I think one of the most important things I have taken from this book and this class is that I am, and always will be, part of the policymaking process. The only aspect of this I can choose is whether I take an active role, or let my silence speak for me.
I'm also pretty happy with the way my perception of the political process has changed. Although I still find it confusing and often shady, I no longer look at it as something completely removed from myself. I am confident that with a little bit of time for background research, I could understand the framework of most policies being formed today. Being able to do stakeholder analyses has helped me understand the push and pull of policy creation, and I've gotten pretty good at putting on my "industry glasses," and considering the economic perspective.
I think the framework that I've set for myself, and the skepticism that I've learned to harbor, will help me professionally, when I have to slough through politics to find the truth as it applies to me and my patients. I still don't think I'm proficient enough in the workings of the government itself, and the checks and balances among congress, senate, and non-partisan committees. I'd like to do a bit more digging into the topic of herbal remedies and dietary supplements; I'm still pretty fuzzy as to the difference between structure-function and medical claims. I'd also like to know a little more about the requirements for clinical research when products are found to be harmful, and how many people have to complain to the FDA before attention is paid.
All in all, Food Politics was successful in making me angry and skeptical, very nearly disheartening me in the process, but left me with a feeling that there is a great potential for change.
Monday, December 1, 2008
Chapter 15: Selling the Ultimate Techno-food
Reading the policy background of Olestra was interesting, because I remember the "revolution" when it hit the market. My mother bought a bag of Nacho Cheese chips, and experienced the laxative effect after eating nearly the entire bag in one sitting. She says that the side effects she experienced after taking the Alli pill were much worse, though. My mother falls victim to health "phenomena" quite too often.
I admit that Olestra interests me from a scientific perspective: the idea that a calorie-free, macronutrient replacement can be created is pretty amazing. I must disagree with the principle of these food replacements, though. The theory that you can continue to eat crap and magically become healthy via robofoods is unrealistic, and even if initial success is achieved, old habits are often restarted. This leads to frustration and often leaves you more overweight than you started.
I'm also hesitant to trust lab-synthesized food replacements' safety. These molecules do not occur in nature, and the effects of long-term exposure to them has never been studied. Once again, I believe we should adopt the precautionary principle when approaching these pseudofoods.
A part of this chapter that really bothered me was the unlawful amount of control P&G seems to have over the policy process. Creating new patent laws to convenience them is beyond unethical. I have the urge to try not to consume any Proctor and Gamble products, but I suspect that would require that I start to hunt and gather.
What I think America needs is a psychological makeover. We need a better relationship with food. This overconsumption, guilt, compensation loop is getting quite old, and making us extremely unhealthy.
I admit that Olestra interests me from a scientific perspective: the idea that a calorie-free, macronutrient replacement can be created is pretty amazing. I must disagree with the principle of these food replacements, though. The theory that you can continue to eat crap and magically become healthy via robofoods is unrealistic, and even if initial success is achieved, old habits are often restarted. This leads to frustration and often leaves you more overweight than you started.
I'm also hesitant to trust lab-synthesized food replacements' safety. These molecules do not occur in nature, and the effects of long-term exposure to them has never been studied. Once again, I believe we should adopt the precautionary principle when approaching these pseudofoods.
A part of this chapter that really bothered me was the unlawful amount of control P&G seems to have over the policy process. Creating new patent laws to convenience them is beyond unethical. I have the urge to try not to consume any Proctor and Gamble products, but I suspect that would require that I start to hunt and gather.
What I think America needs is a psychological makeover. We need a better relationship with food. This overconsumption, guilt, compensation loop is getting quite old, and making us extremely unhealthy.
Chapter 13: Go Forth and Fortify
I have always believed that fortified foods are a science-light movement to squeeze extra money out of affluent, already nutritionally healthy people. I didn't realize until reading this chapter how useless fortification really is. It angers me that the only American populations who need the added help are also the only populations who probably cannot afford it.
The worst part of the fortification movement is that it is negatively affecting the American public. People are ignoring high salt, sugar, and saturated fat content because a label says "contains 40% of daily vitamin needs!" or "Great source of calcium!" The micronutrient obsession which plagues America has taken the focus away from common sense, and sent consumers on goose chase after goose chase, making sure they have enough of a particular vitamin or mineral. What happened to eating vegetables? Sensibility doesn't sell, I suppose. I understand what motivates industry: the bottom line. I also understand that the American consumers are often motivated by fear and paranoia. I believe the only way to get this craze under control is to re-educate. Maybe we need to forget many of the isolated micronutrient studies that have been conducted over the past 10 years.
This book makes very frustrated with the American consumer, because they're trying to act in their best interest, but often end up harming themselves. Industry, though it often acts in ways that aren't concerned with public interest, is at least achieving what it set out to do--make money, lots and lots of money.
The worst part of the fortification movement is that it is negatively affecting the American public. People are ignoring high salt, sugar, and saturated fat content because a label says "contains 40% of daily vitamin needs!" or "Great source of calcium!" The micronutrient obsession which plagues America has taken the focus away from common sense, and sent consumers on goose chase after goose chase, making sure they have enough of a particular vitamin or mineral. What happened to eating vegetables? Sensibility doesn't sell, I suppose. I understand what motivates industry: the bottom line. I also understand that the American consumers are often motivated by fear and paranoia. I believe the only way to get this craze under control is to re-educate. Maybe we need to forget many of the isolated micronutrient studies that have been conducted over the past 10 years.
This book makes very frustrated with the American consumer, because they're trying to act in their best interest, but often end up harming themselves. Industry, though it often acts in ways that aren't concerned with public interest, is at least achieving what it set out to do--make money, lots and lots of money.
Chapter 12: Deregulation and its Consequences
The sheer number of dietary supplements now in America makes it impossible for the FDA or FTC to keep up with health claims and safety problems. I'm not sure how this problem is being handled in Europe, but because they usually work in accordance with the precautionary principle, they are most likely more in control of their problem.
As I said before, I have no problem with people taking pills that aren't shown to have efficacy in biomedical trials. I only take issue with supplements that have been shown to be harmful at recommended doses. I believe it needs to be the responsibility of the manufacturer to prove that their substance isn't harmful before they are allowed to market that product. The only feasible way of doing this now, I believe, is to set a time point, and say that any substance not proven not to be harmful by that time must be removed from the market. This will doubtlessly cause a riotous outrage, so before it's possible, significant public concern must be raised. Such a policy could maybe be suggested on the tail-end of a very public supplement scandal.
Looking back, I think a good time for this would have been during the ephedra/diet pill craze. My mom was on phen-fen at the time, as I'm sure many other moms were, which means that many households had an interest in stopping such a situation from arising again. My mom believed that the fact that the drugs were bottled and on store shelves meant that they were safe.
In the future, I will make sure that my patients know that any pills they buy over the counter at a vitamin shoppe are probably not well tested, there is no guarantee that it is what it claims, and that they're taking them at their own risk.
As I said before, I have no problem with people taking pills that aren't shown to have efficacy in biomedical trials. I only take issue with supplements that have been shown to be harmful at recommended doses. I believe it needs to be the responsibility of the manufacturer to prove that their substance isn't harmful before they are allowed to market that product. The only feasible way of doing this now, I believe, is to set a time point, and say that any substance not proven not to be harmful by that time must be removed from the market. This will doubtlessly cause a riotous outrage, so before it's possible, significant public concern must be raised. Such a policy could maybe be suggested on the tail-end of a very public supplement scandal.
Looking back, I think a good time for this would have been during the ephedra/diet pill craze. My mom was on phen-fen at the time, as I'm sure many other moms were, which means that many households had an interest in stopping such a situation from arising again. My mom believed that the fact that the drugs were bottled and on store shelves meant that they were safe.
In the future, I will make sure that my patients know that any pills they buy over the counter at a vitamin shoppe are probably not well tested, there is no guarantee that it is what it claims, and that they're taking them at their own risk.
Sunday, November 30, 2008
Chapter 10: Science versus Supplements: "A Gulf of Mutual Incomprehension"
I am hesitant to completely disparage any helpful effect provided by dietary supplements. While I, as a proponent of Western Biomedicine, do not believe that most herbs are helpful in treating Western diseases, I know that many folk remedies are extremely valuable to people who ascribe to other cultural beliefs. I think it is our responsibility as nutritionists to consider that biomedicine is not universal, and we must remain culturally competent in order to be able to help people across cultural borders. As much as the scientific world hates it, the placebo effect and nocebo effect exist, and play a big part in personal health.
There is one exception to my tolerance of folk medicine: I do not believe that any supplement which can be harmful at recommended doses should be allowed to be on the market. Consumers have some freedom to choose for themselves whether to spend money on remedies that might not have any effect, but the choice should be taken away from them when the substance threatens their health.
I do not at all agree with the rampant use of health claims in product advertisements. I believe in the precautionary principle when it comes to dealing with these claims, and peer-reviewed studies should be required to substantiate them. Also, the component of the food that "healthy" should be labeled and explained near the claim. For example, if all bran All Bran claimed to prevent colon cancer, the label should say: this product contains fiber, which helps prevent colon cancer, as does any product which contains substantial amounts of fiber.
The use of dietary supplements should be limited, because they provide an excuse to eat less nutrient-dense foods; an approach which unfailingly leads to lowered nutritional health.
There is one exception to my tolerance of folk medicine: I do not believe that any supplement which can be harmful at recommended doses should be allowed to be on the market. Consumers have some freedom to choose for themselves whether to spend money on remedies that might not have any effect, but the choice should be taken away from them when the substance threatens their health.
I do not at all agree with the rampant use of health claims in product advertisements. I believe in the precautionary principle when it comes to dealing with these claims, and peer-reviewed studies should be required to substantiate them. Also, the component of the food that "healthy" should be labeled and explained near the claim. For example, if all bran All Bran claimed to prevent colon cancer, the label should say: this product contains fiber, which helps prevent colon cancer, as does any product which contains substantial amounts of fiber.
The use of dietary supplements should be limited, because they provide an excuse to eat less nutrient-dense foods; an approach which unfailingly leads to lowered nutritional health.
Chapter 9: Pushing Soft Drinks: "Pouring Rights"
I must start my analysis of this chapter with a fact and a confession: soft drinks are one of the worst items, if not the worst single item that negatively affects American health. Also, I have been drinking large amounts of Diet Coke ever since I could walk.
I feel that my story has parallels to the situation of people born in the 30's and 40's, who took up smoking before it was widely acknowledged to be horrible for your health. Though I continuously cut back, it might be too late for me to completely remove the high-sodium, caffeine-riddled drink from my diet. When I compare myself with friends who didn't grow up with soft drinks in their homes, my relationship with soda is much more unhealthy. With the high-profile presence of sodas in schools, most children's exposure will probably be close to my own. Putting and keeping sodas in schools is dangerous and habit forming; I enthusiastically believe that public schools should not be allowed to make contracts with food corporations. These contracts undermine efforts to improve child nutrition, and add unnecessary calories to the diet of the already-overweight American youth.
I feel that my story has parallels to the situation of people born in the 30's and 40's, who took up smoking before it was widely acknowledged to be horrible for your health. Though I continuously cut back, it might be too late for me to completely remove the high-sodium, caffeine-riddled drink from my diet. When I compare myself with friends who didn't grow up with soft drinks in their homes, my relationship with soda is much more unhealthy. With the high-profile presence of sodas in schools, most children's exposure will probably be close to my own. Putting and keeping sodas in schools is dangerous and habit forming; I enthusiastically believe that public schools should not be allowed to make contracts with food corporations. These contracts undermine efforts to improve child nutrition, and add unnecessary calories to the diet of the already-overweight American youth.
Chapter 8: Starting Early: Underage Consumers
I have always been staunchly against advertising nonnutritious foods to children. I believe the fact that they don't have the mental capability to separate the program they are watching from the advertisements means that any influence exerted by industry is unfair and unethical. The effects of these advertisements stay with children throughout their lives, and makes healthful eating a lifelong struggle. Personally, I remember my obsession with Beanie Babies led to my eating a ridiculous number of Happy Meals in the mid-to-late 90's, when a teeny beanie baby was given away with every one.
The argument that it is the parents' responsibility to regulate the advertisement to which their children are exposed is unrealistic: these advertisements have permeated almost every faction of young life. A parent would have to lock his or her child in a room, and strictly regulate any form of media going in. This media includes, but is not limited to television, books, and comic books.
This advertisement needs to be strictly controlled, if not eliminated.
The argument that it is the parents' responsibility to regulate the advertisement to which their children are exposed is unrealistic: these advertisements have permeated almost every faction of young life. A parent would have to lock his or her child in a room, and strictly regulate any form of media going in. This media includes, but is not limited to television, books, and comic books.
This advertisement needs to be strictly controlled, if not eliminated.
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