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December 28, 2006

Your Revolution Is Ready

I heard him for the first time on WHYY's Radio Times. It was mid-October on one of the extremely rare days when my work schedule allowed me to be home in the morning. I was listening to NPR when a show about the New York City ban on transfats came on (I can't get the link to work directly, but enter Kelly Brownell into the search engine and it will take your right there.) On one side of the debate was a libertarian who kept ranting on about how people should have the right to be buy poisoned food if they care to. On the other side was Yale professor Kelly Brownell, director of the Rudd Center for Eating Disorders and Obesity. I was vaguely familiar with the name from earlier encounters with the literature of eating disorders, and I feel certain that at some point we ran into each other at Yale. But I’d never read any of his work or given him a second thought until I heard him on Radio Times. I was very impressed with his performance: the way he quickly and gracefully sliced apart all of the arguments against regulation on harmful substances; how he injected just enough humor into his answers to make it clear that he was in no way rattled by his opponent, and how he presented a clear and concise perspective on how government can improve public health with rational and sane legislation. I jumped on Google, found his email address, and emailed him a quick note saying something along the lines of, “You’re awesome! Keep up the good fight!”

He wrote me back instantaneously thanking me and saying he would try to do as well in the rest of the program.

I jumped up and down like a cheerleader at a football game throughout the rest of the show as he did, in fact, do well, and I went off through the rest of my day happily replaying the best parts of the program in my head. A few days later when it hit the podcast, I listened to it two or three more times while I was working or doing chores around the house. I resolved to pick up his book, Food Fight, and told MR of this intention.

“I have that book in one of these boxes, I’ll dig out my copy for you,” said MR. Great, thought I. But the book wasn’t immediately findable (we had just moved into the new house and most of our stuff was still in boxes) and MR was down to the wire on his own book deadline, so I didn’t want to bug him about it. So I didn’t get the book, even though I desperately wanted it.

Then the New York Magazine article was published, and the giant media frenzy surrounding it, including that awful, snarky article in Salon.com, hit me like a jar of stale gummy worms. Between media appearances, an upturn in my work, and my mother’s illness, thoughts of finding a new book to read were put on the back burner.

During the time when I was so upset about the unfair, sometimes downright inaccurate press we were getting, I took a few minutes to Google Dr. Brownell. I was shocked at the level of personal attacks on him from front groups for the food industry. Unable to justify their positions on rational grounds, they resort to ad hominem attacks, calling Dr. Brownell, and other public health experts who demand responsibility from the food industry, nannys and Nazis who want to control the behavior of others. As I read the vicious attacks on KB, I started to think the press MR and I were getting was pretty mild. It cheered me up, a bit, to imagine KB writing his books, testifying before Congress, and taking on the food industry while these idiots made fools of themselves with their irrational personal attacks.

Then my mother got sick. While I was in the hospital with her, I watched most of the patients in the rooms around her suffer from complications of obesity: heart attacks, strokes, diabetes. The woman in the bed next to her demanded a bag of potato chips as soon as she was admitted to the hospital! I saw the families of patients crowded around their hospital beds, praying for a recovery, all the while feeding their own children the same kinds of foods that landed their parents in the ICU in the first place. I wanted to walk up to them and ask, “What the hell are you thinking? You’d snatch a cigarette or a fifth of whiskey out of your child’s hand, yet you’re buying her chicken nuggets and French fries in the hospital cafeteria while your father is dying of heart disease?”

Then I got sick. I wasn’t sick for very long (just a day, thanks to my CR-revved up immune system) but I was very sick while I was sick. While I lay in bed at my mother’s house, too weak to move and unable to keep down any food or liquid, I had some time to do serious thinking. I was still suffering from the worst of that post-Salon article funk, and as a chronically happy person, I was quite disturbed at my inability to shake the negative feelings. The nasty and sometimes threatening letters that we had received, both at Salon and on the blog, were getting to me to the point where I considered ceasing to do media appearances. I mean, I don’t try to convert people to CR. Is the one in a million person who might get the information and decide to do his or her own research and give CR a try really worth me going through this kind of personal attack on a regular basis?

Yet whenever I considered backing down I would think about KB’s appearance on Radio Times and remember how he calmly and seemingly effortlessly (though I’m sure it’s the result of years of practice) faced down his critics with humor and cold hard facts. I listened to the podcast again. It made me so freakin’ happy that I forgot my post-Traister emotional funk and started bouncing around again like usual. Finally the day came, as I always knew it would. I told MR that I was on my way to Barnes and Noble to buy Food Fight unless he dug it out of its alleged box within twenty-four hours.

The book was on my shelf when I got home from work. I should have threatened earlier.

It was a Thursday night when I sat down in my bed with my nineteen year old calico cat and a four ounce glass of excellent French red wine to begin to read Food Fight. Hard to believe it was just over a week ago, since I have now read the book cover to cover twice. Within a few minutes, MR heard screams coming from the bedroom.

“Baby, what’s wrong?” he said as he rushed in from his office.

“I LOVE THIS BOOK!!!” I yelled, upsetting the nineteen year old calico who is pretty deaf but can feel the vibrations of my voice when she’s lying on my chest.

“That’s great! Why are you screaming?”

“Because I love this book, and it makes me want to run off and join the public health circus! Obesity is the biggest health crisis facing this country, and Kelly Brownell has a plan to do something about it! I want to help him! I can’t just sit here when there’s work to be done!”

Of course I had to sit there because there was a calico cat lying on my chest. But the book was captivating, and it was hard to pull myself away to do things like make dinner and go to work.

We discussed the book more over the days that followed, as I read more and got more excited and added my ideas onto those outlined by KB and his co-author, Katherine Battle Horgen (Let us never forget co-authors. As my partner is the co-author to a famous scientist, I have a special place in my heart for these folks.) I sat in McDonald’s waiting for nurses to show up for 7:30 am meetings, reading Food Fight and dreaming of a world where kids’ meals consist of lean meats, veggies, non-fat yogurt and nuts, with fruit for dessert. Kinda like a bento box for American children. While I sat in traffic for hours every day on my way to and fro RN meetings, I began to construct elaborate fantasies of taking Amtrak to New Haven to interview KB for the blog. I’d bring him a thermos of our fancy Japanese green tea and a megamuffin. If he liked the megamuffin, I’d make him a whole batch. That, as any of you know who’ve read the recipe or tried to make them, is serious.

As I read Food Fight, I found that my outlook improved. I no longer regretted my media appearances, and I started to see the irrational, mean attacks on us as evidence that our message has hit a nerve. Eating doesn’t have to be about consuming whatever the food industry tells you to consume, no matter what the effects on your health. Obesity, heart disease and diabetes are not predetermined outcomes of the natural aging process, but the result of years of suboptimal eating. People can change, and people can work together to change the environment that virtually guarantees that the majority of Americans will be overweight or obese and sick.

There is so much in the book that I found enlightening and inspiring, and I don’t want to summarize it because a) I want you to order it now and read it immediately (your book report is due at the end of January) b) I won’t put it as well as KB and Katherine Battle Horgen did. But there were several points that gripped me and pulled me in like a magnet or a black hole or my super-strong Dyson vacuum.

On page seven, in the very first chapter of the book, KB and KBH talk about how a child might view the culture that (unless he is very lucky) led him to become obese. Fast food and sugary soft drinks in school… television and computer games instead of physical activity… Type II diabetes, possibly a heart attack before age 30.

“Why do you let this happen to me?” asks the hypothetical child.

When I read that line, I thought of the nurses I work with everyday. I have lamented many times in the blog that while we make such huge strides in working conditions and compensation, including winning decent pensions and health care benefits, the nurses’ eating habits will either kill them or incapacitate them before they have time to enjoy a secure retirement. Their lives are typical of the American middle class: too many work hours for not enough money, health care benefits that pay for treatment but not prevention, and a culture that glorifies unhealthy eating and guarantees that working parents will not have time to cook healthy meals or engage in physical activity. They frequently work twelve hour shifts with no time for a bathroom break, much less a lunch or dinner break. Then when they leave work, they’re confronted with convenience and drive-thru foods that are packed with saturated fats, sugar and calories. Like the rats in Michael Tordoff’s landmark studies (which I learned about in Food Fight, pages 25 – 26) when given access to large amounts of high sugar and high fat foods after twelve hour periods of forced fasting, they eat much, much more than needed to maintain a healthy weight. The body, used to reacting to a lack of food by eating as many calories as possible as soon as food becomes available, overconsumes when the calorie dense, possibly addictive foods are plentiful.

My nurses are being set up for obesity and all the diseases that come with it. They work twelve hour shifts (that often stretch to 13 or even 16 hours) under incredible stress with few or no breaks for food, followed by immediate, unlimited access to high sugar and high fat foods. At least three days a week, due to work hours, exercise is almost impossible. Their homes are inhabited by children who demand high sugar and high saturated fat snacks because that’s what the food industry markets to kids.

Why do we let this happen? My nurses live every day with the consequences of unhealthy eating and obesity. They care for the heart bypass post-ops. They bandage the wounds of diabetics who lose their limbs. They do permanent damage to their backs when they lift obese patients, often without proper lift equipment because hospitals won’t spend the money to get the right devices. My nurses know that obesity is a major risk factor for the diseases that land their patients in the hospital, yet the pace of their lives, combined with the easy access to junk food and the difficulty of finding or preparing healthy foods, virtually dooms them to develop the same diseases that they treat every day at work.

Kelly Brownell’s attention to the plight of poor and working class Americans warms my union organizer’s heart. In the chapter “The Inexorable Economic March to Obesity,” he and KBH take on the food supply structure that makes unhealthy foods easy and cheap, while healthy foods are more expensive and take more time to prepare. The WIC (Women and Infant Children) and Food Stamps food programs make it difficult to purchase fresh produce in amounts that can be consumed by a family before they go bad. Subsidies for baby formula, plus a need to return to work too early after giving birth, create a disincentive for women to breast feed, even though it’s well documented that breast feeding both leads to better long term health for the children and to weight loss for mothers. Grocery stores are rarely located in inner city low income areas, leaving residents without cars to get their food from fast food restaurants or convenience stores, unless they have both the time and the money to take public transportation long distances to supermarkets, then to haul home large bags of groceries. I remember when I lived in New Haven, the only grocery store in walking distance was an awful place called Gran Central that had less than fresh produce and crowded aisles full of processed foods. To get to a good grocery store, you had to have a car. Inner city residents have few options and very little time in which to pursue them.

Remembering New Haven and that sad inner city grocery store made me wonder about what would had happened had I done more than just meet Kelly Brownell in passing at some point during my undergraduate career. He became Master of Silliman College (one of Yale's twelve residential colleges, where undergrads sleep, eat and do all sorts of other things, including occasional studying, during their time at Yale) in 1994, my junior year. What if instead of being randomly assigned to Jonathan Edwards College (which is prettier and closer to the center of campus) I had been in Silliman? I can imagine the 20 year old me chatting with the 43 year old Master Brownell over dinner in the Silliman dining hall, exchanging eating disorder stories (while I am grateful to have been spared the horrors of anorexia, many of my close friends from high school at Interlochen, including the anorexic cult figure Marya Hornbacher, suffered and nearly died) and tossing around the ideas that would later become Food Fight. Under the influence of someone like KB, I might have fulfilled my father's dream of seeing me go to grad school. Instead of knocking on factory workers' doors all over the South in 1996 and 97, talking to them about the union in a place where organizers get guns pulled on us, I could have been reading scientific articles and designing studies and struggling through statistics class. Instead of sitting in diners all over New Jersey and Pennsylvania at all hours of the day and night, meeting with nurses who desperately want to improve conditions for themselves and their patients but are scared that they'll lose their jobs if they try to organize, from the year 1998 on up until the present, I could have been running to Pub Med to look up references for KB and sending back and forth drafts of book chapters. I could have been text messaging with him in those Congressional hearings! (I recognize that they don't allow cell phones in most legislative chambers, but just go along with the thought experiment, okay?)

I started to experience serious co-author envy. I wanted to be the person who wrote Food Fight with Kelly Brownell! And if it hadn't been for the ridiculous accident of fate that landed me in JE and him in Silliman, I could have been! Sitting in traffic on the Schuylkill (an experience that lends itself to feelings of helplessness and frustration) on my way to a 7 am meeting with nurses, I imagined the life I might have had, the passion I would feel for my work, the delicious, low calorie, nutrient-packed meals I would have made for Dr. Brownell and all our colleagues at the Rudd Center for Food Policy and Obesity.

Then I got to my meeting, and heard again the stories of the crisis in healthcare that forces nurses to organize to protect themselves and their patients. I listened, as I have for the last ten years, to workers talk about their very difficult daily lives, including the schedules that make it nearly impossible for them to stay healthy in a toxic food environment. And as the meeting went on, I outlined for them a blueprint of how they could, by joining together and taking collective action, not only improve their own economic well-being and working conditions, but guarantee standards of safe staffing that would allow them to give their patients the care they deserve.

Even though I have seen it a million times in the last ten years, that moment when a nurse realizes that she, together with her co-workers, has the power to take back her work place and make a difference still sometimes brings tears to my eyes. Showing people that they have power, and providing them with a difficult but workable strategy for making change is what being an organizer is all about. It's what makes the long, long hours, the intense emotional stress, and the occasional physical danger of my job worthwhile. It's why I can live with the fact that, as yet, I have not written a book or exchanged even one text message with Kelly Brownell.

If I had not become an organizer, I might never have learned how to break through the layers of fear and despair that surround most people when confronted with a situation like the crisis in healthcare, or the obesity epidemic, or their own issues with food and health. By thinking like an organizer, I learned how to break down problems and motivate people to take the small steps that lead to big victories. I learned what really moves people to take bold new action (hope, love, and a strategy that makes sense) and what does not (guilt and fear of punishment)
And by spending my entire adult life working with regular working class people, I learned firsthand what Americans are up against when we try to defy the capitalist food pushing culture and live a healthy lifestyle.

Towards the end of the book, KB and KBH describe the social movement that will be necessary to bring about real food change in this country and the world:

If there is any possiblity for major social action and policy change, scientists cannot force it and health leaders can hnot mandate it. The public must demand it. Grassroots calls for change can then join with efforts from the health community, elected officials, and business leaders. For such a movement to occur, people must care.

Caring occurs when something strikes an emotional nerve and we feel sad, bothered, outraged or frustrated. Our heart is moved, and we feel driven to act.

Emotions come from human experience, not statistics or numbers on health care costs. They come from seeing people suffer. As our mothers, fathers, grandparents, aunts, uncles, brothers and sisters suffer strokes, lose limbs to diabetes, die from heart disease, and have painful deaths due to cancer, and we recognize that poor diet and inactivity are major reasons, we are touched as human beings. We want to see the suffering stop.

I'd like to add to that. People take action when they want to see the suffering stop, but only if they believe that they have the power to make change. When they are presented with a concrete plan for action that sounds like it will work, they are more likely to act than when they see suffering (or feel it in their own bodies) but feel helpless to stop it.

Those of us who have taken control of our life and health by forging a healthy relationship with food know that we have the power to make change. Going from being overweight and sick to living in a body that is well-nourished and vibrant with energy is a radicalizing experience. When you stop accepting what the food industry wants to feed you and start feeding your body what it really needs (see that RDA magic diet!) your perspective changes. No longer are weight gain, heart disease and diabetes acceptable as a "natural" consequence of aging. You don't have to be a CR practitioner to experience this shift: most of my readers are either healthy eaters now or moving in that direction, but are not practicing CR for life-extension. Yet most of us believe that something must be done to make the changes we've made in our own lives easier for others to make, and that means changing the current toxic food environment to an environment that supplies and supports healthy choices. While I certainly would never try to convert masses of people to CR, I think that the CR toolbox provides excellent tricks and techniques for beating the obesity epidemic in an obesogenic food environment. As a short term measure for those of us who can't wait for political change, it's a roadmap for losing weight and regaining health. But it's not a prescription for massive public health improvement: the public's health will only improve when the environment supports healthier choices.

Those of us who have already made the change have felt the revolution in our own bodies. We were in pain before, and now we're not. We were suffering before, and now we know that the suffering caused by obesity is not inevitable. (Loving our bodies instead of engaging in constant negative self-talk and fad diets also frees up a lot of time in which we can do more productive activities!) If we can give people the right tools: information about what they're eating and how it affects their health, better, saner choices in supermarkets and restaurants, and time and incentives for exercise, we can go a long way towards preventing the health care apocalypse that lies just a few years in the future if we don't address the ill health of our nation. We are ready. What we need to do now is to organize.

All around the country, people dissatisfied with their own health, or frightened for the health of a loved one, or angry about the poison that is peddled to children masquerading as food, are ready to take action. We vote, some of us know how to organize legislative and public relations campaigns, some of us know how to cook really good healthy food. We can organize to demand healthier choices from the places where we eat, and we can reward food merchants who provide us with the food we want by spending our money there. Already, parents are moving to get sugary soft drinks and junk food out of schools. People are organizing to get rid of transfats in restaurants, just like they organized to get rid of secondhand smoke in places where we choose to breathe. We can do more, but we need a comprehensive strategy that will work.

I've been working on that strategy. I figure that the best way to get rid of my co-author envy is to imagine a world in which Kelly Brownell writes his next book with me. To save him time and energy, I've already come up with the subtitle: Blueprint for a Social Movement to Take Back Our Health. It's about the next steps in creating a grassroots movement powerful enough to take on the food industry. The little amazon.com blurb can read something like this:

Influential public health expert Kelly Brownell teams up with veteran union organizer April Smith to write this practical, straightforward guide for the activist who wants to do something about the obesity epidemic. They envision a network of ordinary people working together to demand greater responsibility and transparency from the food industry. Through pressure on local governments, campaigns against restaurant industry giants who refuse to come clean about what's in the food, organized funnelling of consumer dollars to food merchants who provide healthy choices, parent initiatives to get soft drinks and junk food out of schools, and labor pressure on employers to provide time for and access to exercise, real people can make real change in the toxic food environment that has led 65% of Americans to become either overweight or obese. You'll learn how to train local activists, how to inoculate politicians against food industry propaganda, and how to work with legislative, business and labor leaders to make positive change. If you're ready to do something about the biggest public health crisis facing the United States, this is the book for you.

I know it's just a fantasy, but as anyone who has ever sat on the Roosevelt Boulevard headed south toward the Schuylkill at morning rush hour can tell you, sometimes a fantasy is all you need.

Of course, when we advocate for changes in the American diet, we become a target for food industry front groups. As I mentioned near the beginning of this entry, I was horrified by the level of personal, nasty attacks aimed at KB by people who claim to respect personal freedom. Clearly, the freedom of activists to speak out is not among the protected liberties in their book. In Food Fight, you'll learn about the sugar industry's attempts to intimidate Marion Nestle, author of Food Politics, into silence. You'll also read about their "shoot the messenger" strategy to undermine the credibility of anyone who dares question their actions. I've barely even started, and I'm already receiving threatening messages! Here's my favorite so far:

DAMN, am I tired of the "soccer-mommy" generation attempting to ban adults from enjoying what they like, whether it's fatty foods or cigarettes or porn, FOR DA CHEEEELDRUNNNNNN.

Die in a fire, and do it soon, before you get "very very involved" in helping Philly pass the same Health Nazi laws that NYC did.

This posted by someone who identifies him or herself as "Soccer Mommies Suck."

When you challenge something that makes a profit, especially when it makes a profit at the expense of others' health, you are going to get a reaction.

In the chapter about the outrageous growth in portion sizes in the last few decades, KB and KBH have a chapter heading that I found hilarious:

"Nelson, Party of Four: Your Muffin Is Ready."

If a serving size is a fourth of a muffin, and each muffin is filled with enough calories for four people to eat as a snack, then we should have four people, not one, eating every muffin.

To win the fight against obesity, it will take a whole lot more than one person. It's time for all of us who have felt the revolution in our own bodies to step up to change our food environment so that others can experience the change that has already transformed our lives. Kelly Brownell is amazing, but he can't do it all by himself (or even with his wonderful co-author!) He needs us, all of us, to take action.

I'll be there.

Dr. Brownell, your revolution is ready.

Posted by april at December 28, 2006 9:26 AM

Comments

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