My work day last spring had been frustrating; the writing had gone slowly (and not too well). In my desire to write an acceptable paper had I forgotten how my neighbors eat today; I was using too many academic studies with their stark numbers and not enough of today’s eating realities. A reality check of the real world was in order.
I also wanted a break from the computer screen, the isolation of my cluttered office, and needed the invigoration of people milling around. I slid my computer chair back, hurried downstairs, and out the back door into the garage, backed my car down the twisting gravel driveway into the oncoming traffic. I abruptly stopped, allowing a runner to slide by the trunk of my car.
As my car picked up speed, I eyed the runner in passing. She was tall, lean, all legs, with her muscles edged, and dressed in marathon shorts and top. In late afternoon’s light, I could see perspiration on her lightly tanned arms, thin legs and forehead below her runner’s cap, giving her a glided Grecian statute’s appearance: a study of the svelte female form in motion. She moved effortlessly, without breaking her runner’s stride.
Having reached the double 8’s in age, I am now more of a voyeur than player, but still find the slim female worthy of a stolen peek. Beyond the natural attractiveness of the female form, my interest has also its professional side: diet and resulting body size.
Food (our diet) has been my career and avocation. I find the subject is never boring, but always stimulating and challenging although confusing in its complexity. My interest was first captured in the 1960’s by graduate studies in food technology at MIT. Following my formal schooling, I worked many years in food-related industry jobs, first in the controversial ag-chem industry, developing new insecticides, followed by 20 years as the research director for a major food company, developing top-selling, juice-flavored, sugary-drinks (motivated by the demands of the market place and my family responsibilities). I finished my professional career educating young, budding nutritionists (who were perhaps a bit too idealistic) at Tufts University about the hard truths of the commercial food world, while they taught me about the intricacies of nutrition.
Now in retirement, removed from any previous mind-blocked doubts, I am armed with a new inquisitiveness about what we are eating and how this affects our weight. I find the time to think about food and diet in broader manner than from any narrow previous prospective.
The temptation and the trap
Driving along this evening and recalling the runner’s slender shape, I wonder how she had avoided our omnipresent weight-gain. I doubt that her running alone could have canceled out the potential dietary trap of our South Shore’s calorie-rich environment.
Control of appetite was a bit of self-interest that evening. I was attempting my annual spring ritual of dieting away a winter of overeating, resulting in a ten pound gain lying around my middle as a soft, donut-shaped mass; a source of embarrassment while showering in the men’s lock room. I find the sad truth is that gaining weight is easy with all the food temptations in our environment, but losing weight is so very hard with these same temptations still in place.
I drove several towns away to Derby Street Stores on Boston’s South Shore. Derby Street is our South Shore’s magnetic mall for up-scale shopping, featuring stores such as Talbots, Ann Taylor, William-Sonoma, and a dozen others selling a variety of merchandise. The mall enjoys a respectable reputation as a destination for shopping and dining among the South Shore’s prosperous crowd.
The mall is laid out in a large square shape, with the various stores and restaurants with their own distinctive store fronts, placed around its parameter with broad sidewalks facing the center parking lot. The parking area is tastefully interrupted by islands of vegetation and trees, with tall traditional lampposts decked with colorful, hanging flower baskets. Derby Street is intentionally designed to separate the stores here from the common highway attached strip malls. This evening, late model, upscale German cars and large SUVs filled the parking areas.
Derby Street also offers a number of casual dining spots - Legal C Bar, Burton’s Grill, Rustic Kitchen and Bar - and several more. Adding to these restaurants, there are snacking opportunities -White’s Bakery, Cold Stone Creamery (an ice cream store), plus Yankee Candy. Many visit the Derby mall solely to eat and shop for food.
In early evening, the mall was busy with shoppers, diners and people just walking around. After a cold New England spring; this was our first warm summer evening, bringing out a good number of South Shore residents. People were dressed in their light summer clothes, enjoying the start of our summer. Up-tempo music played in the background; everyone seemed in a relaxed evening mood, busily talking, laughing, as they sat in the restaurants or strolled on the sidewalks.
Based on previous evening visits, I knew Derby Street was a marvelous place to sit, unwind, and watch our local eating scene. Scanning the busily filling restaurants, I quickly picked one with tables outside on the sidewalk, squeezing into a small table in front.
After looking at the outsize multi-page menu, I decide to order only a small latte; the waitress quickly suggested adding, “a discount-priced, larger latte, or extra flavored-sugar syrup added to my drink, or a cookie”. She was practicing her restaurant-mandated, rote-learned sales pitch to perfection, but I wasn’t buying her calorie-laden offerings tonight, settling for a small, no-sugar-added latte made with fat-free milk as my ticket for sitting. Having been obese as pre-adolescent, fear of gaining weight and calorie counting are never far from my consciousness when eating out.
They are going to up-sell, but you don't have to buy
I noted the great success this Derby Street restaurant was having in encouraging their willing clients to order out-sized meals. The over-filled plates – often with oversized cheese burgers, large three-decker sandwiches with mounds of French fries, and double-size, sweet drinks - that the wait-staff was delivering to the diners, could barely fit on the tiny tables. My fellow diners tonight were enjoying large meals, high in calories from meats and starches, overloaded with fats, oils and sweeteners. No surprise, this is frequently the traditional, preferred fare for many.
My latte ordering scenario with the waitress reminded me from my industry days, how competitive food selling is, has been and always will be. I wondered if restaurateurs with today’s prevalent overweight consumers ever consider that selling so much food to their customers isn’t good for them. In my past time in the food industry, I can’t recall any talk or concerns about selling too much, only how to sell more.
Today eating out for most people is an everyday happening (including breakfast). Growing up in the 40’s and 50’s, I can remember that eating out in a restaurant was special, something to anticipate, a treat. Increasingly today we are eating alone in restaurants, while the tradition of family-together at-home meals is decreasing. This shift in our food sourcing started with women working outside the home, with limited time and desire (perhaps even ability) to prepare food. Today our eating-out lifestyle supports more than 600,000 American restaurants, with fully prepared meals (eaten in restaurants, our homes, at our jobs, or in our cars) consuming half of all dollars we spent on food.
Driving to Derby Stores tonight and passing through the nearby cities and towns, I had seen many restaurants, ethnic eateries, and quick serve outlets. Today’s eating environment provides so many options catering to our desire (need) to avoid preparing our own meals, enticing us to stop to eat and snack at all times of day. While other types of shops are leaving towns for malls, restaurants - Chinese, French, Tia, Italian, Greek, Latin, Vegetarian - and coffee shops make up most of these communities’ down-town businesses. Town centers have become food courts where we are tempted to eat (overeat) in any cuisine culture we wish.
Watching my fellow Derby Street diners and passersby tonight, I saw the same array of body weights present in any American mall today, with the balance more to overweight. A good number were enormous, out of proportion to any normal body shape. While politically incorrect to say, I observed: many men with large pot-bellies and saddle-bags hanging over their belts, having overly-large, flabby arms, legs and fleshy torsos; scores of women with thunder thighs and gigantic derrieres, having weight-lifter arms, and elephant-sized calves with protruding stomachs. Some were so overweight that it hampered their normal walking gait.
Decades ago, I remember, obesity was a rarity. Low body weight was the more common nutritional concern. The previous evening I had seen Woody Allen’s new movie, "Café Society", set in the 1930’s at a local movie theater. The actors’ figures reminded me of how slim we were in this era. I recalled also my school days in the 40’ and 50’s, when an overweight classmate was rare.
Obesity is a recent widespread American problem. Only since 2003, with a U.S Surgeon General Report to the United States Congress, has the obesity problem received serious national attention. The problem began to be high-lighted several years ago by the popular media, but lately other pressing national issues (wars, terrorists and the presidential election) have moved it out of the today’s spotlight. I wonder, has our frustration and inability in solving the pandemic engendered a mass denial?
Avoiding the life-long trap
Doctors who treat obesity have told me that it is a life-long trap. Experts report that only one to two out of ten of those successfully achieving weight-loss during treatment will retain their loss after two years. Similarly a chubby child, doesn’t usually outgrow his or her overweight, but becomes an overweight or obese adult. Among my overweight friends and acquaintances I recall so many dieting failures (in spite of the diet used); almost no one returned for long to a normal weight.
At the mall, many were drinking and eating as they walked by. Every other person had either a container of soda, ice cream cone, or cookies in their hand (some had food or drink in both hands).
Years ago I remembered that it was uncommon (or even uncultured) for anyone to be seen eating or drinking in public. Unfortunately, these eating caveats are a historical way-of-life. Today our more informal social norms give us license to eat where, what, and when, as well as how much we chose. Our modern life style with its growing eating out ways does nothing to encourage dining restraint.
It's actually better to eat three meals a day, despite what diet fads claim about hunger
Adding to any efforts to limit our overeating, we find our daily eating frequency has increased in recent years. No longer do we eat only the traditional “three meals-a-day”, now we eat and snack all day long. Government studies confirm that since the 1970s, Americans have gone from an average 3.8 to 4.9 eating occasions daily; with this increased frequency, we are consuming one third more calories than three decades ago, making it difficult to avoid significant weight gain over time. The average daily diet now encompasses a weight-busting 2,375 calories (versus 2,076 in 1970) with many of the extra calories coming from “fun foods” (colas, chips, fries, etc.).
Today food is everywhere, anytime and often cheap. Plus there are many opportunities to snack for free; samples at the supermarket, candy at the office, coffee bars at car dealers, chocolate cookies at hotel check-ins, and lollypops at the bank and on –and-on. Our meetings for all purposes now including the obligatory “coffee and”. Only with the strongest willpower can one resist the “freebie” environment.
Comparing the slim runner from earlier this evening to Derby Streets’ larded people, I thought: what a capital crime against the natural attractiveness and beauty of the slim human form overeating has caused. Today’s convenient, everywhere available, and often fully prepared food has moved many of us from eating to live to living to eat.
Still slowly savoring my small latte, I watched how the restaurant diners approach their food-laden plates. The table next to me was full of people having an intense discussion while they automatically devoured their meals. Other diners were eating in a similar non-stop, shoveling action, often through three courses, until their plates were bare. Much of the restaurant dining today appears to be simply reflex action, with no savoring of the food, no pausing to capture the highlights of a fine meal (or checking if we are already full). Fast, mindless eating has proven to cause people to increase their food consumption.
Essen, don't fressen
The German language has two basic words capturing differences in eating behavior: essen is to slowly, politely and thoughtful eat, fressen is the hurried, thoughtless gulping of food, as an animal might eat; I fear today many of us fressen our food.
Watching my fellow diners this evening, many seem to be using the license of eating-out to forget about calories. I wondered if they realized (or cared) how calorie-rich their evening meals were. Numerous studies show how unreliable people are about accurately judging their food’s calories, (usually far under-estimating the calories) especially when eating out.
I remembered from a lecture at Tufts, that one out of every three American adults is believed today to be obese (considered to be 20 to 30 percent over normal weight). Assuming a conservative average overweight of 25 pounds per obese citizen, with approximately 80 million Americans presently obese, I figured on my restaurant napkin, this would equate to an accumulated overweigh of some 200,000, 000 pounds in our nation today.
We know concerns over obesity are about more than personal vanity. For chronic overeaters the future heath predictions are grim. There are real dangers from a number of the chronic killer diseases (diabetes, stroke, and heart disease, to name a few) closely associated with being significantly overweight.
Our nation’s shining health history, of continuous improvement in both life expectancy and enhanced quality of life is being seriously challenged by the overweight problem. Current medical predictions are that Americans will eventually live shorter lives in worse health because of today prevalent obesity. I wondered how many of the overweight people I was seeing tonight at Derby Stores would fall victims to overweight-induced, life-shorting diseases.
We can't allow the curve toward better health to go the other way
A study by California’s Kaiser Permanente Clinic that I recent read found the previous four decades of dramatic reduction of fatal heart disease rate among Americans (down 3 percent per year during this period) was now ending; in 2011 the reduction of fatal heart disease – our leading disease killer disease - was now nationally below 1%. The likely culprit for this lower number is Americans’ overweight and related medical problems (such as Type 2 diabetes). Advances in medical science are being sabotaged by overeating.
Beyond human suffering, the financial costs involved for our nation due to overweight related diseases are believed to total hundreds of billions of dollars annually; representing possibly a fifth of our nation’s total annual medical expenses! A good portion of these costs are paid for by our government programs (Medicare & Medicaid) which ultimately fall to the tax payers (us) to fund.
As annual medical costs continue rising, will there be Herculean governmental efforts to prevent Americans from significant weight gain? I wonder how tonight’s Derby diners might receive any attempt to limit their right to eat what they wish, when they wish, where they wish and how much.
Today the health merits of food are discussed and debated everywhere we turn. Diet is a hot topic. Scan the never-ending stream of advice in newspapers, magazines, advertisements and books on dieting. Scientists and academics are adding to the information mix with never-ending diet research reports (often of doubtful practical use), health experts are endlessly debating on the most beneficial dieting programs, and government agencies are churning out oversimplified dietary guidelines. Plus the industry weighs in with its ads and informationals, giving their vested-interest advice.
The public don't trust experts, and we have earned that
Compounding our confusion is the growing distrust many of us has about experts’ advice (often proven wrong in the past) and the research of government, industry and academia (whose motives are now often questioned). Due to information overload and conflicting advice, I suspect we tend to pass off much of what is heard as background noise.
When I eavesdropped on my follow diners this evening the talk is often ironically about their diet. I overheard two overly-large women, very fashionably suited, at the next table feasting on large meals, finishing their second bottle of wine, loudly discussing the merits of various diets. I wondered what source (or sources), if any, they might have consulted for their information. Consumer surveys tell us that the diet-curious, prefer to confer with friends and family for eating advice versus other sources. The constant information din, I suspect, may only serve to further stimulate us to think about food, and in turn even to eat and drink more.
People were waiting for my table. My waitress was restless for me to leave and I had squeezed as much Derby looking as I could for one night. I paid, leaving an extra-large tip to make-up for the food and drinks I had not ordered, and left.
Everywhere I had looked this evening at the mall, there were overweight people (some dangerously so). This is in spite of Massachusetts having one of lowest rate (48th in the nation) of overweight people among all states according to government figures and usually the obesity rate tend to be lower in affluent areas. I saw that overeating affects all economic groups to varying degrees, with the South Shore not being exempted.
As I drove home, I wondered what I had learned at Derby Stores this evening. We seem to know a lot about why people become overweight, especially the environmental factors causing it, and the clinical outcome when they are obese, but we know little about how to actively engage Americans with their present preferred lifestyles in preventing its occurrence.
An abbreviated version of this article first appeared in Priorities magazine, which is sent free of charge to all American Council on Science and Health donors.