Prudence and Madness

Several years ago, the word “malnutrition” usually brings about images of poor African children, bone-thin with protruding bellies, weak with hunger as they lie wrapped in their mothers’ arms, equally malnourished, or lying listlessly on the desert sand amidst vultures, awaiting death to overcome them.  However, recent events caused us to conjure images of malnutrition as big, bulky humans with the same protruding bellies, not because of ascites, but because of excess adipose tissues.  These humans suffer not from hunger of food but rather from not understanding the disaster that is obesity, the other half of malnutrition that has reared its ugly head in the recent years.  Now, suddenly, both hunger and overabundance of food oppress us.

Like those stricken with hunger, children it seems are also susceptible to this rising epidemic.  But whereas the cause of world hunger is more political and economic in nature, obesity is more of a personal issue.

A typical case was that of a mother, who I saw in my clinic, with hypercholesterolemia and hypertension.  I advised her that even with medications, she has to modify her eating habits, so as to keep off the excess weight and keep her blood cholesterol and blood pressure at normal levels.

And her horrified response was: “But how do you expect me to do that?  Do I have to cook separate meals for myself.  The family simply can’t afford it!”

After further discussion, I found out that what her family “couldn’t afford” wasn’t monetary in nature.  It was the idea of switching the entire family to a different, “abnormal” diet that repelled her.

“My kids, all they want to eat are fried foods: fried chicken, fried fish, french fries, burgers, and chips.  I don’t know what to do.  So that’s why I also eat what they eat.  And thus, the high cholesterol,”  she explained.

However, when I suggested that she introduce to them a diet consisting mostly of vegetables, milk, and fruits and with lesser meat and processed foods, she was aghast.  She was adamant to the idea that vegetables are only diet food and children would be missing important nutrients if they’re to eat less meat, since meat builds up muscles and are important to growing children.  And the processed foods she cannot simply remove from the menu because the children want them.

She went on with her litany of what she knows about nutrition and how she was consciously aware of what she feeds her children.  She got a lot of things wrong.  I told her that in the food pyramid guide for Filipino children, it was clearly illustrated that vegetables and fruits are situated neared to the pyramid base; therefore, should be eaten more frequently.  And yes, meat does contain proteins that have high biological value.  But, most people today consume about twice the amount of proteins that are actually needed by the body, and in most instances, in forms laden with saturated fats.  The excess proteins not used by the body only stress the kidneys, which in the long-term, could lead to kidney diseases like acute renal failure.

But still she was adamant.

I realized then what was the heart of the whole matter:  misinformation and refusal to update one’s beliefs.  And it’s dangerous, I fear, because these erroneous beliefs get passed on to the next generation.  And the generation after the that.  How can we fight obesity if even the parents, who should be responsible for the health of their children, refused to be educated about it?

As for my patient, I don’t know what became of her and her family because she did not come to follow-up consultations anymore.  Hopefully, she realized what she’d been told and was busy devising ways to revamp the family’s diet for the better.  Well, if not, sad to say, she’d be one of the thousands of parents wondering why their children are fat when they were not during their younger days.  And these people only kept wondering because they never wanted to take the crucial first steps towards a healthier lifestyle: acceptance, understanding, and action.