Eating Your Broccoli and Other Issues in Public Health. William Wright Department of Biochemistry and Molecular Biology Johns Hopkins Bloomberg School of Public Health 615 N. Wolfe Street Baltimore, MD 21205 Our mothers were Public Health professionals. They wiped our runny noses to reduce the spread of colds and flu, kept us safe from injury and insured that we ate nutritious foods, including broccoli. Foods such as broccoli are important because they stimulate our cells to generate anti-oxidants, which protect us from the reactive oxygen species generated by normal cellular respiration and by our exposure to toxicants. Without this protection, reactive oxygen species mutate our genes and damage our cells. Not all citizens of the U.S. have access to healthy food, however. Many live in areas where the mean family income is less than $45,000 and a supermarket is 1 mile (urban) or 10 miles (rural) from a source of high quality food. The health of the people living in these food deserts is markedly worse than the health of other citizens of the U.S. In order to keep from feeling hungry, the poor who live in food deserts tend not to eat a healthy diet, but rather a diet of processed, carbohydrate-rich foods. As a result, poverty is a highly correlated with the incidence of obesity and a major public health problem in the U.S. is the obesity epidemic (Fig 1). Obese people are at significantly higher risk for a number of medical problems, including heart disease, hypertension, diabetes and stroke. Importantly, there is growing evidence that the effects of obesity are trans-generational. There is a positive correlation between the rates of infant mortality and maternal obesity (Fig 2) and there is growing evidence that children born to obese mothers or to obese fathers have epigenetic mutations (errors in the packaging of genes into chromatin) that can alter the expression of genes associated with heart disease, diabetes, etc. The immediate and long-term consequences of obesity may partially explain why the rate of infant mortality in the U.S. (5.9 deaths per 1000 live births) is higher than the rates in all other highly developed countries, such as Canada, Germany and Japan (4.78, 3.48 and 2.17 deaths per 1000 live births, respectively; data from the CIA). As obesity is positively correlated with poverty, food assistance to poor families in the form of the U.S. Supplemental Nutrition Assistance Program (SNAP) is essential to preventing the problem of obesity from becoming worse. Currently, 15% of the U.S. population receives food assistance. As SNAP budgets $4/day/person in the program, the people of the United States provide $78 billion/year in food assistance to those in need. While SNAP is by far the largest food assistance program in the U.S., faith communities such as the Salvation Army, Catholic Charities and local parishes also feed the hungry, and host farmers markets and community gardens so that the poor have access to the healthy food that can protect them from obesity. Through such efforts, we provide to the poor what our mothers provided to us and, we improve the Public Health of our communities. Fig. 1. The relationship between obesity and average household income in each state of the U.S. Data are from the U.S. Census Bureau and Center for Disease Control. Fig. 2. The relationship between obesity and the rate of infant mortality (deaths within the first year of life/1000 live births) in each state in the U.S. Data are from the CDC and the National Conference of State Legislators.
Posted on: Sun, 07 Jul 2013 05:26:23 +0000