In Why Our Health Matters Dr. Andrew Weil defines health as 

a positive state of wholeness and balance in which an organism functions efficiently and interacts smoothly with its environment. 

I have experienced imbalance at times and am fortunate to have regained my health efficiency again.  Pretty much anyone who has experienced being overrun with common cold virus molecules understands immune system imbalance. There are many things that can cause an imbalance-a virus, a diet lacking in nutrients, a genetic mutation.  But what's behind these imbalances? 

During these times of health care reform debates, much has been made of personal responsibility.  In August 2009, Whole Foods' John Mackey wrote in the Wall Street Journal that obesity is a "self-inflicted" problem, the responsibility of which people ought to take 

very seriously and use our freedom to make wise lifestyle choices that will protect our health.

He's right about one thing: we do need to take responsibility for our health.  But are obesity and other chronic health conditions-aka imbalances-solely self-inflicted?

'We are what we eat' as the saying goes.  So what are we eating?  According to the USDA report Dietary Assessment of Major Trends in U.S. Food Consumption, 1970-2005, Americans are not eating what we should.  In order to meet the USDA's 2005 Dietary Guidelines 

Americans would need to substantially lower their intake of added fats, refined grains, and added sugars and sweeteners and increase their consumption of fruits, vegetables, whole grains, and low fat milk and milk products.

Why We Eat What We Eat
  
So, John Mackey is right, at least to a point.  Digging a little deeper leads me to ask: Why are we eating what we are eating?  One answer is that we are eating some foods because they are heavily marketed to us.  For example, during children's shows, commercials for "fun food" abound and in one study 89% of the analyzed products marketed towards children could be classified as of poor nutritional quality owing to high levels of sugar, fat and/or sodium. You can argue that children shouldn't get their nutritional information from TV or marketing, but the reality is this information seeps in. We can't have an entire industry dedicated to creating, capturing and maintaining customers and not at least consider that it might share some ownership for what it is paid well to convince others to do.

Another reason we eat what we eat is result of basic biology.  In his book The End of Overeating, former USDA commissioner David Kessler writes that consumption of certain combinations of sugar, salts and fats (remember what was being marketed to children?) causes a person's brain to crave unhealthy products. What's more, Kessler shows us the science behind why we don't just want the unhealthy products, but that our brain is different as a result of eating these products such that we can't refuse them.  Ultimately, eating certain combinations of sugar, salts and fats leads to an individual having decreased control over their own response to the cues associated with these foods.  This sounds scarily like we have lost decision-making power over our own bodies.

Even if we do overcome the marketing and the biology, can Americans afford healthier food?  The New York Times writes that a University of Washington study found that 

Calorie for calorie, junk foods not only cost less than fruits and vegetables, but junk food prices also are less likely to rise as a result of inflation.  

So, not only do some of us have a weakened ability to say no to the sugar, salt and fat-laden foods, but this is all many people can afford.  It has been argued that obesity is an economic problem rather than a personal one.  A simplistic way to look at this issue is this: the bill for an average family's grocery shop at Whole Foods is likely to be much higher than the same at other grocery stores.  So Mr. Mackey's expectation that we "use our freedom to make wise lifestyle choices" is a little oversimplified since not everyone is exactly free to shop where so much healthy food is found in abundance.

Interacting With Our Environment

Given the USDA's Dietary Assessment report, we know we need to be making better food choices.  Other reports remind us that we need to choose to be more physically active too.  But these aren't the only ways we could improve how we interact with our environment.  When I read in The New York Times that millions of Americans are drinking contaminated water associated with negative health consequences when we already have rules on the books to protect us from this, I know we also need to become more civically engaged. 

There are endless ways we can do this.  Organizations like Food and Water Watch have Take Action pages that regularly give us an easy way to share our thoughts with our legislators and other leaders about food, fish and water safety.  Government agencies routinely offer public comment opportunities so we can weigh in on pending policies.  For example, the Food and Drug Administration is considering changes to nutrition labels on food products right now and is inviting the public to share their ideas (until January 19, 2010).  And, if time is short making it daunting to articulate smart comments, Fooducate has come up with 7 suggested label improvements for you to consider, cut and paste into the FDA's comment page.

This is just the beginning of what we could be doing.  What I wonder about these days is:

• What will it take to get more people civically engaged on matters impacting health and wellness?
• How would you describe your relationship with your health and how did it get that way?

I would be honored to read your responses to these questions.