One of the issues Joe and I have touched on in relation to health care before (and which we had to delete from our latest podcast due to time constraints) is that of food, nutrition and healthy lifestyles. Now with the passage of health care reform, moving on to those broader questions of healthy living will be the next logical step. However, I would caution that there are two common traps we could fall into here if we are not careful in our thinking.
The first trap is that of seeing healthy living as a matter of personal responsibility. It’s not. Rather, the problem we face is a systemic one involving our food production and distribution as a whole. And seeing it as a matter of personal responsibility is not only factually mistaken, but also encourages the kind of cruel hyper-individualism preferred by the Right. Under this reading, obesity or a lack of health becomes a kind of secular scarlet letter – a mark of moral failing or lack of personal virtue. This thinking also goes on to undermine social solidarity. Why would we want a universal health care system if it means we responsible and disciplined types will be paying for the consequences of other peoples’ bad habits?
The second trap is a bit more mercurial but equally problematic. This is the tendency to confuse scientific-based knowledge of what constitutes healthy living with the cultural aesthetics of what constitutes healthy living. The first order problem in this case is that money gets wasted on misguided programs that don’t actually do much good. The second order problem is that the particular aesthetic prejudices of American elites wind up being imposed on the less fortunate in ways that not only belittle them, but can make their financial circumstances even harder.
And as much as I like Michelle Obama, I think Daniel Engber is right that her recent push for healthier eating – with a major emphasis on fresh fruits and vegetables – shows signs of falling into trap number two:
This strategy may seem unobjectionable. Why challenge this devotion to plants just tugged from the warm soil? A single-minded focus on fresh produce distracts us from the bigger problem: Our children are suffering from a lack of any fruits or vegetables whatsoever. Canned, frozen, dried, juiced—anything would help. Here’s a simple dictum for public health, endorsed by nutritionists across the land: All forms of fruits and vegetables matter.
I know it sounds weird. A crisp salad of watercress and red onions must be more wholesome than, say, a pile of defrosted spinach and some canned beets, right? Not according to any practical measure of nutritive content. Researchers have been studying this question for a long time, and the results are clear. According to a 2007 review paper from UC-Davis,* levels of vitamins, minerals and fiber are similar across fresh, canned, and frozen products. It’s worth noting that the Davis study, and some others like it, were conducted with grants from the canned-food industry—but their findings have not been discredited.
In fact, most public health experts will tell you that frozen produce can be more nutritious than locally grown crudités. That’s because processed foods are harvested at peak quality then packaged so as to arrest the natural processes of respiration and spoilage. A few nutrients may be lost—canning is particularly hard on vitamin C, for one—but the rest are more or less locked in. A fresh bunch of spinach, by contrast, starts bleeding vitamins from the moment it comes out of the ground, and continues to wilt over the course of its long journey to your refrigerator.
Now that you’ve read that, go back to Engber’s earlier point – the lack of any fruits or vegetables whatsoever in the diets of many children. Why is this happening? In a word: economics.
So what happens if you don’t have much money for food? The easiest way to maximize taste, cost, and convenience—the three most important elements of food choice—is to skip fruits and vegetables altogether. Dietary bogeymen like refined grains, added sugars, and added fats happen to be both cheap and delicious.
I would add that this is not simply a problem of an individual in poverty, or of how much any one person can spend on food. It’s a problem of impoverished areas, because the economic circumstances of a given community will determine what resources a person living in that community has access to. For instance, Joe and I have been keeping tabs on a free health care clinic that serves the poorest of the poor here in Los Angeles. And one of the striking things we learned is that many poor Angelinos are unhealthy because they have no access to grocery stores at all. The only places they can go to shop are liquor stores. I think you can imagine the limitations, not just on quality, but on types of food which they have to deal with. Those of us in the middle and upper classes simply do not have to deal with these problems – our difficulties are merely that of buying the canned and processed foods, or spending the few extra bucks for fresh produce.
Access to cheap and convenient food – processed or fresh – is what matters for the health of the poor. This is one of those circumstances where capitalism has actually enabled huge strides in humanitarian and progressive goals. Our modern industrial food system produces huge amounts of cheap and convenient food, canned goods, non-perishables, etc. And this abundance has helped alleviate poverty and hunger both here in America and throughout the world. The problem, of course, is that in pursuit of cheap and abundant production (and due to some very stupid federal policies) our industrial food system has increasingly turned to methods that pump huge amounts of sodium, fat and sugar into those processed goods. What this tells us is that our proper goal here should not be avoiding the industrial food system, but reforming its internal workings. To rein in its worst excesses. This can only be accomplished by collective reform, assistance and regulation at the national level, which gets us back to the fallacy of seeing nutrition as a matter of individual responsibility.
Let’s be honest with ourselves here: Michelle Obama, her husband, and everyone else who is a part of the healthy living movement tends to hail from a very particular subculture of high-earning and college-educated liberals. And this subculture’s emphasis on healthy living tends to come in the form of love affairs with farmer’s markets, alternative produce stores such as Whole Foods, and a general desire to solve the nutrition problem by routing around the industrial food system entirely. (This is isn’t a knock on them. Or, to the extent it is, it’s a self-deprecating knock. I hail from this subculture myself.)
But these options are only available to them precisely because they are high-earners, and they’re also options which largely result from the aesthetic preferences of that same subculture:
By insisting that food from the farmer’s market tastes better and improves your health, our fruit-and-vegetable policies mix up science and culture. Under the guise of evidence-based public health, they export a set of values from one social class to another. They’re reinforcing the idea that fresh is the only kind of produce worth eating—even though it’s more expensive and less accessible than canned and frozen. In that sense, fresh subsidies may be self-defeating: They improve access to one kind of health food while stigmatizing the sensible alternatives.
In other words, if we attempt to take the preference for going outside the industrial system entirely and impose it on the nation as a whole, we could very well be hanging the poor and the impoverished out to dry.