Last Saturday I had the pleasure of volunteering at Slow Food San Francisco’s first annual Childhood Obesity Bay Area Conference at the Commonwealth Club. The conference featured two truly illuminating keynote speeches from Dr. Alan Greene and Dr. David Kessler. I was impressed by the ability of both speakers to boil down this country’s obesity and food problems to very simple, and addressable, root causes: 1) unhealthy taste preferences shaped early in childhood and 2) public acceptance of eating crappy food. The conference left me inspired and excited. Thanks to Laura O’Donohue for pulling it all together!
In case you missed the conference, here’s a summary of what I learned.
Dr. Greene’s answer: get kids to like healthy foods early and ban white rice cereal from babies’ diets
Dr. Greene kicked off by proclaiming that solving the childhood obesity epidemic is “within our reach” and that we as a country can “make significant progress on this issue within a year.” He flipped through one of my favorite series of charts related to obesity: the map of our country with obesity rates by state from 1985 to 2010. His point was, obesity rates are moving rapidly and we can change the trajectory. The difference between the map from 2010 and 2000 is huge, and we can reverse that change over the next ten years.
Animals learn food preferences. They aren’t born with them. At birth, a child could learn to like any food from any culture on the planet, just like he or she could learn to speak any language. There’s a period of ~33 months, starting from before birth until walking, when children are open to new flavors (after walking, neophobia sets in, which makes sense: evolutionarily-speaking, you don’t want your newly-mobile kid walking around and putting new things in his or her mouth). During this pre-walking 33 month window, if a child experiences a flavor 6-10 times, 85% of them will like it. The catch is that 94% of parents will give up on getting their children to eat a specific food before six times. Only 1-2% of parents will try a food ten times. Therefore there is a huge opportunity in driving the tastes of the next generation that is not currently being seized.
If parents aren’t trying more than six times to get their kids to eat their veggies, what are they giving their infants? For the past few decades, 98% of the time, a baby’s first solid food has been white rice cereal. This has been the standard pediatrician recommendation for the past 50-60 years (reinforced by tons of Gerber marketing, “you can’t make baby food yourself, trust us instead…”). On average a baby has eaten white rice cereal 14 times before eating any other solid food. By the time it hits the intestines, white rice flour is 100% glucose and has the same affect on a baby’s metabolism as eating pure sugar. Not only does this practice imprint taste preferences for refined carbohydrates and sugars, hooking kids on junk food for life, but it also causes insulin spikes and fundamentally changes a baby’s metabolism. It’s no wonder that a big chunk of childhood obesity occurs by the time children are only nine months old.
So, to sum up Dr. Greene’s point, there is a long list of problems contributing to childhood obesity including supersized meals, sedentary lifestyles, the demise of family mealtime, and unhealthy school lunches. But if we don’t set our kids up for success from day one, introducing healthier eating later in life will not be enough. There is a clear opportunity to make an impact by changing what kids eat in their first three years. This opportunity has inspired Dr. Greene’s WhiteOutNow movement to end white rice cereal for babies by Thanksgiving 2011. Read more about WhiteOutNow on Dr. Greene’s site.
Another interesting tidbit from Dr. Greene’s work: slowing down eating can also be super powerful in addressing obesity. From a study of four-year-olds at a buffet, the biggest driver of future weight gain was not the type of food eaten or the quantity but the number of bites per minute. At 3.1 bites per minute, kids were significantly more likely to be obese. At 2.2 bites or less, they were unlikely. This boils down to an eight second difference in the duration of each bite. This finding has been reinforced by experiments with the mandometer plate: a plate that tells you to slow down. Using the plate successfully slows down a person’s eating and can have lasting impact on BMI even after the plate is taken away. Too bad the plate isn’t available in the US and is prohibitively expensive. New startup to cheaply slow done eating, anyone? Please?
Dr. Kessler’s answer: create a social stigma around eating junk food
Dr. Kessler came at the issue of childhood obesity from a different angle. He recounted a memory of watching a woman being interviewed on a talk show. She was intelligent and successful in her professional life, but she could not control her eating. She was regularly engaging in eating behavior that she knew was making her obese, but she couldn’t stop herself. Dr. Kessler was captivated by the question, what is causing us to be out of control with regard to food? What drives wanting as distinct from liking?
Dr. Kessler dove head first into brain chemistry, leaving me and my high school-level human biology knowledge well behind. However I did manage to gleam the following tidbits (bear with me for blatant misuse of scientific terms, I’m sure…):
- In overweight individuals, there is excessive amygdala activation both in anticipation of food and until there is no food left (versus in healthy weight individuals, activation ceases at the first bite)
- How does this happen?
- We are wired to focus on the most salient stimuli
- Our food has been designed to achieve salience (via millions of R&D $$ by big food companies)
- Cues and stimuli create urges and thoughts of wanting
- These cues drive behavior, which becomes rewarding and self-sustaining, ultimately rewiring mental pathways and circuitry
- Add in the modern-day developments that corporations have made these food stimuli available 24/7 AND that our culture deems it culturally acceptable to eat fat, sugar, and salt at any hour of the day, and it’s easy to understand what’s driven the obesity epidemic.
So, what can we do when we’re helpless against the “memory habits and motivational circuits that are involved with the emotional core of our being,” as Dr. Kessler put it? We can harness the only thing powerful enough to make a change: social norms. Just as changing attitudes about smoking generated a profound shift, social norms could reverse our obesity trajectory. In summary, “We will succeed when fast food is socially unacceptable.”
How will we get there? That I’m not so sure about, but maybe I’ll find the answer in Dr. Kessler’s book…