Fernand Vedrenne: The Hard Truths Behind the Complexities of a Healthy Diet Fernand Vedrenne - PVNN
May 7, 2013

There is a very popular and widely overused expression stating that “you are what you eat”. While it is true that our health and quality of life largely depend on our food choices, our food choices are also supported by a number of complex socioeconomic factors that are rarely addressed. It is no surprise that public health authorities all over the world have tried to tackle diseases like obesity with nutritional interventions. Nevertheless, these have often been insufficient as they only offer simplistic solutions to a very complex problem. Analyzing the socioeconomic context of food choices can provide a complete framework to better understand related health conditions such as obesity.

It may be surprising for some that in Mexico City almost half of the total cost of treating a child with Type 1 Diabetes can be attributed to dietary changes. Most of the patients attending an important diabetes clinic in the city were struggling to meet their new dietary requirements for many different reasons that included having limited time to prepare food and a clear lack of access to nutritious products in some cases. There also appears to be a relationship between family structure, and adherence to treatment. Children belonging to more united families where caregivers were vigilant also seemed to have better quality of life, and metabolic control. There is a strong need for research that is able to study these phenomena from a critical social science approach.

Due to its high costs and growing prevalence, stopping the growth of obesity is one of the biggest challenges of the 21st century. The World Health Organization has estimated that by 2015, the number of obese people would grow by 300 million in comparison with 2005. Just in Canada, nearly one quarter of the adult population and almost 1 in every 10 children over 6 years old are obese. In 2008, the Public Health Agency of Canada calculated the economic costs of this disease to be around $4.6 billion, and that this number would increase by almost 55% when considering its co-morbidities.  While several studies at the United States have found an association between obesity, the consumption of energy dense foods, and the progressive decrease in physical activity, there is also a considerable amount of literature that describes obesity as a more complex problem resulting from the interaction of socio-economic factors such as the decrease in the minimum salary, the increasing economic disparities, food prices, and food insecurity. Furthermore, there is a considerable amount of literature dealing with the genetic causes of obesity, underscoring the complexity of the issue.

Research has consistently found that obesity and its co-morbidities, just like many other diseases, seem to be more prevalent among the most disadvantaged groups. Gaining a thorough understanding of the circumstances that regulate food choices is of prime importance in order to be able to offer dietary advice, and produce public health policies. This implies that public health authorities also need to look at the disparities in access to food, income inequalities and other elements that encourage people to choose energy dense products when talking about obesity.  Academics like Adam Drewnowski from the University of Washington have speculated about the possible association between access to nutritious foods, food insecurity, and obesity, since there seems to be an inverse relation between energy costs ($/kcal) and energy density (kcal/g).

In Mexico, just under 18% of the families live under food insufficiency conditions. Food insecurity is defined as the inability of a family to cover its dietary needs. Perceived food insecurity makes families undertake compensatory measures. This means that they will look for more energy dense products, which are usually cheaper, in order to cover their calorie requirements with less money, rather than actually decreasing their energy intake. Moreover, an association has been found between food insufficiency and obesity among American women.   Directing the attention toward food insecurity as one of the factors that promote of obesity in society is important because it highlights the idea that health is not only the lack of disease, but the result of an interaction between the biological, social, and psychological aspects of human beings.  

Bearing this in mind, the reason why the prevalence of many metabolic diseases keeps increasing despite the efforts made remains evident.  Health promotion campaigns will be useless as long as they don’t take into consideration all the aforementioned complex issues. It is of great urgency to develop interventions that empower society to change from its very core rather than just offering tips, demonizing snacks and soft drinks, and encouraging physical activity with a paternalistic attitude. The current situation calls for integral solutions that attack the root of the problem little by little instead of simplistic and express band-aids that only make some noise but do not really help.

Go to part two

Fernand Vedrenne-Gutiérrez was born and raised in Mexico City. Fernand studied Food Science and Technology at Universidad Iberoamericana of the Society of Jesus. He attended Wageningen University in the Netherlands for one semester, and participated in a Global Health seminar at the Imperial College of London, and is looking forward to start his Master’s in Applied Statistics next summer. Fernand has participated in different research projects dealing with a wide variety of topics such as bioethics and Type 1 and Type 2 diabetes at the Mexican Institute of Social Security (IMSS) and the National Pediatrics Institute (INP). He is interested in the socio-cultural determinants of health, in addition to other topics such as food policy and food preference, and has made contributions to some publications in International Journals such as BMC Medicine. In his free time Fernand is an avid yoga practitioner and amateur piano player who enjoys talking, debating, travelling and meeting new people. His biggest hope is that his work might be useful to society in some way.

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