Archives

weight, weight, please tell me

This is a post about weight–weighty matters, the weight of the world, mainly the ongoing conundrum of there being too much of it. It is a topic I think about sometimes–trying to wrap my arms around it to contain it properly.

Actually, you will see that I don’t have much to say about it, but am sharing the brilliant voices of others who do. It seems these stories have recently, coincidentally collected in my little basket of big dilemmas.

Before I proceed, and attempt to offer something up on this largely considered nutritional–but so much greater– matter, let me digress for a moment to share something about me and my nutrition work and my nutritionist status. I have a little explaining to do. IMG_0309

I have experienced a lot of changes in the past few years. Some of these are profoundly personal while others are professional. I will stick to the latter and how they have influenced what I write about–perhaps some of you who follow me have noticed–but they are both intertwined.

When I began writing this blog in the fall of 2010-wow-I was perched in a clinical setting that continued to make me privy to the upfront and personal stories of individuals’ eating lives. I had been doing nutritional counseling for many years at that point in time. My clients’ issues strongly reflected, what I refer to in My Story, the massive changes in our food culture and highlighted the intimate art of eating in response to the personal and cultural milieu. The nutritional crises of our time, including the obesity crisis and its shadowed sister–eating disorders–were about twenty plus years deep in the making.

Professionally, I had been riding this unforeseen wave since its onset in the early 1990’s and felt I had something to say to personalize and humanize what was projected as a faceless statistical trend. Having worked with so many people, I was able to synthesize the common experiences that were impacting us all. I could also relate some true experiences of my clients in my writings. I would juxtapose these experiences alongside the larger impacts of poverty, trauma, environmental changes, food adulteration, community access, societal messaging, etc.

But, what I never stopped to share, was that two and a half years ago, I stepped out of direct care. I began doing nutritional program development and administration for a statewide program serving childcare centers–the preschoolers, families and educators. It is a good program. Though its implied mission is to prevent childhood obesity, I strongly prefer a redirection of intention to support the full health potential of all our children and mitigate the effects of what I am wont to refer to as nutritional violence and size stigmatization. Anyway, at that time, the nature of my posts changed and their frequency decreased. I had less material and more other things to tend to.

And now, I have just begun a new position. I am working for a breastfeeding support organization. This is a nutritional and health issue I am passionate about, but for essentially the first time in my career, I am not carrying the title of Nutritionist. I seem to be welcoming this change– it is a natural extension of my life work and public health orientation that fits well with my current circumstances. But it also stirs some emotion. Due to a combination of my personal experiences and the fact that I have not done direct care for a few years now, I no longer feel I can assist others with the acute health challenges of our time and the precise nutritional approaches they demand. So, along with other big changes I am now facing, I think it may be that I am no longer a Nutritionist.

So, my dilemma asks me, “Then what’s with the name of your blog?” For now, I will answer that until I have time to reconsider it, it will stay the same. I am still deeply interested in nutrition and how it relates to our individual and collective health. I am still paying deep attention and I still want to be part of the larger conversation. And, I still want to help people. I may present more concise offerings on my Instagram page which is now called, Lifeseedlings: Budding perspectives and occasional haikus on food politics, nourishment, body respect, eating and cooking. Join me there.

And so, back to the issue of weight which I raised as the focus of this post. I wish it wasn’t all that it was and is. I wish it didn’t dominate the headlines and pervade our thoughts. I am bothered by my own sometimes prejudiced assumptions and that despite my somewhat larger awareness of its complicated nature, I still conflate weight with health and want to help ease and prevent the physical and emotional burdens it encumbers. But it is about time for all of us, those with or without the business to do so, to stop believing that banishing this weight, this unruly fat, is similar to scrubbing dirt and grit off a coal miner’s body–some effort no doubt, some soaps better than others, but once undertaken, the job would be done.

From my observations, I think MAYBE things are changing. We may finally be realizing that plain out calorically restrictive diets of any ilk and fat shaming just don’t seem to be working to solve the problem in the long run nor are they doing anyone much good.

And, while not entirely new, more voices–powerful, angry and/or tender voices, are emerging that challenge the once firmly held ideas and attitudes held by our scientific and medical communities, our society and even our personal selves about the ‘weight problem’. Their words and advocacy may be shifting our perspectives, sharpening our sensitivities, and providing new approaches to care.

Here is a short little syllabus of what I consider to be very interesting insights on the topic. It includes:

  1. Where the story often begins. A post by Your Fat Friend, a personal story about the implications and consequences of early childhood weight interventions; and a discussion on What Harping on A Child’s Weight Looks Like 20 Years Later about the importance of fostering body appreciation for everyone, by Maryann Tomovich Jacobsen on her website, Raise Healthy Eaters.
  2. What No One Ever Tells You About Weight Loss. A powerful and personal look at how expectations about ways to lose weight imply a process that is both isolating and not sustainable, by Nick Eckhart in What I Wish Someone Had Told Me About Losing a Lot of Weight.
  3. How Even Well-Meaning Assumptions about Fat Athletes Can Be Misguided. Here, Ragen Chastain (whose blog Dances With Fat I have written about before) deconstructs such assumptions in her post, What Fat Olympians Prove (and What They Don’t).
  4. Really? Just five amazing stories from an episode of This American Life, entitled, Tell Me I’m Fat. (Transcript or Audio).

This is not required reading, but I hope you find something thought-provoking, attitude- adjusting or maybe even life-changing within. And, though I don’t have Carl Kasell to answer my phone, you can leave me a message here.

Thanks for listening, following/subscribing, sharing and supporting my writing.

Elyn

 

IMG_0316

MyPlate Plate

MyPlate Haiku

Pick your own today

Happy kids in wide-brimmed hats

Sweet summertime fruit. by Nan (Blessings on her new little grandson, Orion!)

 

 

 

 

Advertisements

inventive incentive

To make bread or give love, to dig in the earth, to feed an animal or cook for a stranger—these activities require no extensive commentary, no lucid theology. All they require is someone willing to bend, reach, chop, stir. Most of these tasks are so full of pleasure that there is no need to complicate things by calling them holy. And yet these are the same activities that change lives, sometimes all at once and sometimes more slowly, the way dripping water changes stone. In a world where faith is often construed as a way of thinking, bodily practices remind the willing that faith is a way of life.

Barbara Brown Taylor ~ (An Altar in the World: A Geography of Faith)

On a cloudy and dreary Saturday morning in October, I headed into Albany to catch up with the ever busy Veggie Mobile in order to get a glimpse of the Veggie Rx Program in action. It had been almost two years since I began administering this program that I had helped establish at the Health Center, and as a concerned mom, it was time for a periodic check-up to see how it was doing.       

Veggie Rx is a “prescription incentive” wherein fruits and vegetables are “prescribed” to medically high-risk patients by their health care providers as a means to encourage healthier diets and to improve health outcomes. Similar programs have begun to emerge in the past few years, and are being considered as a model of a viable public health intervention for disenfranchised communities. This medically-housed approach provides powerful messaging, unique for an institution that traditionally proffers mainly pharmaceutical solutions and well-meaning but often weak recommendations for health behavior change. It affirms, “Let food be thy medicine.” 

Veggie Rx was initiated as a collaboration between Capital District Community Gardens (CDCG)* and the Whitney Young Health Center and is funded by the NYS Department of Health’s Hunger Prevention and Nutrition Assistance Program. It was designed as a pilot to serve fifty persons with diabetes and/or hypertension. Once recruited and enrolled, the participants receive “prescription coupons” valued at $7** each, which can be redeemed once per week on CDCG’s Veggie Mobile. This bio-diesel fueled, hip-hop pulsing, “produce aisle on wheels”, toodles around many Capital District neighborhoods most days of the week, year round. It irrigates identified food deserts by arriving at a variety of community locations where anyone can shop, right on the truck. It is somewhat akin to an ice cream truck except that it hawks an impressive array of fresh fruits and vegetables, much of it from local farms. 

I met up with the Veggie Mobile that day in the city’s Arbor Hill neighborhood. Parked at the corner of a side street, it was a burst of color in a rather gray landscape. That brightly painted truck always shows up representing the rainbow, but it is the activity that it fosters that is the pot of gold. Among the customers were two Veggie Rx participants. One was a woman whom I had just enrolled in the program. She was there with her two young granddaughters. ‘Patient with diabetes’ instantly transformed into ‘loving grandma’ as I watched her solicit the girls’ advice for what to choose that week. The other was a gentleman whom had been enrolled for a while but who had not really participated. I had recently called him to discuss removing him from the program—but he asked for another chance. He explained that he had experienced a host of health problems but was feeling better and really wanted to have this opportunity to improve his diet. Sure enough, there he was like a kid in a candy shop–but instead of candy he was purchasing a sophisticated assortment of produce.

After an hour at that location, the dedicated Veggie Mobile staff women closed up shop. I hopped in my car and followed them as they got back on and off the highway and made their way over to the next scheduled stop at a low-income housing complex—not too far from the Governor’s Mansion. Arriving there, about fifteen people were already waiting–men, women and children–including two more Veggie Rx participants. They were surprised to see me and greeted me with smiles and hugs.

This was a busy site, so I assisted with bagging while anchoring myself at a good vantage point. Shopping on the Veggie Mobile begs some patience—but perhaps not any more than waiting in a fast food drive-thru line. Here though, was connection, community and lots of conversation about good food. There was squeezing back and forth as people reached to add another sweet potato, banana or onion to their order. All forms of “monetary green” (cash, SNAP EBT cards, New York State Fresh Connect and Farmer’s Market Coupons–along with the cute Veggie Rx coupons) were exchanged for “nutritional green” (collards, kale, green beans, green peppers and broccoli). It was a beautiful sight to behold.

Despite my sheer love of this program, I am still not sure if these incentive initiatives are token, feel-good, short-term experiments–or the templates for a new health and food revolution. Are they worth the effort for the few that they serve? Can they put even the tiniest dent in the massive problem they are trying to solve and might a few fruits and vegetables a week really affect change?

What I  do know is that I have seen Veggie Rx change the behaviors and well-being of many of those in the program. Let me strengthen that. I have witnessed some profound changes. There has definitely been some powerful “medicine” going down. Participants have started juicing, making smoothies, and taken to more plant-based diets. Many have attested to feeling better and have noticeably become more enlivened. While I have also noted improvements in individuals’ health markers (weight, blood pressure, hemoglobin A1c)–to see these markers shift in a significant way for this highly challenged population will take time. I caution not to base the success of these types of programs solely on those indicators–it is too myopic a lens.

Veggie Rx offers more than just food access and is about something greater than fruit and vegetable intake. Relationship building is the true foundation of this program. This power of relationship–between participants and the Health Center and Veggie Mobile staff–is not to be underestimated. Having undertaken an evaluation of this program and through my direct contact with the participants, I know that they feel better valued as both patients and consumers which increases their engagement in both roles. I also know that they consider this program to be a blessing in their lives–those are their words, not mine.

Participation comes with some requirements which asks something deeper of its recipients–like standing out on street corners in the cold, shopping in cramped quarters, finding a specific time and place to shop, and committing to follow-up medical appointments. Not everyone enrolled has taken advantage of the program, but the majority have–and some quite extensively.

As a metaphor for, or a substitute expression of the universal yearning to return to the land, the capacity to access the bounty of the earth perhaps subconsciously reminds us of the connection to our source and our birthright of health. The mere act of showing up and filling one’s bag with beautiful produce yielded from the soil, reflects a powerful commitment to one’s self. Standing witness on that morning shed light on what a new paradigm of health care could look like–particularly in response to the problems associated with health disparities–but in the larger context as well. I returned home with a reassurance that my little toddler-aged program was doing well. I can’t wait to see it grow.

As always, greetings, thoughts, and inspiration welcomed.

In health, Elyn

*Capital District Community Gardens is now known as Capital Roots.

**An additional food bag valued at $4 is also provided as part of the Veggie Mobile’s Taste and Take tasting program. So,Veggie Rx participants receive $11 worth of fresh produce per redemption.

Related Articles:

Food Trust/Policy Link:  Access to Healthy Food and Why it Matters

Double Value Coupon Program–Diet and Shopping Behavior Study

Building Healthy Communities Through Equitable Food Access

my plate

my plate

My Plate Haiku

Food is medicine

Farmers are doctors, Cooks priests

Eat, pray, eat, pray, love.  By Gordon

I Speak for the Fat People

Although I have taken a little writing hiatus, the nutritional discourse continues unabated. The stories of our communal incarnate experience resonate with frustration, guilt and misunderstandings. This is an older piece that I hope offers some response with a bit of healing balm. Some of its points have been raised and debated among those in the scientific community rather recently. I have published it in three parts previously. Here it is mended back together. Soon, I will return with some new posts. Thanks for waiting.

I speak for the fat people. Like Dr. Seuss’ Lorax who spoke for the trees, someone must speak for the fat people. Unlike the trees who needed a spokesperson because they had no tongues, you would think that the fat people would be able to speak for themselves. Of course fat people have tongues. If they did not have that taste bud-laden sensory organ, they would not be fat. Given the current weight of the world, this group should not be particularly hard to hear. However, in the huge public dialogue about weight and obesity, the fat people are merely statistics. There are no real people behind the statistics, and this is where they have lost their voice.  Therefore, they are stripped of any ability to speak with authority on the topic.

I am not a statistic. Though I have had some years where I toed the chubby line, for the most part I have done my part in tipping the scales toward societal svelteness. Besides my obligation as a citizen to keep the fat numbers down, as a nutritionist it is my professional responsibility to pull people out of the fat pool and to keep them from falling in at all.

It is no big secret that the medical and nutritional community has not done a great job in their role as bariatric (the science of obesity) lifeguards. I myself do not have a great track record of turning people into mere shadows of their former selves. But, I have spent my career as a nutritionist hearing the stories and struggles of the fat people and observing the ways of food and eating that define this turn of the century. I am a spy in the house of girth.

The fat community does in fact have some spokespeople. There are magazines, journals, books and websites–written mainly by  women–who have spent one day too many in the deprived and depraved world of dieting. There are individuals who are doing incredible and poetic work about re-informing and re-educating on misconceptions about weight and health and respectful self-care. Still, many of these efforts are marginalized or featured in venues that only topic-obsessed people like myself pay attention to. Even Roseanne Barr once said, “It’s OK to be fat. So you’re fat. Just be fat and shut up about it.” For every undertaking that sings the praises of body love and acceptance, there are thousands of counter-voices screaming the imperative to whip this fat away.

Therefore, I believe I must use my credentials to speak out. I hope that the fat people can accept me, a thin person–who is often cold and prone to osteoporosis–and an ex-stress and emotional eater to be their voice. Born of thin mother and fat father, I will try to do the cause justice.

Let’s begin by putting  the issue of overweight into perspective. If we look at weight historically, I’m pretty certain that from the beginning of time, there have been fat people. We have all seen the pictures of early Cro-Magnon and Neanderthal men. Even those quintessential hunters and gatherers seemed capable of packing on a few pounds. After them came Confucius, King Henry the Eighth, Mamie in Gone with the Wind, Jackie Gleason, Pavarotti, Aunt Bea and my grandmother. Chances are your grandmother was fat, too.

English: Luciano Pavarotti in Vélodrome Stadiu...

English: Luciano Pavarotti in Vélodrome Stadium, 15/06/02. Cropped version. Français : Luciano Pavarotti au Stade Vélodrome de Marseille, France, le 15 juin 2002. (Photo credit: Wikipedia)

Since our early beginnings, human beings have come in varying shapes and sizes and large-size was not necessarily an aberration of medium-size. It is good that there are large-sized people. A world without them would mean a world with fewer great opera singers, chefs, women of ample bosom, football players, construction workers and cuddly grandmothers.

It is not very difficult to become fat. You do not have to go out of your way to try. If Chinese youth can become fat, then anyone can. Only about 4% of the population has naturally model-thin bodies.That means that many models are starving themselves in order to be models. It also means that the rest of the size 2 wannabes are expending a lot of physical and mental energy in the pursuit of thinness.  Carolyn Knapp, in her book Appetites, tells the story of a woman who describes the angst she feels putting on her stockings every morning. She wonders what she could have accomplished in her life with the time she has spent worrying about her weight.

There are the naturally skinny–and then there are the neurotically and pathologically skinny; and the metabolically hyper-activated skinny–those who sustain themselves on a steady diet of excessive caffeine and nicotine—or maybe extensive exercise. For the rest of us, the possibility of becoming overweight is just around the corner. We are physiologically and neurologically wired to pack it on. The ability to store fat came in pretty handy a time or two during our multi-millenial evolution. We have about 107 compensatory mechanisms that prevent us from starving to death. A bunch of those certainly kicked in to save our forefathers when they were unable to kill a bison. In people who attempt to starve themselves toward thinness, the body fights back–it regains the lost weight plus more, and then absolutely refuses to budge.

In addition, we are wired for comfort. Research shows that the food habits that sustain us are those that we developed while still wrapped in the loving veil of early childhood. Whether that happened to be gazelle, chicken soup, mashed potatoes or cheeseburgers, you will probably turn to those foods as an adult. Believe me, the corporate world certainly knows this. The Happy Meal ensures that today’s toddlers will become tomorrow’s adult fast food consumers. The concept of comfort foods is one I hear a lot about during my spy missions. Women have confessed to me that they would choose a good loaf of bread over sex. The quality of the sex is not indicated in this context.

Then of course, there are our natural temperaments as well as good old genetics. I listened once to a tender story of a woman who was adopted as a child. She never met her birth mother, but she possessed a very old, poor quality home movie that she believes is of her mother. Though she struggles to see the face better in search of subtle resemblances, it is the woman’s thighs that confirm her finding. She states, “Look at the thighs. Those are my thighs.”

On top of all this, let’s sprinkle on a life change, or just daily, chronic stress. Take your pick. Break-ups, abuse, graduate school, poverty, working long hours, care giving, illness, depression or menopause are possible choices. And, God forbid you should simply possess a deep sensuous life affirming passion for cooking and eating. Throw any of these on your plate and if your primal wiring wasn’t enough to enlist you, then current circumstances will. Even the once-thins can become the now-fat–especially in this current milieu where food is literally out to get ya. Not even the high school cheerleader is immune. Any emotional state that is heightened increases for many the desire to seek food for reward. When one is working their way up the weight chart, it is because they are possessed by physical or emotional hunger, or physiological changes that they can neither understand nor control.

I can hear you begin to protest that it has to be more than just this.  Aren’t we soooo bad?  We ate the piece of chocolate cake (and we loved it). How could we? How dare we? That translates into four hours of floor mopping according to the calorie expenditure charts.  That must be fair penance for the crime. As a spy, my days are peppered with the monologues and dialogues of self-hate and recrimination that people utter like a mantra before and/or after each foray into eating. The guilt is palpable. We must have all been ____________ in a previous lifetime. (insert your own response.)

I was heartened to hear once, a man describe his joy-spreading tactic. Essentially, he spends half of his time acquiring special little chocolates and the other half, gifting them to people as morsels of universal love. I am either becoming a very cynical nutritionist or a very empathic human being. The collective psyche is longing for the morsel of joy even at the expense of the perfect waistline. The truth is that we have appetites and hungers because we are merely human, not because we are bad people. However, when all of these human tendencies accumulate into extra pounds, getting rid of that weight is very difficult.

A few years ago, I attended a conference on an obesity-related topic. As a group we were to brainstorm how to counsel a postpartum woman with a BMI of 30. The exercise had me squirming from the get go. As the attendees were getting rather  dead-ended in their attempts to master this case-study, the presenter, a physician and researcher at a major university said, “Let me offer this idea. I am often in my office at my desk and on the phone. I could just sit there and talk on the phone, but instead I stand and pace as I am talking.” My agitated brain said, “Yes, let’s file that idea to use.” Not with my clients but in this article. I could picture Homer Simpson stuffing one more donut in his face while muttering “Ah, vigorous pacing. That’s the ticket.” I wondered when was the last time this guy got out of his office and realized the experiences of real people, real fat people.

Hardly are all defined cases of overweight problematic. Some in the field maintain that the goal is for all individuals to attain an “appropriate” BMI.  Short of that, they will be at risk for various health problems. My intuition and much science beg to differ.  Many people are fine–if not perhaps better off–with a little extra weight on them. Pavarotti once said, “The reason fat people are happy is that their nerves are well protected.” My own observations reveal that the neurotically thin tend to be more frayed than their rounder counterparts. Besides, BMI is just a tool. At times it is a cruel tool—or at least a not very nice one.  It makes no allowance for age, fitness, or even natural body type. Whether we like it or not, our bodies will shift and change as we age. Nature, with no ill intent, seems to want to round us out a bit as we mature. That is how we get to be grandpas and grandmas. Appropriate BMI does not necessarily confer lack of health risks–only ones of a particular nature. Last long enough, and we tend to eventually shrink.

Do not get me wrong. I am not undermining the seriousness of the obesity crisis that we are facing. I understand its consequences perhaps more than most. I see the implications of weight that people struggle with on a daily basis and I strive to alleviate the challenges through educational, lifestyle and nutritional support. I bemoan the forces that are propelling our society into ever-expanding levels of girth, especially those that are now affecting our children.

Still, I feel a need to call TIME OUT! To stop the madness that makes those who are the statistics speechless. To stop pointing the finger merely at the individual without an understanding of the deeper forces that are at play. There are multi-factorial causes that lie at the root of the weight gain epidemic. Many are so abstract or insidious that it is very difficult even for the experts—let alone an ordinary individual–to understand what is going on. Though overeating, bad eating, food addiction and poor lifestyle choices are definitely a part of it, the magnitude of the communal weight gain doesn’t seem to make sense based on calories alone. In the causative mix lie politics, hormones, pharmaceuticals, poverty, nutrition misinformation, dieting, food sensitivities, sensory science, profits, changes in the components of our food, environmental toxins, personal and spiritual alienation and lifestyles spinning out of control. There are strange bedfellows in each and every fat cell.

Now, back to our friend the Lorax. For the record, the Lorax, our venerable spokesperson, was rather portly himself. Based on his picture, I’d put him at a BMI of about 29. I’d describe him as neither apple nor pear-shaped but rather pickle-shaped. According to Dr. Seuss, “He was shortish. And oldish. And brownish and mossy.” The final message of the Lorax in his plea to save the environment was UNLESS. “Unless someone like you cares a whole awful lot, nothing is going to get better. It’s not.”

I too, am rather shortish. Oldish, brownish and mossy may someday also describe me. For now, my intention is not to imply an ultimatum. It is, however, to bring a greater sense of compassion and understanding–and a broader lens to the discussion and to the approaches to care.

I do not intend to deny the role of personal responsibility—be that for everyone. It is a big piece of the puzzle. Though it is critical that we address the current weight epidemic–we should not do it with an assault on the fat people. We must not slap everyone silly in an attempt to squeeze them into a size six dress or Speedo swimsuit. Besides, who would be left to sing the blues? And though I’d have been happy to find my grandmother at the gym, it could not replace the experience of cuddling up on her big, warm lap with wonderful smells wafting in from the kitchen.

In health, Elyn

my plate

My Plate Haiku

Adirondack lake

Soothes us  from the heat–weightless

We float like feathers

By Elyn

obesity, oh wait a minute

I have something to get off my chest. Well, really off my dresser. I’ve had this scrap of newspaper lying there for two months. It’s an article headlined, “Town renamed for sandwich”. I hope I don’t embarrass myself here because this is about Arby’s and Reuben sandwiches, two things I know hardly anything about. Apparently, the Town Board of the somewhat nearby town of Coeymans, rechristened itself Reubenville as part of an Arby’s Reubenville Challenge. By tacking a red and white banner that said “Welcome to Reubenville” over the regular town sign, the town received 5,000 free coupons redeemable for a Reuben sandwich at an Arby’s in another town fifteen miles away.

The Three Graces

The Three Graces by Peter Paul Rubens   (Photo credit: Wikipedia)

Is Arby’s famous for Reubens? Last I knew I thought they made roast beef sandwiches. I suppose they could make Reubens as well–doesn’t seem that far a stretch–but I am pretty sure they didn’t invent them. Though I have been rather ignorant of meaty matters for about forty years now, I once did know my way around a good corned beef sandwich–and was vaguely aware of its non-kosher cousin.

A perfunctory visit to the “Welcome to Arby’s” website has just revealed to me a picture of the Reuben, embedded in what is supposedly a marble rye. It doesn’t look like a New York marble rye to me, if you know what I mean. Anyway, I am now hip to the 640 calories, 30 grams of fat and 1,610 milligrams of sodium that this town name changing sandwich contains–as well as its plethora of both real and hard to even imagine ingredients. I must commend Arby’s for listing the nutritional information for its complete menu in a very clear and accessible way. If you would like a quick lesson in fast food gastronomy I suggest you take a peek yourself. I only wish the town council members would have bothered to do the same before getting that banner made.

I am still pretty bewildered. Does Coeymans have anything to do with Reuben sandwiches or with Arby’s for that matter? Named after its early settler, Barent Pieteres Koijeman, Coeymans’ roots are strongly Dutch. Is there some confusion in the town between the possible German origins of the sandwich and the German-Flemish painter Peter Paul Rubens, known for his beautiful paintings of voluptuous Rubenesque women? Rubens apparently died from heart failure related to chronic gout. Is that what this is all about? My bigger question is, why would any municipality waste its time and efforts responding to such a bogus challenge which serves only to promote the purposes of a corporate food giant and does nothing to protect or promote the lives of its citizens?

Interestingly, physician David Katz, Director of the Yale University Prevention Research Center and a prolific writer on many things of nutritional interest just happened to speak to my burning questions and larger perpetual conundrum about personal health in the context of culture in a piece he posted this week titled “Culture, Power and Responsibility“. This piece is part of his Personal Responsibility for Health (PRH) Chronicles.

Katz writes, “I think we know what it is, and it’s all about power-and culture. Culture is a powerful influence on us all. When personal responsibility involves defiance of the prevailing forces of one’s culture, it becomes a very tall order indeed. Unfortunately, that is just the order associated with personal responsibility for health.

In a commentary published in the Lancet in February of this year, a group of scholars made the very point that the power of culture, and profit, is all too often oriented in opposition to health rather than in support of it. We might ask people to take responsibility in spite of it all, but that’s a bit like pitching someone off our boat and assigning them responsibility for keeping afloat- whether or not they’ve ever learned how to swim. Relevant power is prerequisite to responsibility.”

If you know it’s important to control your weight and attend to your health, but almost everything in your environment and your culture conspires against such efforts- how responsible are you, personally? Are you truly personally irresponsible if you go with the prevailing flow?

How can the whole of our collective responsibility for health be so much less than the sum of what we expect from its parts? Do we truly expect every individual- adult and child alike- to compensate with personal responsibility for the collective abdications at the level of culture, and corporation?

Oh, blessed be. I could not agree more. Yes, I believe that it is the cultural, corporate and governmental abdication of responsibility that displaces much of the onus on an unwitting and poorly equipped populace. And, this is why the actions of both the Coeymans Town Board and the Arby’s Corporation drive me insane. This is also why I feel the ubiquitous conversation about obesity must be redirected.

The collective chatter about obesity is still amplifying. Travelling widely around this nutritional universe as I do, I am bombarded with meteoric messages about fighting, fixing, flagellating, and fracking obesity. The mandate is to leave no obesity behind–neither its grown-up or childhood varieties–adorable pudgy babies and grandmas included. Millions are being spent on the ammunition to obliterate this planetary scourge. The aims appear community-based, but individuals are the intended targets. The drones attack both bodies and psyches alike, unable to discern the difference. For my own safety I have taken to wearing a helmet–well, at least when I am biking.

The increased prevalence of obesity is a physically evident symptom of a culture whose motives ignored or overrode its responsibility to protect the  birthright of health for its citizenry. However, generalizing obesity as a health crisis is complicated by the fact that its definition is too broadly applied, its prevalence poorly defined, its detriment still debatable and its cure misunderstood. There are many other equally important markers of compromised health and well-being. However, by focusing only on the obvious, the approach has been to throw massive resources at obesity programs with uncertain outcomes while abiding the cultural insults.

Rebuilding or restoring our country’s health will necessitate more than these bombastic approaches that seem similar to our political mindset of problem solving. It will require some deep introspection regarding the constructs upon which we structure personal and public life. It will beg that our corporate and political leaders as well as our policy makers take a serious and sensitive look in attending to the environments that either foster or hinder health. There is much to be undone and redone. I have a few ideas of my own.

But while we continue to work toward meaningful change, I will think about the dear people down there in Coeymans in the aftermath of their brief moment of irrelevant fame. I wonder how many of the 7418 citizens even cared if they were one of the 5000 somehow chosen to drive thirty miles for a sandwich. My sincere wish is that those folks may have either a large dose of relevant power or access to good affordable health coverage, because neither their council members nor Arby’s is going to pick up the real bill for that Reuben.

Do you know what I mean? I would love to hear from you.

In health, Elyn 

erin's plate

erin’s plate

My Plate Haiku

Lagoon watercress

Peppers my tongue

With spring joy.

by Roxanne

(Gratitude to Roxanne, who provided a beautiful dinner of field greens with a maple vinaigrette dressing, and brown rice with wild mushrooms and tofu during my Memorial Day weekend bike trip to Martha’s Vineyard.)

so-duh

I have a confession to make. I recently had a soda. Yes, I did. That means, of my own volition, I purchased the vibrantly colored 12 oz can, pulled up on that little flip top, and brought that fizzy, bubbly nectar–rife with all its high fructose corn syrup–up to my own lips…and swallowed. Then I swallowed again. And, I did all of this under the bright lights of the  public eye. I tell ya. That little burst of Sunkist Orange Soda was quite satisfying.

It was a cold winter’s night. Pete and I had gone to our little local community-run movie theater where nice volunteers staff a humble concession stand. I don’t really know how it happened. I was thirsty. Ordinarily, I would have just purchased a water–which was what I was assuming I was about to do again as I approached the counter. However, uncharacteristically, my thirst informed me right then and there that it would not be humored this time by just plain water and it insisted that I consider the offerings stocked in the small glass-front refrigerator.  

I was stunned. I did not know what to do. Healthy-oriented me does really enjoy a few lines of lightly sweetened specialized iced teas but there were none of those to be found in that bastion of freon-cooled fare. Instead, there were just waters, sodas and those pouches of Capri Suns that you stick  little straws into. I panicked. The cloyingly sweet fruit juice concoctions aroused a mild nausea, the sodas provoked my usual disgust and disdain and the concession people were beginning to look at me funny.

Suddenly, the sun logo on the little orange can seemed to wink at me and I found myself saying, “Yes, I’ll have an orange soda.” When I went back to sit in my chair, Pete turned to tell me that the seat was saved…for me. He really did not recognize me with that can in my hand. The last time he saw me with a can of soda was about 1981 when we were parched and poor living in Dallas, Texas.

Now, you might not think this was such a big deal without appreciating that I have about the lowest per capita soda consumption and am kind of like the Carrie Nation of the soda-drinking world. I tote around soda bottles emptied of their original content and refilled with their hidden sugar equivalency. I  paste pictures of skulls and cross-bones on these bottles. I make my victims hold those bottles while I read them the insidious list of ingredients that their beloved brands contain. I make them weep as they promise to not ever imbibe again. When forced on rare occasions to empty the bottles of their original contents so I can use them for my own devices, I don plastic gloves and a face mask. That is how corrosive I consider these substances to be. And, if anyone had ever dared offer my own kids a soda in my presence, who knows what their fate may have been.

So, imagine my inner confusion as I leaned over and whispered to Pete during the movie, “This is pretty good.”  Now, don’t get me wrong. It is not like I never had the stuff. I was raised on soda. The only thing that had stopped me from having a relationship with it long ago was an early adoption of a whole foods/crunchy granola lifestyle, an understanding of the depleting aspects of white sugar and a resistance to large multi-national corporations. If I had not had such a strong philosophical position on such matters way back, I might have just gone along enjoying these nice little fizzies with the rest of the masses. Especially the innocent flavors like orange, black cherry and ginger ale. Sometimes they do just hit the spot like nothing else can. If not bolstered by my iron-clad conviction that soda should be a banned substance, I could easily imagine getting another one of these little cans of sunshine the next time I go to the movies. And then, maybe when I go to a restaurant or if I am on a trip. I could then just keep a few in my own fridge.

Maybe I should have relaxed a little last week with my lovely 35-year-old-client–300 plus pounds, diagnosed with diabetes a year ago whose blood sugars are better but still not in good control. He is drinking way less Pepsi than he used to. Now, he only has one or two cans a day, sometimes none, while on the job during the day as a building maintenance supervisor. Should the fact that he is the father of five– the youngest of which was with him during our consult and who was the cutest thing ever–matter?  Is it just a coincidence that he sees a connection between his blood sugar levels and his soda consumption?

Maybe I shouldn’t have tried so hard last week to figure out what was up with my 34-year-old pregnant client. Prior to this pregnancy, her chart indicated that there was evidence of high blood sugar–hyperglycemia–without a full diagnosis of diabetes. She came in bemoaning her foul moods, agitation and lack of both patience and energy. Came to find out she has been consuming 2 to 3 liters of Cherry Coke for a long while. Imagine her surprise when I pulled out a sugar-filled bottle of her favorite blend from under my desk.

Once again, there is new hoopla in the divisive soda world as Coca-Cola is releasing these commercial spots touting their supposed corporate responsibility in the fight against obesity while at the same time ignoring the true effects of their confectionery concoctions. You can watch one of them here. My peeps, Mark Bittman, Marion Nestle, CSPI and others  are thankfully responding to this deceptive campaign accordingly. This is good because I am busy in the trenches. These little stories I cite above are just examples of situations I really encounter over and over, even in the course of a day. Corroded teeth, eroded stomachs, poor mood regulation, extreme belly fat and of course, diabetes lie in the wake of soda consumption and its adherent addiction. It is this that fuels my manic reaction to the stuff–and will continue to do so.

Being diagnosed with diabetes is like falling down Alice’s rabbit hole. Every day, I meet the people who have unfortunately fallen into the hole chasing some elusive White Rabbit. Reality changes mighty quickly and quite extremely. Simply awakening from a strange dream will not make it go away. Eating cake will certainly not help and the Red Queen is apt to yell, “Off with her toes!”  And, Coca Cola and Pepsico  will have nothing to offer except a Cheshire Cat smug grin.

So, though I enjoyed that little refreshment, it will be a long time until my next one. In the meantime, I leave you with a link to some powerful stories.  A Widow’s Story and Simply Raw.

As always, I look forward to your thoughtful comments and warm hellos.

In health, Elyn

I am so glad to introduce the new My Plates. Thanks to those who have submitted their beautiful plate photos. Photos and haikus always welcome.

erin's plate

erin’s plate

My Plate Haiku

Food is medicine

Farmers are doctors, Cooks priests

Eat, pray, eat, pray, love.

by Gordon

of poverty and light

Amid all of the celebrations of the holiday season it sure is easy to over indulge and to gain those few–oh excuse me for a moment–my dilemma is tugging at my sleeve. Sorry, it seems to be interrupting me to say something about property. Property? Puberty? You know, despite its omnipresence in my life, I often don’t even understand my own dilemma sometimes.

It is like when my son was little and (prematurely) learning to talk, he would get so frustrated when his word was misinterpreted. When I would repeat the statement to make sure I had heard it correctly, like, “You want some bed?”,  he could only surmise that his mother must be severely limited and he would implore the heavens for some relief. Who on earth he would beg says, “I want some bed” and even if they did, why would they say that when standing in the kitchen after nap time? What part of “bread” does my mother not get?027

My dilemma is reacting the same way now. So, with a deep breath, I will take its sweet little face between my hands and ask it to calm down and try to tell me again. Oh, I get it now. Poverty. My dilemma is asking me if I could please not write about holiday eating, but instead about poverty

Oh, poverty. “Right now?” I ask, in the midst of this season of tinsel-tinged holiday cheer?  Yes, it replies. Write about it on this darkest day of the year when we most crave the light to illuminate all that should be revealed. “Can you just try?” it says in that adorable little voice. “About poverty and nutrition?”

What do I know about this topic and what credentials do I have to write about it? Well, I do work in a Health Center that serves the economically poor–the uninsured, the under insured, those whom sit at the bottom of the economic ladder, those lacking in many of the resources that others easily possess. And, I do educate on nutrition. Yet, I am still nervous to presume that I have the right to tread here. My own perceptions are actually a bit blurry. Though every day I am deeply privileged to have my clients share the stories–somewhat intimate–of some parts of the realities of their lives, I cannot claim to really know what their impoverishment feels like. And, though yes, the majority of my clients are poor, some poorer than others–they all mainly go to sleep with some roof over their head and some food in their tummies–even the homeless ones. Furthermore, they possess a richness that nourishes and inspires me as well–whether it be of spirit, honesty, feeling, fortitude, resilience, wisdom, story-telling, family and community connection, self-reflection, humility or appreciation.

Yet, I am still perplexed, so I look back at my dilemma and ask, “But, don’t people already know about poverty and nutrition? That it is complicated but it has something to do with the cheapest (hunger slaying) food often being the least healthy; the battered economy; governmental food subsidies; food deserts; reliance on convenience and processed foods; income inequality; the history of supplemental and commodity food programs and the lack of a just and sustainable food program? And, haven’t I already discussed things like food addiction and the impact of excessive sugar sweetened beverages on emotional and physical health? And, I probably have already ranted about even bigger, more amorphous issues like lack of breastfeeding, TV advertising, health disparities, a stress-based society and may I now even add environmental toxins and gun violence which disproportionately affects our poorer neighborhoods–and how I believe all these things affect our bodies and who we are as eaters.

My dilemma nods and whispers, “Well, is there anything else you’d like to add?”  I sigh. Maybe it is on to something. There are many disparaging assumptions made regarding how the poor feed themselves. Maybe what I can do for today is to shed some light on how poverty in modern-day America infringes upon the hunting, gathering, and metabolic fundamentals required for normal human nutrition–a process that has become quite enigmatic for many, but more profoundly for those who must often do with very limited resources. In the daily conversations that I have about this elusive, ill-defined quest for proper eating–oft imagined as being as simple to prescribe as popping a pill–I am perpetually filtering many realities that are probably rather obscure.

So, here it is. Most of my clients would like to eat better. They would–but there are numerous hindrances. Many are tired. Very tired. Those who work, often work very exhausting types of jobs. Many of them–the home health aides, the certified nursing assistants, the truck drivers, the cleaners, the warehouse stockers and even the retail workers–work variable hours, often with overnight shifts which distress the natural circadian rhythms and thereby the sleep and eating patterns. Those who don’t work are often depressed or in chronic pain. Food provides easy relief. They live in neighborhoods where people get shot and murdered. They forget how to use and move their bodies. Many over their lifetimes have cared for so many others that self-care is just an amusing oxymoron. Often, just the physical requirements that cooking entails become difficult.

Additionally, when money is tight for food, so commonly it is for all the things associated with food preparation and eating. This includes appliances like stoves, ovens, dishwashers, refrigerators and freezers–and even the kitchen table and chairs. Some of my clients live in accommodations where not all of these are provided or where they are not properly working. Some only have a microwave to cook their food. Some live in settings where they have to share a kitchen with random roommates. Some people keep food in their bedrooms to prevent others from eating it. Those who live in group programs have no control over the type of food that is provided.

And, then there are the even smaller things like a set of good knives, measuring cups and spoons, pots and pans, a blender, a cutting board, a steamer or a food processor. For many a modern cook, one could not imagine even basic food preparation without most of these accouterments, if not even more. Yet, for some these are downright luxuries. Just recently, I did a display on winter squashes to promote these nutritionally blessed, fiber-dense and delicious denizens of the food kingdom–but even so, I was cognizant that unless one buys them pre-cut and frozen these pretty gourds demand a whack of a proper, well-sharpened knife to reveal their inner gifts.

Each person has their own circumstances. Though I must serve my clients quickly and effectively I have to obtain some information before I venture in with suggestions. I cannot assess for all of the above. I must pry for information with the utmost gentleness and respect to get a quick sense of where we are starting from. Depending on the person, sometimes it is obvious, sometimes not. The foods that are now commonly touted to be required for a healthy diet, I sometimes must ask permission to utter. I say things like olive oil, brown rice, walnuts, almond milk, and on a good day, quinoa, preceded by “may I?” and followed by “thank-you.” What might seem like a mole hill of a price differential could quite truly be a mountain.

Thankfully, there is usually space for an appropriate conversation about food and eating when the context is understood and appreciated. And, fortunately too, the realm of health-giving foods contains some low-cost and readily available options. My clients are glad to be reminded of them. Usually, they learned of them from their grandmothers as well. But, most importantly is when that light goes on that says that they are worthy of nourishing themselves in the best way that they possibly can. That they matter. Then this abstract matter of nutrition  begins to make some sense.

So, I guess, my main observation is that bottom line, despite our economic differences, we are first most eaters–doing the best we can with what we know and what we have in the moment. And, that somewhere, somehow, it is always about love. I look back at my dilemma for some confirmation. Oh well. It has fallen fast asleep.

Please share your thoughts and comments. I welcome your feedback.

Read below on the new My Plate Invitational

Blessings and light.

In health, Elyn

http://the2x2project.org/health-gap-wealth-gap/

my plate

my plate

My Plate: In honor of the New Year, I invite you to submit a photo of your own beautiful plate to be placed in rotation along with the My Plate Haikus. My My Plate is the prettier template and more personal representation of the My Plate put forth by the USDA as a model of how Americans should feed themselves–which replaced the food pyramid. I can’t wait to see yours. It can portray whatever nourishment, proper eating, or mealtime means to you. Haikus always welcome too. Thank you.

You may include it in a comment or submit to zimmermanelyn7@gmail.com/Subject Line: My Plate Photo

michelle, my first lady

Dear Michelle,

I have been worried about your husband Barack’s eating habits. From following him on the campaign trail during these very arduous times, it seems that news items abound about him chowing down on ribs,  chili dogs, pizza and pastries. Yes,  I know  that  he needs to go meet and greet his constituents and that he is eager to support small business owners around the country. This does mean that he must go and find where the people gather–and that is often in settings that involve the communal act of the serving and eating of food. I deeply appreciate that he is of the people and can get down and chow down with the common folk. I also I know he is a very generous guy and stories have reported that he is sometimes buying goodies to bring back to his hard-cranking campaign workers or public servants in the numerous locations where he has touched down.

pumpkins grown by farmers, carved by zena and tomas

I do not mean to undermine his profound need for nourishment to keep him going, but it seems that a lot of yellow and red light foods are speeding their way down his own gullet–with obvious gusto–and with no traffic infractions being incurred.  Just for those of my readers who don’t live in the world of childhood nutrition education, the traffic light metaphor refers to a system of identifying foods as either green, yellow or red light signifying always, sometimes or rarely ever to be eaten.

I am reminded that when Barack’s friend and mentor, former President Bill Clinton was in office, his legendary appetites were the subject of much attention and downright mockery.  I believe he lusted for Philly Cheese Steaks. So, why are your husband’s eating habits not garnering the same scrutiny?  Unfortunately, unlike pudgy Bill, it is because he is thin–actually, it is worse than that.  He is skinny. I say unfortunately, because being skinny can sneak up and bite ya.  I imagine it must have been a bit disconcerting for you when that burly pizza parlor owner, came right over and just picked poor Barack right up off the ground with that big bear hug.

With all the attention on obesity, we forget that the non-obese can suffer health consequences as well and are equally vulnerable to the effects of poor diet, smoking and stress–which I know are issues your husband contends with. These can be more detrimental than just extra pounds alone. I think I heard that he has quit smoking–so that is good.

I will assume that when at home, our dear President consumes lots of White House grown organic vegetables, and grass-fed, hormone-free animal products prepared by some of the best chefs in the land. And, that he plays basketball and does other activities to stay fit. Hopefully, he also has a team of massage therapists and other holistically-oriented practitioners to assist with his well-being. Maybe he just eats these red light foods when he is on the road–like kids who go crazy for sweets at other people’s homes when such foods are forbidden in their own.

Believe you me, I do know that it is  impossible to control our husbands’ behaviors. Here I am a nutritionist, and my own hubby has quite the pedestrian sweet tooth. No amount of my homemade kale chips can keep him from occasionally going out and finding a bag of Cheeze Doodles and the perfect dish of ice cream. I bet Hilary knows what I mean. Still, I am wondering, if given your highly touted platform and efforts regarding the urgency of improving nutritional status and decreasing the burden of illness on our nation, whether Barack could and should be modeling more healthful eating behaviors.

I was troubled by a story I heard on the radio just last week. NPR reported on what Obama and Romney were doing to sustain their non-stop high-energy requirements on the final leg of the campaign. This was right before Hurricane Sandy changed the agenda. They  interviewed some campaign assistant who started out by saying that when Barack got off the plane that morning, he headed right over to get some Krispy Kreme doughnuts. You probably don’t know that I have a little, shall we say, vendetta against Krispy Kreme, so you may want to read my posts, Kicking Butt with Krispy Kreme and Magic Doughnuts–The Nutritionist’s Nemesis. So, upon hearing that, I was all ears.

It got worse. I was shocked to then hear Barack himself saying something to the effect that all that nutrition stuff is your thing, but he doesn’t care. It is an election year and the White House will be giving out lots of candy for Halloween. My, I don’t know how you felt about that, but I was disappointed to hear such an off the cuff remark that indicated to me a disregard of the real importance of proper nutrition in improving the health of our citizenry. To really turn the tide on the dire consequences attributable to the standard American diet  (SAD) will take more than lip service. It will take courage to exhibit true leadership in this matter–and leading by example. Sugary sweets are not a substitute for the relief this electorate truly seeks; and perpetuating good-natured excuses and exceptions for our food behaviors will not reduce our massive health costs and its drain on our economy. That quick sugary fix will ultimately lead to a massive crash in mood and energy.

Never you mind. Your husband still has my vote. Yet, I am writing this with trepidation as the election is still a few days away. I do wish for him to have four more years–healthy years– in office. I hope it will not take a quadruple bypass surgery for him to appreciate and attend to the benefits of a healthful and vegan diet as it did his friend Bill. It would have been nice if while stumping in North Carolina he had stopped in at that wonderful restaurant, The Laughing Seed Cafe that I mentioned in Forks on the Road.

Though Barack might not need them, the future of health care, Medicare and Social Security are seriously on the line right now–and we need him to make sure that those programs are there for those of us who will. Perhaps too, with a second term, he can work to integrate some more holistic preventive health measures into Health Care reform.  Please, keep up your good work and see if you can get Barack to eat his beets. I read that he does not like them. Do let him know that betalain-rich beets are blessed with many healthy benefits. Great for the cardiovascular system and the lowering of high blood pressure. And, that makes those beautiful red gems a nice little aphrodisiac food too–wink wink.

Respectfully,

In health, Elyn

PS.  As you ready to advance your agenda for the upcoming term I hope you consider the work of chef, food justice activist and author Bryant Terry whose inspiring work is focused on opening the doors to a future where everyone in this country has access to tasty and healthful food.  http://www.bryant-terry.com/

Trick or treat?  Thoughts or comments?

http://www.huffingtonpost.com/2010/03/01/obama-doctor-president-st_n_480450.html

http://www.linkedin.com/today/post/article/20121010160411-203080237-x-ray-vision-carrots-changing-how-our-children-eat

http://www.thedailybeast.com/articles/2012/09/11/pizza-shop-owner-scott-van-duzer-on-bear-hugging-president-obama.html

http://www.nypost.com/p/news/national/president_barack_obama_diet_7PxbdwfaMCyEKla9ZEc8HO?photo_num=14

My Plate

My Plate Haiku

Are we what we eat

Or do we eat what we are

Are they the same thing?

by Julie