Naked Chef Wears His Cup Well

Last night, I attended a celebration in honor of chef Jamie Oliver, the “Naked Chef”, who won the “Healthy Cup” from my graduate alma mater, the Harvard School of Public Health.  Previous honorees include Lee Iacocca for his work to battle Diabetes and Senator Tom Harkin, who put wellness on the American agenda.  Oliver was singled out for waging a “food revolution” aimed at eliminating childhood obesity through healthier school lunch programs.  Although his televised efforts were received somewhat mockingly--failing to get public schools in West Virginia to reform school lunches, or a fast food owner to spend more per unit to serve a healthier product-- his passions did ignite the public to remove flavored milk from the Los Angeles school system and FDA-sanctioned  “pink slime” from MacDonald’s hamburgers.

I accepted my invitation to this event, I admit, because I have a tendency to be somewhat star struck.  I loved Jamie Oliver’s early cooking show, where he seemed to blend foods much like an artist mixes colors on a palette.  His free-styling in the kitchen was inspirational and fun. I was pleasantly surprised to discover that this seemingly wild spirit with dubious grammar turned out to be a deeply passionate and committed man, surprising even the staunchest of academics with his humility, poignancy, and deep understanding of facts about nutrition and politics.  He was practically verklempt by the incongruous scene:  a former grade-school dropout lecturing a packed auditorium of Harvard scientists about what he considers the most critical health issue of our day.  He is waging a one-man war against juvenile obesity; he invites everyone to join him, but he is prepared to fight alone if necessary. 

Oliver told a remarkable story about his going into one of the poorest communities in England where there was no lunch program for students.  Through his own Foundation, he supervised the construction of school kitchens and developed programs to teach cooking with the goal of bringing proper nutrition and food awareness to these unfortunate children.  A kid spends two meals a day, five days per week, forty weeks per year over a ten to twelve year period at school.  As Oliver pointed out, over half of childhood is spent at school.  Children develop not only their eating habits but also a general palate for food that is retained for the rest of their lives.  With no other resources in this impoverished school district, he felt called upon to fashion a solution.  When he showed up to launch the project, he was swarmed by kids yelling “naked chef, naked chef,” straining to capture a shot of him on their smartphones.  He stopped and held up his phone, asking, “Who has one of these?”  Much to his surprise, every kid in this impoverished school held up a snazzy phone.  “Priorities,” he remarked, shaking his head in disgust with no sense of irony.  The schools did not have the resources to provide proper nutrition and the families could not feed the children properly, yet each child was walking around with more technology in their pocket than that used to launch the Mercury rocket.

As I gazed around the packed auditorium, I was struck by the vast disconnect between nutrition and medicine.  The Harvard School of Public Health is an integral part of the Harvard Medical campus, sitting just next door Harvard Medical School.  Our physicians are quick to prescribe the latest pill for hypertension or high cholesterol, yet they have little formal training in the specific ways nutrition contributes to healthy lifestyles.  Thus, health care costs continue to skyrocket while we are raising the first generation in half a century or more that faces a lower life expectancy than their parents. 

   

On the way home, I listened to a couple of pundits on the radio kicking around the pros and cons of various politically-derived health reforms.  Having spent my career in healthcare information technology, I know from experience that any austerity measure thrown at the healthcare system results in huge increases in infrastructure costs.  Look at DRGs, managed care, and HIPAA.  Every time you regulate something, it has to be captured, reported, and measured.  Because of the hidden costs of monitoring and re-engineering, system wide cost savings never materialize.

Instead of re-re-engineering, what if we invested in juvenile nutrition programs instead, revolutionizing the way our children eat and helping them to develop positive food values?  Epidemiology teaches us that when you introduce a new agent, it takes about twenty years to see the effect.  This means that measures implemented today would begin to see results by the time today’s school age kids enter the work force, when they themselves become the insured subscriber population.   This kind of approach is really the only sustainable solution to growing healthcare costs.

The fact is we have allowed lifestyle changes and convenience-based foods to affect our health status in monumental ways that we are just beginning to understand.  If we do not turn back the tide, no amount of health reform will ever curb health care costs.  With a sicker population comes a greater burden for care.

Jamie Oliver’s message his hard to hear.  We as a society do not welcome change and we do not like problems with inconvenient solutions.  But everything he says rings true.  We owe it to ourselves and our children to listen and learn.

Tomorrow's blog:  Artful Dodger