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Real health care reform starts in the lunchroom

Posted: Thursday, July 30, 2009

When you get a flat tire, you patch it up and keep moving. But if you keep running over nails, your tire eventually gives out, no matter how many patches you apply.

Congress faces a similar situation as lawmakers attempt to patch our nation's failing health-care system. Will universal coverage, electronic records and cheaper prescriptions make Americans healthier? Or will the system eventually burst and leave us stuck with a new crisis?

Health-care reform is important. But as a dietitian, I think Congress desperately needs to focus on the biggest "nail" bedeviling Americans' health - rising obesity rates caused by our high-fat, meat-heavy diets. It's time to reform federal nutrition policies that actually encourage children to eat unhealthy foods.

As a nation, we've been getting heavier for years - and that trend shows no sign of stopping. Adult obesity rates increased in 23 states and did not decrease in a single state over the past year, according to a new report from the Trust for America's Health and the Robert Wood Johnson Foundation. The percentage of overweight and obese children is now at or above 30 percent in 30 states.

The United States currently spends more than $100 billion per year on obesity-related health care expenditures. And as today's children - heavier than any generation in history - reach adulthood, these costs will rise even higher.

The obesity epidemic has a simple cause: We're eating too much unhealthy food. A study presented recently at the European Congress on Obesity found that Americans' weight gain over the last 30 years can be attributed almost entirely to changes in food intake.

The average American now eats 200 pounds of meat a year - about twice the global average - as well as about 32 pounds of cheese. Our plates are piled high with artery-clogging cheeseburgers and fried chicken even as we skimp on fruits and vegetables.

But instead of encouraging more healthful habits, federal subsidies have pushed more and more high-fat meat and dairy products into school lunches and other nutrition programs. In 2007, the government allocated the majority of child nutrition funds to meat, dairy, and eggs, and only about 20 percent to fruits and vegetables. This has to change.

We must help children develop a taste for fruits, vegetables and other healthful foods early in life. The upcoming reauthorization of the Child Nutrition Act, which regulates the National School Lunch Program, gives us the perfect opportunity to make a huge difference.

A few simple changes could lead to major improvements in the country's health. As Congress prepares to reauthorize the Child Nutrition Act, the legislation should be revised to ensure that foods are chosen with children's well-being - not industry interests - in mind.

Lawmakers should help every school offer low-fat, vegetarian meal options. The government should also award additional funds to schools that take extra steps to serve nutritious meals. This would cost a little more up front but would pay off in a big way when the next generation has lower rates of obesity and diabetes.

The alternative is grim. According to current estimates, one in three children born in 2000 will develop diabetes at some point in life. Because of diabetes and other obesity-related medical problems, today's children may live shorter lives on average than their parents. They will certainly require more visits to doctors and more expensive medicines.

We need to go back to the drawing table and decide what we really want out of health reform. Do we want more people in the doctor's office because they're sick? Or do we want people living healthier lives and avoiding medical care simply because they don't need it?

• Susan Levin is nutrition director for the Physicians Committee for Responsible Medicine, a vegan organization in Washington.



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