So, I’m slowly coming up for air after a month of travel and finishing up my MFA. I have a few things left to do this week, and then the MFA is complete and I can focus on the MPH for the next year. And, of course, get back to blogging!
Today I displayed a poster at the UW’s Maternal & Child Health/School of Public Health research festival, based on a few projects I did last year. You can download a higher resolution pdf of my poster here: CapstoneDGcopy. (NOTE: due to some error in the file, some people get something scrambled/random boxes instead of the correct image. Working on fixing this.)
The poster is based on my critique of an intervention trial called Pathways published in 2003 in the American Journal of Clinical Nutrition. (Full text) In this intervention, over 1,000 predominantly American Indian school kids in schools spent grades 3-5 receiving what the researchers thought would reduce or prevent obesity: reduction of saturated fat in the diet, exercise in school, and education of kids and their families about these principles. At the end of the intervention, saturated fat had indeed been reduced in the intervention schools, as compared to the control schools. But not one of the measures of obesity was any different from the control schools.
What did the researchers do? Well, a great deal of money probably went into the study; a whole supplement issue of AJCN was devoted to the preparation for it in 1999. Whether to save face or their attitude was genuine, they concluded the study was a partial success, in that they had reduced dietary fat, even if it hadn’t actually affected obesity.
It makes sense that their intervention didn’t reduce obesity; saturated fat doesn’t cause obesity. Looking at a population level from USDA data (which is, admittedly, imperfect, but makes sense in this case), saturated fat isn’t what’s increased significantly in our diets during the obesity epidemic. Corn sweeteners and vegetable oils have, as have grains to some extent. Further, traditional American indigenous diets have focused on animal foods high in fats and fat-soluble vitamins.
Meanwhile, fat-soluble vitamin deficiency continues to be a concern; we move animals off pasture and lose naturally-occurring forms of vitamins A, D, K2 and omega-3 fatty acids that are found in the fats of animals eating what they’re meant to eat (not grain). We reduce saturated fat, switch kids’ lunch beverages to skim milk and juice instead of whole milk, and we contribute to the deficiency problem. Additionally, vitamin deficiencies have a bi-directional relationship with obesity.
So what do we do instead? Interventions that make sense: reduce sugars, carbohydrates and vegetable oil in diet. Focus on vitamin deficiency as related to obesity prevention and intervention. Focus on traditional diets and family involvement that isn’t condescending: learn from people what foods have been traditionally protective in their communities, instead of telling them information about how to eat that is not having an effect. Increase exercise, but increase it outdoors with vitamin D exposure from sunlight (in non-winter months especially) and where kids can move about in and interact with a natural environment.
But to continue repeating the same mistakes and covering our footsteps when they don’t work? It’s not only ineffective; it’s harmful. Kids, and adults, deserve better.
(Since I’ve had a request, if you’d like to read it, my original critique of the Pathways intervention is here: health promotion critique DG )