the palate

Obesity is not a new problem to the everyday American. Over the last few decades, we have been bombarded with news of overwhelming obesity and of the alarming childhood obesity running rampant. In the hospital, we see countless patients coming in with obesity as a direct cause of their acute presentation or obesity as an inseparable compounding factor. Sensational television and Internet series highlighting the lives of obese patients suffer through have created more awareness of this complex issue.

With nine out of 10 Americans consuming too much sodium and over 70 million people suffering from hypertension, physicians, government, and industry must develop a joint public health intervention. Ultimately, it will take a synchronized effort -- the public understanding the effects of the sodium in the food they eat, consumers demanding lower sodium in their purchase options, the government setting out goals and guidelines for sodium reduction in food production, and the food industry responding to these coordinated calls for change -- to reduce the salt in our food.

The struggle to overcome polarization in the debate regarding food subsidiary program funding and regulations is not a new one. However, this is the first clinical trial conducted to examine the effects of incentivizing or placing restrictions on the food choices that low-income individuals and families have via a food subsidiary program modeled after SNAP.

Last week, a review published in JAMA Internal Medicine undertook an historical analysis of a set of documents related to research on sugar and its role in the etiology of heart disease. A healthy diet cannot come down to solely one ingredient, so while it is indisputably crucial to discuss and be exposed to the harms of sugar, let us not let this outrage drown out the rest of the conversation.

Unfortunately, food at public schools within the United States. is notorious for its poor quality, even though millions of children rely on it everyday for their nutrition. As physicians, we can work to improve the health of children by advocating for increased school-lunch funding, curricula that connect our children with their local food system, and encouraging the elimination of fast foods and vending machines from our schools.

We know that obesity is linked to chronic diseases such as diabetes, hypertension, and cardiovascular disease, but is there a link to overall mortality? This past July, the Global BMI Mortality Collaboration published a global meta-analysis examining the relationship between body mass index and all cause mortality. Lowest all-cause mortality was seen in those with BMI between 20-25. A higher risk of mortality was seen in the populations both below and above this range.

By reducing meat consumption to the 90 gram daily limit suggested by the Harvard healthy diet, greenhouse gas emissions could be reduced by billions of tons and cut climate change mitigation costs in half. Decreasing meat consumption even further would compound the benefits, as plant-based alternatives to meat produce 20 to 150 times fewer emissions per unit of protein.

Providers in the Penn State Health System in Central Pennsylvania will be able to prescribe a weekly box of fresh and locally grown produce to patients identified as either at-risk for chronic disease or food insecurity through a new innovative program called Penn State ProduceRx.

A better understanding of the epigenetic mechanisms involved in metabolism may inform our ability to affect health outcomes with early nutritional interventions, creating a new interface for disease prevention and public health intervention with the next generation.

The patients at the WCCC are uninsured, and they often work multiple jobs, with long hours and low wages. In some ways, they’re not so different than medical students when it comes to budgeting their time and money for food, and their concerns are shared by many.

The Palate, interviewed Meghan Bhatia and Monica Mullin, second year students at Queen’s University School of Medicine in Ontario, Canada. Meghan and Monica, who both interested in nutrition and student wellness, created a cookbook of student recipes during Queen’s Wellness Month.

Physicians can prescribe coupons that are redeemable for free or reduced fresh produce either directly in their clinic or through partnerships with retailers or farmers markets.