Adequate nutrition should be priority for whole family

Earlier this year, JAMA Pediatrics published an essay about processed food and its impact on health. The author, Dr. Robert Lustig, describes processed food as “an experiment that failed.”

Processed food, according to Lustig, has led Americans to eat more refined carbohydrates, develop obesity and type 2 diabetes, harm the environment, and spend more on diet-related health conditions.

The health, economic, and environmental issues raised by Lustig are important ones. But in the essay, Lustig also notes:

“One-third of American mothers today don’t even know what real food is or how to cook; they and their children are destined to remain hostages to the processed food industry.”

This characterization of American mothers reinforces the problematic assumption that women bear the primary—if not sole—responsibility for children’s health.

In a brief reply to Lustig, Ethical Considerations for Nutrition Counseling About Processed Food, Anne Barnhill and I argue that the focus on mothers also represents a missed opportunity to engage fathers—and the broader society—in promoting children’s health.

The focus on mothers as being responsible for children’s healthy eating also reinforces an unfortunate tendency to locate responsibility for preventing risks at the individual level, without adequate recognition of the societal factors that constrain or shape individual choices.

For example, the decision about what a family eats is shaped not only by how healthy or unhealthy a food product is, but also by whether there is a supermarket in the neighborhood, the cost of fresh produce compared to fast food, and time availability.

While the norm in the 1960s was for children to be born into families with two married parents in their first marriage, often with a father as primary breadwinner and mother in the home, today’s family structure is often far more diverse. For example, one-quarter of children today live in single-parent household, and a growing number live in same-sex households.

Nutritional guidance must recognize these changing household arrangements so they can make recommendations that take into consideration the populations whose health they are trying to improve.

-By Stephanie Morain, Ph.D., M.P.H., assistant professor at the Center for Medical Ethics and Health Policy at Baylor College of Medicine