In the land of the Mediterranean diet, visions of America.
Jerusalem — Israel is a Mediterranean country, but over the years its diet has
become less about fruits, vegetables and olive oil, and more about fast food — which has fueled a childhood obesity problem similar to the one seen in America.
The mom-and-pop stores that once sold only the basics have been all but replaced by mega supermarkets whose aisles are brimming with sugary cereals, sweets and processed foods. Drink and snack dispensers can be found in many Israeli schools, where hot lunch programs aren’t necessarily monitored for nutrition. Drink and snack dispensers can be found in many Israeli schools, where hot lunch programs aren’t necessarily monitored for nutrition.
“Overall, Israel is in a bad way, just like America,” says Professor Elliot M. Berry, director of the department of human metabolism and nutrition at the HU/Hadassah Medical School. “There’s too much going in and too little going out activity-wise. Unlike a bank balance, we need to be in overdraft.”
Statistics vary, but experts agree that a significant percentage of Israeli children — especially teenagers — weigh too much. According to the MABAT Youth Survey BMI, 12.8 percent of the nation’s children are either overweight or at risk of being overweight, while 5.7 percent are outright obese. A 2009 report by the Knesset Research Center put the obesity figure at over 10 percent.
“Unfortunately, it’s a worsening problem,” says Berry. “There’s a national committee that presented its recommendations in 2006, but it’s a work in progress.”
Moria Golan, director of Shahaf, an organization whose primary mission is to eliminate eating disorders, says the obesity epidemic will continue until parents start serving better food in reasonable quantities.
“Most obese kids are genetically pre-disposed to obesity. But while genetics loads the gun, the environment pulls the trigger,” says Golan.
Through trial and error, Golan and her team discovered that for children to maintain healthy eating habits, parents must first bring healthy food into the home.
“The idea is not to control the child but to control the environment,” Golan explains. “If you control the child, you don’t increase his self-control.”
In the past, Golan says, Israeli health professionals emphasized healthy eating habits, but paid little attention to family dynamics. “Today, the emphasis is on improving parental practices” in order to find a balance between being too lenient with one’s children, and too demanding.
“Israel is a very child-centered society,” Golan notes. “Parents either tend to be too permissive or, at the other extreme, authoritarian instead of authoritative.”
Neither is conducive to establishing self-control in children, she says.
Shahaf runs an eight-week program that helps parents adopt a parenting style that increases the child’s self control. It helps convince parents that they, not their children, must decide what food comes into the house, and what stays on supermarket shelves. A second goal is to trust the child’s decision on how much “real food” to eat within the parameters of healthy eating.
Golan gives an example: “Your child wants an additional portion of dinner [not sweets], even though he’s had a whole meal.” The “responsive” parent will serve the additional portion immediately,” Golan says, while the “demanding” parent might say, ‘You don’t need to eat any more.’
“Neither is good,” Golan says, because the moment the parents are out of the picture, the child doesn’t know how to regulate his eating. “The idea is to say, ‘If you’re hungry, then have some more,’ which puts the decision-making into the child’s hands.”
The Ministry of Health also believes that parents must do more to keep junk food out of their children’s mouths.
The ministry periodically conducts focus groups of parents and children to “find out what they think and what they know” about nutrition, says Ruth Weinstein, who heads the ministry’s department of health promotion.
During the focus groups, “parents would say, ‘My child only wants to eat Bisley, Bamba and Coca-Cola,’” popular Israeli snack foods. “We asked what they had at home and realized there’s a problem with parental authority. They don’t feel they can tell their children what to do.”
Weinstein says education must begin at birth.
“We know it’s better to prevent than to treat, so we start in infancy,” Weinstein says.
While the Health Ministry has always championed breast feeding, it recently began touting weight control as one of its benefits, Weinstein says. Studies have shown that breast fed babies tend to be less obese in childhood (breast milk has fewer calories than formula).
A year-and-half ago the ministry created a campaign to show employers why it’s worthwhile to enable employees to express their milk in the workplace.
The ministry is currently conducting a breastfeeding survey to determine how long mothers breastfeed their babies and what conditions encourage and dissuade them from doing so. The women will be tracked for two years “because we want to base our recommendations on science,” Weinstein says.
Weinstein says the ministry recommends that families eat meals together because, according to studies done in the U.S., “there is less risk-taking behavior and less obesity” in families that eat together at least once a day.
“When you eat together, you see what people are eating, and you also talk. Family dinner time is a valuable tool,” Weinstein says.
In cooperation with the ministries of education, sport and the environment, the Health Ministry is also actively promoting physical activity. Projects around the country include a program that encourages children to walk to school. Responsible adults have committed to accompanying school children at various points in a given community.
Unfortunately, not all ministry guidelines are heeded.
Schools often fail to comply with a regulation banning soda and snack machines from school premises, and the Ministry of Education does not supervise school lunch programs.
“We want to have the supervision under Ministry of Health jurisdiction,” Weinstein says.
Weinstein is more hopeful about an initiative that will give schools that promote good health a Health Ministry “stamp of approval.”
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