There must be something wrong with the majority of Americans who don’t meet the recommended levels of daily physical activity, calorie limits, and fruit and vegetable consumption . . .
or, there’s something wrong with our environment.
Sometimes you read something and it clicks: bits of free-floating information suddenly coalesce into an answer that’s so simple you can’t believe you didn’t know it all along.
That happens to me a lot while talking with Patrick Mustain, Communication Manager for the Rudd Center for Food Policy and Obesity, writer for the Scientific American Food Matters blog, and All-Around Smart Guy. I was lucky enough to get a little of his time for an interview on America’s burgeoning health problems.
If you’re tired of hearing the same failed diet and exercise solutions offered up again and again, keep reading.
Tell me about the Rudd Center: why is Yale University interested in obesity research? For that matter, why are you?
I came to the Rudd Center because they are one of the leading voices addressing the environmental determinants of obesity. While I don’t speak for the Rudd Center or for Yale, I can safely say that these and other public policy organizations recognize that sedentary lifestyles and poor diets are increasingly expensive and burdensome. Most people understand that being physically active and eating a healthy diet are important, yet the problem grows. As a personal trainer I spent years looking at how to convince people to make healthier choices, and eventually it became clear to me that the environment in which people make those choices might be a more important place to focus our efforts.
The Rudd Center is doing just that: examining environmental barriers to healthy choices.
What kind of barriers? Move more, eat less seems like a simple message; why doesn’t everyone do it?
Around every holiday season you’ll see this scene play out on the news:
Well Jim, It’s that time of the year again, but how are you going to make it through this holiday season without packing on the pounds? I don’t know about you, but I sure find it hard to resist Aunt Margaret’s snickerdoodles! Ha Ha!
And then Jim responds:
Ha ha, you bet, Lisa, I’ll be honest, I can’t say no to that eggnog. Yes, folks, we all know how hard it is to stick to your diet and exercise routine this time of year, and that’s why we’ve brought in [health expert] Martha to give us some great exercise and diet tips!
Then Martha proceeds to say the exact same thing she said the year before. It’s the same thing that every trainer, doctor and nutritionist says every year on every news channel. We ask the question all the time and it’s answered the same way, all the time, and we continue to be bewildered that it’s just so damn hard to stay healthy these days.
There is nothing natural or normal about restricting calories or burning energy simply for the sake of burning energy. Since the beginning of life itself, our evolution and development have been largely driven by a single directive: get energy. Diet and exercise inherently contradict deeply rooted aspects of our physiology and psychology.
Diet and exercise are also in competition with the most important thing that our culture tells us to do: consume.
What kind of impact does consumer culture have on our health environment?
Consumption is one of the most significant reasons why we continue this absurd cycle. The solutions to our over-consumption problem are being packaged and sold like consumer products themselves. The problem is, those products don’t really work.
There has been little to no indication that any diet or exercise program works over the long term. We are presented with success stories all the time, but anecdotes undermine the reality that even in best-practice, clinical settings, no intervention has actually been shown to keep weight off, for a majority of participants, five years after the intervention.
I hope people will soon realize that the approach we’ve been trying is not working. Plenty of very smart people are are out there studying how we move, how we eat, and why. There are answers to these problems—supported by stacks and stacks of studies—that are available right now. We know so much more about what needs to happen to improve people’s health than the general public realizes. I hope we will soon see these things we know reflected in our public policy and in community level interventions targeted not at a person, or even a group of people, but at an environment that makes it so hard to eat well and move better in the first place.
A lot of people will look at your perspective as deferring personal responsibility; what role does individual choice play in getting—and staying—healthy?
A popular refrain from public health nay-sayers is that health-promoting regulations undermine personal responsibility and stifle the marketplace. According to this ideology, when every person is working in his or her self interest, everyone wins. Let’s, for the moment, ignore the moral implications of that (which are profound) and objectively assess the individually focused, market-based approach to health behavior by asking one very simple question:
does it work?
There are a gazillion marketing studies out there looking at why consumers make decisions that are clearly not in their best interest. (For more on that, read Duke Scholar Dan Ariely’s Predictably Irrational, or watch this video.) We are hardwired to make choices based on immediate gratification and ignore long-term consequences; marketers understand these cognitive mistakes very well, and spend a lot of money finding ways to exploit them. They call it “creating value for the consumer.”
Humans are not rational. Most of us make decisions that go against our self-interest every day. Those who say “people need to take responsibility” have every right to say that, but they should understand that what they are expressing is purely a moral sentiment, not a practical suggestion.
It is important to remember that most of the decisions that we consider irresponsible today actually made a lot of sense 10,000 years ago. Consuming as much energy as possible, especially from dense sources like fat and sugar allowed early humans to forage, hunt, escape predators, and make baby humans. Expending that often-scarce energy for anything other than getting more energy, making babies, or the general work of survival was a waste.
We have a food surplus unlike anything ever seen in the history of life. Because our psychology and physiology aren’t that much different than they were 10,000 years ago, we are responding to that surplus by eating too much and not moving enough, and it’s making people sick.
There is no incentive for the market to actually solve this problem. The solutions that health research has identified as being most effective in curbing obesity involve buying less, not more. Planning our cities in ways that naturally encourage walking and integrated physical activity will do far more for a community than bringing in a private gym and hoping people make the choice to attend a Pilates class every few days. Deciding, as a society, that companies should not be able to spend billions of dollars to influence children’s eating habits will do far more for children’s health than spending a couple million on another public health campaign that tells people that eating vegetables is a good thing.
Market forces can do a lot of good, as we see all the time with the quality of life increases that come from competition-driven innovation in technology and medicine. But the market isn’t in the best position to help solve health-behavior problems when the solutions would end up hurting the market, at least, in the short term.
A community approach to health is not mutually exclusive with personal responsibility; deciding what kind of a society we want to live in is something we have to do together. It certainly isn’t about taking away people’s freedom to do unhealthy things. It’s about us demanding freedom from the influence of a hyper-consumer culture that from all evidence appears to be making us very sick.
Have you come across anything in the course of your work that has really shocked you?
I have only recently come to understand just how stacked against us our food environment really is. Pick any random street corner in America, and the closest place to you that sells food is probably filled with highly-processed packaged foods, refined carbohydrates, saturated fats and salt. You may find some granola bars, nuts or bananas, but most of the food in most places is not stuff that people should be eating every day. There is something terribly wrong with that. We should demand better.
There is such an enormous amount of information out there regarding health, fitness, nutrition and obesity: how can people distinguish the good from the bad?
A simple rule is looking for information that comes from a .gov or .org website versus a .com website. In most cases where a commercial health and fitness magazine or website is actually providing legitimate information, they got that information from research that taxpayers have already paid for. If people go to myplate.gov, or cdc.gov/healthy living, they’ll get the most current nutrition, physical activity and lifestyle information that’s out there. The food industry does put a lot of effort into shaping US food policy, but the peer-review system that underpins .gov content helps weed out commercial bias and bring legitimate research to the forefront. It’s not a perfect system, but it’s the best one out there.
One thing to avoid is any product or information that encourages body dissatisfaction. You can be shamed into buying things easily—it’s a ubiquitous industry-favorite tactic for driving sales—but research indicates that you can’t be shamed into being healthier. The internet is flooded with anecdotes about people who claim to have changed their lifestyle with “what’s your excuse”-type products, but they are the exception to the rule by an enormous margin. You won’t see glossy spreads of skinny models in sports bras at, say, ACSM.org, but you’ll get the best research-based fitness information that’s out there.
And, obviously, people can follow your blog! There are smart, responsible fitness and health companies out there and Reembody is one of them. Keep up the good work!