Technology, Diet and the Burden of Chronic Disease – Another Perspective

Terry D. Etherton

In the April 6 issue of the Journal of the American Medical Association (JAMA), Dr. David Ludwig concluded in a commentary “Technology, Diet, and the Burden of Chronic Disease” that “reducing the burden of obesity-related chronic disease requires a more appropriate use of technology that is guided by public health rather than short-term economic considerations”.  In the commentary, Dr. Ludwig’s usage of “technology” pertains primarily to food technology.

When I read this article and got to the last paragraph…I thought:  Here we go again!  Another not so subtle condemnation of food technology with a different “slant”…if you make food technology better it could help reduce the burden of obesity! My opinion is that this strategy won’t do much to solve a very serious public health issue…the ongoing obesity epidemic.

As I have written on countless occasions in my blog, we have the best and safest food system in recorded history.  This was achieved by developing and implementing a huge array of food technologies over the past decades that span the spectrum of food production practices, harvesting and processing, product development, food safety, nutrition, packaging, cooking, and shipping so that we have all the food you see at your local grocery store. Research advances in food technology have played an essential role in evolving the current food system, which is a present day “wonder”.  I haven’t found many individuals who wish to go back to the food system and technology used in 1850.

Despite the “wonder” of our present food system, it is a fair point that not all the food available in the market space meets the criteria for “healthy” and can be included in a healthy diet on a routine basis.  However, this is where moderation comes into play.  All foods, in moderation, can be included on occasion in a healthy diet.

My point?

Food technology is not the cause of the obesity in the United States and other developed countries.  And, please don’t think that there is NOT a major public health crisis due to overweight and obesity in the United States.  There is an ongoing obesity-related public health epidemic  in the United States.  The most recent data published by Ogden et al. who work at the National Center for Health Statistics (which is part of CDC) indicate that about 74% of Americans over the age of 20 are overweight, obese or extremely obese!  The medical care costs of obesity in the United States are staggering – totaling about about $147 billion annually.

The argument is not about whether we need to dramatically reduce the incidence of overweight and obesity in the United States but how to fix the problem.

On the face of it, the fix seems simple, individuals who are overweight or obese just need to reduce energy intake and increase energy expenditure (via physical activity).  The difficult reality is that obesity is remarkable difficult to treat.  This is clearly demonstrated by the fact that the federal government and various health organizations in the United States have spent billions of dollars over the past decade on population intervention programs and initiatives to reduce the incidence of overweight and obesity, and, yet, about three quarters of the population is still markedly above ideal body weight!

Much of the responsibility for the obesity epidemic reflects choices individuals make relative to the dietary pattern they consume daily (i.e., their daily food choices) as well as the quantity of food (energy intake) they ingest. Public health experts clearly recognize this; however, the problem is that population-based  intervention programs that effectively modify eating behavior of overweight/obese individuals so that they consume healthier dietary patterns, and reduce over-consumption of energy on a life-long basis are difficult to implement and sustain.  I can’t predict what the timeline may be for developing strategies that reduce the incidence of obesity in the American population.  In the meantime, however, I do know that we shouldn’t place the blame for the obesity epidemic totally on the food industry.

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