Preventive Medicine Column

Dr. David L. Katz

Kids these days- and adults, for that matter- are consuming far too many spoons full of sugar.  This sugar excess contributes importantly to the epidemic of obesity, and all of its consequences- diabetes in particular.  Diabetes and other complications of obesity require pharmacotherapy much of the time.  And there we have it: spoons full of sugar, helping medicine go down.  I don’t think Mary Poppins had this in mind.

There has long been considerable attention to the contributions soda- termed by some of my public health colleagues ‘liquid candy’- makes to the prevailing diet. Soda contributes lots of calories and sugar to the ‘typical’ American diet, and since excesses of calories and sugar are implicated in obesity and ill health, soda is certainly part of the problem.

It is not, however, the whole problem- nor even half of it.  A study published on-line by the CDC on Feb. 29th indicates that more than half of the excess sugar in the diets of children comes from food rather than drink, and most of that food is eaten at home.  The study also suggests that sugar intake, as a percent of total calories, rises as kids get old enough to make more of their own food choices.

This of course does not exonerate soda.  It simply reveals that the problem of sugar excess is pervasive throughout the food supply, both in what we drink, and in what we chew.

Most of us in public health deem sugar excess an important liability of the modern diet, and an important threat to public health.  Some go much further, and declare it an outright poison.  I think that takes things too far.  Rather, it’s the dose that makes the poison- of sugar, as of almost anything.  That we consume too much sugar, and that it does us harm, is what we need to know.

We need to know because we are unlikely to fix problems to which we are oblivious.  We need to know because, ostensibly, knowledge is power.  In that spirit, we in public health have cause to welcome some important new allies to the mission of advancing health through better nutrition.

There is a wonderful exhibition at Yale’s iconic Peabody Museum, entitled “Big Food: Health, Culture and the Evolution of Eating.” Big Food puts on visual display our evolving food environments, increasing obesity rates, and decreasing physical activity levels.  The Peabody now gives you dinosaurs to the right, and perhaps some of the things that will speed Homo sapiens toward a similar fate to the left!    All too often, the things that extend the shelf life of food tend to shorten the shelf life of those eating the food.

Big Food can teach you things you never knew, and maybe some you never knew you never knew.  It examines behavioral choice in nutrition and exercise and the influence of social, environmental, and cultural settings.  It explores our origins as hunter‐gatherers, societal pressures such as the growth of portion sizes, and media influences on food preferences.  And it calls on us all to become advocates for a healthier lifestyle.

Most importantly, in the manner of museums catering to families with children, Big Food is fun.  It’s edutainment: education, and entertainment combined.  Big Food may shock you with those spoons full of sugar- the incredible numbers of them, and the surprising places they hide in your food.  By doing so, maybe it will be the reason you- or someone in your family- won’t need medicine to go down after all.

Big Food opened February 11 at the Peabody Museum of Natural History in New Haven and runs through Dec. 2, 2012.  I’ve seen it, and think it’s great; I encourage you to take your family.  I add a shout out of thanks to Anthem Blue Cross & Blue Shield Foundation for footing much of the bill.  Of course, this is enlightened self-interest on their part; a bit less sugar, and a bit less medicine may mean the costs of coverage go down!

The Peabody is not the first museum in CT to put food and health on the exhibition menu.  The Stepping Stones Museum in Norwalk, CT has a permanent exhibit called ‘Healthyville,’ which focuses on lifestyle choices and health in children.  Like the Peabody exhibition, Healthyville is interactive, engaging, and empowering.  Stepping Stones takes things up a notch with satellite-enabled classrooms that allow children to interact with peers around the world, and with an ‘edible garden’ that allows Healthyville messages to be extracted from the organic grounds, during the growing season.  I encourage families with young children to give Healthyville a visit.

Museums applying their unique talents for making learning fun to food is a very welcome development. Will Big Food, Healthyville, and other such efforts change outcomes for the better?  Will they cause fewer spoons full or sugar, and a bit less medicine, to go down?  We don’t know for sure yet.  But the food for thought is refreshingly wholesome, and looks to me to be right in the sweet spot.  So my advice to you and your family is: dig in!




Dr. David L. Katz;