Oversized and Undernourished: The Epidemic of Childhood Obesity

Pre-Listening

1. Even if you never have children, how do you think the obesity epidemic growing among the young now will affect your future? Explain.

2. Who or what is responsible for obesity among children?  That is, whose responsibility is it to do something about this problem (i.e., individuals; parents; communities; city, state, or federal government; food producers; food marketers; employers; insurance companies; the healthcare system; etc.)?

Dr. Howell Wechsler of the Centers for Disease Control

1. When discussing sedentary behavior, Dr. Wechsler states that television       watching has been correlated with obesity in children. But he said that it “may have more to do with what television induces them to eat, than the fact that it displaces physical activity.” (to add a listening link, it is on page 2 of the transcript) What does he mean by this statement?  Do you watch much TV?  What messages about food, appearance, exercise and health do you find there?  How, if at all, do you think these messages affect your personal eating habits?

2. Dr. Wechsler says that the invention of the microwave has had an impact on children because now they can prepare their own meals instead of waiting for Mom and Dad to come home and prepare a meal. (to add a listening link, quote starting from “The invention of the microwave” and ending at “come home to do it” is on page 3 of the transcript) Dig deeper into the connection Dr. Wechsler is drawing between children preparing their own meals and microwaves: what kind of foods do people most often microwave? Is it the same kind of food you would use to prepare a meal for a whole family?

3. What changes will need to be made in the way we produce, market and eat food if we start to see obesity as a problem of society rather than just of individuals? What can governments, schools, the food industry, media, farmers and ranchers, activists and others do both individually and collectively to address the obesity epidemic?  What policies at what level of government and business need to be changed or enacted to combat obesity?

4. Dr. Wechsler draws a distinction between obesity as an issue of appearance and as an issue of health.  But since obesity is a problem that people can physically see on other people, it ultimately becomes an issue in both respects for both individuals and society.  In your observation, how do people deal with the stigma of obesity?  How far if at all, does your concern about your body image affect your eating habits?  What are the consequences of ignoring the deeper health problems associated with obesity? What do you think needs to be done to avoid treating obesity solely as an issue of appearance?

Miriam Nestle, professor at New York University and author of Food Politics and What to Eat

1. Nestle says that “there is a whole field of advertising and marketing that specializes in selling things to children,” that “television is the strongest predictor of children’s food choices,” and that research documents that “children [can’t] tell the difference between information and sales pitches.” One conclusion she draws from these facts is that federal regulations are needed to control the marketing of food to children since the food industry hasn’t been able to regulate itself. (listening link with quote starting on “What do you think can be done to limit the marketing of junk food to children?” to “…that imperative is something they just can’t do” on the end of page 5 and beginning of 6 on the transcript.) Do you think this is a good solution? Explain your position and discuss opposing viewpoints, offering other possible solutions in place or support of Nestle’s suggestion.

2. Discussion: How did you feel to learn that the ingredients of junk food are subsidized by the government, making them cheaper than health food and thus more profitable for companies to grow, make into products, and sell?

3. Nestle suggests that to help people make different food choices, there are three steps. First, eat less. Second, eat less often. Third, eat different (healthier) kinds of food. Would you structure the first, second, and third steps in the same order, or a different order? Explain why or why not.  After listening to the whole program, do you think there is anything missing from the three steps?

Amy Salzman, nutrition columnist for Parents Action for Children

1. We hear a lot about self esteem and respecting ourselves, but Salzman puts a new twist on the matter by giving people a way to really practice self-respect – by eating foods that actually nourish your body. Most kids are used to hearing the age-old parental advice, “Eat your vegetables because they’re good for you.”  How can parents, teachers and other elders convey the message of healthy eating as a gesture of self-respect?  How can their advice be given in ways that kids will hear and heed?

2. Discussion: Salzman, as well as other guests on this program, point to the importance of the family dinner for healthy eating and detail how it is pushed aside by our busy schedules. When you grew up, did you eat dinner with your family? What about other meals? Was it a rushed or leisurely time to be together?  Did you enjoy family conversations or watch TV while you were eating?  What effects do you think your family eating experiences have had on your approach to eating, preparing and enjoying food?  On reflection, have your experiences eating with family or others been an important aspect of your life?  If you are an adult, have you continued the tradition you were raised with (eating together vs. eating apart, eating out vs. eating in)?

3. Can you think of a store that you have ever been in like the one described by Mark Sommer (listening link on page 7 starting with “First of all” and ending with “reason that through with your child”): one that doesn’t put junk food on the shelves? If you have, dig deeper. What kind of neighborhood was the store located in? What kinds of people shopped there? What was the experience of shopping like? What effects do you think the prominent placement of pre-packaged and non-nutritious food in most supermarkets has on the ability of individuals to make healthy choices?  Which are you more likely to choose, a brightly packaged bag of ready-to-eat “healthy baked potato chips” or the fresh gnarly potatoes lying bare in a produce bin?

4. Salzman points out that many people simply don’t have access to healthy foods because of the neighborhoods they live in and the circumstances of their lives. (listening link on page 7 starting with “One thing I want to say is that a lot of people simply don’t have access” to “variety of foods in a way that would be considered ideal”) She views changes in school lunch menus as one way for children living in low-income neighborhoods to gain exposure to healthy food. What other approaches would give families more opportunities to access and eat fresh, healthy food?

Wil Bullock and Sharon Riley of Boston Food Project

1. Bullock relays the spiritual and creative aspect of growing food that hooked him into agriculture and then healthy food. How large a role do you think a lack of direct experience with growing food plays in people’s current unhealthy food choices? (listening link at end of page 8, starting with “For me, the best way I can put it” to “really change people’s lives and give a lot of people access to food”)

2. Riley describes how the Boston Food Project’s culinary education program teaches kids how to prepare the food that they just grew.  With the growing popularity of pre-packaged foods, many people have forgotten how to cook with fresh ingredients.  How does this “cooking illiteracy” contribute to the obesity problem and how can children best gain familiarity with cooking with fresh fruits and vegetables for themselves, their families and friends?  How could teaching “cooking literacy” to kids when they’re growing up affect obesity and other health problems when they become adults?

3. Part of the problem that Riley and Bullock address is the lack of access to healthy food in their urban area. (listening link starting with “I think that’s part of the issue we’re dealing with” and ending with “access is not available to a lot of people” on page 9) In the interview, Riley discusses some of the solutions that they are trying to implement. Do you think these solutions would work in your neighborhood markets?  Despite their proximity to agricultural production, rural communities often face the same lack of access to healthy food.  What special challenges do rural communities face and what challenges derive from their proximity to food production?

Dr. Matthew Gilman, associate professor at Harvard Medical School

1. After listening to this interview (and the rest of the program), which do you think is a bigger factor in obesity – the environment or genetics? Explain.

2. What other factors does Dr. Gilman point out contribute to overweight infants aside from a mother making poor eating choices?

3. Considering obesity as a public health issue, what are the costs of only the affluent members of our society having access to fresh or organic foods while less affluent members are left behind, unaware and unable to purchase the foods that contribute to good nutrition and health?

Concluding Discussion Questions

1. Take out the piece of paper where you jotted down your first reactions to the two questions asked before you listened to the program. For a review of the questions, refer back to the beginning of the study guide. Looking again at the questions and at your initial responses, has listening to the program changed any of your thoughts? Why or why not? What new understandings have you reached as a result of listening to this program? Fill in the Responsibility Matrix below and share and discuss your responses.

2. Try to answer the narrator’s questions posed at the conclusion of the program: If you have kids, what are you doing to assure they’re healthy and well fed? If you’re a kid, how do you deal with the pressures of a fast paced life without resorting to fast foods? Or if you’re not eating healthy, in what are ways can you make a change in your own life?

3. After listening to this program, explain how a child can at the same time be overweight as well and undernourished.