In the September 2012 issue of the American Journal of Public Health, Mary T Bassett, MD MPH, discusses the role of government in "leveling the playing field" so that consumers have a real choice when choosing a food item.  A level playing field could increase consumption of higher quality foods.
   This statement, her article and my own studies lead to the same conclusion.  Most of us make food choices based on taste, cost, marketing shaped preferences, availability and convenience.  Healthiness comes in last - after these attributes have been considered - by us or for us.
   Dr. Bassett made mention of the food industry's support for initiatives that encourage physical activity as a strategy to reduce obesity.  This is clear by the placement of actual exercise icons on some food packages.  
   Here is a sad truth.  Exercise is not a popular way to spend leisure time.  Two hundred years ago that didn't really matter, we moved for sustenance and survival.  In the more recent past, our physical activity levels during work and non work hours has decreased.  We have become sedentary and for that reason alone need to exercise.      
   Both of these energy expenditure issues play a role in our obesity (over fatness) epidemic, but a much smaller one than you'd expect.  Trends of weight status in the US and similar countries show a steady and sharp rise beginning in 1970 and continuing to this date.  It has occurred in every age group - infants included.
   Certainly, the entire country did not have a sudden cellular shift  that made us ALL genetically predisposed to gain weight.  And with regard to burning less calories from work and travel, the best estimates from scientific studies suggest at most a decrease in 100 calories expended.
   Could it be then, that the entire country made a conscious and deliberate decision to gain weight?  Even before we learned of the connection between fat and disease, we knew that being too large for our bones was uncomfortable and stigmatizing.  Few of us would invite those things. So I say NO, we did not seek out calorically dense, nutrient poor, portion inappropriate foods. They came to us.
   Sure, our changing culture had us looking for convenience and increased the number of meals we purchase away from home.  We did not however, know that our 200 calorie meal had doubled into a 400 calorie one- before adding the super sized sized milk, juice or soda.
    Today, we find ourselves in need of a few less calories (compared to 1970) but consuming a WHOLE lot more - often passively.  Calorically dense foods are what the food industry offers  - at a price we can't refuse.
   Our environment changed around us, we got fat, our heart disease, diabetes, cancer and stroke risk went up.  Indeed the playing field from which we make our choices became leveled against us.

The article referenced in the opening paragraph : Mary T. Bassett.  Of Personal Choice and Level Playing Fields: Why We Need Government Policies on Food Content. American Journal of Public Health: September 2012, Vol. 102, No. 9, pp. 1624-1624.
 
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