Israel’s population is getting heavier, as is happening in most of the Western world. A recent sub-committee of the Health Ministry presented a 150-page document for the prevention and treatment of obesity, a scholarly review with convincing data and references to support every suggestion made. But as we emerge from another three-day holiday of the New Year, it’s time for some personal reflections on the issue of weight gain.
I am a geriatric Ashkenazi Jew, the product of a Lithuanian Jewish heritage via South Africa, living in Israel for the past 50 years. My wife is a Sabra from a Polish Ashkenazi family. We define ourselves as secular and traditional Tel Avivians who observe the major Jewish holidays. The tradition weighs heavy in our holiday meals, and the menu is fixed and unchanging.
Having just completed this year’s Rosh Hashanah eating routine, it is easy to review the main meal over each of these three days (the holiday eve followed by two whole days).
- Starters: gefilte fish and chopped liver, chicken soup with kreplach.
- Main course: roast beef and/or breast of chicken, potatoes, rice, three salads, vegetables.
- Dessert: fruit compote and honey cake.
- Freshly baked challah with all courses to sop up any remaining soup or gravy, or to spread with horseradish and to eat together with all items.
If these meals were consumed only on a few special occasions (with modifications for Passover, when matza becomes the filler – a huge source of unnecessary calories), I could justify the gastronomic gorging, indicating that at all other times, people eat less and healthier. Alas, for my family, Friday nights are also special, with all children and grandchildren gathering with us for a Shabbat meal with its own unique features such as compulsory chicken soup, and chocolate in some form for dessert, either as a cake or in ice cream or in pure form. Thus far, I’ve accounted for some 50 meals in the year, leaving some 300 days to cut back and reverse the adverse effects of our cultural gluttony. One could imagine that for most of those “non-special days,” we revert to an optimal Mediterranean diet of plenty of vegetables and fruit, olive oil and fish.
The challenges of eating healthy
Alas, not so. Anyone standing on a street in a hi-tech area anywhere in the country at noon will see another cultural phenomenon as hordes of young executives stream out of the offices to enjoy a business meal of Pad Thai or pasta, augmented by starters and a bread basket as part of a business lunch. To be fair, there are those who beeline to the salad bars, where they can eat three times the recommended amount of healthy vegetables, justifying an evening in front of the television with a takeout order. The other challenge to healthy eating is the explosion of good restaurants that keep opening (and closing) throughout the country.
From Metulla to Eilat, one can choose eateries offering a wide variety of cuisines, including take-out or ordering from a company that sends you any meal you may desire within half an hour, delivered by a sweating youngster on a motorcycle who has driven down sidewalks through multiple red lights to ensure that your steak entrecote arrives hot.
“If no action is taken to modify the current situation, within 20 years mortality rates around the world will increase by approximately 30% due to overweight and associated diseases.”
Israeli Health Ministry report
The erudite report of the Health Ministry includes suggestions for intervention aimed at the family, the health system, industry, government, the media and schools. This blueprint for stopping the obesity epidemic also contains severe warnings, such as “If no action is taken to modify the current situation, within 20 years mortality rates around the world will increase by approximately 30% due to overweight and associated diseases.” That’s a sobering warning, even though it’s a problem for my kids and grandchildren, not for me. I remember very clearly a lecture on obesity by a famous endocrinologist during my pediatric training in Chicago some 50 years ago, who presented the gloomy prognosis for the overweight and describing the “U-shaped curve,” showing that the vast majority of overweight people lose some weight over a period of time, only to return to their overweight level as time passes.
So, I drink a toast to the Health Ministry for producing a serious document for change. Like the Palestinian issue, road accidents, COVID-19 and the Iranian nuclear bomb, the overweight Israeli is a serious problem, with serious health and economic implications. It should be noted that in the midst of the COVID crisis, then-health minister Yaakov Litzman introduced compulsory labeling of foodstuffs for health hazards, such as too much sugar or fat. I wonder how many people today look at those red labels, understand what they imply and return the item to the shelf in the supermarket. Many of my American friends have clearly adopted a lifestyle with healthier eating habits and more exercise. Many Israelis are also running more and keeping to the Mediterranean diet.
But old habits die hard. Eating well is still seen as the essential element for healthy growth, and the Jewish mother has not lost her role as preserving the life of her offspring by ensuring an adequate quantity of food eaten, with less attention to quality. The number of shows on prime-time TV devoted to food attests to the centrality of food in the Israeli gestalt. It has always been hard to persuade a young child (or their parents) to eat carrots and broccoli instead of Bamba and chips. To write the 150-page document is the easier part. Finding a way to convince parents to enforce a few simple family habits, such as drinking water instead of sweetened drinks and not allowing snacks between meals, would be a good way to start. ■