Health Reform, Meal Reform, and Wal-Mart

My friend MK Czerwiec — she’s an R.N., M.A. (in medical humanities and bioethics, from Northwestern), and comic-strip artist — wrote a while back that the elephant in the room in the health-care “debate” is one of the principal reasons we get sick and our medical costs run so high: Great American Diet. You know: the massive number of calories we consume, the processed food, the fat, the salt. She points to writers like Michael Pollan and David Kessler who discuss our diet’s impact on both personal and societal health. And she’s in the midst of cartooning the issue (here).

Enter Wal-mart, by way of a commercial we saw tonight while watching a recorded episode of “Monk.” It was a short thing, and the theme was how busy, budget-conscious moms can feed their families while saving big bucks. Here’s a sequence of sloppy screen shots:


Step 1: Mom’s shopping for breakfast at the fast-food drive-thru. Here’s how much it’s going to cost her to shove a pile of greasy, empty calories down her kids’ maws.


Step 2: But wait. Mom’s got something up her sleeve. Or actually on a plate that at least her daughter seems to be less than thrilled to see.


Step 3: Turns out Mom’s gotten out of rancid old Mr. McGreasy’s breakfast line and done what any good mom should. She went to the store and loaded up on what Alex Trebeck and the “Jeopardy” crew would call comestibles. Let’s see: There’s Yoplait, Jimmy Dean sausage, egg and cheese croissant sandwiches, and a jug of Sunny D non-juice.


Step 4: Mom saves. Over $600 a year. And if you could read the fine print in the ad, which is pretty hard to do even in a still photo, you might be able to understand how that $600 is derived.

Now, it would be easy to say, “Let’s not be a snob about other people’s food choices.” Or, “Let’s not be a hypocrite.” And I’ve got a friggin’ mountain of breakfast pastries, cookies, brownies, Dairy Queen shakes, and lots more under my belt to make me humble about what I say about Wal-mart’s suggested breakfast menu.

But look at the Sunny-D ingredient list from the company website. Note that the company chemists have mixed in a variety of artificial sweeteners to cut down on the amount of high fructose corn syrup that they dump into the bottle. Yoplait does have identifiable food in it along with the inevitable high fructose corn syrup. The Jimmy Dean croissant sandwiches? Jam-packed with caloric goodness. (In fact, if one limited one’s self to single servings of each one of these products for breakfast, you’d be talking about 700 calories.) And the croissant features a “War and Peace”-length ingredient list:

Croissant: Enriched Bleached Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate [Vitamin B1], Riboflavin [Vitamin B2], Folic Acid), Vegetable Shortening (Partially Hydrogenated Soybean and/or Cottonseed Oils, Water, Salt, Mono- and Diglycerides, Annatto Extract [Color]), Skim Milk, High Fructose Corn Syrup, Yeast, Water, Contains 2% or Less of: Salt, Eggs, Wheat Gluten, Enzymes, Sugar, Natural and Artificial Flavors, Mono- and Diglycerides, Calcium Propionate and Potassium Sorbate (Preservatives), Soy Flour. Cooked Sausage Patty: Pork, Water, Contains 2% or Less of: Sodium Lactate, Salt, Sugar, Spices, Sodium Phosphates, Monosodium Glutamate, Sodium Diacetate, Caramel Color. Precooked Egg Patty: Whole Eggs, Water, Soybean Oil, Nonfat Dry Milk, Modified Corn Starch, Salt, Xanthan Gum, Natural and Artificial Butter Flavor (Butter [Cream, Milk], Partially Hydrogenated Soybean and Cottonseed Oil Soybean Oil, Lipolyzed Butter Oil, Natural and Artificial Flavors), Citric Acid. Pasteurized Process American Cheese: American Cheese (Cultured Milk, Salt, Enzymes, Artificial Color), Water, Cream, Sodium Citrate, Salt, Sodium Phosphate, Sorbic Acid (Preservative), Lactic Acid, Artificial Color, Enzymes, Soy Lecithin.”

The point being: You’re not a criminal to make this stuff, buy it, eat it, or feed it to your family. We all do it, or have done it, and we all have had good reasons for it. But ignorance shouldn’t be one of those reasons any longer. it’s one thing for people to eat this way because they feel they have to–it’s a cheap way to eat, at least at first, and it’s perceived as convenient. It’s another matter altogether to promote the idea that this is good, wholesome, nutritious food that also happens to be inexpensive food. That’s an untruth on a par with selling cigarettes as healthful.

Food, ‘Food,’ and Health

My Chicago friend MK observes the current debate over the medical industry and how care is delivered (my formulation, now hers) fails to address a basic topic: “how we are getting sick in the first place.” She cites an estimate from Michael Pollan, the food industry critic and author of “In Defense of Food” and “The Omnivore’s Dilemma,” that two-thirds of the medical expenses we incur as a society are directly linked to what we eat and drink.

That reminded me of an hour of KQED’s Forum that I heard about a month ago with Dr. David Kessler, former head of the Food and Drug Administration. He recently published a book called “The End of Overeating.” It’s an attempt to expose how we respond physiologically and neurologically to processed food (i.e., fat, sugar, and salt). Borrowing from advanced neurological research, he argues that the constant availability of, bombardment with, and ingestion of foods high in fat, high in salt, and high in sugar programs us to want more and more of the same (and boy, do we get more and more). The ultimate prescription is to disrupt that programming with a focus on what Pollan and others call ‘real food.’

Pollan’s formula is deceptively simple: “Eat food. Mostly plants. Not too much.” (Written immediately after a breakfast that consisted of coffee and a ClifBar.)