Category Archives: policy

data saving lives, policy, quantified self, technology

Google mucking around with contact lenses and health data

Interesting highly-speculative piece on Google’s visit to the FDA for a meet and greet.

The eye is a great place to stick a sensor given it’s continuity with the innards. It’s also a great place to view the innards. While we’re there, why not be powered by the innards at the same time?

http://www.bloomberg.com/news/2014-01-10/google-x-staff-meet-with-fda-pointing-toward-new-device.html

Google X Staff Meet With FDA Pointing Toward New Device

By Brian Womack and Anna Edney  Jan 10, 2014 4:01 PM ET

Google Inc. (GOOG) sent employees with ties to its secretive X research group to meet with U.S. regulators who oversee medical devices, raising the possibility of a new product that may involve biosensors from the unit that developed computerized glasses.

The meeting included at least four Google workers, some of whom have connections with Google X — and have done research on sensors, including contact lenses that help wearers monitor their biological data. Google staff met with those at the Food and Drug Administration who regulate eye devices and diagnostics for heart conditions, according to the agency’s public calendar.

As technology and medicine merge to give consumers more control over their health, innovators from mobile-health application developers to DNA analysis companies have struggled to meet the demands of federal oversight. The FDA ordered Google-backed 23andMe Inc. in November to halt sales of its personal gene test, saying it hadn’t gained agency approval.

Google, expanding beyond its core search-engine business, is investing in long-term projects at its X lab that may lead to new market opportunities, including the Glass devices, driverless cars and high-altitude air balloons to provide wireless Internet access. While some projects may not deliver significant profits and revenue, the company is committed to making bets on research and development, according to Chief Executive Officer Larry Page.

Photographer: David Paul Morris/Bloomberg

Google has introduced Glass devices, computerized eyewear that lets users check e-mail… Read More

“Our main job is to figure out how to obviously invest more to achieve greater outcomes for the world, for the company,” Page said during a call with analysts last July. “And I think those opportunities are clearly there.”

Google Glass

Already, Google has introduced Glass devices, computerized eyewear that lets users check e-mail or access their favorite music. The devices, now being used by testers and developers, aren’t yet widely available for consumers.

FDA’s public calendar also shows the Google representatives met with the head of the agency’s office that reviews device applications for marketing approval, and the FDA adviser who wrote the agency’s guidelines for mobile medical apps. The FDA classified Google’s visit to Silver Spring, Maryland, where the agency is based, as a meet and greet. Jennifer Rodriguez, a spokeswoman for the agency, confirmed the meeting and declined to provide further information.

One of the Google participants was Andrew Conrad, who joined X last year. Conrad is a former chief scientist at Laboratory Corporation of America Holdings and co-founder of its National Genetics Institute.

Photographer: Krisztian Bocsi/Bloomberg

A Google Inc. logo sits on a wall outside the entrance to the company’s offices in Berlin.

Among other attendees was Brian Otis and Zenghe “Zach” Liu. Courtney Hohne, a spokeswoman for Mountain View, California-based Google, didn’t return messages seeking comment on the company’s meeting with the FDA.

Engineering Work

Otis is on leave to Google from the University ofWashington in Seattle, where he is an associate professor in the electrical engineering department, according to the university’s website. Otis has worked on biosensors and holds a patent that involves a wireless powered contact lens with a biosensor.

One of Otis’ colleagues is Babak Parviz, who was involved in the Google Glass project and has talked about putting displays on contact lenses, including lenses that monitor wearer’s health.

“Noninvasive monitoring of the wearer’s biomarkers and health indicators could be a huge future market,” Parviz wrote in a 2009 paper titled “Augmented Reality in a Contact Lens.”

In 2012, the two were among the co-authors in a paper titled “Glucose Sensor for Wireless Contact-Lens Tear Glucose Monitoring” for the IEEE Journal of Solid-State Circuits.

‘Wearable’ Lenses

“Advances in technology scaling, sensor devices, and ultra low-power circuit design techniques have now made it possible to integrate complex wireless electronics onto the surface of a wearable contact lens,” according to the paper.

In a presentation, Parviz said a tear drop provides many different components to give sensors various types of information about how a body is operating.

“There is actually one interface on the surface of the body that can literally provide us with a window of what happens inside, and that’s the surface of the eye,” Parviz said in a video posted on YouTube. “It’s a very interesting chemical interface.”

Liu, formerly with the medical-device manufacturer Abbott Laboratories (ABT), also holds a patent that involves devices that use bodily fluids to read levels of human substances such as glucose or cholesterol.

To contact the reporters on this story: Brian Womack in San Francisco atbwomack1@bloomberg.net; Anna Edney in Washington at aedney@bloomberg.net

healthy habits, nutrition, policy

Recommended vs actual eating…

Great post from Marion – recommended vs actual. As she says… oops!!

http://www.foodpolitics.com/2014/01/what-are-americans-eating/

What are Americans eating?

I’ve only just come across this USDA chart, which first appeared in an article in Amber Waves.

USDA’s Economic Research Service (ERS) researchers looked at 1998-2006 grocery store food expenditures and compared what consumers buy to dietary guidelines for healthy eating.

Oops.

business, entrepreneurship, healthcare, management and leadership, policy, politics

HBR Blog: Resolving Health Care Conflicts with a walk in the woods

4 step process to resolving conflict:

  1. Have each stakeholder articulate their “self-interests” so that they are heard by the others. What does each need to get from this exchange?
  2. Look at where the overlap among these self-interests reveals agreement, what we call the “enlarged interests.” In our experience, these agreements always outnumber the disagreements.
  3. Collaborate to develop solutions to the remaining disagreements, or “enlightened interests.” This is the time for creative problem solving.
  4. Certify what has now become a larger set of agreements, or “aligned interests.”

Any outstanding disagreements are held to the side for future negotiations.

[…….]

The inclusion of all stakeholders is essential because people only truly embrace solutions that they help create. Anytime that one party tries to impose something on another, the natural inclination of the imposed upon party is to resist. A little time spent upfront engaging in joint problem solving saves many hours — and headaches — that come with a mandate.

http://blogs.hbr.org/2013/10/four-steps-to-resolving-conflicts-in-health-care/

We have been engaged in health care negotiation and conflict resolution for two decades. We have worked on conflicts as mundane as work assignments and as complex as hospital mergers. We use and teach a simple four-step structured process that works in cases ranging from simple one-on-one interactions to extended multi-party discussions.

After assembling representatives of all stakeholders in a conflict, the first step is to have each stakeholder articulate their “self-interests” so that they are heard by the others. What does each need to get from this exchange? The second step is to look at where the overlap among these self-interests reveals agreement, what we call the “enlarged interests.” In our experience, these agreements always outnumber the disagreements.  The third step is to collaborate to develop solutions to the remaining disagreements, or “enlightened interests.” This is the time for creative problem solving. The fourth step is to certify what has now become a larger set of agreements, or “aligned interests.” Any outstanding disagreements are held to the side for future negotiations. We’ve taught people in as little as 30 minutes how to use this approach. (See our book Renegotiating Health Care for more detail on the process.)

We call this process the Walk in the Woods after a play that dramatized a well-known negotiation over nuclear arms reduction. The delegations from the United States and the Soviet Union were at loggerheads. During a break, the two lead negotiators went for a walk during which they unearthed their personal as well as each nation’s deeper, shared interests in peace and security. This understanding enabled them to break the deadlock and move forward.

The same negotiation principles that can reduce nuclear stockpiles can be effectively applied even at the front lines in health care. For example, there is often pressure to change who does what when new technologies are deployed or initiatives are undertaken to lower costs. Consider the situation in a traditional orthopedic practice where a physician sees every patient who comes through the door. Is this really best for the patient, the practice, and the larger system?

Most patients who arrive at an orthopedic office suffer from straightforward conditions such as a simple, non-displaced fracture or a sprain. These can be adequately treated by a properly trained physician’s assistant (PA), and patients can typically be seen much more quickly by a PA than by a specialist. If outcome quality and patient satisfaction can be maintained and costs lowered, this should be an easy move to make. Such shifts in responsibility, however, are often resisted and the resulting conflict can be acrimonious. Why?

Both physicians and patients have come to expect to interact with each other. Doctors prize their clinical autonomy and their relationships with those they treat, and the fee-for-service model rewards them for taking care of patients themselves. Patients, meanwhile, want to be treated by an “M.D.” and often a board-certified specialist rather than their primary care physician (PCP). The PCPs value their relationships with the specialists in the network and focus on their gatekeeper role rather than stretching the scope of care they provide. Insurers want to control costs, of course, and they and others exert pressure to divert simple cases from high-cost specialists to less expensive physician’s assistants or other non-specialist care-givers. No one is happy with the resulting conflict: Orthopods fear losing their patients; patients are anxious about getting lesser care; PCPs worry that their relationships with specialists will erode; and insurers and administrators find the resistance by all parties frustrating, time-consuming, and expensive.

Now, imagine that the physicians in our orthopedic practice host an open house Walk in the Woods discussion that includes referring PCPs, patients, and representatives from insurers. Engaging in the four-step process, the parties would find that high outcome quality, patient satisfaction, and keeping care affordable are on everyone’s list of self-interests. Through the process, the orthopedists could educate both the PCPs and patients on when a specialist’s expertise is truly needed. Patients could articulate how they weigh the trade-off between waiting time and the provider they would see. The insurers could explain some of the cost implications of different options. One can envision the idea of physician’s assistants treating routine injuries emerging from the process as each party identifies the benefits that meet their combined and self-interests:  The orthopods may be freed up to see a greater number of more complex and interesting cases; the PAs are able to work to the level of their ability; the PCPs expand their relationships with more members of the orthopedic practice; the insurer reimburses less for uncomplicated treatments; and patients would get appropriate care, save time, and help keep premiums down.

The two aspects of this approach that can be extrapolated to myriad other conflicts are the use of a structured process and inclusion of all key decision-making stakeholders. The structured process minimizes the ego battles and tangential scuffles by keeping all parties focused on productively resolving the central issues. Depending on the number of parties and complexity of the negotiation a Walk can take from 10 minutes to 10 days or more.

The inclusion of all stakeholders is essential because people only truly embrace solutions that they help create. Anytime that one party tries to impose something on another, the natural inclination of the imposed upon party is to resist. A little time spent upfront engaging in joint problem solving saves many hours — and headaches — that come with a mandate.

data saving lives, facts & data points, healthy habits, nutrition, policy

Sugary Drink Tax in India could reduce diabetes

20% tax on sugar sweetened beverages (2014-2023) could

  • avert 11.2M cases of overweight and obesity
  • 400,000 cases of type 2 diabetes
  • the largest impact would be on young rural men
  • impacts even bigger if the 13% linear sales growth rate is exceeded

Study: SSB tax could dramatically reduce diabetes incidences in India

09-Jan-2014

Related topics: Policy, Food safety, Beverages

India could prevent an estimated 400,000 people from contracting diabetes over the next 10 years if the government were to impose a 20% tax on sugar-sweetened beverages (SSB), a new study has suggested.

According to a study published this week in PLOS Medicine by researchers at the Public Health Foundation of India, New Delhi, along with academic institutions in the US and the UK, it is estimated that imposing such a tax across India could avert 11.2m cases of overweight and obesity, and 400,000 cases of type 2 diabetes between 2014 and 2023, based on the current rate of increases in SSB sales.

Statistical analysis

The researchers analysed soft drink consumption from over 100,000 households between 2009 and 2010, studying how they responded to price changes in the past, then using that information to predict how a tax on soft drinks would influence consumption trends.

The findings come at a time when Indian health policymakers have been arguing that a combination of education and disincentives should be used to curb the consumption of soft drinks.

If SSB sales were to increase more steeply than the current rate, as predicted by drinks industry marketing models, the researchers estimate that the tax would avert 15.8m cases of overweight and obesity, and 600,000 cases of diabetes.

“Sustained SSB taxation at a high tax rate could mitigate rising obesity and type 2 diabetes in India among both urban and rural subpopulations,” the researchers wrote.

“Future research should replicate the findings observed here in other rapidly developing middle-income countries where SSB consumption is increasing at a rapid rate.”

The researchers combined data on how price changes affect the demand for SSBs with historical data on SSB sales trends, BMIs, and new cases of diabetes to estimate the effect that a 20% SSB tax would have on energy consumption, the prevalence of overweight and obesity, and the number of new cases of diabetes among Indian subpopulations.

Surprising results

The researchers were surprised to observe that the largest relative effect of the SSB tax was likely to be among young men in rural areas.

“Given current consumption and BMI distributions, our results suggest the largest relative effect would be expected among young rural men, refuting our a priori hypothesis that urban populations would be isolated beneficiaries of SSB taxation“, they wrote.

They also calculated that the gains from the tax could be even bigger if sales of sweetened beverages in India grow in the coming years not at a linear 13%, as has been the case since 1998, but more steeply as the drinks industry predicts will be the case.

healthy habits, nutrition, policy, politics, words

Industry response to launch of Action on Sugar

increase fibre content (as a bulking agent) instead of reducing portion size – they have half the calories, but are more expensive and less stable.

New word – rheology: the study of the flow of matter, primarily in the liquid state.

Sugar under siege: Reformulation can win the battle, says Barry Callebaut

By Oliver Nieburg+, 09-Jan-2014

Related topics: Carbohydrates and fibers (sugar, starches), Chocolate and confectionery ingredients, Sweeteners (intense, bulk, polyols), Suppliers, R&D, The obesity problem, Health & Wellness, Confectionery

Replacing sugar with fibers in chocolate could be more effective in reducing global sugar consumption than cutting portion sizes, but will come at a cost, according to Barry Callebaut.

Campaign group Action on Sugar was established today with the aim of pressuring manufacturers to reduce sugar in products by 30% over the next four years. Its chairman told ConfectioneryNews that the organization favored cutting sugar by reducing portion sizes rather than substitution.

Portion control: Foolproof plan to cut calories?

Marijke De Brouwer, innovation manager at Barry Callebaut, said that global salt reduction came through reformulation, so why couldn’t sugar?

“Reducing the portion size is rather easy because it’s only playing with the weight, but with portion size you do not reduce the sugar percentage.”

Fibers for positive health impact

She argued that reformulation would have a greater impact and suggested replacing up to 30% of sugar in chocolate with fibers to perform a bulking function.

 “It has a positive health impact. Fibers have some functional benefits versus sugar.”

A fiber replacement would help increase global fiber consumption and would also limit calories in a product since sugar is 4 kcal per gram and fibers 2 kcal per gram.

The cost

Asked why the practice of replacing sugar with fibers had not yet been widely adopted by the chocolate industry, De Brouwer said: “It’s because of the price impact.”

Barry Callebaut acknowledged that fibers were more expensive but would not say by how much.

Fibers may also impact processability depending on the application, potentially adding an extra cost to ensure products have the same rheology, taste and texture.

“If you want to guarantee it has 30% less sugar, you need to avoid contamination,” added De Brouwer.

She said that brands could feasibly combine reformulation with portion size reduction to cut sugar.

Health implications

Action on Sugar contends that added sugar in food and drinks is an unnecessary source of calories in the diet that is responsible for rising global obesity. It adds that sugar is linked to other damaging health effects such as type II diabetes.

The World Health Organization (WHO) recommends that no more than 10% of calories in a person’s diet should come from added sugars for optimal health, but The Sunday Times claims to be in possession of a leaked WHO draft document that says the organization is considering cutting its recommendation to 5% in light of fresh scientific research linking sugar to obesity, heart disease and tooth decay.

What’s the reference?

Action on Sugar hopes manufacturers will reduce sugar by 30% in products over the next four years compared to current levels of sugar in that product.

For example, if Mars opted only for portion control, a 51 g Mars bar would become 42 g.

healthy habits, nutrition, policy, politics

Consensus Action on Salt & Health (CASH) launches

And so it begins… the long march to effect entirely legitimate change.

With a strong and independent food regulator, the UK is the western democracy best placed to see this through. All strength to their arm – it’s going to be a doozy!

From Marion Nestle: http://www.foodpolitics.com/2014/01/action-on-sugar-to-the-food-industry-reduce-sugar-now/

Action on Sugar to the food industry: reduce sugar now!

A group of public health experts based mainly in Britain have announced a new anti-sugar campaign.

Called Action on Sugar, it is modeled on Great Britain’s campaign to get the food industry to gradually reduce salt in processed foods—voluntarily.  That campaign is considered to have led to a reduction of 25% to 40%.

Action on Sugar’s objective: Reduce sugar in packaged foods by 20% to 30% over the next 3 to 5 years.

Action on Sugar is a group of specialists concerned with sugar and its effects on health. It is successfully working to reach a consensus with the food industry and Government over the harmful effects of a high sugar diet, and bring about a reduction in the amount of sugar in processed foods. Action on Sugar is supported by 18 expert advisors.

As one of the experts put it, “Everywhere, sugary drinks and junk foods are now pressed on unsuspecting parents and children by a cynical industry focused on profit not health”—just like the tobacco industry behaves.

You have to love the British press:

New Picture

 

 

Source: http://www.actiononsugar.org/

  • To achieve a reduction in refined added sugar intake in the UK and ensure it does not contribute to more than 5% of total energy intake.

• To reach a consensus with the food manufacturers and suppliers that there is strong evidence that refined added sugar is a major cause of obesity and has other adverse health effects.

• To persuade the food processors and suppliers to universally and gradually reduce the added sugar content of processed foods.

• To ensure clear and comprehensive nutritional labelling of added sugar content of all processed foods and beverages, using the recommended traffic light system.

• To educate the public in becoming more sugar aware in terms of understanding the impact of added sugar on their health, checking labels when shopping and avoiding products with high levels of added sugar.

• To ensure that children are highlighted as a particularly vulnerable group whose health is more at risk from high added sugar intakes.

• To ensure the body of scientific evidence about the dangers of excessive refined added sugar consumption becomes translated into policy by the Government and relevant professional organisations.

• To conduct a Parliamentary campaign to ensure the Government and Department of Health take action, and that, if the food industry do not comply with the sugar targets, they will enact legislation or impose a added sugar tax.

• To work with other organisations and stakeholders in order to maximise the message about what is a healthy diet, ensuring this includes reducing the current national high added sugar intake.

• To work with experts in individual countries, the World Health Organisation (WHO) and individual ministries of health and other relevant bodies.

business, data saving lives, healthcare, management and leadership, policy, rapid learning health systems

Toby Cosgrove: Leaning in to healthcare changes….

 

  • frames consumer need for selection apps
  • frames payer need for analytics

http://www.linkedin.com/today/post/article/20140107180116-205372152–leaning-in-to-healthcare-changes

“Leaning in” to Healthcare Changes

January 07, 2014  


Healthcare is in the midst of an unstoppable transformation. The pressure to reduce costs, improve quality, and provide a better patient experience is relentless. How will providers respond? Which organizations are best positioned to succeed?

These changes have been a long time coming. Forces favoring consumerism have completely transformed the airline, manufacturing and retail sectors. Now it’s healthcare’s turn. The primary drivers are information technology and high-deductible healthcare plans. Patients didn’t shop around when it was the insurance company’s dollar they were spending. But when you’re paying for routine healthcare, x-rays, and colonoscopies out of your own pocket, you start looking at the price tag.

Information technology is going to be the comparison driver. Consumers can already compare rates for hotels, airlines and appliances with the swipe of a finger. Soon there will be apps showing you which healthcare providers provide which services at what costs. You’ll be able to sort them from lowest to highest cost, and make your choice: Does it matter to you if your angioplasty (a minimally invasive procedure to open blocked arteries) is performed by a highly regarded academic medical center backed by full cardiac surgery capabilities, or if it is performed less expensively at a private cardiology practice, where you would have to be transported elsewhere for life-saving surgery in case of an emergency? I know what I would choose, but you, as a consumer, will have to make your own risk-benefit calculations.

In addition to consumerism, the Center for Medicare and Medicaid Services (CMS) will be exerting its own pressure, paying doctors and hospitals less for their services and demanding more accountability for quality, safety and patient experience. Private insurers, who usually follow the lead of CMS, will also be paying less and demanding more. Toss in all the unknowns that accompany the federal government’s Patient Protection and Affordable Care Act, and you are looking at Force 5 cost headwinds.

There is no escaping the conditions that are forcing this transformation. The providers who succeed will be those who “lean in” to the changes – hospitals and medical centers who embrace cost awareness not as an onerous duty, but as a patient care issue. Because along with lowering costs, we are improving efficiency, reducing variability of outcomes, and accelerating medical innovation. All of this adds up to better patient care, and that’s what we’re here for.

facts & data points, healthy habits, nutrition, policy

Traffic lights don’t kill people…

Punchy demonstration of the effect of traffic lights on food purchases. No wonder unhealthy food industry is opposed to them…

http://www.rwjf.org/en/about-rwjf/newsroom/newsroom-content/2014/01/infographic-promoting-healthy-food-choices-using-traffic-light-guide.html?cid=XEM_A7869

Infographic: Using Traffic Lights to Promote Healthy Eating

A workplace cafeteria used “traffic light” labeling to indicate the healthiness of food and drinks and rearranged items so that healthier, green-labeled items were more visible. According to a study of 2,285 Massachusetts General Hospital employees who regularly used the cafeteria sales of healthy items jumped, and after two years, employees continued to make healthier choices.

Infographic: Can a Traffic Light Guide You to Make Healthier Choices?
nutrition, policy, politics

Industry walks away from regulation…

The food industry play book in action in Scotland…

Scotland abandons responsible food marketing standard

By Caroline Scott-Thomas+, 11-Dec-2013

Related topics: Food safety and labelling, Legislation, Sugar, salt and fat reduction, Marketing

The Scottish government has shelved a standard for responsible food and drink marketing intended to tackle Scotland’s obesity problem, after food industry participants withdrew from discussions.

The government said in April that it would develop a third party certified publically available specification (PAS 2500) on responsible food and drink marketing in partnership with the British Standards Institute (BSI). A Steering Group was set up, consisting mainly of food industry and marketing associations “to give the process credibility and to ensure engagement and industry buy-in.”

However, in a letter addressed to Steering Group members seen by FoodNavigator, the BSI said that although there seemed to be agreement that the project should be attempted, “it was apparent that there was considerable scepticism in respect of the validity of the objectives for the PAS, amongst some sections of the stakeholder community”.

The industry ‘supports balance’

The standard was intended to provide a benchmark for the responsible marketing of food and drink to cut consumption of food high in fat, salt and sugar, but industry trade body, the Food and Drink Federation (FDF), says that it did not recognise that current approaches to food promotion already encourage balanced diets.

“By changing product recipes, creating new healthier options, investing in consumer education, providing clear labelling and promoting a wide range of products, the industry supports individuals to find the right balance,”said FDF director of communication Terry Jones.

“The PAS process did not recognise this context. It would restrict the information available to consumers and risk undermining one of Scotland’s most important industries and putting up prices for hard pressed consumers.”

No one from the FDF responded prior to publication to a query about which information would be restricted.

Government ‘could not continue without industry involvement’

The Scottish government said that it was now considering industry responses to draft proposals on other voluntary measures to encourage healthy choices, and aims to publish strategies for marketing and reformulation in April next year.

Referring to the shelved specification, a government spokesperson told this publication: “Unfortunately it could not continue without the food industry’s involvement. However, we welcome the assurance from all parties that they remain committed to constructive engagement on the issue of marketing of HFSS foods.”

Consumer watchdog organisation Which? urged the Scottish government to set out how it is now going to ensure action on more responsible marketing.

“People tell us that responsible marketing is one of the main areas they think Government should address to make it easier for people to eat healthily so it’s disappointing that talks have ended because of the withdrawal of the main industry groups,” a spokesperson said.

complex adaptive systems, healthy habits, nutrition, policy

RAND: Top 5 Obesity Myths

  •  Obesity is not genetic
  • Obesity is not due to lack of self-control
  • Lack of fresh fruit and veg is not responsible
  • We are not too sedentary – we simply eat too much
  • Education about diet and nutrition will not conquer obesity
  • What’s really needed is regulation – for example, limits on marketing that caters to our addiction to sugar and fat — OH DEAR

The top five obesity myths

Published: December 29, 2013 – 1:01PM

The obesity epidemic is among the most critical health issues facing countries like the US and Australia. Although it has generated a lot of attention and calls for solutions, it also has served up a super-sized portion of myths and misunderstandings.

1. If you’re obese, you can blame your genes

As obesity rates have soared, some researchers have focused on individuals’ genetic predisposition for gaining weight. Yet, between 1980 and 2000, the number of Americans who are obese has doubled – too quickly for genetic factors to be responsible.

So why do we eat more than we need? The simple answer: Because we can. At home and at restaurants, a dollar puts more calories on our plates than ever before. Before World War II, the average US family spent as much as 25 per centof its total income on food – in 2011, it was 9.8 per cent. And people eat out now more than in the past. In 1966, the average US family spent 31 per cent of its food budget dining from home – in 2011, it was 49 percent. Because restaurant meals usually have more calories than what we prepare at home, people who eat out more frequently have higher rates of obesity than those who eat out less. Meanwhile, the food industry has developed tens of thousands of products with more calories per bite, as well as new, effective marketing strategies to encourage us to buy and consume more than necessary. We should blame these business practices, which are modifiable, for obesity rather than our genes, which are not.

2. If you’re obese, you lack self-control

According to a 2006 study, “research on restrained eating has proven that in most circumstances dieting is not a feasible strategy”. In other words: People won’t lose weight by trying to eat less because they can’t easily control themselves. Unfortunately, this puritanical view of personal resolve plays down how our surroundings and mental state determine what we eat.

Research shows that if we are overwhelmed with too much information or preoccupied, we have a tendency to surrender to poor dietary choices. In one study, for example, people asked to choose a snack after memorising a seven-digit number were 50 per cent more likely to choose chocolate cake over fruit salad than those who had to memorise a two-digit number. When adults in another study were asked to sample a variety of foods after watching a television show with junk-food commercials, they ate more and spent a longer time eating than a similar group watching the same show without the junk-food ads. In the same study, children ate more goldfish crackers when watching junk-food commercials than those who saw non-food commercials.

Our world has become so rich in temptation that we can be led to consume too much in ways we can’t understand. Even the most vigilant may not be up to the task of controlling their impulses.

3. Lack of access to fresh fruits and vegetables is responsible for the obesity epidemic

The US Department of Agriculture estimates that fewer than 5 per cent of Americans live in low-income communities without access to fresh food, but about 65 percent of the nation’s population is overweight or obese. For most of us, obesity is not related to access to more nutritious foods, but rather to the choices we make in convenience stores and supermarkets where junk-food marketing dominates. Since we are buying more calories than we need, eating healthily could be made more affordable by eliminating unnecessary cheaper low nutrient foods and substituting higher quality foods that may be slightly more expensive.

Obesity is usually the consequence of eating too much junk food and consuming portions that are too large. People may head to the produce section of their grocery store with the best intentions, only to be confronted by candy at the cash register and chips and soda at the end of aisles. Approximately 30 per cent of all supermarket sales are from such end-of-aisle locations. Food retailers’ impulse-marketing strategies contribute significantly to obesity across the population, not just for those who do not live near a green grocer or can’t afford sometimes pricier healthful choices.

4. The problem is not that we eat too much, but that we are too sedentary

According to the US Centers for Disease Control and Prevention, there was no significant decrease in physical activity levels as obesity rates climbed in the 1980s and 1990s. In fact, although a drop in work-related physical activity may account for up to 100 fewer calories burned, leisure physical activity appears to have increased, and Americans keep tipping the scales.

There is compelling evidence that the increase in calories consumed explains the rise in obesity. The National Health and Nutrition Examination found that people consume, on average, more than 500 more calories per day now than they did in the late 1970s, before obesity rates accelerated. That’s like having a Christmas dinner twice a week or more. It wouldn’t be a problem if we stuffed ourselves only once a year, but all-you-can-eat feasts are now available all the time. It’s nearly impossible for most of us to exercise enough to burn off these excess calories.

5. We can conquer obesity through better education about diet and nutrition

According to a physicians’ health study, 44 per cent of male doctors in the US are overweight. A study by the University of Maryland School of Nursing found that 55 per cent of nurses surveyed were overweight or obese. If people who provide health care cannot control their weight, why would nutrition education alone make a difference for others?

Even with more information about food, extra-large portions and sophisticated marketing messages undermine our ability to limit how much we consume. Consider Americans’ alcohol consumption: Only licensed establishments can sell spirits to people older than 21, and no alcohol can be sold in vending machines. Yet there are very few standards or regulations to protect Americans from overeating.

In the 19th century, when there were no controls on the quality of drinking water, infectious disease was a major cause of death. Once standards were established, the number of these fatalities plummeted. Similarly, if Americans did not live in a world filled with buffets, cheap fast food, soft drinks with corn syrup, and too many foods with excess fat, salt and sugar, the incidence of obesity, heart disease, high blood pressure and diabetes probably would plummet. Education can help, but what’s really needed is regulation – for example, limits on marketing that caters to our addiction to sugar and fat.

The Washington Post

This story was found at: http://www.smh.com.au/lifestyle/diet-and-fitness/the-top-five-obesity-myths-20131229-301ch.html