3Qs: Health in America

The newly released 11th edi­tion of Modern Nutri­tion in Health and Dis­ease has been called an “author­i­ta­tive ref­er­ence on nutri­tion and its role in con­tem­po­rary med­i­cine, nursing, and public policy.” We asked co-​​author and editor Katherine Tucker, a pro­fessor of nutri­tional epi­demi­ology in the Depart­ment of Health Sci­ences, to expound upon the cur­rent state of health in America.



Katherine Tucker, professor of nutritional epidemiology in the Department of Health Sciences and coauthor of a new textbook on nutrition and disease, says that following a healthy diet could prevent diabetes, heart disease, and many forms of cancer. Photo by Mary Knox Merrill.

Some 42 percent of the American population will be obese by 2030, according to a report in the American Journal of Preventive Medicine. What is the solution to solving this public health crisis, for which the textbook devoted two full chapters?

This is by no means a simple problem, and its solution lies in uniting all stakeholders. The textbook highlights the complexity of the epidemic and the new research that has been conducted in order to better understand its causes. What we do know is that there is a high correlation between obesity and the consumption of low-cost and nutrient deficient processed foods. Foods with ingredients such as refined flour and sugar and high fructose corn syrup have long shelf lives and a lot of calories to keep us satisfied, but we need to return to eating real, whole foods that can restore our metabolic balance.

When we look at the social determinants of health and obesity, we notice that low-income communities often lack high quality food in corner stores, which are often considered to be too expensive. Increasing availability of fresh fruit and vegetables and whole grain products at reasonable prices is key. On the other side of the equation, a post-World War II movement toward efficiency has reduced our physical activity. I am thankful for the publicity that people like first lady Michelle Obama have given to the importance of exercise through her Let’s Move initiative. Programs like this won’t solve the problem, but incorporating healthy habits can go a long way.

Four-dozen pages of the textbook are dedicated to the link between diet, nutrition, and cancer, and this year’s Annual Report to the Nation on the Status of Cancer noted that maintaining a healthy weight throughout life might be among the most important ways for non-smokers to avoid the disease. Armed with information linking obesity to cancer and other chronic health problems, why is it so difficult for many people to control their weight and stick to a healthy diet and exercise regimen?

The World Cancer Report noted that many forms of the disease could be avoided by eating a healthy diet. The problem, however, is that many healthy people don’t think about the prospect of getting a chronic disease like diabetes, which may only appear in earnest several years down the road. Each risk factor, including obesity and Type 2 diabetes, increases the likelihood of early mortality form heart disease or cancer or another illness.

The million-dollar question is how to get people to follow a healthy diet and exercise routine. In today’s world, we’re constantly in front of a computer screen or TV. We don’t know how to cook, and physical education and home economics classes have been removed from the school curriculum in favor of more academic courses. Doctors, for their part, have gone to medical school and are not well trained in nutrition and obesity prevention; they do, however, know how to prescribe and perform laparoscopic weight loss surgery. Prevention must be viewed as more important if we are to change the population’s health.

One of the textbook’s new chapters focuses on the connection between diet and exercise performance. What should we be eating in order to stay in shape?

I often get asked this question, and there’s not 100 percent agreement on the answer. What everyone can agree on is that resistance exercise combined with a high protein diet is the best way to build lean muscle mass. Unfortunately, many people try to boost their protein intake and muscle mass by drinking shakes and taking supplements, which can have negative side effects. At the same weight, having more solid muscle mass, as opposed to fat mass, keeps your metabolism balanced and your bones healthier. You often hear about carbohydrate loading—a strategy used by athletes to maximize the storage of energy in the muscles—but that’s designed to maximize performance rather than health.

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