Let Them Eat Cake!

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Obesity rates in the U.S. and other nations both developed and developing have been rising dramatically over the past two decades, and this is certainly a matter of public health concern. Lately, attention has been focused on a particularly alarming trend not only are there more obese American adults, but there are increasing numbers of obese children and teens. Weight is increasing at younger ages, as is the appearance of obesity-related diseases such as type 2 diabetes mellitus. But how to stop this trend? One method being touted focuses on foods sold in vending machines in schools across the country.

A recent article in the New York Times cited statistics from the Centers for Disease Control and Prevention showing that 98% of American high schools and 43% of elementary schools make food vending machines available to students. Depending on the foods and beverages chosen, that represents a lot of potential calories.

Some school districts are declaring bans on so-called "junk foods" like sugary sodas and high fat snacks. This is a popular move in many schools: the San Francisco Chronicle reports that the school district there is considering such a ban, even though it could cost the district over half a million dollars per year in revenues that could be used for a variety of student activities.

The British, too, seem to be considering such a fix. Last week the Guardian reported a stirring of interest in such school bans. They also noted the WHO's suggestion that governments tax "sugar-rich" items and "clamp down on TV ads" for such foods.

Poor Nutrition and Obesity Are Not the Same Problem

Leaving aside the question of any causal connection between sugar consumption and obesity, what seems curious is the assumption that removal of such foods from students' immediate vicinity will somehow alleviate the obesity problem. A couple of issues are being conflated.

First, the issue of obesity. A large majority of nutrition scientists have stated (again and again) that what matters in the area of weight gain is the number of calories consumed and burned up. It isn't really important if the excess calories come from potato chips, cola, or yogurt, but how many calories are ingested. Yet, we keep reading about "junk food" and sugar, as though if we replaced such foods with more nutritious ones in school vending machines the obesity problem would be solved.

The second issue is that of appropriate nutrition. American children and teens are not, on the whole, consuming the recommended amount of calcium (for example). Perhaps providing more milk-based beverages would help them meet this goal if they chose to drink them. But such changes wouldn't necessarily do much about the obesity problem.

Some clarity of purpose would be welcome in the debate on how to deal with the obesity epidemic. Obesity in children and teens does not bode well for future public health goals, and we should be aware of the problem and should be trying to solve it. But taxing this or that food or changing offerings in school vending machines are feel-good moves that likely won't contribute much to solving the problem. Obesity is a result of interplay between genetic and environmental factors, and calorie expenditure exercise! must also be taken into account, a fact largely forgotten in the shuffle. Obesity it is too complex a problem to succumb to a quick fix. So let them eat cake just not too much of it!

Ruth Kava, Ph.D., R.D., is ACSH's Director of Nutrition.