ONE THIRD OF OUR ECONOMY THRIVE ON MAKING PEOPLE SICK AND FAT. Big Farming grows 500 more calories per person per day than 25 years ago because they get paid to grow extra food even when it is not needed. The extra corn (sugar) and soy (fat) are turned into industrial processed food and sugar-sweetened beverages—combinations of fat, sugar and salt that are proven to be addictive. These subsidized ($288 billion) cheap, low-quality foods are heavily marketed ($30 billion) and consumed by our ever-widening population with an obesity rate approaching three out of four Americans. The more they eat, the fatter they become. The fatter they become the more they develop heart disease, diabetes, cancer and a myriad of other chronic ailments.
Today, one in 10 Americans have diabetes. By 2050 one in three Americans will have diabetes. The sicker our population, the more medications are sold for high cholesterol, diabetes, high blood pressure, depression, and many other lifestyle driven diseases. The Toxic Triad of Big Farming, Big Food, and Big Pharma profits from creating a nation of sick and fat citizens.
This structure is built into the very fabric of our economy and culture. It could be called the medical, agricultural, food industrial complex. It is what is known as “structural violence”—the social, political, economic and environmental conditions that foster and promote the development of disease.
But there is a way to turn the Toxic Triad into a Health Trinity. Through innovation and creativity we can create a new economy based on products and services that make people thin and healthy instead of sick and fat. Business can do well by doing good! We just have to change the default choices and behaviors both at a policy and a grass roots level. I learned a few things about this in Haiti from my friend Paul Farmer.
Addressing Structural Violence
When I was in Haiti in January 2010, after the earthquake, I visited Zanmi Lansante, the health center started in the 1980’s by Dr. Paul Farmer. Much to the world’s amazement he showed how, in one of the poorest places on the planet, he could successfully treat complex infectious diseases such as tuberculosis and AIDS. The conventional wisdom was that poor people sleeping on mud floors would not take complex regimens of medication so we should essentially leave them to die. The problem wasn’t that doctors didn’t know what medications to prescribe, but that poverty and social conditions such as lack of access to health care, food, shelter, jobs, clean water, and sanitation prevented effective treatment.
Paul Farmer didn’t accept this. Through his foundation, Partners in Health, with the help of the Clinton Foundation and the Gates Foundation, he demonstrated the flaws in conventional “wisdom” and has successfully treated “impossible to treat patients in impossible conditions” around the world. He did it because he addressed one simple thing: Structural violence.
To successfully treat people in Haiti, Paul Farmer did not simply focus on what medication regimens were needed to cure tuberculosis or treat AIDS. He “accompanied” patients into their lives. By using local, trained community health workers he helped patients change the conditions of their lives, find shelter, food, jobs, clean water and sanitation—all necessary “structural” changes that allowed for effective treatment. He addressed the system, not just the symptom.
We must do the same if we are serious about addressing the wave of chronic illness sweeping across the world. We must focus, not only on the individual, but the system that has created 1.7 billion overweight citizens worldwide if we are to slow and reverse the national and global epidemic of obesity, diabetes, and heart disease threatening not only our health, but the survival of our economies.
Big Food and Big Farming and Big Pharma: How They are Killing Us
The default condition of a human being in the 21st century is to be obese. Nearly 75 percent of Americans are overweight. This is not an accident. Specific, traceable forms of structural violence promoted by Big Food, Big Farming, Big Pharma (see my recent blog on “Dangerous Spin Doctors”) and government polices is leading to the global spread of obesity, diabetes, heart disease and cancer.
Current food policies and subsidies encourage Big Farming to overproduce corn and soy which are then used to create sugary, fatty, factory-made, industrial food products sold as processed, fast, or junk food as I noted above. The government essentially stands in line next to you in fast food chains helping you buy cheeseburgers, fries, and cola. But in the produce isle of your supermarket you are on your own—the 2010 Farm Bill offers little support to farmers for growing fruits, vegetables, and healthy whole foods.
The resultant omnipresence of cheap, high-calorie, nutrient-poor processed foods (or “food like substances”) in homes, schools, government institutions and food programs, and on every street corner creates default food choices that drive obesity. How can you eat fruits and vegetables when you can’t buy them in your neighborhood convenience store or their price has increased five times as fast as sugar-sweetened beverages?
Big Food takes advantage of this glut of processed food to drive up profits through the use of mass media technologies. Other than drinking sugar-sweetened beverages, the number of hours of screen time or television watching is the single biggest factor correlating with obesity which, in turn, drives the diabetes epidemic. In addition to the metabolism-slowing, hypnotic effect of watching television, relentless food marketing focused on children is one of the major factors driving this problem. The average two year old can identify, by name, junk food brands in supermarkets, but many elementary school children can’t readily differentiate between a potato and a tomato as Jaime Oliver recently demonstrated.
Big Food claims that the problem is one of personal responsibility— that processed foods can be part of a healthy diet as long as they are eaten in moderation. But the more we delve into the research on food marketing practices, the impact of food deserts where healthy foods simply can’t be found, and the biologically addictive properties of these overly available cheap, high-calorie, nutrient poor junk/processed foods, the clearer it becomes that environmental factors override our normal physical and psychological mechanisms that control weight.
There is an element of blaming the victim in all of this that misses the structural violence—the environmental conditions—that drive obesity and disease and lead to what is not being called an “obesogenic” environment.
As I explained in my recent blog on food addiction, it is not a failing of personal responsibility, moral fiber, or will power that drives people to over consume these unhealthy foods. Industrial, processed food has been found to be addictive. We are like rats in a cage with unrestricted access to processed sugar and fat. When given a choice between cocaine and sugar, rats always choose sugar. So do we.
Poverty and food scarcity also drive poor food choices and are linked to obesity, and diabetes. The poverty rate in 2009 was 14.3 percent, the highest since 1994. As I pointed out in my article “Not Having Enough Food Causes Diabetes” there is a correlation between the poverty rate and the obesity rate. The poorest states in the nation are the fattest.
The government’s approach to these issues echoes Big Food. Government interventions like industry initiatives are predicated on education and encouraging personal responsibility. The rhetoric is that regulating the food industry strips away our right to choose, and that the market should be self-regulating.
It’s true that market-driven forces often do effectively control commerce. Companies can produce and sell poor-quality products, and if consumers choose to not buy them the market regulates itself—companies begin supplying what consumers demand instead. This model works in our society unless those products affect our health, safety, or the greater social good. In this case, we expect our government to step in and take action.
Consider cars or medication. The government has mandated the production of safer, less polluting cars and protects us from harmful medication. In cases like these, government regulation is accepted. Poor diet causes many more deaths than auto accidents, yet as a society we resist government regulation over Big Food. Why?
If our normal protective biological mechanisms don’t work in this toxic food environment—and they don’t—it is lack of government oversight that erodes personal freedom. Big Food may make the right “noises,” but it will not self-regulate just as Big Tobacco wouldn’t.
Perhaps more to the point, there is an element of blaming the victim in all of this that misses the structural violence—the environmental conditions—that drive obesity and disease and lead to what is not being called an “obesogenic” environment. The main factors of which are:
- Industrial processed, fast, and junk food is addictive. Processed food full of sugar, fat, and salt is neurochemically, biologically addictive in the same way cocaine, heroin, nictoine and caffeine are addictive, and it increases food and calorie consumption and obesity as a result.
- Big Farming’s influence over the global increase in obesity. Agricultural practices and government subsidies promote the growing of cheap corn and soy which is turned into the sugar, fat, and processed food that drives disease and fosters the spread of this cheap, calorie-dense, nutrient-poor food across the globe.
- Unethical, manipulative food marketing that drives eating habits. There is very little government control over Big Food’s marketing practices which shape behavior in insidious ways, especially in children.
- Poverty’s relationship to obesity and disease. Poverty promotes obesity, diabetes, and chronic disease because processed food is cheap while being high in calories and low in nutrients.
- The destruction of the family kitchen and home cooked meals. The family meal, and family and local food culture, has been replaced with convenience or fast foods. This has led to a generation of Americans who can’t recognize any vegetable or fruit in its original form and can’t cook except in a microwave.
- Obesity is contagious. You are more likely to be obese if you have fat friends, than if you have fat relatives. Social norms promote weight gain.
- Environmental toxins. These contribute to weight gain, obesity, and diabetes. Not only do we have to worry about what we eat, but also the burden of plastics, metals, and pollutants which have been shown to poison and slow our metabolism leading to weight gain.
Important initiatives have been created by the Obama administration within the health care bill and Michelle Obama’s Let’s Move program that mark a beginning of a shift that needs to happen in our food climate, but to really change our obesogenic environment we need to create healthier default choices for citizens. We must focus on specific actions we can take personally and politically to alter our food landscape.
Ending Structural Violence: What We Can Do to Create a Healthier Nation and World
What can be done to change the social and economic conditions that fuel the fattening of America and the world? The public can vote with its fork and with the ballot! Here are some choices we can start making individually and as a society today:
- Eliminate unhealthy foods from all schools, child-care and health care facilities, and all government institutions. The government must establish rigorous standards for school nutrition consistent with current science (through the USDA). Similarly, we need to create nutrition programs for other public and government-run institutions.
- Stop food advertising to children. Food marketing directed at children should be banned (through the FTC). This has been done in over 50 countries across the globe including Australia, the Netherlands, and Sweden. We should follow suit. The FDA should also restrict unproven health claims on labels.
- Develop more funding for nutritional science. Congress should mandate greater funding of nutritional science and place guidance for dietary policy with an independent group such as the Institute of Medicine.
- Change the Farm Bill. Agricultural policies should support public health and encourage the production of fruits and vegetables, not commodity products like corn and soy.
- Lobby reform. We must change campaign finance laws so that corporate political donations from entities like Big Food, Big Farming, and Big Pharma can no longer control the political process.
- Tax sugar. Scientists suggest a penny an ounce tax on sugar-sweetened beverages. This would reduce consumption, obesity, health care costs, and provide revenue to support programs for the prevention and treatment of obesity.
- End irresponsible relationships between medicine and industry. Public health organizations like the American Heart Association and the American Dietetic Association should avoid partnerships, endorsements, or financial ties with industry that compromises their independence and credibility. Coca-Cola sponsoring events at the American Dietetic Association, or the American Heart Association promoting chocolate sugary cereals as heart healthy because they have a few grains of whole wheat—is this credible?
Perhaps the most important initiative we could enact is the creation of a “Health Corps for the nation—a workforce of community health workers to educate and support sustainable change by addressing structural violence in homes, schools, the workplace and most institutions. By following Paul Farmer’s model in Haiti, we would create jobs, improve health, and lower health care costs.
My friend, Memhet Oz, has started working on this. He created HealthCorps, an organization that trains college students in lifestyle change and then provides them with the infrastructure to go into schools and communities around the country and share what they have learned. We should follow this model on the national level.
If pushed, Big Farming can start growing healthy food to feed the nation and Big Food can come up with innovative solutions that satisfy consumers and supply healthful, economical, convenient, and delicious foods for our world. However, these industries will not police themselves.
With appropriate checks and balances put in place by government, it can become profitable to create products and foods that create and promote health. When this happens the Toxic Triad can become the Healthy Trinity!
To learn more about how we can change our obesogenic environment, end structural violence, and create policy to guide us toward health see the recent blogs section of drhyman.com.
To your good health,
Mark Hyman, MD
This article is great! It provides specific things that can be done. Thomas Jefferson said that the role of government is to protect us from harm from without and to prevent us hurting each other. The role of government is to protect us from preditory behavior of others beginning with military force outside our borders and criminal behavior within. But it does not end there. Big Food, Big Farm and Big Pharma are preditors, along with other big powerful industries and corporations that prey on the citizenry to feed their greed. They will not regulate themselves and they resist attempts by government to regulate them by screaming “Big government!! and socialism and economic interference with the free market system etc.” they use their money to buy poloitical influene. We have to keep informing people until the movement reaches critical mass and can’t be stopped.
o
GARDENS/MINI-FARMS NETWORK
Workshops: USA – TX, MS, FL, CA, AR, NM, WA; México, Rep. Dominicana, Cote d’Ivoire, Nigeria,
Honduras, Kenya, Malawi, Mozambique, Haití, England, Nicaragua, India, Uzbekistan
Workshops in organic, no-till, permanent-bed gardening, mini-farming, mini-livestock farming, using bucket drip irrigation, in Español or English
Healthy Eating
For wellness and weight loss
“The rapid rise in consumption of ultra-processed food and drink products is the cause for the rapid rise in obesity and related diseases in the world.” http://www.theatlantic.com/food/archive/2010/11/how-ultra-processed-foods-are-killing-us/65614/
EAT: [organic, if possible. From: garden, CSA, farmers, ranchers, farmer's market, farm stand]
1. Bread, tortillas: 100% whole grain
2. Butter
3. Cereals: 100% whole grain
4. Chocolate: natural dark
5. Coffee
6. Dairy [grass fed]: whole milk, cream, cheese, yogurt, full-cream powdered milk.
7. Eggs [free range]
8. Fish: farm raised?
9. Fruit: fresh, frozen, canned, dried
10. Grains: whole
11. Juices: pure fruit
12. Meat [grass fed,]: fresh, frozen, canned
13. Nuts
14. Oils: unrefined, cold pressed
15. Pasta: 100% whole grain
16. Poultry [range raised]
17. Sesame seed: unhulled, organic. anti-constipation
18. Sugar: Stevia, Deremara
19. Tea
20. Vegetables: fresh, frozen, canned, dried
RARELY EAT: [read labels]
1. Chips/snacks
2. Corn syrup
3. Fast food [most but not all]
4. Fried foods [only at home]
5. Frozen dinners
6. Processed foods
7. Salt
8. Soft drinks
NEVER EAT: [read labels]
1. BHT, BHA, TBHQ
2. Brominated vegetable oil [BVO]
3. Colors, artificial
4. Energy drinks
5. Flavorings, artificial
6. Flour – bleached
7. Food dyes
8. Food from China
9. Fruit drinks
10. Genetically modified [GMOs]: Hawaii pineapples, Aspartame, AminoSweet, MSG, etc.
11. HF corn syrup/corn sugar
12. Hydrogenated oils: Crisco, etc.
13. MSG [names such as natural, hydrolyzed vegetable protein, yeast, malt flavoring, yeast extract, textured protein, etc]
14. Nitrates/nitrites
15. Oils: cottonseed, palm
16. Olestra
17. Packaged cereals
18. Packaged mixes
19. Sweeteners: Aspartame, AminoSweet, Equal, NutraSweet, Saccharin, Sweet’n Low, Sucralose, Splenda, Sorbitol, etc.
20. Vegetable drinks
READ/View: [I have the following]
1. Article: “What Really Makes US Fat” Mother Earth News, Oct/Nov 2008
2. Book: “Eat Fat; Lose Fat” $11.
3. “Food Inc” – factory dairies, poultry, etc.
4. “Toxic America”, CNN, Dr. Gupta
5. “Flu Factories” Boy near Mexican pig factory [American owned] was first case. humansociety.org/swineflu
In the supermarket, do not use a cart [must for junk food]; use a hand basket [large enough for real food].
Ken Hargesheimer, minifarms@gmail.com
The reason I like Dr. Ron Paul so much is that he applies Hippocrates’ “First, Do No Harm” to the political sphere. And the same exact principle applies here — STOP SUBSIDIZING SICKNESS (processed foods, drugs, etc.). I think an initiative to stop taxpayer subsidies to processed foods would be a winning strategy — with someone like you or Michael Pollan to champion it. Otherwise we will keep going in the same self-defeating feedback loop of subsidies and sickness. And no tax / regulation / restriction will really do anything to remedy the situation. Since organic foods have been such a growth industry, why not just let free consumers in the market have their way? America is based on individual freedom and it is our birthright — wouldn’t Jefferson also champion such a concept of natural health liberty?
This is an excellent article!! It is exactly what I have been trying to tell my friends and family for years! But they thought I was paranoid and would not listen. I hope and pray that Dr. Hyman’s ideas and methodolgies are able to penetrate the fog of food addiction for our nation on economic, cultural, and personal levels.
Thank you, Dr. Hyman, for your work that can affect the world in such a powerful way!
I think that a “health corps” that would follow people into their homes would be way too intrusive. It is a good idea to eliminate agricultural subsidies.
One thing that could be mentioned as contributing to obesity is the excessive use of psychiatric drugs in our society. Too often, children and othersare pathologized as being “bipolar” because of emotional highs and lows. Young peoples’ natural energy and enthusiasm is now more likely to be pathologized as “bipolar mania”. This causes prescription of toxic drugs to suppress emotions which often have the effect of slowing metabolism and increasing the risks of both diabetes and obesity. For more information, please visit http://www.wildestcolts.org or http://www.icspp-online.org.
Excellent article. Thank you. Good pointing out the addictive nature of the fat/salt/sugar combination in foods, not just comparatively speaking to narcotics, but with results that show this to be the actual case. That is a forewarning, one we (I) have to mount a fight against to prefer & select whole foods over the convenient, bad foods in the midst of hunger pangs. Here, structurally, we also no longer ‘prepare’ for having better foods, that is, prepare for the dinner table, as you noted, reserving time for preparation, since we often work late or do things that prevent taking the time to prepare better meals.
I would add to this article the terrible fact that CEO’s & other executives of Big Food and Big Pharma (and probably Big Farming) have been permitted to swap in-and-out of national/congressional government oversight roles/offices, making for unconscionable political and monetary payoffs as well as passing their own rules, regulations, and laws to concretize their structural violence systems. This should be outlawed; this incestuous behavior has infected our political systems and like the hidden, growing black rot at the core of a fruit, is what keeps this problem festering in Washington’s District of Corruption.
While I agree with a large proportion of your article, I think you are somewhat ill informed about agriculture in the USA. I was raised on a Kansas farm and currently farm several thousand acres in Western Kansas and Eastern Colorado. Myself and the vast majority of grain farmers that I know, who grow wheat, corn, and soybean, are motivated primarily by the price we get for these commodities. This price is determined by the futures markets in Chicago and Kansas City which relflects world wide demand. While we do receive government subsidies, they are not large enough to affect our cropping decisions. We farmers, like doctors, (I practiced optometry for 40yrs), are motived by what our land is capable of producting, and what the world market will pay us for it. Very few of us do anything to promote or to create this market.
While it is appealing to ask for greater government controls, always remember who controls the government. Government is controlled by the established wealthy and big business. Do you really think that those in power will do something not in their best financial interest? Plus, what has happened in the past with tight governmental agriculture controls? China in the ’60 lost approx. 40 million people to starvation. Russia’s agriculture cannot feed their citizens.
Also, how can we expect a government that allows drugs to be advertized to solve our problems.
While it may seem to be the worst solution, I believe that total freedom from government will ultimately give a long term solution to our problems. But, I also laud your efforts to try to change the current establishment.
I am delighted to read through your articles, research and findings on
how we could live a better healtheir life. We are what we eat.
As an African, the foundation I inhabited of eating got polluted when
I crossed over to the western world over thirty years ago. The old
fashioned way of food preparation and eating ought to be established
so that we can live a better life with healthy choices.
Attacked by stroke two years ago, my life has changed drastically. I am
living with diabetes and high blood pressure which I am trying to control
with watching my diet and using prescribed meds. I have just finished using
a three months supply of an oral chelation therapy supplements by Dr. Gary Gordon . Although the swelling in my left leg has reduced, the leg is still heavy
with a continous constant twitching pain. I still have stiffness in my left fingers
and also looking forward to regain functionality in my left hand/as to raising it up.
Dr. Hyman, I need your advice please. Thanks
Essy
Thank you, Essy, for your message and your interest in Dr. Hyman’s work. Your question and constellation of symptoms represents a complex medical condition. Questions regarding conditions like these cannot be answered in a responsible manner via the Internet.
If you would like information on becoming a patient at The UltraWellness Center please see “How to Become a Patient” at http://www.ultrawellnesscenter.com. That site is designed to give prospective patients a comprehensive source of information about The UltraWellness Center. You may also feel free to call The UltraWellness Center at (413) 637 9991.
Regardless of becoming a patient at The UltraWellness Center, it sounds like you need to consult with a doctor. Please seek medical attention for the issues that you outlined in your message.
Wishing You the Best of Health!
The quote in large type reads “There is an element of blaming the victim in all of this that misses the structural violence—the environmental conditions—that drive obesity and disease and lead to what is not being called an “obesogenic” environment.”
It should read “now” instead of “not.”
I was deeply disappointed in Secretary Tom Vilsack’s aid to Monsanto in the approval of genetically modified alfalfa. I am also deeply disappointed in the Obama administration’s seeming disinterest in supporting GMO labeling. I don’t understand why we, the consumers, don’t have the right to know how our food is being produced? Although I now cook almost everything I eat from scratch and shop at farmer’s markets, during the winter, in particular, it is necessary to do some shopping in stores. If GMOs are as safe as Monsanto and Secretary Vilsack imply, what is the harm in labeling them?
Thank you for your good work Dr. Hyman.
Thank you for an insightful, timely and overdue message. A major problem with getting your points across is that most of those who even bother to read info like this don’t need to be convinced, so the message goes no further than the “choir”. And while government agencies might be best positioned to deliver the message, with all the political partisans, anti-government fanatics and anti-Obama racists — not to mention the companies and their lobbyists that are making a fortune producing deleterious products — the deck is stacked against effective government intervention without multiple other voices pursuing the same agenda. Another problem with messaging is that too many people are to poorly educated to understand what is being said. The message has to be simplified to such an extent that even the poorly educated and illiterate can understand and “get it”. This means there must be a healthy dose of explanatory examples that drive home the point(s). Finally, your messages must take into account the fact that, as with the healthcare bill and most other things in modern life, the will be both intentional and unintentional misrepresentations, misstatement, not to mention outright spin and lies. All of these issues (and several I haven’t thought of) will have to be addressed for meaningful reform and regulation to be effected. Again, thank you for taking on a monster that needs to be addressed.
An example of big Pharma takeover, here in Canada Bill 36 is now in the process of taking away 50% of our natural health products. There have been 20,000 products taken away from us that were not long ago available to us from USA. Police state anyone? Canadians’ choices for health maintenance are becoming dictated by Health Canada. While the super caffeinated “Red Bull” has been approved and consumed by kids,a encapsulated “parsley” by your Natures Sunshine has been refused a NPN (natural product number) Who really has the control here? An angry Canadian
Awesome article. I have written my representatives (both in the US and Canada) about many of these issues and it feels like I’m jousting at windmills; I hope you are successful in expanding a grassroots movement for reform. I do see a few changes here in Canada re. the pharm industry but not nearly enough.