Marc Ambinder has written a terrific article on obesity for The Atlantic. It's comprehensive and insightful, both objective and personal. Ambinder himself suffered from obesity until a year ago, when he went from 235 to 150 pounds following bariatric surgery. The operation immediately improved his severe diabetes, and within months it relieved years of suffering from sleep apnea.

The article includes explanations for the recent increase in obesity, observations on contempt for the obese (including "fat porn" TV shows), acknowledgement that weight loss is not simply a matter of will power, and an assessment of the political obstacles that make solving this important problem so difficult.

Sugary soft drinks are under attack from obesity experts, health commissioners, nutritionists, Congress, and President Obama. And the soft drink industry is fighting back.

Health experts have proposed a tax on soft drinks of one cent per ounce. That's an extra 12 cents on a 12-ounce bottle of Pepsi, which may not sound like much, but it adds up. If a two-liter (67.6 ounces) bottle of Coke sells for $1.35, the price would go up 50 percent.

Health experts claim the tax could cut consumption by 10 percent and, they hope, reduce obesity. Even if the tax had no impact on weight gain, there's the appeal of generating $15 billion a year in revenues.

Congress likes the idea of a tax on soft drinks because they could use the money to finance health care. The Congressional Budget Office did an estimate last December on a less drastic federal excise tax -- three cents for every 12 ounces -- and came up with a projected income of $50 billion over ten years. Currently there's no amendment taxing soft drinks in either the House or Senate versions of the health care reform bill. But that battle isn't over yet.

Michael Pollan has a great editorial in today's New York Times on Big Insurance and Big Food. Could health care reform motivate the insurance industry to lobby for healthier food? The argument goes like this.

According to the Centers for Disease Control and Prevention, three-quarters of health care dollars are spent on preventable chronic diseases. Smoking is an obvious culprit, but many (if not most) chronic diseases - diabetes, heart disease, cancer - have a connection to poor diet. We eat too few fruits and vegetables and too much sugar, salt, refined carbohydrates, and saturated fat.

You already know Denny's doesn't exactly serve health food, so is it worth getting worked up over how much salt is in a typical Denny's meal? The Center for Science in the Public Interest (CSPI) thinks so. They've initiated a lawsuit against Denny's over the salt content of their meals.

Salt is 40% sodium, and it's the sodium you want to limit in your diet, especially if you have high blood pressure. The recommended amount of sodium in the daily diet of a normal, healthy person is 2,300 mg. People with high blood pressure are advised to limit their sodium to 1,500 mg. The lawsuit claims that 75% of Denny's meals contain more than 1,500 mg and that this puts the health of unsuspecting diners in jeopardy.

Not only is there too much salt at Denny's, but it's almost impossible to find out how much you're eating. Some information is online, and if you're very persistent, you may be able to get one of Denny's little pamphlets with nutritional facts. According to the lawsuit (PDF), however, "the nutrition information available from Denny's is so incomprehensible that calculation of each meal's sodium content is impossible for the reasonable consumer to perform."

In an earlier post, I asked whether foodborne illnesses were on the rise. (Not just peanut butter: What's happening to our food supply?) A recent story in The New York Times addresses that same question.

Heather Whybrew, a college student in Washington State, became gravely ill after eating a salad in her school cafeteria. Carl Ours, of Ohio, was temporarily paralyzed after eating chili dogs and drinking beer. Mari Tardiff, of California, spent three months on life support after she drank unpasteurized milk. ... Is it becoming more dangerous to eat?

In 1996, the CDC improved its method of collecting information on foodborne illnesses. The Foodborne Diseases Active Surveillance Network (FoodNet) began monitoring seven foodborne diseases in clinical laboratories throughout the U.S. Although this change makes it difficult to compare historical information before and after 1996, public health officials believe food is definitely safer now than it was a century ago, before refrigeration, pasteurization, and municipal sewer systems.

It's probably safer now than it was 10 years ago, although there's still plenty to worry about. According to Caroline Smith DeWaal, director of food safety at the Center for Science in the Public Interest, "The trends clearly show that consumers should be more worried about the food supply because the hazards are becoming more pronounced."

Whenever there appears to be an increase in an illness, one of the first questions is whether there's really an increase or if it's simply that more cases are being reported. This is as much an issue for foodborne illnesses as it is, say, for the apparent increase in attention deficit disorder diagnoses. If food is now safer, why are there more contamination scares and more recalls?

A new movie, Food, Inc., will be in theaters starting June 12. The film documents how industrialized agriculture has changed the food we eat and explores the impact of this change on health, food safety, and the environment. In the movie's trailer (see below), a woman eyeing vegetables in a grocery store says "Sometimes you look at a vegetable and say, well, we can get two hamburgers for the same price." That about sums up the problem with the American diet, a problem directly related to a decrease in health (diabetes, heart disease) and an increase in weight (the so-called "obesity epidemic").

Here's the official description of the film:

In Food, Inc., filmmaker Robert Kenner lifts the veil on our nation's food industry, exposing the highly mechanized underbelly that has been hidden from the American consumer with the consent of our government's regulatory agencies, USDA and FDA. Our nation's food supply is now controlled by a handful of corporations that often put profit ahead of consumer health, the livelihood of the American farmer, the safety of workers and our own environment. We have bigger-breasted chickens, the perfect pork chop, insecticide-resistant soybean seeds, even tomatoes that won't go bad, but we also have new strains of E. coli--the harmful bacteria that causes illness for an estimated 73,000 Americans annually. We are riddled with widespread obesity, particularly among children, and an epidemic level of diabetes among adults. ... Food, Inc. reveals surprising--and often shocking truths--about what we eat, how it's produced, who we have become as a nation and where we are going from here.

Kenner, the producer/director, and Eric Schlosser, author of Fast Food Nation, started talking about a documentary of Fast Food six or seven years ago. By the time the film was funded, both Kenner and Schlosser were heavily influenced by the ideas of Michael Pollan, author of The Omnivore's Dilemma and In Defense of Food .

By studying the fossilized bones of long-dead humans, physical anthropologists can determine the course of our species' evolution. But those fossils, which often include bones deformed by lesions and distinctly unhealthy teeth, also allow anthropologists to speculate on the health and the lifestyles of our distant ancestors.

Individual anthropologists have long speculated that health declined with the invention of agriculture, but that was based on examining remains from isolated locations such as burial sites. A research project called A History of Health in Europe over the Past 10,000 Years has been computerizing a large collection of data from 72 researchers.

Contrary to what we would intuitively expect, fossil evidence confirms the conjecture that human health went into a serious decline with the advent of agriculture. Health continued to decline through the Middle Ages, and it wasn't until the mid-19th century that it started to improve. By studying these patterns, which are often related to changes in diet, anthropologists hope to apply what they're learning to the future of human health.

What do fossil remains tell us about the health and daily lives of our ancestors?

Skeletal remains provide a number of clues about human health. Physical trauma and dental health are pretty easy to observe. Variations in height can indicate whether food was adequate for growth during childhood. By analyzing bone specimens, scientists can even determine what people ate. Bones also reveal degenerative joint disease, and some bone changes indicate anemia.

Fossils and other archaeological findings also allow anthropologists to speculate on the number of people living in a settlement as well as the main source of their food and their social and economic status. This provides clues to lifestyle: Were these people rich or poor, urban or rural, and did they engage in farming or hunter-gathering.

Lifestyles of the Dead and Fossilized

Pulling together the evidence collected so far, anthropologists observe a marked decline in health about 3000 years ago, at a time when agriculture became widely adopted throughout Europe. (The cultivation of crops was actually "invented" several times and goes back at least 10,000 years.) Evidence includes an increase in skeletal lesions from tuberculosis and leprosy, probably caused by living in close quarters with domesticated livestock and being exposed to the accumulated waste products present in human settlements. When people live close to animals and close to each other, conditions are ideal for contagious diseases caused by viruses, bacteria, and other microorganisms. Most ancient cities were periodically devastated by epidemics.

Try this simple test. Ideally you'll need a fruit-flavored jelly bean, but you can also use hard candy, a cough drop, or a piece of Mentos "freshly picked" gum. It should be chewable and relatively odorless. You won't need to swallow it, so you can do this even if you're counting calories.

Hold your nose and put the jelly bean or equivalent in your mouth. Keep your nose closed and chew (with your mouth closed). Notice what you taste. If it's fruit flavored, you probably notice a sweet and maybe a little sour taste. Now pay close attention as you let go of your nose. There's a rush of flavor. If you were eating a strawberry jelly bean, you'd notice the complex fruit flavor that we identify as strawberry.

How we taste food: Flavor is more than taste

Technically, taste is what happens on your tongue. Flavor, on the other hand, is a combination of taste, smell, and touch. Our sense of smell allows us to distinguish thousands of different odors, whereas the tongue detects only five basic tastes: sweet, sour, salty, bitter, and savory (umami).

When you eat a jelly bean, odors are released by chewing. These gaseous molecules get pumped up into your nasal cavity, where they interact with a postage-stamp sized area on the roof of the nasal cavity called the olfactory (smell) epithelium. There are millions of olfactory receptor cells here with microscopic hairs (cilia) waving in the passing air currents. Information from the receptor cells is sent to the olfactory bulb, which is part of the brain. From there, signals get relayed to other parts of the brain, including those involved in memory, speech, emotion, and decision making. There's a very complex process going on whenever you identify a distinct odor or flavor.

Last year it was tomatoes contaminated with Salmonella. Except not really. After the tomato industry lost $200 million, it turned out it wasn't tomatoes after all, but jalapeno and serrano peppers from Mexico. Tomatoes aren't off the hook though. There have been 12 Salmonella-contaminated tomato outbreaks since 1990 serious enough to involve multiple states.

In 2007 it was the bagged spinach food scare, also a Salmonella problem. In 2006, spinach contaminated with pathogenic E. coli was recalled. That was traced by the FDA to a California town where spinach fields were bathed in the runoff from nearby cattle ranches.

We spend a lot of energy on calories -- counting them, avoiding them, feeling guilty about them. But what are calories, anyway? Well, they ARE energy. Specifically, calories are the energy we get from the food we consume. And that makes them a good and essential thing. Calories wouldn't be a problem if we consumed them and then used them through physical activity. But when we don't use as many calories as we consume, they accumulate and we gain weight.

When we count calories, we're really counting how much energy we get from our food. One Twinkie has 150 calories. That's the supply side. On the demand side, calories measure how much energy it takes to do things. If you raise a small apple one meter (39 inches), you'll burn 2.4 calories. You'd have to raise an apple over 62 times to work off one Twinkie (and they usually come in packages of two).

One group that opposes the nomination of Sanjay Gupta as the next surgeon general is the Center for Consumer Freedom (CCF), an organization that promotes the interests of the restaurant and food industries. Anyone who suggests eating less can expect criticism from an industry that wants us to eat more. Gupta took on the topic of obesity in 2006 with his "Fit Nation" campaign.

In the CCF we encounter two of my favorite and related subjects. One is the difficult balance between corporate and public interests in a free-market economy. The other is how the "personal responsibility for health" mantra works against our best interests. If you are personally responsible for your own healthy lifestyle, then the food industry is totally innocent of contributing to heart disease, high blood pressure, diabetes, and obesity. The slogan of the CCF is "Promoting personal responsibility and protecting consumer choice." They're a wolf in sheep's clothing.