Tuesday, December 1, 2015

Warning Fatigue

The City of New York has a new regulation for purveyors of food in the city. They are now requiring a warning label, in the form of a salt shaker icon, on menus in the city. This is for foods that contain more than the recommended daily allowance of sodium (currently 2,400 mg). This is under the guise of informing consumers about eating too much salt in their diets, with the hopes that it will curtail the number of people with high blood pressure and heart disease.

While we Americans consume far too much that is bad for us: sodium, fats, sugars, and (more importantly) calories. It's important to know what we put into our bodies, and understand how it effects us. Knowing what to eat regularly, and what to save for special occasions is one of the more important things we can learn about life, but it's typically not something we're taught well enough. It doesn't help that eating at restaurants is becoming the rule, and not the exception.

When I was young, it was a rare thing to eat at a restaurant. Big Macs were not a regular item on the menu, and generally saved for when we were traveling. Today, however, people will eat fast food several times a week. I am as guilty of this as anyone. My excuse tends to be that I'm too busy, or that I forget to take food with me. I also tend to eat what sounds good at the time and not what is healthiest. My point is not to show that I'm a fat slob (although there are people who could argue that I am), but that I, unlike most people, have learned about nutrition, yet I still choose to eat unhealthy foods.

The crux is that I get to choose what I eat and where. That choice can depend on a lot of factors like the amount of money I have, the amount of time I have, and the kinds of foods available, but in the end it's my choice.  It isn't up to government to decide what I eat, or when, or where.

However, this poses a problem for society, and that problem is the health problems caused by food. What we eat is a large part of how healthy we are. People who eat a lot of red meat, sugary drinks, and fat laden  food have a higher incidence of diseases that tend to be caused by, or made worse by the foods we eat. Diabetes, high blood pressure, heart disease, cancer, and the list goes on and on and on.  This isn't including all of the food borne illnesses that can range from heartburn to a severe case of deadness.  One of the most recent is the Costco E. coli poisoning. It wasn't the chicken that caused the issue, but the celery. Not every farm worker washes their hands after defecating while harvesting produce. It's cringe worthy, but true.

If you're a public health professional trying to reduce the medical costs brought on by food related health issues, where do you start? How do you tackle educating the public on making healthier choices that will reduce the amount of money spent caring for people sickened by obesity and other food related health issues?  In short, you can't.  You can't dictate how other people live their lives.  You can educate and inform, but you can't dictate.

In this case, warning the public about the sodium content is somewhat misguided.  The problem with having warnings plastered everywhere, is that people get tired of them. Despite the good intent of the regulation it will likely prove as ineffective as the soda regulation New York unsuccessfully tried in 2014. It just comes off as "the boy who cried wolf".  The problem in this case is that even when there is a wolf, unless he's attacking, you don't really care as long as it stays that way.