Hospital Food - Symptom or Cause?

I've spent way more time consorting with our fine, single-payer healthcare system in 2012 than I have in the past few years combined. I'm just back from an overnight stay on the pediatrics ward. All is fine, or so we are assuming until tests come back. In fact, my daughter had such a good time there that she didn't want to leave. And she discovered a new, delicious food - peanut butter and banana sandwiches.

The pediatric toddler menu was very interesting. Breakfast was milk, cornflakes, a slice of wholewheat toast with strawberry jam option, and apple juice (which my daughter insisted on eating with a spoon). Lunch was the aforementioned sandwich, chicken noodle soup, milk, canned peaches, and apple juice. Notice anything missing?

That's right, the fruit-and-vegetable category was entirely filled by fruits. I don't know if the hospital has assumed that children won't eat vegetables, or has discovered from experience that they don't (in which case, do they only not eat vegetables prepared in typical hospital-food fashion, boiled to death?). I admit that I have little experience with children not eating vegetables - whether because of luck, parental modelling of finding delight in vegetables, or perversity, our kids like almost all vegetables, and as they age they discover the odd vegetable they refused has become tasty.

I mostly keep quiet about this, though, because perusing the internets tells me that my children have freakish tastes and I'd better not offer advice or brag about them. It's a very touchy subject, and people tend to assume that opinions are actually judgments on their parenting. Especially since it often takes the form of a struggle: parents puree and disguise vegetables, bargain with their children to get a few tastes past the gag reflex, and sometimes, give up and only serve the vegetables that are tolerated.

I am of the generation that ate what was on their plate Or Else, and I have vivid memories of crying while I choked down purple cabbage with soya sauce and sesame seeds, and bit beets in half to swallow the chunks down with milk. I still don't like beets, although I'll cook them for my husband and son (as of last summer, my daughter didn't like them yet). I have a bit of the Or Else mentality - not enough to cause a major power struggle - but I've rarely felt the need to employ eating rules.

What do you think? If children are presented with a variety of good food, eating is joyful, and coercion is not employed, will they come to eat their vegetables? And can this be done in a hospital?

Lentils of Superiority

"Why do poor people eat so much junk food? Don't they know it costs more? Why can't they cook and eat nourishing, protein-laden, inexpensive beans and legumes?"

Leaving aside the issue of a potential lack of kitchen appliances, cooking knowledge and skills, implements, access to certain foods, and time, here’s George Orwell’s opinion on why the poor may eat the way they eat, from Wigan Pier:

“When you are unemployed, which is to say when you are underfed, harassed, bored and miserable, you don’t want to eat dull wholesome food. You want something a little bit ‘tasty.’ There is always some cheaply pleasant thing to tempt you. Let’s have three pennorth of chips! Run out and buy us a twopenny ice cream! Put the kettle on and we’ll all have a nice cup of tea ! That is how your mind works…. White bread-and-marg and sugared tea don’t nourish you to any extent, but they are nicer (at least most people think so) than brown bread-and-dripping and cold water.”

 Brown bread-and-dripping, or, lentils of superiority.

Solution for picky eaters?

Children don't always eat carrots, but rabbits do.

Dietary Regimes, Obesity, and the Tough Fix

I'm frustrated when I hear, "Gee, I know it sucks that small farmers can't make a go of it, but with today's input and capital costs you have to be big to stay in farming." That's why I really like Tony Winson's work. Faced with that assertion, he'd get to the root of it. He'd ask why the input and capital costs have increased so much, and what the returns really are for economies of scale, and what externalities are being sloughed off by large farms, and by gum, he'd have some answers. He knows that there are structural and systemic forces that are producing the agri-food system we have.

At the AFHVS conference in Missoula, I got to hear Winson present on his latest theoretical innovation - dietary regimes, building on Friedmann and McMichael's work on food regimes. Winson's thesis is that rather than just being products of idiosyncracy or cultural preference, diets are created and reproduced by specific material conditions, socio-economic-political climate, and technical developments. Okay, I'll be specific at the risk of jargon turning you off: he attributes them as well to "distinct phases of capital accumulation". But the argument still makes sense without an understanding of that.

Therefore, diets can be divided into distinct eras (regimes) based on elements of their production. For example, with the neolithic revolution, diets started to take on a class character. The second industrial diet regime, which Winson dates from 1950-1980, is probably the most apparent to us: the degradation of food intensifies with the trends of suburbanization, mass marketing, convenience foods, a car culture of fast food, women working out of the home, and a decline of farms and self-provisioning. This is not to say that those things are unequivocally bad, but that they had definite effects on shaping diet in a certain direction. They have lead today to the expansion of this diet to developing countries and a shift from state to capital as the dominating structural force. They have also lead to food that Winson describes with the absolute best use of language I have heard in a while:

 “nutritionally compromised edible commodities”.

Excuse me while I fan myself vigorously. 

The importance of framing dietary changes in terms of a dietary regimes approach is that this approach gets at what is behind these changes. And if we can get at the root of them, we can more effectively shape what is happening in a healthy way.

Here's an example. In this light, although choice of course plays a role, obesity is not merely "taking in more calories than one expends" - something one could easily choose not to do. It is a result of a complex web of factors including the aforementioned growth in mass marketing and convenience foods; the increase in sedentary work and a longer work day; the inaccessibility (due to price, location, or culinary knowledge) of healthy foods; unwalkable neighbourhoods; and even psychological factors, such as a tendency to self-medicate with food, that are socially influenced. While an individual may choose to eat unhealthy food, that choice is easier, and far more likely to be made, in the food system we have now.

Society-wide obesity cannot be solved by educating obese people about nutrition and promoting exercise. But that focus on individual responsibility and choice does "serve to shift our gaze from the social conditions that produce [obesity], to pathologizing the individual that carries the weight (literally) of our social plight. The advantage of this shift in focus is that it dilutes attention from the structural change that would be needed to actually make a difference."* And that structural change is not only difficult, but challenges some pretty powerful interests.

* Russell-Mayhew, Shelly. Eating Disorders and Obesity as Social Justice Issues. Journal for Social Action in Counseling and Psychology, Volume 1, Number 1 Spring 2007.