#WhyCookseries/MyHealth/1 #CSM1
This post is part of the Why Cook? Series: 6 Reasons to be a Lifestyle Cook, a discourse on the pillars of The Cooking Subversive Manifesto (CSM). Providing great reasons to cook are powerful motivators to make cooking a lifestyle choice especially when we understand how forces have conspired to make us choose otherwise.
America’s obesity rate is 42.4%.1
The United States may lay dubious claim to being democracy’s chief champion of late, but when it comes to obesity, it is without a doubt the leader, and has been so for nearly 2 decades among countries tracked by the Organisation for Economic Cooperation and Development (OECD).2 That’s not exactly something to be proud of.
We’re inured to this data point because we’ve sat with this fact for far too long and it’s only becoming worse. We’ve vilified the subjects—overweight people, because in the back of our minds, we’ve been taught to associate being fat with gluttony, poor self-control, laziness and other reprehensible traits we like to think we’re absolved of. Because we’ve appropriated blame to the wrong culprits, we’ve missed the real offenders, and they’ve been able to hide in plain sight. Before we point fingers, let’s first understand the magnitude of the problem.
Why the US Covid-19 death toll is so high
We’ve just reached the grim milestone of 800 thousand deaths in the United States, with no real end in sight. From the onset, the huge American death toll, disproportionately higher than in other developed countries, begged the question: why so high?
In a John Hopkins Coronavirus Resource Center tally of global deaths attributed to coronavirus, the US has 239.43 deaths/100,000 people. It is the 6th highest in the world, preceded by Brazil, Romania, Czechia, Hungary and Bulgaria; and the highest among wealthy nations. While we can debate on the ramifications of polarized attitudes towards masks and vaccines (we don’t have the monopoly on anti vaxxers and conspiracy theories), the data is clear on the primary causes of American deaths. According to a study published by The Lancet.3
Consistent with reported COVID-19 outcome data from Europe, the United States, and China, higher caseloads and overall mortality were associated with comorbidities such as obesity, and advanced population age.
Let’s unpack the comorbities part. Comorbidy, the simultaneous presence of two or more diseases, entered our lexicon when covid-19 exploded. Comorbidity is a bulls-eye target for coronavirus; the chances of getting very sick or death is much higher. But what diseases are strongly associated with covid deaths?
In this screenshot of Covid-19 deaths with contributing conditions released by the CDC for 2020 and 2021, I circled 9 diseases linked to obesity. That’s half of the top 18 (see note4) diseases associated with covid-19 deaths that can be linked to obesity, which is directly associated with poor diet and unhealthy lifestyles.
Even without Covid-19, 3 of the top 7 leading causes of death in the US, heart disease, stroke and diabetes, are linked to obesity. A recent report by the New York Times suggests that covid 19 lives in fat cells. If proven conclusively, that will be the most direct link yet of Covid-19 to a poor diet.
Covid-19 exacerbated what we’ve known all along: Americans are unhealthy and unless we make lifestyle changes, we are literally going to pay for it with our lives.
When I was a child, my mom told me her father had diabetes. She said that they would find ants gathered near the toilet, because his urine was so sweet. To an 8-year old, that was the sort of outrageous, fun and slightly gross family factoid to brag about to friends. As an adult, the implications were serious. Though my mom didn’t have diabetes, both her parents did; my father had it too, and two of my siblings are on medication for it. The CDC says I am highly predisposed to diabetes if it runs in the family (check) and if I’m Asian American (check). Add to the melee, heart disease is also a familial companion.
You would think this less-than-glorious health history was enough incentive to get me cooking. It was not. In Manila, we had household help who cooked for us, I frequently dined out, and frankly had no interest in it. I turned to cooking in my 30’s out of necessity: I downshifted from a corporate career in Manila and moved to the US as a music student. I simply couldn’t afford to keep eating out. But I also had not understood the pernicious actions of big corporations, particularly the food industry, nor their sustained influence on lifestyle and culture, which diminished cooking life skills in our eyes. I didn’t know then what I know now. So despite a lifetime eschewing junk and processed foods, I became prediabetic. That’s a red flag for me to be vigilant about diet and lifestyle so I never cross over to diabetes. I have no ailments, am not on any medication and I want to keep it that way. So though my cooking journey began with economic reasons (the fifth tenet of the manifesto, I Cook To Save Money), it’s now sustained by others, primarily, that I Cook to Reclaim My Health.
To Solve a Problem, Understand What Caused It
There’s nothing like statistics on death and disease to put a damper on holiday celebrations. I admit, the timing may not be the best as we look forward to celebrating with feasts and abundance. A snapshot of America’s health today, however dire, is not without use. 2022 is around the corner, and what better way to counter a grim trend than to make new year’s resolutions that benefit you and your family?
But resolutions are only resolute if you can counter forces that undermine. So we need to understand how we got into this predicament in the first place.
Why are we Fat?
There are really just 2 big reasons5:
1. We eat too much. (overconsumption)
2. We eat unhealthy stuff.
Easy, peasy, right?
Well, not exactly. This is one of those Matryoshka-esque problems where an issue opens up to another and then another, and sometimes is intertwined with others. As an example:
Overconsumption can be traced to reduced cooking and preparation times which has its genesis in mass food production and consequent growth in prepackaged foods; but it’s also related to sugar addiction which fails to satiate hunger. And if you think sugar is just that white table stuff, think again, because sugar has over 60 names and comes in many forms most don’t even recognize. The general public’s confusion on understanding exactly what is healthy and what’s not is a product of the machinations of greedy, unethical corporations, poor science, complicit government actions and a culture that makes us too busy to figure things out for ourselves. Confounded yet? Exactly! It’s a lot to unpack and why we haven’t been able to solve this decades-old problem. And because it’ll take me a few passes to paint the general picture, I’ll start with how we started to spend less time cooking.
When did we start spending less time in the kitchen?
In his book, Cooked: A Natural History of Transformation, author Michael Pollan traces the fascinating history of cooking from when man first learned to make fire to where we are today. As a starting point for my discussion, I will jump to post World War II in the United States where Pollan recounts:
…the food industry labored mightily to sell Americans—and American women in particular—on the processed-food wonders it had invented to feed the troops: canned meals, freeze-dried foods, dehydrated potatoes, powdered orange juice and coffee, instant and superconvenient everything.”6
Post war America was a different world. Women, who were the traditional cooks, had entered the workforce; a proliferation of cars gave rise to suburbs where cooking became an isolated chore when once it was a communal activity; technological advances in the food industry were making packaged foods cheaper and more palatable every day and labor saving kitchen devices like the microwave oven were proving to be indispensable appliances.
The combination of changing societal and technological norms of postwar America, increased wealth, the burgeoning idea the food industry peddled that women should be “liberated” from the kitchen7 and most especially the prevalence of ready-made food that could be picked up or delivered all conspired to convince Americans to spend less time in the kitchen. In 1965 it was 146 minutes a day.8 By 2019, it was 36 minutes.
*2019 data from US Bureau of Labor Statistics9
In a 2003 study titled, Why Have Americans Become More Obese? 10, researchers Cutler and his colleagues linked increased caloric consumption, primarily from snacks, directly to the rise of obesity. Data collected (1977-78 vs 1994-96) showed that men and women consumed 268 and 143 more calories per day than they did 14 years before. The question was, what was making Americans eat more? They’re conclusion: Less cooking.
Binge America
A simple home-made Pizza Margherita, even if you use store-bought dough, tomato sauce, mozzarella and happen to grow basil leaves in your window sill, will likely take more time to make then having pizza delivered. You’ll have to roll out the dough, perhaps half-bake if it’s a thick crust, slather sauce, arrange toppings and then bake again to finish. While you were at it, you probably popped a piece of mozzarella into your mouth with a leaf or two of basil and perhaps sampled the tomato sauce with it. Your home-made pizza took more time, but not only was it more fun, you tasted along the way, which reduced the chance of wolfing it down when it came out of the oven. But more than that, a craving for pizza, not the healthiest of foods to begin with, becomes more difficult to satisfy if you had to make it from scratch. But pizza delivered is just a phone call away. And that is why delayed gratification was the link Cutler and associates made when they concluded that:
Less Cooking Time=Less Delay in Gratification=Eating More
Yet how many Americans actually make their own pizzas? Pre-made food, because it’s accessible, is not only easier to eat, but makes you likely to eat more. The time and effort involved in cooking, delayed gratification and eating slowly all help to curb our appetite. When Netflix releases a whole season of your favorite show, you’re not just watching one episode. It’s why the term “binge-worthy” exists.
Lest you think we’re immune to the allures of instant gratification, let me assure you that we’re not. Jeff and I are as guilty as everyone else of Netflix binging and snacking while we’re at it. We live in a modern world subject to time-sucking temptations and frankly, our self-control is not as iron-clad as we would like. So instead of fighting human nature, we’ve just become a little smarter working with it. Besides reducing our screentime by cooking (including preparation and clean up) we make sure snacks at home are healthy for when the munchies hit.
So yes, Americans are eating more. But we’re also eating too much of the wrong stuff. It’s not like we don’t know who the usual suspects are; we do. We know processed junk foods are some of the worst offenders, yet they are almost 60% of calories11 consumed in the United States. But eating is not a rational behavior; and corporate America is counting on that.
The Companies We Hate To Love
Forget covid for a sec: prior to the pandemic, it’s long been known that being overweight and obesity can lead to heart disease, the leading cause of death for both men and women in the US. That’s 1 out of 4 deaths, according to the CDC.12
Perhaps even more than overconsumption, the rise in obesity is attributed to poor diets—specifically the increase in sugar, sodium and other toxic additives in ultra processed foods. Unhealthy ingredients like high-fructose corn syrup, partially hydrogenated oil (trans fats) and flavor enhancers are used by the food industry because they are cheap and make nutrient-deficient lab concoctions edible. “But they make us sick”, you might say. Well, in America it’s all about free choice and capitalism. You’re not forced to drink a can of Coke (high- fructose corn syrup) or eat Kellogg’s Froot Loops (partially hydrogenated oils) for breakfast, but it’ll be hard to resist because all your life you’ve been told it’s the right thing to do.
My second job out of college was a brief stint as Account Executive for the Coca Cola division of the McCann-Erickson advertising agency in Manila. The Philippines was one of the few markets where Coca Cola was way ahead of Pepsi, so dominant a player that we broke out of the soda category and considered the whole beverage industry as our competitive field. We ran radio ads to compete with coffee, juice and milk with our Coke in the Morning campaign; we printed Coke Tuba posters targeted to the Southern Philippines where locals consumed Coke with Tuba, an alcoholic libation of fermented coconut sap. Coke ads were hip, featured cool music, had great looking, laughing models, and the sales pitch was always oblique. Coke ads evoked warm and fuzzy feelings. I was a kid and still recall when the mega-hit commercial of the 1970’s spawned the memorable tune, I’d Like To Teach the World to Sing:
I'd like to teach the world to sing
In perfect harmony
I'd like to hold it in my arms
And keep it company
So sweet. Just like Coca Cola, addicting the world to its empty sugary charms. I wasn’t a Coke or Pepsi drinker and I already knew about the deleterious effects of sodas, but still, I was hooked. I loved my job with the Coke group also because its branding strategy, front and center of Filipino lifestyle and culture meant aligning with the music pop stars of the country and part of my work was to travel with artists and help organize Coca Cola concerts. That was a dream job for someone in their 20’s.
I also had an unusual personal history with Coca Cola: my mother was one of their first models in a video advertisement; and as a student activist, I marched against Coke, the premier face of imperialism.
US occupying forces during the great wars brought Coca Cola with them introducing the world to the “pause that refreshes”. Regimes came and went, but more durable was a non-violent Coca Colonialism that tied profitability to notions of liberty and the American dream. The Philippines’ relationship with Coke, like mine, was complex and conflicted. An article in the New Yorker published in 1959 is filled with wry , often humorous anecdotal evidence on the world’s infatuation with Coke. In a former US colony like the Philippines, liberated from the Japanese by the Americans in World War 2, the sentiment ran strong, as evidenced by an account of Filipino General Carlos Romulo in his memoir “I Saw The Fall of the Philippines”:
This day that was to mark the turning point in the Battle of the Philippines began for me with an incident that seemed of the greatest importance. In fact, so vital did it seem at the time that that night, upon my return to the tunnel on Corregidor after one of the most terrible days a man could ever experience, I wrote a detailed account of that day on my typewriter with a ribbon that could hardly make itself legible, and with trembling hands I added the important notation: “I had a Coca-Cola.”
Pearl of the Orient: A Coca Cola infomercial on the Philippines
The World Wars are decades past and discussions on Coca Colonialism are long buried. But these antecedent events are important to comprehend where we are today. If you still think I’m overstating Coca Cola’s sway on our culture, look no further than at the brand’s most iconic figure and ambassador of goodwill and cheer, Santa Claus. The jolly, rotund man in red is a visage largely shaped by Coca Cola which you can read about on the company’s page, “Five Things You Never Knew About Santa Claus and Coca-Cola.”
We hate to love companies that are bad actors if their brands are associated with positive ideals deeply ingrained in who we think we are or want to be. Like an abusive boyfriend, they know how to sweet talk their way back. Our ambivalence is why they are still around and why we still consume their products despite the harm they’ve caused us.
Big Business, our Sugar Daddy
Big Business is omnipresent. They’ve been targeting you since you were a babe with a multi-media onslaught that includes ads on television, internet and social media. They infiltrated your videogames through advergames. At school, you bought soda from their vending machines and the tomato-based pizza served at your school’s cafeteria was your vegetable option. You even got free Big Business- branded school supplies.
Obesity among youth has more than tripled since the 70’s and affects 1 in 5 of school-aged youth. 13 If you were a kid who celebrated your birthday party at MacDonald’s, then Big Business may have lassoed your little heart and you feel a tiny tug whenever you spot the golden arches as you drive by. Food ads on television comprise half of all ad time in children’s shows, according to the American Psychological Association.
We must not underestimate how well Big Business understands and manipulates our collective psyche. We know it’s powerful, because despite our best intentions, we continue to poison ourselves when we consume unhealthy foods. What rational being does that? Unless it’s because we’ve been deliberately misled and have not seen the whole picture yet. Which is why this story isn’t over.
We reduce caloric consumption when we cook by delaying gratification. And if we’re eating a home cooked meal, perhaps we’re not consuming unhealthy ultra processed food as much. That’s already a win. But healthy cooking is as much determined by what and how we cook. Remember I mentioned a confluence of forces that helped confuse America and the world on what healthy eating means? When we take a detour from the Cooking Subversive Manifesto tenets to introduce a few more bad actors, we’ll see how what we eat is even more nefarious than how much we eat in the battle of the bulge and other diseases. In the new year, we’ll take a glimpse at America’s food and farming in the post, “I’ll Have The Poison on the Side, Please.” : Chemicals in our Food.
Additional References:
High US covid death toll causes: https://jamanetwork.com/journals/jama/fullarticle/2771841
Food waste: https://www.nrdc.org/sites/default/files/wasted-2017-report.pdf
Growth of the Suburbs: https://americanhistory.si.edu/america-on-the-move/city-and-suburb
Santa Clause: https://www.coca-colacompany.com/company/history/five-things-you-never-knew-about-santa-claus-and-coca-cola
Impact of Food Advertising on Childhood Obesity: https://www.apa.org/topics/obesity/food-advertising-children
2017-18 data from NCHS: https://www.cdc.gov/nchs/data/databriefs/db360-h.pdf
2001 OECD Obesity rate (p.55): OECD (2001), Health at a Glance 2001, OECD Publishing, Paris, https://doi.org/10.1787/health_glance-2001-en and 2017 OECD Obesity Update : https://www.oecd.org/health/obesity-update.htm
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30208-X/fulltext
Due to space limitations, the screenshot begins with the 4th comorbidity ranked, Respiratory failure. Excluded from screen shot are: 1. Covid-19, 2. Influenza and pneumonia, 3. All other conditions and causes (residual) So out of the top 18 listed, 9 are connected with obesity: https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm
Although a sedentary lifestyle (lack of exercise) and genetics contribute to weight gain, food intake is a primary reason
Chapter VI of Cooked: A Natural History of Transformation, by Michael Pollan
In an interview with NPR, Pollan describes a KFC billboard with a big bucket of chicken and the slogan “Women’s Liberation” https://www.npr.org/2013/04/21/177501735/fire-water-air-earth-michael-pollan-gets-elemental-in-cooked
1965-1995 data: https://pubs.aeaweb.org/doi/pdfplus/10.1257/089533003769204371
https://www.bls.gov/charts/american-time-use/activity-by-hldh.htm
Cutler, David M., et al., ”Why Have Americans Become more Obese ?” Journal of Economic Perspectives, 17 No.3 (2003):93-118; https://pubs.aeaweb.org/doi/pdfplus/10.1257/089533003769204371
https://bmjopen.bmj.com/content/6/3/e009892
1 of 4 deaths is attributed to heart disease; Nearly half of American adults already have heart it. https://www.cdc.gov/heartdisease/facts.htm and https://www.heart.org/en/news/2019/01/31/cardiovascular-diseases-affect-nearly-half-of-american-adults-statistics-show
https://www.cdc.gov/healthyschools/obesity/facts.htm
I Cook to Reclaim My Health