From the Dean: Food for Thought

From the Dean: Food for Thought

Food, glorious food!” No one of a certain age can forget the rousing song from the musical Oliver!, based loosely on the novel Oliver Twist, by Charles Dickens. When the deprived boys in the orphanage sing their song as gruel is being ladled into their bowls, they fantasize about “hot sausage and mustard,” “cold jelly and custard,” and “a great big steak.”

Today, we in public health tend to think of sausages, custard, and steaks—in the quantities in which they are consumed by average Americans—as a formula for disaster. The obesity epidemic in the U.S., and indeed all over the world, threatens to overwhelm the health statistics of a generation. The data are sobering: Mississippi, the first state to exceed 25 percent prevalence of adult obesity (BMI > 30), achieved that dubious distinction in 2001. A short six years later, 30 states fell into the same category!

Childhood obesity has tripled since the 1970s. We no longer talk about juvenile and adult-onset diabetes, as many juveniles are now experiencing the “adult-onset” version of the disease. Today’s kids, we are told, may be the first generation to lead shorter lives than their parents.

The reasons for the obesity epidemic are many and complex. They range from reduced physical activity to lack of access to fresh fruits and vegetables, from aggressive junk food advertising to the low cost of food relative to other goods and services. The latter is especially applicable to so-called fast food where portions have ballooned, along with the number and size of the products’ consumers.

Addressing the obesity epidemic has become a focal point of chronic disease control. But obesity is not the only food issue that demands attention, and chronic disease not the only problem. As demonstrated by recent outbreaks of food-borne illnesses associated with salsa and peanuts, food safety remains a serious concern. The Centers for Disease Control and Prevention estimates that Americans suffer 76 million cases of food-borne diseases annually, resulting in 325,000 hospitalizations and 5,000 deaths. Agencies including the U.S. Department of Agriculture, the Food and Drug Administration, the Environmental Protection Agency, and CDC are charged, in part, with ensuring the safety of the food supply, as is the Department of Homeland Security. (Campylobacter, salmonella, E. coli, and Norwalk-like viruses are not the only potential contaminants of food, and contaminants need not reach their destination unintentionally.)

Given the paltry resources devoted by the government to food safety, it is perhaps remarkable that we suffer “only” 76 million cases per annum. The limited resources reflect a more general governmental miserliness when it comes to product safety. Consider, for example, that the Food and Drug Administration—responsible for the safety of all manufactured food products, all pharmaceuticals, all medical devices, and all cosmetics—has a budget considerably less than that of the University of Michigan.

But I digress. Back to food. Can it be made more glorious through genetic modification? Or does that represent yet another threat? Are we what we eat? Or, more literally, does what we eat alter who we are?

In public health, food is … well … food for thought. As you will learn in this issue of Findings, our faculty are doing lots of deep thinking about such frontier science issues as the epigenetics of nutrition and health, and e-health approaches to diet. With former Harvard Professor Karen Peterson at the helm of our Human Nutrition Program, we expect our strong educational efforts to flourish, while a new era of nutrition research dawns at SPH.

I will close by mentioning an ironic twist on Oliver! (Yes, the pun is intended.) At Ann Arbor’s breakfast-for-the homeless-program, a favorite dish of the clients—society’s contemporary orphans—is a latter-day bowl of gruel, in this case grits or oatmeal, upon which the clients ladle unbelievable quantities of butter and sugar. The one healthy item available to them, fresh apples, often goes largely untouched, the result in part of the dentition problems from which many clients suffer. They suffer as well, as do we all, from a genetic predisposition to seek fat and sweet. And for many, although not all, their knowledge of, and perhaps more importantly their commitment to, healthy eating is limited. Public health has much work to do.

-Kenneth E. Warner

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