National Issues Forums Institute (NIFI) director Frank Fear suggested the following as a possible issue for development into a deliberative framework.  We welcome your comments and additional information about this issue.

Food, Nutrition, and Health in Precarious Relationship

Many issues facing Americans today are imposed on them, such as the national macro-economic changes that are affecting families’ economic security. However, every day in this country Americans are doing something to themselves: consuming food—in type and amount—that has negative implications for their long-term health.

Part of the problem is the abundance of “cheap food” (the infamous “dollar menu”), which makes certain types of food (“fast food,” particularly) readily and easily available. But there is also the proclivity of the American taste bud: preferences for high-calorie food with high levels of salt, sugar, and fat, often coming in the form of “comfort foods,” loaded with simple (rather than complex) carbohydrates, such as potato chips and donuts. Rather than becoming options that people consume occasionally, these foods have become staples of the American diet, perhaps best characterized in the form of a lunch consisting of a burger, fries, and a Coke.

Another dimension of the problem is the amount of food consumed. Consider the “super size me” phenomenon that expands (often doubling) the amount of food available per serving. While bigger portions are often interpreted as “good value” (getting more for your money) the bigger portions available are often high-calorie, carbohydrate-loaded foods rich in salt, sugar, and fat. Less available—and often less attractive to eaters—are healthier options, such as fresh fruits, vegetables, and lean protein. Healthier options cost more (on average) and they are often less available to consumers—because of the existence of “food deserts” in many communities—and they are viewed by many consumers as less attractive (that is, less tasty) alternatives.

The bottom line is that Americans are “hooked” on eating foods that do not contribute to nutritional balance and a healthy lifestyle, and they are becoming sick over it. A significant portion of the American population is overweight; lifestyle diseases, such as diabetes, are becoming increasingly prevalent; and many chronic diseases are linked significantly to food consumption patterns (e.g., heart disease). Coupled with the general inactivity of the American population—including youth—we are facing a crisis, a health crises, that we have inflicted on ourselves. And that crisis is literally costing the country—in skyrocketing health care costs associated with treating lifestyle-related illnesses.

But it’s not as though Americans are doing this to themselves alone, unassisted. The food and restaurant industry urges Americans to eat. Quickly accessed and less expensive food is marketed aggressively. “Fast food” fits the American lifestyle: eat quickly and get on your way. This applies not only to prepared-for-purchase food, but also for food prepared for consumption at home (pre-measured and ready for cooking). Metaphorically, the saucepan (at one time a primary cooking instrument) has been replaced by the microwave.

While one might argue that institutions are simply giving Americans what they want, there is also the question of how much this demand has been created by the food and restaurant industries. And to keep costs down, a good portion of the food available in groceries stores and restaurants is mass produced. The goal of producing a lot of food and as quickly as possible has created its own special brand of challenges, such as what happens in the animal industry with the use of growth-assisted hormones and housing animals (e.g., chickens) into limited-space areas for efficient production.

The overarching implication is clear: food insecurity, which used to be interpreted singularly in terms of hunger (that is, people having enough to eat), is now understood more broadly in terms of the relationship among food, nutrition, and health. When food insecurity is viewed more broadly, the conclusion is that many Americans are food insecure: that is, they are not eating (in type and amount) food that contributes sufficiently to nutrition and health.

While there is abundant evidence of counter movements in this country—the local food movement and increasing emphasis on sustainable and organic food production are several examples—these efforts (at least to date) have had limited reach. For example, it is often more expensive (sometimes significantly more expensive) to buy organic products. Besides, the decisions to buy (say) organic food is a lifestyle choice: made by people who have decided how they want to live their lives and have the ability to act on that choice. What about the low-income mother in an urban center who finds it an economic necessity to feed her family “dollar meals” at the local fast-food place—as a primary means to stay within her food budget?

All of this illustrates the complexity of the situation we face as a society. At issue is what to do about it? What actions might we take to bring about needed change—at the individual and household levels, at the institutional and community levels, and through policy changes at the state and Federal levels?

Thinking through and deliberating on the options is a necessary if Americans are to eat themselves back to health.