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In Monday's “Food for 9 Billion” radio feature, “Greece's diet crisis,” I reported on the rise of obesity in Crete, a beautiful and fertile island with one of the healthiest traditional diets on earth. It’s a classic example of the phenomenon known as the nutrition transition, in which people begin to eat more meat and processed food as soon as they can afford it. The nutrition transition is one of the main reasons that the global obesity rate has roughly doubled since 1980.
As Americans learned a long time ago – and as people are learning today in China, Brazil, Mexico, India and many other countries – the shift can be startlingly swift. It's also extremely hard to reverse. That's true of dietary change in general and obesity in particular. Obesity tends to gain a toehold during periods of relative prosperity, but really digs in its heels when times get tough.
What does all this have to do with the world’s ability to keep itself fed? Here are a few things to consider:
All of which is to say that the obesity epidemic is not just an urgent public health issue, but also a serious threat to global food security. So what’s to be done?
That was what I hoped to find out when I traveled to Chania, in western Crete. I had heard that chefs and other foodies were working to revive interest in Cretan cuisine. I knew that local dietitians had begun volunteering at primary schools and that school snack bar operators had agreed to take junk food and soda off their shelves. I'd been told that a respected pediatrician had opened a special clinic for overweight kids. It all sounded encouraging.
From close up, though, I could see what these people were up against. The head of the Cretan Gastronomy Network, Yiannis Apostolakis, admitted that students at the university cafeteria where he works complain when he serves Cretan food. ("All they want is chicken," he said with a sigh.) Yiannis Tsivourakis, executive chef at the posh Minoa Palace Resort, said that so far, only tourists have signed up for his Cretan cooking classes. Vaso Kourasmenaki, who operates a food kiosk at a local high school, said now that fast food is no longer available on school grounds, kids are scaling the school wall to buy it on the street. The mayor of Chania, Dr. Emmanouil Skoulakis, said the cash-starved city government is deeply concerned about obesity but can’t afford to do much. Ditto for the national government in Athens.
Not that it’s clear what “doing much” would even entail. There's surprisingly little consensus on the most effective ways to stem the obesity tide. This is a relatively new problem, it turns out, and we're still in the experimentation phase.
Several people I spoke with said the key is education – from health classes in schools to media campaigns extolling the virtues of exercise and healthy eating. Others called for more government control of the food industry, more vigorous promotion of local products or more investment in sports and recreation.
John Cawley, an economist at Cornell University and editor of “The Oxford Handbook of the Social Science of Obesity,” told me that he was intrigued by economic approaches aimed at individuals.
“It doesn’t help just to tell people to live their lives in a different way,” he said. “If you want people to change their behavior, you have to change their incentives.” For example, some companies have offered employees cash rewards for meeting weight targets or for eating or avoiding certain foods.
Governments around the world have tried a number of policy interventions, including raising taxes on fast food and junk food, imposing size limits on sugary drinks, banning trans fats, requiring detailed nutrition labels, and placing restrictions on advertising.
It’s too early to know which, if any, of these will make a difference over the long term. And what works in one place won’t necessarily work in another. In Greece, for instance, everyone seemed to reject the idea of raising taxes on anything until the economy picks up.
If the way forward is murky, one thing seems clear: The battle against obesity will be waged on many fronts, from dining rooms, classrooms, consulting rooms and boardrooms to the halls of power. How and whether to coordinate those efforts might be one of the weightiest questions of our time.