June 06, 2011

Caveman Diary 4: Paleolithic Eater by Day, Intrepid Dietary Researcher by Night


I have now made myself curious about this possible connection between (a) the rise in food stamp (SNAP) use by the American population, and (b) the perceived fall in the rate of increase in obesity in the United States (or even a slight decline in total obesity). Certain family members will recognize this as a possible symptom of a mania for getting to the bottom of things. It can't be helped.

Our story so far:

(A) Food stamp usage in the United States has, along with obesity itself, reached epidemic proportions: 40 million people and counting, and on a steep upward slope. About 14% of the total population, in fact, is now enrolled in the SNAP program. Essentially, the eligibility rules follow the federal poverty threshold guidelines, where gross income is allowed at 130% of the threshold (currently about $22,000 per year for a family of four) and net income is fixed at 100% of the threshold.

(B) Conveniently, and certainly not by coincidence, the U.S. Department of Agriculture busies itself, when it is not cutting deals with corn growers or giving bum advice about how to eat the wrong foods, in conducting surveys of what Americans eat. These studies are collected as part of the NHANES series, which sounds like a Michael Jordan commercial but refers to National Health Assessment...(et cetera) . These surveys and statistical tables specifically cover, among many other subjects, the percentage of total energy (kcals) and food by group which Americans eat away from home. Further, these surveys are broken down by income group, including those at, or within 130%, of the poverty threshold.

(C) A major caveat of SNAP use is that they are not convenient for buying crap at a fast food "restaurant," since their usage is forbidden for (i) hot foods or (ii) foods eaten on the premises where they are purchased. I imagine that someone could still use food stamps to buy a 40-oz. barrel of flavored water laced with caffeine, salt and, most important of all, high fructose corn syrup at a McDonald's or Taco Bell, but somehow I think this would be only occasional compared to previous, non-SNAP use. A major feature of our fast food culture is that places like McDonald's are used by the poor as family dining restaurants; the statistics on food intake strongly suggest this behavior. Indeed, the Department of Ag admits that eating out in such places is a big part of the obesity problem:

"Studies examining the relationship between the food environment and BMI have found that communities with a larger number of fast food or quick-service restaurants tend to have higher BMIs. Since the 1970s, the number of fast food restaurants has more than doubled. Further, the proportion of daily calorie intake from foods eaten away from home has increased, [29] and evidence shows that children, adolescents, and adults who eat out, particularly at fast food restaurants, are at increased risk of weight gain, overweight, and obesity. The strongest association between fast food consumption and obesity is when one or more fast food meals are consumed per week. As a result of the changing food environment, individuals need to deliberately make food choices, both at home and away from home, that are nutrient dense, low in calories, and appropriate in portion size."
The above pablum, by the way, is from the current version of the "Dietary Guidelines for America," that yearly document which was promulgated by the McGovern subcommittee in 1977 and has provided misguidelines for Americans ever since. It's beyond lame and stupid, which you would expect, and well into counterproductive territory. It does not take into account that the massive doses of high fructose corn syrup, sucrose and other carbs we allow Americans to consume "away from home" in effect disable the ability of individuals "to deliberately make food choices." As the legendary French polymath and metabolism researcher Jean-Francois Le Magnen stated the problem (and it sounds so much better in French): "L' appétit vient en mangeant." The appetite comes in eating. Thus, eating a large bag of popcorn at the movies, which contains 1,100 calories, seems easy, particularly if washed down with a 32-oz. Coca-Cola. The spiking insulin levels engendered by all that carbohydrate suppress the leptin and other feedback mechanisms that tell the poor eater he's full. He doesn't feel full; he wishes he had another bag of popcorn, because he's only halfway through the 12 previews before the movie starts.

But who is Tom Vilsack, Democrat of Iowa, going to blame? Those lazy layabouts at McD's swilling all that HFCS and gobbling up Big Macs (the buns heavily fortified with HFCS as well, so they'll stay "fresh") because they lack "will power" and self-control and "wisdom" to "deliberately" make good food choices that are "appropriate;" or the Corn Refiners Association, who are poisoning us in the first place? Tom, grinning at you up there, will have to get back to you on that. Suffice it to say that the "Dietary Guidelines," beyond a passing reference to "sweetened soft drinks," never betrays any anti-corn sentiment. On the contrary, it suggests that Americans really ought to give Iowa a try.

(D) Thus, if high fructose corn syrup is indeed the culprit, and if a major purveyor of HFCS is the fast food industry (which it is), then the inability of the poor, in particular, to buy humongous portions of HFCS-doctored foods (and most foods at fast food restaurants contain the sweetener, but particularly oversized soft drinks), might suggest a reason for the decline in obesity. And if this is the case, then an important forensic clue as to the origin of the obesity epidemic (at least in part) might be at hand, because the poor of America, those wretched of the Earth, are at the highest risk of obesity and obesity-related diseases, so they make a dramatic cohort for research purposes. And they were knocking back about 34% of their total sugars from "eating out" up to about 2008, and Americans on average are eating about 141 pounds of sugar per year, and it's higher yet among the poor. So if the obesity epidemic is easing up...

I believe this is one of those situations best considered through what is called a multivariate linear regression analysis, but I wouldn't be surprised if at least a suggestive clue is in there someplace. I don't think Secretary Vilsack's number-crunchers are going to tell us, because I doubt they really want to know. They just want you to eat a "balanced meal," wherever you eat it, with at least half the plate covered by fruits and vegetables. God, that sounds good: my steamed broccoli right there next to a big pile of peaches, strawberries and grapes. This is just crazy enough to work!

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