More Thoughts on Obesity

Sorry for the lack of posting recently, this crazy thing called grad school got in the way. But I did want to follow up on last week's post about how best to address the problem of childhood obesity. Before we get to that though, a few things. First, I am not, nor do I pretend to be an expert on any issues, least of all obesity. I'm just a wee public health student sharing my thoughts. Second, I do love that my last post about soda taxes prompted so much discussion, I think it's great that you all are not only reading, but sharing your thoughts. So please continue to do so!

Ok, on to the main attraction. Last week, I talked about how I wasn't a huge fan of a soda tax as a way to fight childhood obesity. So lets talk about what I am a fan of. I should start by saying, I don't think any one thing will be successful, it will take a comprehensive plan. But here are some key elements:

• Better health education about nutrition. We have to help parents and children understand what proper nutrition is and what it means to be appropriately physically active. I think this is one area in which public health has been a bit behind in the times. It's easy for people to be swayed by food advertising, the public health community has to do a better job getting the message out there. And it's got to be more than just about counting calories--portion sizes, healthy choices, healthier cooking methods, being active--all these things can be part of a comprehensive, culturally appropriate, health education campaign. This means it can't be a one-PSA across the whole country sort of thing, it needs to be tailored to particular audiences.
• Provide incentives for grocery stores to open in what are currently food deserts (areas that lack access to affordable, quality and nutritious food). Too often these food deserts coincide with low-income areas, which means that not only is there limited access to healthy options, these options are prohibitively expensive. As has been pointed out by many, obesity disproportionately affects low income people. If we're really going to solve this obesity problem, we have to give everyone an equal opportunity to access healthy nutritious food.
• Re-think the way we currently subsidize food. The way we currently subsidize food has made food cheaper, which is good, but it has tended to make unhealthy food the cheapest, which is bad. We should revisit these subsidies and figure out a way to subsidize fresh fruits and vegetables and drive the cost of these, and other healthy options, down. Again, that gives people a better opportunity to make healthy choices with a limited budget.
• Change how we build and maintain our communities. Why can't we make sure that we build more sidewalks so that people can walk safely in their neighborhood? And we need to ensure that our children have safe places to play and be active. There's a group here in Boston that has had some really good success in working within communities to empower youth to help clean up parks and make them safe places to be. Working within the community to make changes will be an important part of being successful.

There are of course more components, but at the risk of putting you all to sleep, I think I'll stop here. Just as a note, a lot of these things are also a part of First Lady Michelle Obama's new Let's Move campaign--hopefully it will be successful. Also, if you're interested in a really neat map tool that clearly illustrates some of the disparities that we face in area of nutrition, I'd encourage you to check out the FDA's Food Environment Atlas (thanks to Rachel for the link!).

Finally, because I don't want to be accused of hiding information, a study came out recently which showed that taxing unhealthy food was more effective than subsidizing healthy food. I haven't had a chance to read the whole study, but it is interesting and certainly seems to support what some of you all were saying about a soda tax. However, I still think that if you don't have access to healthy food, then taxing unhealthy food only makes it all cost more. I'd rather go the method of improving access and empowering individuals to make healthy choices.

As always, please share your thoughts! And remember, as part of my marathon training, I'm raising money to support research to fight childhood obesity and solve these important problems. I'd appreciate your support, you can make a contribution at: http://www.tuftsmarathonchallenge.com/runners/miriamst.

Marathon Training--Bode Miller style

So after all the soda tax conversation here, I thought I'd give a little running update. The short version--training is going well. The slightly longer version is as follows.

I've had a pretty good week running-wise. On Sunday, I did 14 miles with the Tufts crew, and felt pretty good. This was followed by a really good 7 miler Tuesday. Tuesday was the kind of day where I set out to just do 5ish, and ended up feeling so good that I did more.

But back to Sunday, for the past several weeks, my runs at Tufts have included "the Hill." Here's a little bit about "the Hill." While I didn't run it for the first month or so I was running at Tufts, I kept hearing people talking about "running up and over the hill" but I didn't really know what they were talking about. I saw this hill as I was running, but it was super steep and I kept thinking to myself "there's no way that's the hill they are talking about, it's crazy to make people run that!"

And then, one day in January, I realized that yes, that hill I had been seeing all along was in fact "the Hill." It's about 2 miles long, super steep at first before becoming a bit less steep and more rolling as you get towards the top. The first time I ran it, I thought I was going to cry....it just kept going. But then, as I kept running it each week, it started getting easier and easier. And this past week, I actually started to enjoy it. Weird, I know.

It helps that when you get to the top, our wonderful Tufts coach is there, taking a ridiculous number of pictures and providing water, Gatorade, mini cookies and jelly beans to fuel us up for the rest of the run. To the right is a picture of me and my running buddy Ann making our way up the last part of "the Hill"--determination at its finest.


For those of you wondering about the title of this blog post, Thursday is usually a running day for me. But today, instead of running, my wonderful mother and I went skiing at Cannon Mt in New Hampshire, which just happens to be Bode Miller's "home" ski mountain. Despite the questionable weather--it was a great day. I don't know if skiing all day is entirely the same as a run, but my legs sure are tired!

PS: Thank you very much to everyone who has supported me in my fund raising efforts for the Boston Marathon--I really appreciate all your generosity! I still have more to go--so please visit http://www.tuftsmarathonchallenge.com/runners/miriamst and help me make each and every mile count!

How Not to Solve the Obesity Problem (Or Why I Am Against a Soda Tax)

For several years now, people have been searching for ways to fight the obesity problem in the US. An idea that seems to be gaining support is a soda tax. This is usually described as a tax on what are known as "sugar-sweetened beverages," namely soda (it's unclear to me if other sweetened beverages, such as juice drinks, would also be included). Mark Bittman wrote an article in the New York Times last week about this issue entitled "Is Soda the New Tobacco?" where he addressed this issue. It's an interesting read, and I'd encourage you to read it if you get the chance.

In my humble opinion, a soda tax is a terrible idea. I could go on for quite some time on this issue, but I'll try and keep my points succint. So here are my main reasons for opposing this idea:

• Soda isn't tobacco. A lot of people have tried to make that link, that soda companies are doing the same thing as tobacco companies were doing 50 years ago. But I just don't think that's true. Cigarettes and tobacco products are a pretty specific thing that has been definitely linked to cancer and other diseases in even moderate quantities. With soda, the link isn't so clear. While certainly drinking too much soda can lead to obesity, drinking an occasional soda probably isn't harmful. If people were to unconditionally stop drinking soda, I don't know that the obesity problem in this country will go away. And my fear is, if we can tax soda which can potentially lead to obesity, what else will we tax? Eating too much meat can lead to obesity, as can too many cookies, too much chocolate, too much cheese....the list goes on. It's too much of a slippery slope to me.
• Diet soda isn't all that great. A lot of these soda tax proposals don't include diet sodas. Indeed, companies are often proud to claim that they've removed full calorie soft drinks from schools and other places, while leaving diet sodas in their place. Now, I hate diet soda because it tends to give me a horrible headache, but more importantly, there's some evidence that diet soda isn't all that great for us either. I think it would be a bad idea for us to focus on "regular soda" as a public health issue and ignore the possible perils of diet soda.
• Finally, and perhaps most importantly in my opinion, a soda tax is a regressive tax--it hurts the poor more than anyone else. Go to a low-income area and chances are there aren't a ton of full-service grocery stores. But there probably are a lot of small convenience stores. If you go into these, you'll notice that there isn't a whole lot of options for drinks and by far the cheapest options tend to be soda. You won't find single servings of milk, or 100% juice or other healthier options. So what this tax will do is force poor people to pay more for soda, but they still might not have the ability to choose healthier options. It's essentially a poor tax.

Now I know the spirit of a soda tax is a good idea--by taxing soda you can raise money to pay for more anti-obesity programs. But I think there has got to be a better way to raise this money than by levying a tax. And I say this as a concerned public health person, not just someone who enjoys an occasional soda....

So there's my opinion in a nutshell, I'd be happen to expand more if anyone wants to hear more. What do you all think about taxing soda? Do you think it would be an effective anti-obesity program? I would love to hear your thoughts. And as a reminder (and a shameless plug) I'm running the Boston Marathon to raise money to find innovative solutions to these problems, Your support would be very much appreciated, visit: http://www.tuftsmarathonchallenge.com/runners/miriamst to help me make every mile of the marathon count.

A preview for upcoming blog posts: a running update is coming in a few days followed by my brilliant thoughts about obesity and what I think would work waaaay better than a soda tax.

I Believe I Can Fly

More good news on the running front--I ran 11 miles on Sunday with no pain in my shin! Hooray!! My new plan involves taking Advil before running and continuing with my icing/yoga routine. Hopefully this will be the last you hear of shin splints attacking me. With just about two months left until the marathon, I am beginning to up my mileage--I think I will shoot for 14 this coming weekend. I also have two more scheduled runs on the marathon course itself--I'm looking forward to these as a way to prepare myself for what marathon day will bring. And finally, I believe I will be ready to run 26.2 miles on April 19...this training program is making me feel very confident in my abilities!

A friend recently asked me how I can possibly run in the winter when it's so cold. This may be an unpopular opinion, but I actually prefer running in the cold. When I trained for the Marine Corps Marathon a few years ago I trained all summer and that was HOT. Very very hot, like walk outside and start sweating at 6am hot. I prefer winter, you can always just put more layers on. For example, on a recent very cold run, I wore running tights with another pair of workout pants on my legs. On my upper body, I wore a long sleeve running shirt, a lightweight fleece and a windbreaker. And I finished it all off with a hat and two (yes two) pairs of gloves. I actually stayed quite cozy, except for my nose. If anyone knows how to keep my nose warm while running, I'd appreciate that knowledge.

A preview for the next blog post--I'll be talking about why I am vehemently against a soda tax as a way to combat obesity...look for that in a few days. If you have any subjects you want me to write about in my semi-intelligent way--preferably running or obesity/public health related, just let me know. I'm happy to take requests. And since my mother managed to post a comment (thanks Mom!!!) I know you all can too. It'll make me happy to know you actually make it to the end of these blog posts.

(Oh yeah, and if you want to make me really happy, please help me make every mile count and support me in my quest to run the Boston Marathon--visit: http://www.tuftsmarathonchallenge.com/runners/miriamst. Your support will be very much appreciated!)

Little Victories

Yesterday I ran 4 miles. Now ordinarily that wouldn't be much of an accomplishment, since I had been routinely doing closer to 8 on most of my weekday runs. But after my week off, I was happy to get through 4. The good news is that my leg seems to be doing much better. It hurt a bit towards the end, but nowhere near the "you must stop running right this instant" pain that I felt last week. So that is a very good sign. I will keep up with the icing and the Advil taking and with luck I'll be back to my regular running schedule soon.

In other news, today I received my official registration card from the Boston Marathon! That's right, there's no going back now, I am an official entrant--in 67 days I will be at the start line in Hopkinton headed to Boston. Yes, I know I could just drive, but doesn't running 26.2 miles seem like more fun? What that means for you, my dear readers, is that you have 67 days to motivate me and help me make every mile count--go to http://www.tuftsmarathonchallenge.com/runners/miriamst to support me--anything you can give will be very much appreciated.

To all my DC friends, I hope you are digging out after the "snowpocolypse" (that's what you all are calling it, right?). And hey, if you want less snow, just move to Boston :)

Where has all the running gone?

So all you astute readers may have noticed that there hasn't been a running update here recently. Well, that's because there sadly isn't much of one. About a week ago, I developed a shin split in my left leg. It got pretty painful and was even hurting when I wasn't running. I decided the best course of action was just to stop running for a week. Let me tell you that wasn't a fun decision.....

So for the past six days, I've been resting. I've spent a lot of time icing my leg and taking Advil and doing a lot of yoga and pilates to try and keep my muscles well stretched. It seems as though it's getting better. And now, a week later, I'm getting antsy for running. So tomorrow I'm going to give it a shot--just a few miles and hopefully all will be well and I can get back to my regularly scheduled training.

If any of you have any experience dealing with shin splints (this is my first time with this problem) I'd love to hear your advice. Or if you just have any motivational or inspirational words, I'll take those too. As a hint, if you want to really motivate me, you can make a contribution to my running cause here (remember--all money goes to research to fight childhood and adolescent obesity--yay!)

My Thoughts on the Surgeon General's Report

First of all, did you know that the plural of Surgeon General is Surgeons General? I really like sharing that fun fact with people, so there you go.

Ok, on to bigger and better things. I mentioned a few days ago that the US Surgeon General, Regina Benjamin, released a report that was her "Vision for Healthy and Fit Nation." This evening, while watching Tuesday night's Biggest Loser, I thought I'd take the time to read through it and share with you a few thoughts. If you're interested in reading the full report (just a warning, it's about 20 pages long), you can find it here. Overall I was impressed by the report, here are some key points:

• I REALLY liked that Dr. Benjamin didn't call for sweeping government regulations. She didn't argue for a soda tax (which I am very much against), didn't call for the government to ban unhealthy food or even to enforce stricter menu labeling. Instead, she argues that a combination of factors--personal decisions, schools, the environment and the medical community--can work together to fight obesity.
• My absolute favorite line in the report: "Interventions to prevent obesity should focus not only on personal behaviors and biological traits, but also on characteristics of the social and physical environments that offer or limit opportunities for positive health outcomes." This is just great--and very connected to a lot of what we discuss in my courses at BU--that it's not just about personal decisions. Where we live and the opportunities we are given have a lot to do with our health status. And only by improving the physical and social environments (making communities safer, ensuring that everyone has access to grocery stores, cleaning up parks and allowing kids to play outside) can we really improve our obesity rates.
• Throughout the whole report, there was quite a bit of emphasis placed on breastfeeding as a way to combat obesity. While I do agree with it, I was surprised to see it emphasized so much.
• If I had one criticism of the report, I'd say that I wish it focused a bit more on the food industry, particularly in how it relates to school lunches. While Dr. Benjamin encourages schools to provide nutritious food, it would have been great for her to also pressure those corporations that provide this food to ensure that the food supplied to schools is truly healthy and full of the nutrients that children need. I know that fighting big food companies is a politically difficult thing to do, but that would have been nice to see.

So as I said, I really did like this report. While I wish there had been a tad more fanfare to the release of this report, I do love that this administration is taking a stand against obesity and is trying to come up with new solutions to this growing problem.  As most of you know, I'm running as a part of the Tufts Marathon Challenge, which is raising money to fund new innovative research to fight childhood and adolescent obesity. With your help, we can hopefully find new ways to implement some of Dr. Benjamin's suggestions. Any amount you can contribute would be so so helpful. You can donate online here.

Ok, now that I've rambled for way too long, it's your turn. I know that some of your are at least somewhat interested in public health issues--so what do you think is the best way to fight obesity?