One Thing...

In the Classic Billy Crystal Comedy, City Slickers, Billy Crystal asks Jack Palance, who plays Curly, the crusty cowboy, what his secret to a good life is. Curly answers, "The secret to a good life is one thing" and holds up an index finger...and then he dies. We never know the answer.

Similarly, in getting to better health in this country, I've been trying to figure out what the "one thing" is that this country should be doing. Figuring out this one thing is important, because we have information overload. There's too much detail, too many problems with complex inter-relations, and therefore no one can act. A 1000 page national health bill was passed, and no one but a few paid experts actually knows whats in it--though the general agreement is that it about providing more access to doctors through changing eligibility and payments; not about a healthier America.

I think I have my answer, and the one thing we should do something about is food. It keeps us alive, it gives us great comfort and enjoyment, creates common ground and cultural history, but can also make us obese, trigger all kinds of disease because of chemicals and nutritional imbalance. And obesity is the number one public health crises in America.

But back to one thing. Food is an extremely complex subject, as I learned when I was ill and actually had to research what made a truly healthy long term diet. I guarantee you the answer is neither simple, nor is what most of us do every day.

In school lunch programs, which could be a major tool in combatting obesity; there are many studies about what is wrong and how to change. But theSchool Nutrition Association, a 55,000 person professional organization whose mission is to advance good nutrition for all children, Tom Baranowski, Professor of Pediatrics Baylor College, gave the following report cards to the efforts across the nation to promote positive change.

Report Card For School Health Behavior Promotors -

IOM Committee on School Nutrition

January 28 2009

Why? Why do all the well intended, well research change efforts fail so miserably? The best answer I can come up with was provided to me in an excellent book called "Switch - How to Change When Change is Hard", by Chip and Dan Heath. Their point is that you need one thing, that motivates both your brain and your heart--and it must be simple. They cite a public health experiment in West Virginia, in one of the most obese towns in the country, to improve diet and nutrition. For years, the town has been told how to eat right, given access to community health professionals, and nothing happened. But then, two researchers found that if you wanted to cut out half the saturated fat in our country's diet, you would cut out whole milk. That's right. I suspect most of my blog readers don't drink whole milk, but most of the country does. In fact, they think its downright healthy.

So they tried an experiment in this town. They showed pictures at all the grocery stores of one glass of whole milk on the left, an equals sign, and five slices of bacon on the right. This was followed by the instructions to buy 1% or fat free milk. Guess what happened? There was a 37% increase in the purchase of lowfat/nonfat milk, that lasted beyond the experiment date. This is a huge needle move for any public policy experiment. What does this prove? According to the Heath brothers, it shows an important truth. Its not that people don't want to change, its that they don't know how; there are too many options.

So for our country, I believe the one thing is food. But we need to find our individual "one thing" that we can do for ourselves and our kids. It has to be simple and irrevocable. For me, its no processed sugar (sugar feeds my chronic fungal infection and sets off my fibromyalgia attacks). That's kind of a big one, so for your family it might be no bleached flour, or no refined oils. Eating less sugar is not a valid option--because it gives you too much wiggle room. Your one thing must be binary. I think you'll find this "one thing" goal setting does lead to change, and then you can find your next "one thing". Diets don't work because there are too many options--too much too choose, too much behavior to modify.

I would be happy if the country replicated West Virginia's experiment. Its a place to start. Curly was a very wise man....