My pants are too tight. Again. I’ve spent the bulk of my adult life in a size 2 or 4. Now I find myself continually inching up the rack at Kohl’s.  What is it about hitting your forties that makes maintaining a healthy weight such a challenge?

Well, there’s correlation, and there’s causation. Here are some other things that correlate with my arrival to the fifth decade. Two teenage children and a seven-year-old involved in theatre, soccer, orchestra, and more. A busy career. A husband with a busy career. Lots of take-out and dining out. Did I mention less exercise?

Perhaps it’s my lifestyle rather than my age that has caused my waistline to expand. And when I say lifestyle what I really mean is the type and amount of food I put into my mouth in pursuit of convenience. We all know I’m not alone.

The Problem With How We Eat

As of 2000, poor diet and physical inactivity were responsible for 16.6 percent of deaths in the U.S. and well on their way to surpassing tobacco as the primary villain in our national healthcare story.

The Journal of the American Medical Association reports that more than a third of adults in the U.S. are obese. This represents a 75 percent increase since 1990. The CDC estimates that this adds $147 billion dollars to the healthcare tab in the U.S. each year. Other sources have pinned 6-10 percent of our healthcare spending on obesity. We haven’t even accounted for the medical costs associated with the other one third of us who are simply overweight, not obese.

Beyond obesity, other aspects of our health are connected to a highly-processed, nutrient poor diet. Type 2 diabetes  now affects 23-25 million Americans and is the 7th leading cause of death in the U.S. The number of people in the U.S. with the disease is expected to double by 2034. Worse, diabetes is connected to heart disease, stroke, kidney disease, blindness and a laundry list of other issues.  We know that the bulk of Type 2 diabetes can be controlled with changes in diet.

Other diseases associated with our modern, convenient diet? Heart disease, certain cancers, hypertension, stroke, osteoporosis, and dental disease.

When we look at these facts as a whole, we have no choice but to point the finger at the food we eat.

An Unlikely Solution

Solutions are everywhere in the form of fad diets, diet products, exercise programs and more.  Intuitively we know that our food intake is directly related to the number on the scale and our overall health. But we typically think in terms of amount of food, and maybe type of food – fat, carbohydrate or protein. What we don’t consider is that the way our food is prepared may be one of the biggest factors in our health problems.

Michael Pollan, author of The Omnivore’s Dilemma and Cooked: A Natural History of Transformation, suggests that the single most important factor in achieving a healthy weight is preparing your food at home. The cycle of “success” we have created for ourselves is hurting (or killing) us, and it’s doing the same to our economy. We eat junk so we have more time to work so we can realize career success. As we achieve success, we continue to work grueling hours. With success the presentation of our food improves. Unfortunately its nutritional value remains mostly unchanged as convenience continues to trump quality.

Restaurant and packaged foods are manipulated to create “craveable” (read: addicting) foods that leave you wanting more. Indeed, it’s a rare home cook who would add the salt, sugar, and fat found in a typical restaurant meal. The simple act of cooking at home (from whole foods and not boxes labeled Stouffer’s or Hamburger Helper) renders our food healthier. But who has the time for that? Worse, many don’t have the money. The 99-cent menu at McDonald’s makes cooking at home seem downright wasteful.

The point here is that we have created a culture that rewards an unhealthy lifestyle, because we perceive it to be growing our economy. But the cost in health and healthcare spending is beginning to exceed the benefit. The $8,000 per year per person we spend on health care in the U.S. is unsustainable. Decisions must be made.  

But perhaps all medical problems don’t need medical solutions. Perhaps the decisions and “treatments” should come from somewhere else, like the food choices we make for ourselves. We know that government initiatives like food pyramids and food plates haven’t helped the problem. We need individuals and households to make better food decisions. We need community-based movements that will improve the quality of food available to those individuals and households.

Where Do We Begin?

The well-known advice to “shop the perimeter” is an excellent place to start. Avoiding those inner aisles of the grocery store, where the highly processed, “craveable” foods live, will point your purchases toward the whole foods on the perimeter. But be aware that food manufacturers are wise to this trend. Just because a bottle of salad dressing or a carton of yogurt is on the perimeter doesn’t mean it isn’t loaded with high fructose corn syrup or some other non-food additive. If a product on the perimeter has a food label, it needs to be read. In fact, the presence of a food label should serve as a red flag, as any reading of cereal boxes will demonstrate.

Farmer’s Markets are a second step. They have demonstrated spectacular growth over the last two decades, more than quadrupling in number. Farmer’s Markets give many of us access to local, fresh produce for a large portion of the year. They are a great way to meet your farmers and understand where your food comes from. They add to the community aspect of food. These markets begin to elevate our meals from drive-by sustenance to a social event.

Unfortunately, cost and availability play a big role here. People may know they need to cook healthy whole foods at home. But when those foods are out of physical or financial reach, as is the case for many living in poverty, the urgent overrules the important.

But even this roadblock could be overcome with individual, household, and local action. The Food is Free Project is a community-based movement that takes these pieces into account. Food is Free seeks to make fresh produce accessible to the affluent and the poor alike through front yard gardens. Their approach builds community, conserves precious resources, and eliminates the cost and availability objections to cooking at home. With neighborhoods growing and sharing their own harvests, the Food is Free Project also brings back the time-honored concept that meals are communal events.

Farmer’s Markets, The Food is Free Project and movements like it, led by individuals, households, and communities, can stop obesity, diabetes and other diseases before they become a medical problem. If we want to lessen the need for health care rationing and create a population that is growing healthier instead of sicker, we need to begin at home. By the time we’re in the doctor’s office, it’s too late. The alternative is a governmental agency, funded in large part by the food industry, making decisions about what we put into our bodies, and an economy that suffers for it.

So what are you having for dinner tonight?