Transcendental Gastronomy
In 1826 a French lawyer and politician named Jean Anthelme Brillat-Savarin published the book Physiologie du gout, ou meditations de gastronomie transcendante, in which he presented 30 essays on various culinary and epicurean themes. The book has not been out of print since.
In one of his meditations, Brillat-Savarin declared, “The destiny of nations depends on the manner in which they nourish themselves.” He would have a feast-day with observations on how Americans are chowing down, and the rapidity of obesity’s rise.
1. Between 1970 and 1990, the mass of fatty tissue in children less than one has doubled
2. 44% of the population over age 60 have syndrome X
3. In 2007-2008, the prevalence of obesity was 32.2% among adult men and 35.5% among adult women (Flegal, et al, JAMA, January 2010)
One has to wonder why children less than one are so much fatter than the preceding generation. It certainly isn’t because they’re couch potatoes gorging on French fries and Big Macs. Could it be that our epigenetics are changing? Likely a multifactorial problem, it could be related to increased expression of an inflammatory phenotype, to increased levels of omega 6 fats in our diet, and/or to increased levels of persistant organic pollutants in our environment.
The fact that almost one in two adults has metabolic syndrome, and one out of three are obese (two out of three are overweight) is certainly concerning when we consider the burgeoning rolls of baby boomers entering their Medicare days. How are we going to pay for all the chronic diseases that are associated with obesity and metabolic syndrome?
Dr. Walter Willet, Chief of Harvard’s Department of Nutrition, states “Weight sits like a spider at the center of an intricate, tangled web of health and disease.” We need to work on not letting overweight and obesity become the new norm, and instead focus on whatever measures we can take (unfortunately this is not a problem to be solved with a single magic bullet) to prevent them.
As physicians we need to advocate for availability of more healthy food choices for our patients, and removal of those foods that provide empty calories. I predict that future generations will look back on sodas in the same way that our generation now looks at tobacco. We can start promoting positive change here at home with our own cafeteria, asking our catering and food supply company to consider removing the high glycemic foods such as sodas, candy, and chips and replacing them with healthier options, or at a minimum placing such products, with no redeeming nutritional value, in a less salient place than the checkout stand. We could choose not to be one of the 46% of hospitals serving fast food in our cafeteria. We could ask for healthier choices than doughnuts and muffins at our own staff meetings. Guacamole anyone?
