, I love my meat, but I love it lean and clean. Much debate has been going since who knows when. Humanization of animals have left us living in a society where farms rescuing amputated farm animals are seen as heros and giving prozac to your dog or cat is the norm. Don’t get me started, the whole issue is beyond ridiculous. The latest article in the New York Times magazine almost made me threw up. Anyhow, for the ones that understand nature and understand the equilibrium of the food chain, a wonderful book The Compassionate Carnivore by Catherine Friend
“At last, the perfect book for people who would like to eat meat but have moral, ethical, or health concerns about doing so. Catherine Friend loves animals but eats meat and gives a thoughtful, personal, clear-eyed perspective on how to do both, humanely and sustainably.” —Marion Nestle, Professor of Nutrition, Food Studies, and Public Health at New York, University, author of What to Eat.
As for the NYTimes Magazine article, at least the moral of it was well written:
“Dodman’s theory, essentially, is that the causes of mood disorders and obsessions in humans and our pets aren’t so different — faulty genetics, dreary environments. Whether cubicle- or cage-bound, we get too little exercise; we don’t hunt, run or play enough to produce naturally mood-elevating neurochemicals. Strangely enough, I had already heard this theory — from a pharmaceutical company executive who, for obvious business reasons, didn’t want to be named. “All of the behavioral issues that we have created in ourselves, we are now creating in our pets because they live in the same unhealthy environments that we do,” he said. “That’s why there is a market for these drugs.”
By ANNIE MURPHY PAUL
The offices of Dr. Mark Chames, an obstetrician at the University of Michigan Health System in Ann Arbor, are outfitted with some special equipment. The blood-pressure cuffs used on patients’ arms are actually thigh cuffs, originally designed to strap around a leg. Standard scales, which measure up to 350 pounds, have been supplemented by ones that accommodate 880 pounds. Before the new scales arrived, some patients were weighed at the hospital loading dock.
After decades in which the obesity epidemic spread to every demographic group in the nation, it has also ended up here: the maternity ward. One in five women who give birth in the U.S. is obese, according to Susan Chu, an epidemiologist at the Centers for Disease Control and Prevention. And doctors are seeing more pregnant women who are morbidly obese, weighing 400, 500, even 600 pounds. Excess weight makes pregnancy riskier: obese women are more likely to develop hypertension and diabetes, and to deliver prematurely. The need to manage their conditions, and to meet their logistical needs, is giving rise to a new medical subspecialty, what some are calling “bariatric obstetrics.” Chames, who already sees at least a dozen morbidly obese pregnant women each month, will direct his hospital’s new Center for Bariatric Obstetric Care when it opens later this summer.
The challenges of caring for these patients begin early. “We perform an anatomical survey of the fetus, but in an extremely obese woman, the ultrasound signal often can’t penetrate through all the tissue,” Chames says. He must use a vaginal probe instead. A thorough examination is especially important in obese women, Chames said, because they are at greater risk of having babies with neural-tube defects and other malformations.
Birth brings more difficulties. The fetuses of obese women are often too large to fit through the birth canal; their mothers are about twice as likely as normal-weight women to need a Caesarean section. Longer surgical instruments are required, as are extra-wide operating-room tables, reinforced to support hundreds of additional pounds.
To head off such problems, patients at the bariatric obstetric clinic at St. Louis University in Missouri are counseled not to put on any pounds at all during pregnancy, and are even encouraged to lose weight. Dr. Raul Artal, the chairman of the ob-gyn department and the clinic’s director, acknowledges that the notion of weight loss during pregnancy can be startling. “It goes against everything we were taught in medical school, everything we’ve always told our patients,” he says. Some scientists warn that we still know little about the potential dangers of this approach. Emerging evidence, however, suggests that obese women who maintain or lose weight during pregnancy experience significantly fewer complications and deliver healthier babies.
In light of these findings, Artal and other obstetricians say the official recommendations on weight gain during pregnancy — which currently advise obese women to put on at least 15 pounds — need to change. The guidelines were issued by the Institute of Medicine in 1990, a time when low-birth-weight babies, not obesity, seemed the more pressing concern. In fact, a panel of experts has begun meeting to review the recommendations, not only for the obese but for all women. Their scrutiny comes at a time when studies show that many American women put on pounds in excess of the current guidelines and keep them on after they deliver. “Pregnancy,” Artal says, “is itself a major contributor to the obesity epidemic.”
It may contribute in still another way. New research suggests that the intrauterine environment provided by an obese woman makes it more likely that the fetus will grow up to be overweight later in life. A study of 1,044 mother-child pairs published last year in The American Journal of Obstetrics and Gynecology, for example, found that greater weight gain during pregnancy was associated with heavier children at age 3. Experiments with animals, in which variables can be strictly controlled, indicate that the mother’s body composition during pregnancy plays a role independent of genetic endowment or postbirth diet in predisposing offspring to obesity. The precise mechanism has yet to be established, but scientists theorize that the mother’s dietary intake, weight or circulating levels of nutrients and hormones sends a signal to the fetus, influencing its appetite control, metabolism and the way its genes are expressed.
If these theories are confirmed, we may come to view pregnancy not as a nine-month wait for the big event but as the crucible of a major health problem, obesity’s ground zero. “The reason this is so important is that the effects of excess weight during pregnancy reach into the next generation,” Susan Chu says. The maternity ward, in other words, is not just where obesity has ended up; it may be where it begins.
Annie Murphy Paul is writing a book on the effects of prenatal experience.
Why Do We Eat When We're Not Hungry?
“We are a nation of mindless eaters,” says Professor Brian Wansink. Wansink is taking a scientific approach to that question. His lab at Cornell University often looks more like a restaurant, CBS News medical correspondent Dr. Jon LaPook reports.
His theory is this: We eat with our eyes more than our stomachs.
“All of these cues around us are suggesting how much to eat and what to eat. At the end of the day we have been essentially directed by these cues and not necessarily by our own thoughtfulness,” Wansink says.
In one test, subjects think they are trying a new kind of pasta. They fill their plates, but after a mishap, they serve themselves again. They don’t know it, but this time they are given a slightly larger plate.
“We’ve done this time and time again and people tend to serve themselves 25 percent more in the bigger plate,” Wansink says.
Wansink estimates we make over 200 food choices every day. Most of them are influenced by factors we don’t even notice, like the size of the serving dish or the distance back to the kitchen for a refill. In one experiment, he found that just adding food coloring to every tenth Pringle — to suggest a portion — cuts potato chip intake in half.
“Coloring every 10th Pringle will lower intake from 24 to about 12,” Wansink says.
In real life — where nobody is coloring our Pringles — this research translates to dishing out set amounts of food rather than eating from a large box.
He also advises limiting variety as a way to eat less, especially at those all-you-can-eat buffets.
“It’s the perception of variety that leads people to eat more,” Wansink explains. “And it’s not just the more variety there is, its the more variety we think there is.”
And who you sit by can be as important as what you eat.
“One way you can do is just change the pacing key in on the person who is starting last,” Wansink says. “Pace yourself with the slowest eater. Wait until the last person at the table begins eating.”
People think willpower the key to conquering mindless eating. Wansink’s research concludes self-control is only part of the puzzle.
“The biggest mistake people make is to think that they are the master and commander of all of their food decisions and not realize that a lot of what’s tricking them are the barriers and the traps they set up for themselves,” Wansick says.
A couple of days ago, I sent an email to the Association of Children’s Museums asking them what they were doing to make sure that the Museums dedicated to children where acting on the food issue, making sure that healthy food was being promoted at the same level as Fast Food and Soda vending machine. As i reported some days ago, most of the museums and public institutions are selling chicken nuggets and french fries for kids menu and filling their shelves with sodas, gatorades, and sugar saturated products. Pushing healthy solutions to a often useless corner. The explanation - french fries are cheaper to produce, easier to sell, kids love it, the equation is easy.
The Children Museum Association emailed me back saying that an initiative was already in place. Good to Grow has for mission:
Good to Grow! is the children’s museums field’s response to the growing prevalence of childhood overweight and rise in related health issues. Building on a history of leadership on social issues affecting children, children’s museums have acted to counter this crisis by taking leadership in their communities to improve the health and wellness of families through programs, exhibits, partnerships and advocacy. The Good to Grow! initiative is managed by the Association of Children’s Museums on behalf of its members.
Through Good to Grow!, children and families engage online and at children’s museums with these key concepts for healthful living:
- Eating good foods;
- Getting plenty of exercise;
- Tracking screen time (computer and TV); and
- Connecting with the outdoors.
This is great news. Now we just need to pressure all public institutions and museums, and theme parks to follow and apply those much needed guidelines and understand their own responsibility in the equation.
