By Kelly D. Brownell, Ph.D.
[Kelly is the director of the Rudd Center for Food Policy and Obesity at Yale, and a leading advocate for sensible nutrition. His influence is tremendous – though I wish it were even more so – and he is a major force behind the national push for the soda tax. (Which I wrote about here.) We’re hoping to coax him for updates on his work and his insights regularly. – mb]
A profound and welcome change has swept the country. Once relegated to the backwaters of public policy, nutrition issues such as childhood obesity have exploded into the limelight and captured the attention of public officials who now realize something must be done. Though “treatment” remains popular, the prevailing public health view is that we must focus on prevention, and that officials must change the factors driving poor nutrition.
The urge to act can be found at all levels of government, and there is support from surprising quarters. For example, a group called Mission: Readiness, run by senior retired military officials, recently announced that obesity and lack of physical fitness threatens national security because only 1 in 4 youth ages 17-24 meet minimum standards for military service. [Check out this frightening and ironically amusing PDF – mb.]
The food industry has tried to contain government action, claiming it can police itself, but fewer public officials are biting, and industry must feel as if the genie has left the bottle. The restaurant industry fought menu labeling in restaurants with lobbying and lawsuits, but menu labeling has now been signed into federal law. Trans fats have been banned from restaurants in many states and cities (and the entire country of Denmark). Santa Clara County in California just set nutrition standards for fast food meals that come with toys. School systems around the country are kicking out soft drinks and snack foods, and the most controversial action of all, and the one opposed most aggressively by industry, taxes on sugar-sweetened beverages, is being seriously considered in 15 states and cities.
The role government is to play in nutrition is being shaped right here and now; yet some question whether government should be involved at all, worrying about “nanny states,” ineffective government action, and a slippery slope whereby innocuous first steps pave the road to intrusion into personal freedoms. Pitted against this is the position that government is already involved in nutrition (e.g., by establishing subsidy policy that favors some crops over others), that protection of the public’s health is squarely in government’s sweet spot of responsibility, and that too many years of inaction have created a slippery slope whereby industry has had its way, abused the public trust, and aggressively recruited children as customers.
The stakes are high for government leaders, for industry, and for public health, so it’s important we get this right. Until recently, government has taken the role of cheerleader, not involved in the game but imploring people from the sidelines to play harder (that is, eat better). Those days have passed and now government is actively involved in the game. Whose side do you want it to be on?
One can imagine a constructive role for government by thinking of defaults. The public’s health is affected by default conditions such as the quality of the air we breathe and the water we drink. There are food and physical activity defaults, too, and for the most part they’re terrible, and they make healthy decisions increasingly unlikely. Portion sizes have grown enormous, pricing incentives encourage purchase of large quantities of calorie-dense foods, schools sell junk food, marketing budgeted is powerful and relentless, and physical activity has been subtracted from the school environment. And that’s just a few examples.
We deserve healthy defaults, and this is especially true for children. Scaling back industry practices that contribute to ill health, creating better food and activity conditions, and doing so in ways that support parents, protect vulnerable populations, and make it easier for people to lead healthier lives seems a reasonable and responsible role for government to play. It is now assuming just that role, and rightfully.