Eat to live, or live to eat?  Most of us fall in the latter category, and some will barely fulfill the first.  What do you think when you hear someone say, they have no appetite or could care less about how food tastes?  Surely, something must be the matter with them.  Yet, we roll our eyes in disgust when others say they cannot control their eating, that they live for it, look forward to it, can't stop thinking about it.  Something must be the matter with them, too.  Are they addicted, or is it a personality disorder?  Are all tongues (and brains) created equal?

I know I have a fairly well developed palate, for good or bad.  It means I can usually pick up on the subtle tastes, flavors, textures in a food.  I can usually pick up a layer or two of information that those dining with me can't.  So, when food isn't great, I pick up on the bad part faster, and when it's excellent, it sends a super thrilling sensation.  I live to eat, but have to practice eating what will nourish me- not just amuse.  It is a game, instead, to make rules about what can and cannot go in- due to allergies, limited pantry, preferences, dietary considerations- and still make it delicious.  

When it comes to health and wellness, we have all heard "You are what you eat" since we were children.  Does that make me a carrot stick?  Or an Oreo cookie? our children minds would wonder?  Or, is it more like, garbage in, garbage out?  Certainly, some people tolerate "garbage" very very well.  Others follow extreme and excruciating restrictions, and still suffer along.  A patient with Crohns or Celiac or Ulcerative Colitis can't eat whatever they want, whenever.  If they are lucky, they can find food on a menu that doesn't try to kill them before dinner is over.  They eat to live, at best, in a food oasis.  

Sustainable eating must be something that nourishes you, but what is nourishment?  The gastric bypass patient can barely eat what is around, and slowly loses nourishment from the foods they allowed.  Chronic malabsorption and gastric atrophy result in relative malnourishment in an obese body.  The flesh may reduce, but their blood might be missing key ingredients.  A fat body may be starving, slowly, from an inability to access nutrients from within their body or within their diet.  This paradox can also be observed when eating nutritionally depleted but calorie and preservative rich foods.  Eventually, the damage to the innate immune and endocrine system can't repair itself well.  If you lack the digestive enzymes to break down simple proteins, fats and sugars, you can put all of them in your mouth and still not get them to your blood, or build your flesh.  Chronic use of medicines such as antacids and proton pump inhibitors accelerate this process.  

Still, what of the rest of us who aren't on all these medications, who do not have all these diseases, why shouldn't we eat what we want?  Well, we should.  And we should also examine why it is we eat what we eat, why we want what we want.  We know alcohol and tobacco do a number on our bodies, and we can drink and smoke and expect to get cancer, heart and lung disease, strokes and heart attacks.  Certainly, what we put in our bodies matters, and our health is directly impacted.  Whether we agree that what we eat should or shouldn't matter, it does matter.  And it does affect the quality of our lives- our sleep, our mood, our energy, our concentration, our digestion, our joint and muscle function, our sense of well being.  I'd rather get you off the diet soda and energy drinks than give you Ambien or Xanax.   

I gather that most of us have a food or two that we can't imagine life without.  The suggestion to give up a much beloved food makes many angry, defensive, hostile.  Like with the stages of grief, there is anger, depression, denial, bargaining- and acceptance.  Acceptance that what we want may be destroying our own bodies and minds.  It's so much easier to tell a mother she is doing a bad job disciplining her kids than recognize that the bowls of sugar and milk they consume might be setting off little fire alarms in their little brains.  The government still refuses to set a daily recommended limit on sugar consumption, children's cereals are absolutely chock full of more sugar than anyone should consume in a day. Milk does not do many bodies any good.  There are many other ways to get calcium.  Our dietary needs change over time, and are different to begin with.  Unfortunately, many of us grow up with beliefs about what food we should or shouldn't eat, or what has to be served, that conflict directly with our own bodies in evidence.  

Yet the FDA and the USDA only regulate a certain level of quality and access.  Their policies will never undercut the political and economic interests of the companies whose fees pay for their existence.   How sustainable can it be if subsidized agriculture and subsidized pharmacy trump common sense?  How can good medical studies be paid for, if the money to do it comes from the very people who profit?  It might be cheaper to feed a kid whatever they ask for, and then just medicate them for the immune and mood problems as they crop up.  It is certainly easier to just let you kids decide what they should eat.  Especially if it comes precooked, preformed, precolored, prechewed, and preserved in super delicous, brain teasing appetite stimulants.  Why pay for a 70 cent apple that you have to chew when you can get 2 fruit cups for the same amount?  The apple might spoil before you eat, the fruit cup can live in a survival shelter for years.  

The considerations for ethical food must include its impact on our bodies and health, as that impacts our personal environment, our work life, our home life, and the health and well being of others.   So far, we can't quite claim damages for Secondary Obesity, but that isn't that far off.  As children, we get to eat what our parents can pay for, and what they serve us.  As teenagers, we show our independence by choosing what we want- and that will almost always be in the drug like haze of soft drinks and bags of crazy flavored foods.   As young adults, in college or at low pay jobs, it comes down to what we have access to physically, and economically.  A 99 cents menu makes the most sense, even if the cost means more health problems down the road- when we hopefully have a job with insurance.  Finally, as grown adults, slightly more empowered, managing the schedules of work, spouses, children, and self leads to making the easiest choices to fulfill our obligations of sustenance.  By then, most of the chronic problems from disease of diet and lifestyle have set deep roots, and made their way into the medicalized realm of healthcare.  Insurance will pay for the meds, but not the groceries or the chef.

Somehow, along the way, we were supposed to learn to make all the right decisions.  Perhaps they don't teach nutrition in schools anymore, but how could we trust that when we see what they are allowed to serve at those schools and still call it food?  Perhaps, like with smoking, it is a personal choice.  All the folks with chronic addiction to nicotine will tell you how much they want to quit and yet their bodies refuse to let go.  Asking a person who has been chemically indoctrinated their whole life with brand name food and commercial jingoism to identify what part of their choices might be harming them is a hard task to take on.  Sarah Palin raged at Michelle Obama for suggesting that S'Mores are dangerous.  And Sarah is lucky her family is mostly healthy, and apparently, very well off financially. For the diabetic or asthmatic kid, that little smore is yet another very delicious little poison.  Why should we feel obligated to support an economic policy that makes us physically feeble and medically dependent?

(part 2)