"The World is Fat"

The World is Fat by Barry Popkin recently came out in paperback, so I bought it & read it. Overall, I found it a bit disappointing, as the insights he offers about the modern diet, the role of soft drinks in obesity, and the decline in exercise throughout the world are very well known. The same material in a similar form appears in many other food books that I've read, and some of them are more amusing or penetrating. His presentations of composite families in middle America, Mexico, Mexican-American Los Angeles, and India are interesting but he really doesn't have the gift of a fantastically vivid writer to bring the somewhat repetitive vignettes to life.

The very rapid changes in India, China, and Mexico that he documents were the most interesting part of the book. "The World is Flat -- and Fat" according to one chapter title. Popkin describes how rapidly -- just in the past 20 to 30 years -- the economies and options for food and work have changed in third-world countries. In contrast, he describes the slower changes in American life. We took more than 100 years for the introduction of packaged and prepared foods, fast-food and dining out as a habit, supermarkets with wide choices, transportation and labor-saving devices permitting a sedentary life-style, and home entertainment via TV and computers. The latter give us something to do while not walking, hauling wood and water, or laboring in the fields -- and also provide us with commercials advertising the modern calorie-rich diet. A time-line of labor saving devices in America, many from the early years of the 20th century, supports the point about the pace of change.

In contrast, much of India has only recently come online on the electric grid, and Mexican women only recently could rely on ready-made tortillas and soft drinks to feed their families. The shock in these countries of adjusting to this changing world is not comparable to anything America went through. Americans responded with a slow increase in average weight. In contrast, one third of Mexican adults were overweight or obese in 1988; the figure increased to 71 percent of women and 65 percent of men in 2006. Diabetes went from obscure to widespread in that short time period. (p. 105)

One very important point Popkin makes throughout the book is that many factors have contributed to statistically increased obesity and related illnesses, both in the US and elsewhere. Specific targets of blame including fast food, sweetened beverages, and lack of exercise are different in different cultures -- always, a collection of factors characterize modern living. While sugary drinks are a major public health problem in Mexico, in China they are comparatively unknown, but other risks are growing. Popkin does not propose any magic bullets either via public health measures or individual choices.

The book's final chapter is an indictment of the food industry's efforts to suppress criticism. They have played an ugly role in recent struggles to regulate the food industry or widely inform people of scientific findings about food in the US and abroad. Because I follow food politics in newspapers and other sources, this wasn't news to me. However, this discussion is definitely comprehensive and useful.

Despite the newness of the book, several recent findings slightly alter my view of the conclusions. For example, there's the disaster of the so-called Smart Choices labeling, where the blue-ribbon panel was co-opted by the food industry -- or sold out. Also, just this week came an announcement that obesity levels in the US have leveled off for the last decade -- American Obesity Rates Have Hit Plateau, C.D.C. Data Suggest -- which he had no way to know.

The issues of food politics and public health measures that may counter a whole collection of dangerous trends are very complex, and clearly it takes a lot of time and effort to follow them. Popkin's book is surely a good way to catch up and review what I've been reading, but doesn't give me any choice but to keep trying.