"An ounce of prevention is worth a pound of cure." This was the phrase Benjamin Franklin used to light up the call for the first Fire Company ( or Department) in Philadelphia in 1736. Fires affected owners of buildings and businesses in highly adverse ways. It put them out of business, ruined their momentum and often took a large toll on their families. By establishing a safer way to extinguish fires and provide insurance on buildings that protected the insured from fire damage, Franklin knew he could prevent the social, economic and political damage from a fire. But little did he know that "An ounce of prevention is worth a pound of cure" would come to the forefront on another kind of fire that carries an even more financial, political and economic toll to not just Philadelphians but to his entire country. The childhood obesity epidemic is the fastest spreading epidemic in the country and it is an epidemic that is basically all about fire, the fire inside the body that turns needed calories into available energy for life to sustain itself.
Even though the current Congress lacks a fundamental understanding of this idiom, every pediatrician knows that the most effective coaching for parents and children that can be done is to coach on changing behavior. If "An ounce of prevention is worth a pound of cure" is going to be effective then a family's caloric behavior around the dinner table has got to change. The pediatric clinics that are most successful in reducing childhood obesity are the ones that are organized to focus on prevention. You can't cure a child of obesity, but you can prevent that child from becoming obese by focusing of behavioral changes made from within the family unit as well as the environmental unit.
Michael Pollan's in his new book Food Rules sums it up in his Food Rule #70:
Breakfast Like a King,
Lunch Like a Prince,
Dine Like a Pauper.
By decreasing the number of calories throughout the day one can manage the most deceptive of fires, the internal fire of burning calories. Taking in more calories than you use up results in the storage of the extra calories in the form of fat. Obesity is the result. Marion Nestle and Malden Nesheim in their engrossing book Why Calories Count tackle this life threatening event when they examine the relationship of calories to body weight.
Imagine a calorie of energy as one big pie. In that pie are social, political and economic behaviors that are playing out in the present day human population. Food companies, fast food chains, school food service personnel, medical professionals, restaurants, grocery stores, political contributions to our elected officials from food companies, food service companies and agriculture are all part of each calorie. Understanding how these different dimensions influence the number of calories our bodies take in each day is the key to getting a grip on the relationship calories have to body weight.
Most of us in America eat breakfast at each meal. We never experience lunching like a prince, or dining like a pauper. We breakfast like kings with our bacon and eggs, we breakfast like kings when we grab a hamburger and fries and a coke, we breakfast like kings when we grill a 12 ounce steak in the evening and down a couple of beers. We breakfast all day. But this breakfasting isn't from one physiological influence. We weren't born to breakfast all day. But we will die sooner than later if we continue to behave this way. It's the social, the economic, the political behaviors that are influencing our all day breakfasting. Nestle and Nesheim clearly broaden our view of how calories take on the flavor of foods that have a nutrient density of zero.
David Katz MD, Director, Yale Prevention Research Center, has a wonderful article on what prevention really means. He writes, "If we got down to the bedrock of true prevention -- lifestyle as preventive medicine -- we could add years to life, add life to years, and save a whole lot of money by putting to use the science and sense long at our disposal. Doing so will, of course, require changes in how we think about health, changes in our culture. But culture is what we make it, and we can change it for free. Which brings us to the bottom line, figuratively and literally. We have the science we need to eliminate outright most of what ails us. Prevention could save us a whole lot of dollars if, when we used the term, we made a bit more sense."