Bring back Home Economics: JAMA Editorial

I gave a talk two weeks ago, where I spoke about the origins of the college I went to, the College of Human Ecology at Cornell. It was originally started as the school of home economics. Its leader was Martha Van Rensaleer, a visionary female. The goal of the college was to teach women the skills they needed to be effective in the home in NY farms.

Martha Van Rensaleer went on to become a advocate for women and children's health and wellbeing. In 1930 she helped form the National Children's Charter which said:

"“For every child health protection from birth through adolescence, including: …the insuring of pure food, pure milk, and pure water.”

I think we can help guarantee this to our children by teaching them home economics skills, as this editorial states. We can also continue the great work of Martha Van Rensaleer, by teaching people nutrition through state cooperative extensions, such as the same Cornell Cooperative Extension that MVR was a leader of in the 1900s. The country's agricultural schools can be the birthplace of educators in nutrition and innovative farmers. They successfully improved nutrition in the early part of last century. They could do the same in this century.

Food Politics � Here’s a thought: bring back Home Ec

How should we tackle Obesity?

On February 26th a large, well designed trial comparing different weight loss diets was published in the New England Journal of Medicine. It was a good behavioral intervention over two years. They compared high and low protein, high and low fat, and different amounts of carbohydrates. The result: no difference in weight loss between any of the diets. Overall, the participants lost 6.5-9 pounds at the end of 2 years. This is a mild, but significant reduction.

We have now had a bunch of trials that show that many different diets "work", but only modestly. If we try and take these interventions into the clinical (i.e. non-research) world, we will likely have even less success.

So what do we take out of this? The editorial by Martijn Katan (linked to below) says it best:

"We do not need another diet trial; we need a change of paradigm."

He goes on to talk about how behavior change is hard, and we will only be effective if we work at a community level:

"Like cholera, obesity may be a problem that cannot be solved by individual persons but that requires community action. ...the apparent success of such community interventions suggests that we may need a new approach to preventing and to treating obesity and that it must be a total-environment approach that involves and activates entire neighborhoods and communities."

I have been advocating for this for some time. Obesity treatment (via dieting) is not the answer to this large public health problem. Obesity prevention through large scale public health research and interventions is the answer. Let's start taking responsibility for our laws, policies, and community designs that contribute to obesity. Let's all work together to make our communities healthy places for our children, spouses, friends, and parents to live in.

NEJM -- Weight-Loss Diets for the Prevention and Treatment of Obesity

The Food Bill

A new article by Michael Pollan in the NY Times, talks about one of the most important bills in Congress. It is called the "Farm Bill", but affects the food system, the environment, and immigration.
Some select quotes:
On the Current Farm Law: "The result? A food system awash in added sugars (derived from corn) and added fats (derived mainly from soy), as well as dirt-cheap meat and milk (derived from both). By comparison, the farm bill does almost nothing to support farmers growing fresh produce."

"The public-health community has come to recognize it can’t hope to address obesity and diabetes without addressing the farm bill. The environmental community recognizes that as long as we have a farm bill that promotes chemical and feedlot agriculture, clean water will remain a pipe dream. The development community has woken up to the fact that global poverty can’t be fought without confronting the ways the farm bill depresses world crop prices."

"One of these years, the eaters of America are going to demand a place at the table, and we will have the political debate over food policy we need and deserve. This could prove to be that year: the year when the farm bill became a food bill, and the eaters at last had their say."

This is the year. To get BE ACTIVE on this issue check out the Oxfam Farm Bill Website.