Sunday, March 17, 2013

supporting *everyone* in adopting good health behaviors

I always appreciate reading Linda Bacon on health and size (emphasis is mine):
Ernest:  So what are the real parameters determining one’s health?
Linda:  My main goal is to take weight out of the equation, recognizing that its value has been exaggerated as a health indicator, and that we’ll get much better information from attentiveness to other, better-established, health indicators, such as glucose sensitivity. I’d rather re-frame your question to put our focus on supporting everyone in adopting good health behaviors. This would be of great benefit to everyone, regardless of whether one is big or small, has trouble with glucose regulation or not. If our focus is on fat, we miss diagnoses in thinner people, who may suffer from the diseases we blame on fat, and we pathologize fatter people, despite the fact that many of them are not, nor will they be, sick.

Tuesday, March 12, 2013

the soda ban and a personal animus

Mayor Bloomberg's soda ban was struck down this week in New York. For the moment, at least. I feel this was the right thing to do, and the judge's ruling that noted the "arbitrary and capricious" nature of the particulars of the ban was spot-on. There are nasty implications in attempting to affect public health - by which Bloomberg means obesity - in this way.

But here's the thing: I have come to find soda kind of evil, a word that I never use about food. I understand the urge to want to slap it back. I can't override my animus toward it, even though I like to drink it sometimes. This is my bias.

I try really hard not to extrapolate anecdotally from my own experience with regard to food and health. If you pay any attention in life, you see that even with some large-scale patterns, everyone's body is a different machine, responding differently to meds, foods, sleep, movement, emotion, temperatures . . . everything. I can't assume my experiences are anybody else's. And (to be brief) I find a lot of talk about nutrition exhaustingly prescriptive and rigid, when it's not overtly paranoid and moralizing; that's all nutrition, good and bad, even with interesting and compelling facts about the science of junk foods. But given my own point of view I am still closer to having the same urge to cap off soda serving sizes that Bloombergians do than I am than in regard to any other food and public health topic.

I love cold clear sweet things, by the way; I think I have an especially strong cold sweet tooth, in fact. I love granita, sorbet, Popsicles, unsweetened juice bars, Italian ice, all-fruit smoothies, Pop-Ice, slushy frozen fruit juice, good sugar-based sodas of all kinds, all of it. I often order sorbet at ice cream stores, which people treat as if I'm denying myself (I have problems with lactose, but that's not usually why I order sorbet). One of my happiest eating experiences recently was just a black cherry soda over ice at a diner. I can't even describe how good it tasted with my food, how satisfying it was. Seriously, a good soda is a beautiful thing. There is an itch that gets scratched when something sweet and cold goes down your throat that nothing else can do. I think it's a travesty to not have a cold soda to drink with your pizza. Nothing soothes my tum like ginger ale or cola syrup.

But I don't think soda - the kind with high-fructose corn syrup - is evil because it's delicious and tempting, I find it evil ultimately because it tempts but does not deliver. It has a sorcerer's apprentice quality. You reach for it to slake your thirst and hit those sweet (hah) spots (ahh) in your throat only to find that afterward you're thirstier than you were before and want another. It doesn't end. It's like a weird curse in a fairy tale. In my experience there's no off button with soda, no click of satisfaction, like it's not really food. It doesn't ever really fill you, except in uncomfortable ways. It doesn't really satisfy, except in an initial rush of sensation - you end up chasing the dragon. It's good at washing things down, but that's about all it does really well in quantity.

I don't have the same experience with Mexican Coke (made from sugar) that I do with regular Coke (made with HFCS). I may want more than my stomach does, but I do get to the point of "ahhh," rather than wandering further and further afield from it. Honestly, anything with HFCS as a major sweetener, like Slurpees, makes me feel only thirstier and more unsatisfied. I haven't drunk diet soda that often, but my impression is that the Off Button with diet soda is even farther out of reach. No Ahhh there. And maybe even more of that almost salty feel on your tongue that makes you want more.

Sometimes I wile out over soda and drinks tons of it. But in general I try to shape my consumption, as much as I can, to really enjoy it when I drink it and to drink the amount I want: treat it less like a beverage and more like dessert. Then it tastes much better. But that can still be difficult. When I go to fast food places I usually order a small soda, but about half the time they bring me a large anyhow. (Can you imagine that happening with any other food or beverage?). Or I ask for a cup or glass to be half-filled at a regular restaurant, and am handed a glass that's filled all the way. (Sometimes I ask for this too because I get tired of spilling glasses of soda; it's like there's a law it has to be filled to overflowing.) On planes I ask for the cup to be half-filled, which is a hassle to remember, I know, but it is still pretty hard to get them to do it. Or at a restaurant with free refills I have to say to the waiter over and over NO, please, don't refill my glass.

I have had a lot of experiences with restaurants thrusting way more soda at me than I was asking for. When you are trying to drink a small quantity of it you do get a window into how people really do expect huge quantities of it. It's hard to turn off the blast. So I get the urge to want to slow it down.

I also think there are a lot of dangerous paths you can start trekking when looking at processed food, paths that end up obsessively demonizing it, ratcheting up its appeal and power, giving us fewer tools to navigate the food world that's out there. And I don't agree with Bloomberg's "obesity kills" M.O. of slapping drinks out of people's hands - he sounds less concerned with the health effects of soda than with an oversimplified parity between health and size that makes me tremble for the fat kids of New York and more misguided policies they will be facing. Fat kids - and the thin kids who will be presumed to be safe from such effects.

But I do think soda is kind of - evil. I can't get past my own feelings about it, can't help remembering my own experiences with it that just never seemed to end. It seems like the perfect drink for a world where we devise tortures for ourselves about food, even when we have enough: stapling stomachs so that we can't absorb nutrients, living in fear of foods and our hungers, starving even when amidst plenty, always wanting more, not believing we can have or want satisfaction.

dude, there's no actual sugar in those