«Supersized Your Diet Is Our Concern In 1999 The Centers for Disease Control and Prevention declared that obesity had emerged as a growing epidemic in ...»
Associate Professor of Economics and Business
Your Diet Is Our Concern
In 1999 The Centers for Disease Control and Prevention declared that
obesity had emerged as a "growing epidemic" in the United States. Both prior
to that pronouncement and in its wake, public health advocates have urged
government action to take on this disease. However, these proposals have not
been widely embraced. Implicit in some of the resistance to government involvement in our diets is the sense that diet is a personal choice; because the consequences fall essentially on each person alone, it is a matter of private concern and responsibility. But this is a misconception. A careful examination of the food market reveals that other people are unavoidably positioned within the elbow range of our fork-and-knife wielding fists. What we choose to eat affects their pocketbooks, what goods they are able to enjoy, the culture that molds their food decisions, our common physical environment, and even (if Gandhi had it right) the quality of our democracy. We have a clear stake in one another's dietary excesses, and the harm is broad enough to require ameliorative government policies.
What is excessive?
While public health officials have not reached a consensus on all elements of a healthy diet, the orthodox experts are consistent on many of the fundamentals. One assemblage of those recommendations is presented every five years in the Dietary Guidelines for Americans, issued jointly by the United States Department of Agriculture and Department of Health and Human Services.
This publication includes the familiar, though reconstructed, “food pyramid.” One measure of excess in the collective diet was made by Linda Scott Kantor of the USDA's Economic Research Service. She compared per capita food consumption with the serving recommendations of the food pyramid, and concluded that the diets of most Americans are not consistent with that guidance. While on average we do eat about the recommended amounts from the "grains," "meat and beans," and "vegetable" groups, we are deficient in diary consumption, and even more so in fruit. However we eat sugars, fats, and oils in clear excess.
The high consumption of sugars, fats, and oils means that many Americans are eating too many calories. Over the last twenty years, adult daily caloric intake has increased by about 150 calories. That full increment adds an extra 15 pounds of body weight over the course of a year, and this additional poundage has become a particularly obvious indicator of our dietary excess ("Portion"). Clearly we are eating too much relative to the energy we expend through physical activity, and increasing numbers of us are too heavy.
For epidemiological purposes, adult obesity is defined in terms of the "bodymass index," or BMI. This international standard relates height to weight and is obtained by multiplying weight (in pounds) by 703 and dividing that product by height (in inches) squared. By recent convention, "obese" is a BMI of 30 or more, and since the late 1970s the obese group grew from 15 percent to 27 percent of the population. "Overweight" refers to those with a BMI of 25 up to 30, and this group increased from 32 percent to 34 percent.
Excess poundage on young people is also on the rise, and as with adults the trend accelerated about twenty years ago. The portion of 6 to 11 years olds that is overweight has nearly doubled to 13 percent. Among 12 to 19 year olds the occurrence nearly tripled to 14 percent (U.S. Department of Health and Human Services).
A familiar attitude toward overeating is to attribute responsibility for the behavior principally to the individuals who overindulge. As succinctly stated by a food industry researcher, “Americans are fat because we don’t use will power" (Paul). In explaining our increased caloric intake, to focus on our loss of will power or self-discipline is, in essence, to see those as independent or innate virtues that we have freely chosen to squander, or which have been exogenously degraded over the last twenty years. But this framing of human behavior, of course, explains nothing at all.
The USDA and DHHS also focus on individual responsibility. As stated upon the release of the 2000 update of the Dietary Guidelines for Americans, [t]he dietary guidelines give consumers the information they
ultimately, it is up to consumers to take action and follow the guidelines’ advice. “Government can shine the spotlight and direct resources to solving the problems of obesity and poor nutrition,” says USDA Secretary Daniel Glickman, "but only
As early as 1985 the emphasis on poor choices made by individuals was among the "simple generalizations of the past" rejected by the National Institutes of Health. Instead, they argued "that obesity has multiple causes." Based on studies of "animal models of obesity, biochemical alterations in man and experimental animals, and the complex interactions of psychosocial and cultural factors that create susceptibility to human obesity," they asserted the disease to be "complex and deeply rooted in biologic systems" (NIH quoted in American).
Without doubt, understanding our biologic system is critical to understanding our eating excesses. A common assertion is that humans evolved in a scarce-food environment, and to improve the chances of survival in lean times, our distant ancestors learned to eat high calorie foods when they became available. This urge is now part of our genetic makeup. But while recent research efforts have sought to identify a “fat gene,” no one has suggested that the rise in obesity in the past twenty years resulted from a change in genetics. Rather, what has changed is the social, physical, and cultural context which molds our decisions. To illustrate, consider the other culprit in the obesity story: Whether we choose to get exercise in completing local errands is encouraged or restricted by the layout of our communities, including the proximity of homes to stores and the safety of the walking and biking options. Much has been written concerning the current design of our physical
reliance on automobiles and machines with screens.
While it is apparent that Americans are increasingly unable to resist the temptation of food, it is equally obvious that this phenomenon is systemic, with the majority of adults now suffering with this behavior. So to understand the behavioral modification that has occurred, we need to look further; and as soon as we move our focus from particular individuals to the common environment, a more illuminating explanation emerges. What has changed is the extent to which the temptations have grown. We now live in an environment which confronts us with greater opportunity and encouragement to eat in excess.
An important element of this new food environment is that we eat outside the home more often. Two decades ago 19 percent of our food energy consumption was eaten away from home; today it is 34 percent (Hunter). In 1970, 34 percent of our food spending went for eating out meals and snacks. By 1980 it was 39 percent (USDA Economic Research), and now it is about half (Nestle and Jacobson, 19). These statistics matter because “eating out” entails eating foods with more fat, saturated fat, and calories and confronting growing quantities of food (Liebman and Schardt, 10 and 6).
A critical determinant of how much people eat (after about the age of four; Lord) is how much is on the plate. People tend to eat the amount before them (Rozin, 66), and portion sizes have increased markedly since the 1980s ("Portion"). The economics of the larger servings are easy: Food is only part of what is covered by the restaurant tab. Diners are also paying for rent, advertising, packaging, and very significantly, labor. The marginal cost of
price that customers pay. This sales strategy has been widely adopted because Americans tend to conceptualize "value" as a lower price per bite (as opposed, for instance, to an enhanced quality of food.) And increased portion size is not something left at the eatery. As people have faced growing portions, the popular sense of what a “standard” serving is has grown, too. Nutrition writers are working hard to teach consumers the amounts of food in the various USDA defined "portions," e.g., the meat serving is about the size of a deck of cards, and the pasta serving of 1/2 cup is about the size of a small computer mouse ("Portion").
Clearly there are more opportunities to eat out. In 1982 there were 352,000 eating and drinking establishments in the United States. As of 1996 the number had reached 466,400. Among them are 170,000 fast food restaurants (Nestle and Jacobson, 19), which provide menus brimming with calories, fat, and cholesterol. Reportedly, McDonald’s has the corporate goal of being within four minutes of every American (Brownell, 4).
Many of our youth need not “go out” to eat fast foods. Fast food franchises provide meals in more than 5000 schools (Bryant). These chains have also become a staple in the food courts that are now central to shopping malls, and are beginning to pop up in the “food marts” that increasingly accompany gasoline pumps. Those markets and other “convenience stores” are also becoming more common. In 1980 there were 35,800 such small grocery stores offering their food selections and extended hours. In 1997 the number had grown to 62,100 (U.S. Bureau of the Census).
meals has become another common means for excessive food consumption.
According to industry sources thirty percent of all calories are from snacks and one-third of Americans snack four or more times each day ("Fun"). The Snack Food Association reports that sales of chips, cheese puffs, cookies, and snack bars reached $30 billion in 1999 (MacArthur). Here, too, portion sizes have grown, and bigger portions of candy, chips, popcorn and other “hedonistic" foods are particularly effective in prompting greater consumption. People partake of about 50 percent more when obtaining these in bigger packages, compared to only about 25 percent more of other foods (Liebman, "Supersize").
Vending machines are also part of the food environment. In schools alone vending sales of soda, chips, and candy are approaching $1 billion per year ("How"). “Liquid candy” is available in 2.8 million drink machines which annually deliver more than 27 billion soft drinks. The 1997 annual report of the Coca-Cola Company stated its promotional strategy to place its products “within reach, everywhere you look: at the supermarkets, the video store, the soccer field, the gas station — everywhere" (Jacobson, "Liquid"). In 1997 the average consumption of all soda was 54 gallons, up from 35 gallons per person per year in 1980. Based on quantities sold, soda is far and away our leading beverage, and it is the leading source of sugar for the average American (Liebman, "Sugar").
Soda companies are prevalent in another aspect of the food environment that further encourages excessive consumption: they are huge advertisers. In 1997 Pepsi spent nearly $200 million and Coca-Cola spent $277 million to
environment, these recent statistics reflect changes that have been on-going.
In combination, the advertising budgets of soft drink companies rose by 28 percent from 1988 through the 1990s. Over the same time period, the promotional spending by candy and snack producers rose 40 percent, and restaurants spent 86 percent more (Liebman and Schardt, 12). Many of these and other food and beverage commercials target young people, and reach them even in the classroom, as millions of children are required to watch televised advertisements each school day. These food ads are among the 10,000 that are seen each year by the average American (Bryant), with fast food messages leading the way. In 1998 McDonald's alone spent $1 billion on advertising (Nestle and Jacobson, 18).
Ready accessibility of the products and extensive advertising are important mechanisms that nurture consumer impulses to eat. Additional efforts are put into developing more tempting foods, many of which have little or no nutritional value. The development rate of new food products has increased more than five fold over twenty-five years ago, to more than 30,000 annually (Holmstrom). Additives are key to food design. These include the emulsifiers, starches, and gums to enhance "mouthfeel," and the minute amounts of chemicals to achieve the critically important dominant smell. Then come the fats, sugars, artificial sweeteners, colorings, and preservatives, aimed to enhance the taste, appearance, and shelf life. Incidentally, while most additives are safe (apart from encouraging unhealthy eating levels), there are some about
disease (Jacobson, "Adding").
The broad point is that the increase in overweight and obese persons has occurred in an environment in which food temptations have grown. The increased availability and attractiveness of food prompted obesity expert Kelly Brownell to characterize our food environment as "toxic" (Brownell, 3). Clearly, this environment has emerged from the activities of consumers and producers, and it requires a non-orthodox perspective on how markets operate. Namely, aside from externalities, mainstream economists overlook that many of our "private" market actions affect people not directly involved in the exchange. In actuality, our individual choices in the food market weave together and affect the consumer behaviors of others. This perspective is requisite in explaining both the regional distinctiveness of diets around the world, and the enhanced odds of being obese if you are an American. Unfortunately, the changes that have made our food surroundings "toxic," that have enticed most Americans to overconsume, are working to have their way with all of us. Those who have not succumbed are in the shrinking minority. The excessive eating of the 60 percent who are overweight or obese is a legitimate community concern, because those indulgences are encouraged by and further encourage the toxic food environment that is common to all of society's members.