I am in complete control of my own behavior... or am I?

I was reading the Yale Rudd Center blog today and read an interesting post about a new study. This study found that the amount of food that people consumed was influenced by the amount of food another person in their company consumed, but these people were completely oblivious to the impact the other person's intake had on their own intake. My comment to the post:


I think this is the core problem that public health advocates seeking to prevent obesity are facing. The U.S. is highly individualistic, and as a result individuals are assumed to have sole responsibility for their choices. This is why so many people object vehemently to proposals for changing the food environment (e.g. menu labeling laws, trans fat bans, even school food policies that limit the sale of junk food). They don't want anyone "telling them what to eat." They want to be able to choose to eat themselves to death if they want to.

What no one seems to understand is that allowing the "toxic environment" to exist unchanged is also limiting choice and controlling behavior. The ubiquity of unhealthful foods and the scarcity of healthful (and convenient) foods encourages a certain type of eating pattern, and not one that we want to encourage. This type of environment greatly limits choices for those of us who want to eat anything other than a traditional Western diet. When I go to a restaurant, I may have 3 options to choose from, whereas someone who isn't concerned with the nutritional value of their meal may have 50+. Is that fair?

Mara brings up an interesting point about people influencing others to restrict consumption. I believe there is some evidence to support that, but I think people more frequently encourage each other to eat MORE, simply because more people are eating too much than eating too little, so we are more likely to be around someone who is overeating than someone who is undereating. And for every time I've seen women competing to show restraint, there have been at least 20 times where I've seen one women egg another on to cheat on her diet or indulge in something she doesn't think she should have. "Oh go ahead! Have a cookie! Be BAD! I'll have one if you do!" Or my favorite: "Live a little!" I'd rather live long, thanks.

Mandatory Flu Vaccines for Children

The conspiracy-theory generation of parents in New Jersey are in an uproar over a new rule requiring all preschoolers to receive the flu vaccine prior to enrolling in a preschool or day care center. (Read the article here). This is just another example of baseless fear leading to irrational thinking. Really, people are far too worried about things they have nothing to worry about and not worried enough about the things that could really be harmful to children(like trans fat and violent movies).

The American Academy of Pediatrics (AAP) recommends annual influenza immunization for all children, both healthy and with high-risk conditions, aged 6 months through 18 years. This recommendation was based on the results of extensive research on the safety and efficacy of these vaccines in children. What are the objections of these parents based on?? Unsubstantiated rumors. Personally, I'd trust the pediatricians.

I heard one parent interviewed for a news piece on this story say something to the effect of, "What does getting my kid vaccinated have to do with anyone else's kid? It's illogical to me" (i.e. if I want to risk my child getting the flu, what business is it of yours?) Obviously, this guy thinks he knows more than all of the doctors and public health officials who promote vaccination. If it doesn't make sense to him, it mustn't make sense at all. Having taken an introductory course in epidemiolgy, I can tell you that it is perfectly logical that the decision of one parent not to vaccinate his child will affect other children. This is because when people are vaccinated, they can't get the disease, and more importantly, they can't spread the disease to others. It's called "herd immunity." Smallpox wasn't eradicated because every person in the world got the vaccine. It was eradicated because enough people got the vaccine that it simply could not pass from person to person anymore.

There is more risk in not vaccinating children than there is in vaccinating them. The consequences of flu in young children range from seemingly minor annoyances such as increased doctor visits and school absenteeism to hospitalization and death. Either way, the costs in terms of money, time, and suffering are high. There is simply not sufficient justification for refusing to immunize children, even against seemingly innocuous illnesses like the flu.

The CDC has some good, credible information about vaccines here.

How to not overeat at a Chinese buffet

I came across an interesting article the other day, written by my idol, Brian Wansink and Collin Payne. Dr. Wansink is the director of the Cornell Food and Brand Lab, which conducts a number of fascinating studies on why people overeat. You may have heard of the stale popcorn study, for example.

Anyway, this article was about a study on eating behaviors of obese vs. non-obese customers at Chinese buffet restaurants. They found that patrons with high BMIs were more likely to use larger plates, and less likely to use chopsticks vs. forks or to browse the buffet before serving themseleves vs. taking food immediately. Leaner people left more food on their plates and chewed more per bite of food than heavier people.

While this was an observational, correlational study not without limitations, it couldn't hurt to try the following strategies the next time you visit a buffet:

1.) Use only small plates
2.) Browse the entire buffet and then decide which items you want to eat, rather than piling on anything that looks good as you go.
3.) Use chopsticks, even if you're not that good at it.
4.) Chew slowly

Reference: Wansink, B., Collin, P.R. (2008)Eating behavior and obesity at Chinese buffets. Obesity, 16, 1957-1960.
Photo from http://www.flickr.com/photos/samsmith/

Why I will not give out Halloween candy

As the shelves of drug stores and supermarkets are being stocked with bright orange-colored bags of sugary treats, I'm starting to think that Halloween has us all tricked. Despite the preponderonce of junk food that kids have available to them on a daily basis, this innocent-sounding holiday has everyone rushing out to buy even more junk with which to fill trick-or-treaters' ever-expanding bellies.

Obesity rates in children have tripled in the last three decades, and now over 30% of children and adolescents are overweight (also called "at risk" for overweight, but I don't accept this term. A child who is "at risk" for overweight at age 17 would be considered overweight at 18, with the same BMI). Kids are surrounded by opportunities to eat large portions of high-fat, high-sugar, high-calorie foods of low nutritional value all.the.time. Do they really need another excuse to eat candy??? Let alone superfluous quantities of candy that will undoubtedly keep their sweet tooths satisfied and rotting for months to come.

Maybe giving out candy on Halloween was defensible when candy was a special treat that kids only got to have once in a while. But these days, kids can get candy at the movie theater, at the corner store after school, at the vending machine IN school, at birthday parties, at home, at the checkout line in the grocery store, and virtually any other place where kids are found. And when they're not eating candy, they may as well be. Pop tarts, donuts, or Count Chocula are breakfast staples and Hostess cupcakes are commonly found in lunchboxes. Sorry, but I don't see a good reason for doling out even more sweets to this generation of children, tradition or not.

Now I'm not a complete Halloween humbug. I think it's a fun holiday, but candy need not be an integral part of the celebration. This year, I'll be giving out toys from the party store's goodie-bag aisle. You might be thinking, Kids don't want toys! You may as well be giving out toothbrushes! Well, here's the evidence:

"Halloween: Trick, treat, or toy. This study investigated whether children would choose toys over candy when offered both on Halloween. Seven households gave 284 trick-or-treaters, ages 3 to 14, a choice between comparably sized toys and candies. Both boys and girls in the group were just as likely to choose toys as candy. The implication of this study is that nutrition professionals should encourage adults to create holiday traditions that do not rely on unhealthy foods. Schwartz, M.B., Chen, E.Y., & Brownell, K.D. (2003). Trick, treat, or toy: Children as likely to choose toys as candy on Halloween. Journal of Nutrition Education and Behavior, 35, 207-209." - From the Yale Rudd Center for Food Policy and Obesity