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December 12, 2006
The Preventable Apocalypse
The other day at a staff meeting for my union, we were discussing the crisis in health care.
Of course, all of the solutions forwarded involved single-payer health care, health insurance for all, and taking the advertising and profit dollars out of the system, turning those funds into better nurse staffing, free health care for every citizen, and prescription drugs as determined by medical neccessity, not by the ability to pay.
I'm for all that. Of course I am. It really is better in Canada! We already put up with huge waits in the hospital as it is. My mom was at an excellent suburban hospital, but even there, she spent six hours waiting in the emergency room before the test was run that determined that she had a terrible infection. During that wait, the infection migrated into her bloodstream, forcing her doctor to prescribe IV antibiotics, causing her terror and suffering, and extending her hospital stay by days. If she could have been seen earlier, the infection could have been stopped in its tracks. That's in the USA, for a woman with fully paid, execellent health insurance. Imagine what happens to those who no insurance! At least she could go to the hospital!
As we discussed the ongoing and worsening crisis in health care, one thought weighed heavily on my brain: the only solution to this problem is for fewer people to get sick. The numbers are just too huge. 65 percent of Americans are overweight, and half of those are obese. Childhood obesity rates are soaring. These people are going to get very, very sick. We know that obesity is a serious risk factor for heart disease, stroke and diabetes. But all of these people don't have to get sick. Heart disease, stroke and diabetes can for the most part be prevented with a sane, sensible diet.
There are a few voices crying in the wilderness, for example, my idol Kelly Brownell at Yale, standing up for the NY ban on transfats and calorie labeling on menus. He is constantly attacked in the press for being the "food police," as though people really want to eat poison. If you think the attacks on me were bizarre and hostile, you should check out the attacks on him!
I have often said that I am not interested in "converting" people to CR, and that's true: there are only about four people I've ever met whom I've actually tried to get to move towards CR. For most folks, the rigor isn't possible. But here is something possible and desirable: everyone can and should eat a healthy diet and achieve a healthy weight, one that will minimize their risk of that trinity of killers mentioned above: heart disease, stroke and diabetes.
I recognize that most people are overweight. I was too, before I discovered the powerful effects of good nutrition. I battled my weight for my entire adult life, but I found that once I gave my body the nutrients it needs, it was no longer even an effort to maintain a below-normal weight. I'm not starving -- I'm having a great time! Anyone can do this! CR, real CR, the kind of calorie restriction the defies biological urges and might actually slow the aging process requires software, strict attention to nutrition, and iron self-discipline, not to metion social support and a commitment to long term goals. But just eating right and maintaining a healthy weight doesn't require much effort at all. Just the right information, and some incentives.
Most people lack the right information. They've been told that nutrition is too complicated for them to understand, so they ought to just give up. Or they've bought the low fat gospel, or the low carb heresy. Simple calorie counting, plus adding up RDA's till you get to 100 percent, isn't even mentioned in popular diet books. Yet it's the easiest thing in the world. Most people put more effort into balancing their checkbooks than they put into balancing their diets.
What I did to lose weight was easy. Cut empty carbs (no more bread or pasta or rice, no sugar, no non-red wine alcohol), increase protein (hello eggwhites!), find nonfat, organic sources of calcium (all that cottage cheese and yogurt) and search for hard to find nutrients in small calorie packages (Lewis Labs Brewers Yeast.) It took some time because I had to do the research for myself. But I can make all that information available to you, and you can run with it. My readers have lost 10, 20, 50 pounds, while enjoying their food and having fun with their families and friends. Eating healthy isn't about self-denial -- it's about giving yourself what you truly need. When you satisfy those deep internal cravings for nutrrients you've been lacking, those surface, fake cravings disappear. Now you might still have a PMS craving for chocolate (I know I do -- once a month, I eat M and M's. I don't worry about it... it's the PMS craving, it only comes once a month, and it's satisfied with a handfull of cheap chocolate!) But you won't have that constant feeling of gnawing in the stomach. You won't need to overeat to feed your body what it truly craves.
People who knew me forty pounds ago always ask what I did to lose weight. The answer is simple and non-glamourous: I ate fewer calories and got better nutrition. I didn't follow a fad diet, I didn't become a Buddhist or go on a retreat, I didn't take diet drugs. I just ate fewer calories and higher quality food. I got sick of how I looked and felt and decided to change.
What I did was easy, yet most of the people I see are suffering with overweight and obesity, and many of them with the early stages of obesity-induced disease. They've tried diets, but they feel like they've failed. Their environments do not support healthy living. They will end up costing millions of dollars in prescription drugs, medical treatments and surgery. And they will lose what could be the best years of their lives to ill health.
It's not fair, it's not right, and it can be stopped. Here's what I want to see happen:
1. Calorie labeling on menus in all chain restaurants. McDonalds does it -- so can everyone. Give the people the information, so they can make informed decisions.
2. Economic incentives for maintaining healthy weight. Employer programs where for every week when an employee loses a pound or maintains a healthy weight, that employee gets paid more. The money saved in health insurance will more than make up the difference. If there's one thing I've learned from organizing workers, it's that when money that could take care of the family is involved, workers are willing to change. They'll work double shifts for incentive pay, why not eat healthy and exercise for incentive pay? If it could mean a better Christmas for the kids, or getting out of debt, workers will do it. I would love to work with hospitals to put together nurse-friendly health programs because I know how hard nurses work, and how very difficult it is to maintain sanity, much less health when you're taking care of critically ill human beings for twelve hours without so much as a bathroom break. These women (and guys!) take care of their patients, then they go home and take care of spouses, kids, elderly parents, and their communities. The last person they have time to take care of is themselves. But if they knew they would get more money in their paychecks for losing weight, it might be worth spending the time it takes to pack a healthy lunch. They'd start demanding healthier options in the hospital cafeteria. Money talks -- its power could work for health, instead of lining the pockets of the poison merchants who claim they are just giving people what they want.
3. Tax credits for families that meet health benchmarks. If you and your kids are a healthy weight, you get to pay less in taxes. Sure, this will help those who are "naturally skinny," but no one is naturally obese. Weight is controllable -- people need incentives to put their time into controlling it.
4. Free, easy, accessible weight management counseling and support. New Jersey has a free quit smoking health program. People who want to quit can get the help they need. The same should be government funded for weight management. No one should have to go this alone. The information and support should be free and accessible to all, not just the rich.
5. A consumer movement to demand healthier choices in grocery stores and restaurants. When the consumers demand it, the producers will provide it. If McDonalds can put together a few healthy meals (Grilled Chicken Caesar salad with lowfat balsamic dressing, fruit and yogurt parfait) then any restaurant can do it. The day when I can walk into a McDonalds and order an eggwhite omlette with tomatoes, green peppers, mushrooms and onions topped with salsa will be the day I know we've won.
None of this is far-fetched. Many employers, including the state of Pennsylvania, are already offering economic incentives for healthy living. We can define achievable benchmarks: BMI, weight, cholesterol, a combination thereof, that the vast majority of people can reach without drugs or surgery. Weight isn't determined by genetics -- it's determined by what you eat and how much you exercise! Sure, there are some genetic factors, but no one was born to be obese and die early of heart disease. Right now, we live in an obesogenic enviroment: it's hard to eat healthy because there aren't a lot of quick and easy choices available. But it's not that hard, with the proper information, and as more and more people find it an economically advantageous proposition to lose weight, it will become easier.
People who defend the food industry like to talk about personal freedom. Well, I want to talk about real freedom. Freedom from illness and disease. Freedom from the daily self-loathing that comes with looking in the mirror and seeing a much fatter person than one wants to be. Freedom to dash up the stairs, or work a sixteen hour day without exhaustion, or run and play with the kids, or buy a dress in a normal store instead of a plus size boutique. No one wants to be fat and unhealthy. How about providing people with the tools they need to get healthy, and the incentives to make it a priority?
Sure, it will cost a lot. But the upcoming apocalypse will cost a whole lot more. Paying for the 65 percent of Americans who are overweight or obese to get health care as they age will cost a lot more than paying for them to get healthy. Paying for children who get type 2 diabetes as teenagers to have medical treatment their entire lives will cost more than it would cost to help them lose weight and conquer diabetes.
Back in 1999, I worked on an organizing campaign at a large hospital in New Jersey. Management put out a flyer that said: "You can stop it! Make it stop!" They referred to organizers calling nurses to urge them to talk to their co-workers. It was a bizarre flyer that was good for many laughs over the years, as the nurses voted overwhelmingly to organize the union, and thanked the organizers profusely for our role in helping them get a voice on their job. But the flyer became my favorite anti-union flyer of all time, since the message was so simple. I think it fits our context much better than it ever fit its original purpose.
You can stop it. Make it stop.
Obesity is curable. Obesity-induced diseases are preventable. The information is not glamourous, and the cure takes work, but it is a hell of a lot easier than CR, and the payoff is amazing.
Eggwhites. Olive oil and flax oil. Low calorie, high nutrient vegetables. Fresh, whole fruits. Nuts. Low calorie, protein rich meats (turkey, seafood.) Legumes. Non-fat, organic dairy.
I lost thirty-five pounds on a food budget smaller than what I spend for food for my cats. It's a lot cheaper than grabbing takeout.
When are people going to get serious about losing weight and getting healthy? I suspect it will only happen when the economic incentives line up to make it more advantageous than living overweight.
Until then, I will continue to be the left wing. The extremists who make room for the moderates. The Greenpeace to the Sierra Club of non-CR'd, healthy eating. So far, the urgings fo the USDA, the Mayo Clinic, the Harvard Nurses' Study, and everyone's grandmother pushing moderation, balanced eating and healthy weight have prompted the American public to do precisely nothing. Yet many of you who say that you don't want to do "extreme" CR have used the examples and information and recipes you've gotten here to improve your own diets and get healthy. The media isn't interested in "normal" people eating a healthy diet, but they're interested in skinny freaks who think they can live longer by refusing to give into the culture of "EAT EAT EAT!" And that media interest, snarky as it often is, has brought many of you here.
Welcome. Let's work together to end the preventable suffering that threatens not only our health and happiness but the economic foundations of our nation. Each of us has a part to play, and there is nothing more important than putting healthy meals on the table for your own family. My highest respect to all the parents out there who provide healthy meals for their kids and defy the take out culture to raise children who will know what real food is. I know you're busy, I know what you're up against, and I worship the ground you walk on. You are saving the next generation -- stop by our house for a nice dinner and a glass of pinot noir!
We all have our parts to play, and we should just expect to get some flack for it. People who
make money off of unhealthy eating, or aren't prepared to face their own unhealthy habits, are going to attack us. As Zeynep says, we can't let these idiots get us down. In the world of healthy eating, there really is such a thing as the last laugh.
As the president of the CR Society, Brian Delaney, likes to say:
Onward!
Posted by april at December 12, 2006 7:57 PM
Comments
I’m not there yet but I’m on my way. Thank you for your commitment to this journal. It is my Diet Buddy now. The thing that I remember when I am hanging off the wagon, clutching desperately, bloody-knuckled and desperate for a hand up. That may sound extreme but it has been so long since I cared about my weight or appearance that I can’t remember by noon what my resolve was in the morning. Truthfully it is the dark hours that get me. But I will prevail and I am truly grateful for your example and guidance. I so look forward to the time (maybe tomorrow) when I can lay down at the end of the day and know that I did it right and can do it right again tomorrow. I want to completely CR even though I only found out about it 3 days ago. I have wondered about what life would be like if you could just stop eating the way a person just stopped smoking. I like my body and don’t want to damage it so I thought that was a ridiculous idea but, somewhere in the back of my mind it seemed like there must be some similar solution. Where food was only science, a formula for optimal performance. I would adore some drink or intravenous solution but maybe that is a cop-out. Something tells me that this is it, the solution I have been begging for. In the last year I have gained thirty pounds. I don’t think I have changed my diet but surly it didn’t just appear. I am basically healthy, although I was poisoned about five years ago by the same man who killed my diet buddy. We both looked and felt great. That’s when I stopped caring. But I can’t go on not caring. I will be 500 pounds if this keeps up! I might be exaggerating slightly but I have a small frame and it is getting tired of the excess weight! So here is my plan. I will gradually lower the calories while packing on the nutrition. LOTS of EGG WHITES! And I will keep you posted as to my success. Then I have someone, whether or not your read these comments, that I am doing it with. Thank you for the help. I am not sure what I thought about all your suggestions in this entry but they are at least a step in any direction for improvement. Somebody has to squeak because this wheel really needs oiled! And something is better than nothing! Sincerely Kelly
Posted by: Kelly McCulley at December 12, 2006 11:00 PM
Hi April ... I saw this site to quickly and nearly effortlessly self-design healthy dinner-loaf recipes and was wondering if you ever have seen it? Since it is food related, I thought of you and Mr orange guy. It seems like a kinda fun and funny idea! Any thoughts on it? http://www.veganlunchbox.com/loaf_studio.html
Posted by: CRWilliam at December 13, 2006 1:54 AM
Hi Kelly!
Of course I read the comments! I wrote you the other day at the email address you provided to thank you, but I'm not sure if you got it.
Thank you so much for your comments... things like that really keep me going! We're all in it together. I have bad days too, but my bloggiefriends keep me on track! Do keep us posted and know that we're here for you... let us know what we can do to help!
april
Posted by: April at December 13, 2006 4:27 AM
Hi April,
I appreciate the irony of reading your post and then reading in the NYT this morning that only 7% of people dieting actually count their calories. You're right, it seems that very few people find this way of life sustainable. This fact surprises me because
CRON seems so simple and logical, especially as compared to some diets out there (lemon juice and cayenne pepper, anyone?). In any case, I just wanted add my support--I look forward to reading your posts. Your enthusiasm keeps me inspired.
Posted by: Rachel at December 13, 2006 10:06 AM
As a Canadian, I feel I must comment on your suggestion that the Canadian health care system is considered to be so much better than that in the U.S. Truth is, even though medical insurance is free to lower to mid-income families, the medical system is in a state of crisis when you look at the statistics...its just not good:
On one recent day, emergency rooms in 23 of Toronto's 25 hospitals had to turn away ambulances.
In Winnipeg, "hallway medicine" has become so common that hallway stretcher locations have permanent numbers.
Ambulances filled with ill patients have repeatedly stacked up this winter in the parking lot of Vancouver General Hospital, where an estimated 20 percent of patients in the midst of heart attacks must wait an hour or more for treatment.
Waiting lists for surgery in some Canadian hospitals can stretch from months to as long as five years.
Canada has a predominantly aging population, stretching the demand on the health care system far beyond its capabilities. We have a shortage of both doctors and nurses in this country. There are almost daily horror stories on the news accounting the public's experiences with extensive waits in emergency rooms, patients dying as a result of hospitals turning them away by sending them home with little or no treatment. Its just not as rosy as you may think!
Posted by: Shauna at December 13, 2006 11:58 AM
April,
I saw this reported
http://www.mercurynews.com/mld/mercurynews/news/politics/16228365.htm
and thought .. it doesn't say anything about the single most obvious way of reducing health care costs - help people to be healthier by eating less.
Maybe, though, if employers have to pay for health care costs, it will be more economically obvious to them that their employees who could have better health should be helped to have better health.
artifex
Posted by: artifex at December 13, 2006 1:20 PM
Here,here! What a fantastic entry, April! I love how you bounce back after a low point and end up even more fired up than before.
To Kelly: April isn't the only one who reads these comments. This site has become my Diet Buddy as well. You are definitely in the right place. A little over 6 months ago, I weighed around 150 pounds (I'm 5'2). Then I learned about CR and gradually started incorporating the principles into my daily life. This morning I was astonished to discover that I weigh 109 pounds. I feel like a completely new person. If I can do it, you can do it. My only advice is to be gentle with yourself, especially in the beginning. April's advice and a few good books (I just love Walford and Delaney's book, The Longevity Diet) will really get you started in the right direction. Definitely keep us all posted. I check out this blog almost every day and I know many, many others do as well. We can all be your diet buddies!
Posted by: Robin at December 13, 2006 1:22 PM
In response to Shauna's comment, I can advise that the situation in Calgary is almost the same. Stories such as those she described are all too common here. What is very ironic is that Calgary is supposedly enjoying incredibly wealthy times! True, we do not have to pay for basic care and most employers cover the (very low) fees charged by Alberta Health care after three months of employment but actually accessing medical care when you are ill can be a nightmare. Our short-sighted government, in the interests of ridding the province of debt, closed or (literally, in one case) imploded several large hospitals in the late 1990s, with the result that medical personnel were laid off or let go. Not surprisingly, many doctors and nurses headed south for more lucrative and secure employment prospects. Now, Calgary's population has skyrocketed, and doctors and nurses are in incredibly short supply and hospitals are filled to overflowing. Our newspapers are now reporting the same type of abusive situations for nurses as April describes. We also have almost as bad obesity rates here as in the U.S., with gak everywhere and very few people having a clue about what constitutes a healthy diet.
The coming apocalypse, as April has so appropriately called it, is approaching fast. JD
Posted by: Judith at December 13, 2006 4:31 PM
Hi April,
Great post! Totally made my day. I've been reading your blog since the NY Magazine article *(along with the recommended reading and Cr Society posts) and of course working on my CR-ON. 10 pounds off during the holidays..can't beat it! Woohoo...but more importantly, more energy, higher spirits..better feelings all around. Now before dinner time, both kids are asking for salads with dinner, it used to be a battle but now it's getting so easy! That alone is HUGE!
Keep it coming you're doing a great job and thank you so much for the inspiration.
DJHinVA
Posted by: Deborah at December 13, 2006 7:04 PM
Yippee! I did it! I am so relived and a bit proud and have this wonderful since of control. Today I had Relive mixed with oj and mango juice for breakfast (Relive is a vitamin powder that keeps me sane, really) all though that may not be the best breakfast it was under 100 calories and packed with digestible nutrients and knowing that I had an early lunch date I opted to hold back on the calorie count until lunch. We went to the Olive Garden for lunch. I had a lovely tossed salad and a bowl of minestrone soup. NO bread no cute little after dinner mint. Lunch was not very pleasant because my daughter pouted the entire time about not being allowed to eat bread sticks or order pasta. My husband thinks I am cruel and gave the child her bread, which she would not eat because she hates the idea of the two of us being at odds and did not want me to be disappointed with her. She only sucked on half of her dinner mint and left the rest. Then it was nothing but water until 6 pm when she and I had 4 ounces of grilled chicken, steamed broccoli, a third cup of cottage cheese each. I also had an ounce of blackberry wine, diluted. My new rule and most important is that I will not eat after dark. I can’t tell you how wonderful it is to communicate with somebody that really does care (my husband thinks I have gone insane and I have had no opportunity nor desire to share my new way of life with anyone other than my five year old who doesn’t have any choice other than to eat what mommy cooks/purchases. I met a croner at the health food store today. She works there and I walked up to her an said, “Are you a croner?” Looking up an seeing someone approximately 80 pounds overweight (ok, I don’t look 80 pounds fatter than I should be but I am 215 pounds! That cant be good and I am starting to get a poofy belly! I have never carried weight in my stomach! It’s horrifying!) anyway she boldly said, “Yes, I am.” I told her I am on my way but that I have only started. Are all croners nice? You guys are. She was very pleasant an also very unique. Rather lovely in a very, very thin way. I’m sorry but I would much rather be oddly thin than grotesquely fat! So, the goal is, nothing to eat until the sun is shinning (in my neck of the woods) and then it’s egg white buffet! Thank you. This is the first time in a very long time when I felt like I might eventually see the light that is rumored to be at the end of this tunnel! Blessings. Kelly
Posted by: Kelly McCulley at December 14, 2006 7:49 AM
USA was very successful in her anti-tobacco campaign. Now, most Americans see cigarettes as the devil, the biggest sin. The tobacco lobby was very powerful too. So, I don't see why a similar approach could not be used to fight obesity.
Posted by: istanbulwitchy at December 14, 2006 11:56 AM
When you quit your Union Organizer job and start your non-profit foundation aimed at making the US a healthier place, please please please hire me! I back this 100%. So much of what we are "fed" (not literally) about govt infringement makes me want to scream. I think there should be huge efforts to get our youth healthy and happy -- not to mention as much as the population as possible. Actually, I don't know that we can't be a lobby -- maybe email me offline at some point to swap ideas?
Oh, and about the M&Ms -- why not indulge your PMS with a lovely square of organic chocolate, rather than that high fructose corn syrup multi-national crap? ;-)
Posted by: Gina at December 15, 2006 9:10 AM
Would like to be part of CR world and know what foods to have in my frig and pantry. What about menus and recipes and COSTS. i accidentaly came upon all this while looking for cheap eats during what I hopr is temporary bleak no money period. Thanks. Appreciate start-up info.
Janet Spiegel
Posted by: Janet Spiegel at December 28, 2006 6:41 PM