Shoku-iku is the Japanese word for “eating education” or food education. Since 2005, the Basic Law of Shoku-iku has been Japan’s national food policy. It serves as a “blueprint for conscious eating.” Starting in kindergarten, students learn to connect health, nutrition, food, and the environment. More than 4,000 diet and nutrition teachers teach in public schools. The result: 3.7% of Japan’s adult population is obese (around 2.8M people out of the total adult population of 86M). This is striking because 38.2% of the US adult population is obese (around 73M people in the total adult population of 219M). We’re talking obese, not overweight. How is Japan reducing obesity in adults, while obesity continues to rise in the US? What can we learn from Shoku-iku?
Overweight or Obese
Do you know the difference between overweight and obese? The World Health Organization defined overweight and obesity “as abnormal or excessive fat accumulation that may impair health.”
The Body Mass Index (BMI) is a weight-for-height index used to classify overweight and obesity in adults. BMI is measured by weight in kilograms divided by the square of your height in meters (kg/m2).
In simple terms, overweight is a BMI equal to or greater than 25, and obese is equal to or greater than 30. There is a TV show called My 600-lb Life about people who are “super-morbidly obese” with BMIs of 50 or more. Participants weigh at least 600 pounds, with BMIs over 100.
Teachers v. Physicians
It’s interesting that the US has no strong national food policy to teach children or adults about healthy eating. As important as food is in our lives, food policy is almost an afterthought – it’s important but not a priority.
What are some of the problems in educating people about food and nutrition (metabolism, disease reduction and healthy diets)?
Let’s talk about one big problem: The medical community and your physician. One article said that nutrition is important in medicine, but pharmaceutical therapy is the method of choice in patient treatment.
On average, older adults in the US take four medications daily, driving up profits for companies like Eli Lily and Pfizer.
Drugs also drive up the cost of healthcare: Cancer drug therapy can cost upwards of $100,000 per patient. Doctors prescribe drugs because they work – for example, drug treatment for Ebola or HIV/AIDS.
Preventive medicine is not a priority in today’s healthcare. It’s easier to treat the disease after the fact than to prevent the disease in the first place…
But Japanese diet and nutrition teachers understand how to prevent diet-related diseases. Simple suggestions for students include:
- Avoid food from convenience and fast food stores.
- Always eat breakfast.
- Eat traditional Japanese meals over fast food.
These food educators know the health risks from lifestyle-related diseases in children and adults. They plan school lunches that included steamed rice, vegetables, green beans and salad.
One Solution: Lead By Example
Do you ask your physician about food and diet? A study recognized the most physicians “don’t feel comfortable” talking about nutrition with their patients.
Why? Because they had maybe one class on nutrition in medical school. Maybe one class…
Less than 20% of medical schools require a class on nutrition. The same study suggested 25 hours of nutrition education over the four years of in-class medical training.
One solution for the lack of nutritional training in US physicians is to team up with people in the culinary industry. Some doctors are working with chefs to learn about nutrition.
And a researcher is collecting data to show a link between a physician’s lifestyle and patient outcomes: When a doctor practices good health, the patient will follow their example.
Learning to eat healthy and practicing good nutrition gives physicians a toolkit to share with the patient. Leading by example is a great tool for preventive medicine.
Let’s Get a Clue About Food Policy
Our current US food policy relies mainly on inspiration: If people want to eat healthy, they have to be self motivated. Farm-to-school programs are helping children learn about good eating, but we need a better road map.
And it starts with nutrition. If we don’t understand nutrition, we’re clueless about our health and quality of life.
The food pyramid was a reflection of basic foods (milk, margarine, bread, cereal, potato, protein). It’s now outdated because it didn’t say how much to eat of the basic foods.
The new focus is on the food plate, a logo that shows five basic foods for building a healthy diet. The place setting for a meal shows the relative amount of fruits, grains, proteins and veggies, or dairy.
The food plate is a good start for a US food policy. A better clue: Nutrition and diet teachers in public schools and teaching in medical schools.
Sources: Food education the law in Japan
The Food Education Project
“Shokuiku”: Japan’s Cultural Shift in Nutritional Perception and Education
Obesity Update 2017
WHO: Obesity and Overweight
My 600-lb Life
The Nutrition Gap: Are Doctors Ready to Think Outside the Pillbox?
Nutrition: What is it and why is it important?
U.S. Doctors Are Teaching Themselves About Nutrition
Predictors of US medical students’ prevention counseling practices
National Farm to School Network
Food pyramid (nutrition)
Prevention is better than cure.