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We recently had the opportunity to interview Kansas City's only Board-Certified Lifestyle Medicine Practitioner, Trey Bennett, to learn more about his health journey and his perspective on the current food and healthcare systems as a nurse practitioner who once suffered from the effects of diet-related disease himself. Read his inspiring story below. Tell us a little bit about your health journey. I feel like I’m nearing the summit of my health journey, but it’s been quite the hike. I grew up in the same zip code where my office is located now. Back then, there were corn fields and cattle pastures within a mile of my house. I was raised on meat, potatoes, and more meat (BBQ of course!) My family ate what is now recognized as the standard American diet (SAD). I also joke that I was on the "See Food Diet"— I would see a commercial or even think about food, and that was what I ate. My whole family suffered many health complications as a result of this diet, and I myself struggled with chronic sinus infections and severe acne. As a family, we saw a dietician who recommended what I call the "modified American diet," which consisted of lean meats, low fat dairy, and reduced fat foods (like SnackWells). I remember a few of their recommendations specifically: a McDonald's Egg McMuffin with no cheese was a “healthy” breakfast option and Three Musketeers was the recommended candy bar because it was lower in calories. The over-arching theme was to eat everything in moderation, including the truly healthy foods. Food was my coping mechanism, and I would eat large volumes of baked chips, SnackWells cookies, low-fat microwave popcorn, cheese, meat and just about anything I could get my hands on. My dad had high cholesterol, so he started taking a statin in his 40s. He suffered side effects and had several medication and dosage changes. Eventually, he was diagnosed with Syndrome X and prediabetes and he was recommended the Atkins diet. As a family, we began eating "everything in moderation," with an Atkins influence. Fast-forward to 2012, I was working as a bedside RN at Kansas City’s best hospital on a busy medical progressive care unit. I started to make the connection between the SAD and the standard American diseases that I saw every day: heart disease, type 2 diabetes, obesity, and cancer. I realized I was seeing the true cost of chronic disease in America—the degradation of quality of life and years lost were incalculable. I knew I wanted to help people earlier in the course of disease, before they landed in the hospital. I attended a biometric screening incentivized by my health insurance. My total cholesterol was 162, my total cholesterol to HDL ratio was 5.6, and my fasting glucose was 101. The nurse circled all three as high which got my attention, and I’m so thankful she did. I was under the age of 30, cross training 3 times per week, but my objective numbers showed I wasn’t as healthy as I thought. This sent me on a journey to find a truly sustainable healthy lifestyle for myself and the patients I saw every day. I discovered Forks Over Knives on Netflix and I was surprised to learn that brown rice, beans, potatoes, and other plant-based foods had the optimal levels of protein. I threw out a huge jug of whey protein I had used on workout days, and I stopped buying animal-based foods. I didn’t go plant based overnight, but I used the meat, dairy, and eggs I had in the kitchen to flavor plant-based dishes. As an example, I cooked up a whole package of turkey bacon and diced it up and threw it in the freezer to sprinkle on salads and plant-based dishes. I transitioned over about a month to whole food plant-based (WFPB) nutrition. I felt healthier than ever, and I was able to eat massive portions of nutrient dense, calorie light foods and still remain lean. The next year, all my biometric screening measurements were normal! I knew I had found my long-term healthy lifestyle. Like most of us in the US, you grew up on the Standard American Diet. What made it challenging to get to better health? Growing up in Kansas City, the SAD foods and BBQ were by far the most accessible foods. That remains true today. I know for a fact that my exposure to ultra-processed food was at its peak during my public school years. At home, everything was “healthy" diet food. SnackWell’s, caffeine-free Diet Coke, Diet Sprite, lean meats, and low-fat dairy. At school I had more unhealthy options than healthy ones, so I gravitated toward the Nutter Butters, Ho-Hos, chocolate chip cookies, cheese fries, chips, and regular soda instead of the diet foods I was used to at home. Back then, I didn’t know SAD foods from healthy foods. It didn’t seem to matter, as long as everything was in moderation. I thought if the balance of moderation and excess was disturbed, my doctor would tell me. Thinking back, my body was telling me I needed a change, but I wasn’t listening. What made you decide to work as a healthcare professional, and how has your work changed your perspective on chronic illness, nutrition, and the food and healthcare systems? I credit my father for guiding me in the direction of healthcare. He knew I loved and excelled in science, and growing up in scouting, I developed a love for helping others. I've recently realized that chronic diseases are traps—once you or a loved one falls in, it's difficult to find the way out. This is because the industry is focused on making you more comfortable with chronic disease through pills and procedures that treat symptoms. Currently, the causes of these chronic diseases—years or decades of suboptimal lifestyle choices—are not effectively addressed by the quick fixes offered by reactive sick care. I'm excited to be an expert on the forefront of a seismic shift from our current sick care system, to one based on prevention, healing, and longevity: Lifestyle Medicine. As a nurse practitioner, what do you think are the biggest challenges for your patients who are experiencing diet-related disease and who want to improve their health? Changing dietary and lifestyle habits isn’t easy for most, even if we have the right knowledge and resources in front of us. Our behaviors are nothing more than a collection of learned habits that result from decades of the food industry's influence on the choices available to us, and we’ve often practiced our habits for so long that they become subconscious. Our brain loves the efficiency of these subconscious habits. This is why we often get the same brands or types of products we have for years, and is why we often know what we get at certain restaurants without even looking at the menu. I love this quote: “People don’t decide their futures, they decide their habits, and their habits decide their futures.” This helps patients see the significance of their habits long-term and how making small changes can lead to big results over time. I encourage people to be thankful for the signs or symptoms that got them to this turning point. For many, sudden cardiac death, stroke, or stage 4 cancer is their first symptom. We must always remember that America's number one causes of death are silent killers. Whatever the symptoms may be, they have opened your mind and given you the opportunity to change your lifestyle and reverse them. Do you think institutions such as schools, hospitals and workplaces can help prevent chronic disease by serving healthier foods and fewer disease-promoting options? I know they can do a better job of this. Especially now that the nutrition science is clearly defining the differences between health-promoting foods and disease-promoting foods. Institutions need not wait for food regulation to change from above; they have the responsibility to the citizens they serve to start protecting their health now. Institutions should focus on providing minimally-processed, nutrient-dense plant foods to their clients. These are the foods we absolutely know promote health and longevity. If they feel they must continue to offer less-healthy options, it is important to ensure the majority of the food is health-promoting by keeping healthy food options free from disease-promoting animal products. People can always add these to the dish later if they must. It is in the interest of these institutions to have healthier, happier, and more productive students, employees, and patients. Consumers are more informed than ever; it's time for institutions to catch up before the competition does first. ------- Trey Bennet is a Board-Certified Lifestyle Medicine Practitioner in Kansas City devoted to providing accessible, high-quality care to help his patients prevent, heal, and reverse illness. Learn more about his work at www.ihpkc.com. Want to lead the way for healthier menus in a healthcare facility or other institution in your community? Sign up here.

In Part One of this series, I shared the top two reasons I’ve come to believe nutrition and public health advocacy are more effective than trying to educate people out of the diet-related disease crisis we’re in. Here in Part Two, I’m sharing three more. 3. Our food system hasn’t always been this way The standard American diet has changed dramatically over the past 70 years. Not that good kind of growth-mindset, glow-up change either. More like a swift spiral into hyper-processed, lab created, cheeto-dust-stained everything kind of change. Our food system hasn’t always been this way and it didn’t change because consumers invented, manufactured, marketed, and sold frozen pizza rolls, fish sticks, and corn dogs en masse. It’s not that 320 million Americans got together and decided to forgo all nutrition sense and trade in whole, unprocessed foods for nutrient-poor, calorie-dense food-type products. Unfortunately, a few food industry executives, agriculture lobbyists, and advertising companies did though. And thus began the shift toward an ever-increasingly imbalanced food system. Cheap, easy to produce and prepare processed foods high in sodium, sugar, saturated fat, and cholesterol have crowded out the fruits, vegetables, legumes, whole grains, and unprocessed foods that used to fill our plates. Even now, though, with more evidence-based nutrition science available than ever before, people continue to make food choices that jeopardize their health and the health of their loved ones. Even though we know those cheap, hyper-processed foods are bad for our bodies, they’ve come to make-up almost 60% of our diets. Why? Because the food system and our food environments influence behavior more than nutrition education alone can compensate for. Because the number one determiner of food choice is food environment, as the food environments changed, so did our eating habits. When our food system looked different, we ate differently. Today, we can’t count on the food industry to suddenly begin caring more about our health than their quarterly earnings, so it’s up to us to fight for a food system that does. Institutional and political advocacy is the systems-level fight we have to take on in order to make that happen. 4. Compared to advocacy, nutrition education is expensive High quality, rigorous nutrition education is resource-intensive. Think of it this way: if one person or organization has a finite set of resources and they invest those resources into educating individuals, the best-case scenario is that slowly, steadily, some individuals change their behavior. Consider the scale of the problem and you’ll quickly realize the individual education process takes a lot of time, money, energy, and person-power to make it work. Now, imagine if that same person or organization invested some of those resources into influencing a key decision- or policy-maker. The best case scenario in that case would be improved policies and systems that support change for many many more people than education alone can reach. Like I mentioned earlier, the key factor in food choice is food environment, so advocacy that influences a food environment like a hospital or school cafeteria, or changes a policy that sets nutrition standards for 30 million kids, means even without direct nutrition education, more people are likely to make default healthier choices. The same principle that applies to “if healthy food isn’t a choice, then no one can choose healthy food” applies to unhealthy foods too. If deep-fried chicken nuggets aren’t a choice, then no one can choose them. Investing in policies and practices that remove or limit the least healthy, most dangerous food products from menus is so much more resource-efficient than trying to convince individuals to make specific, logical, healthy choices in the lunch line (when they’re stressed by hunger!) 5. The quality and safety of nutrition education is not guaranteed I’m not sure about you, but in general, I tend not to trust nutrition advice from anyone other than professionals. There are too many industry-funded “studies” that propagate misinformation and cause deliberate confusion. No time is this more evident than when a new fad diet emerges. Suddenly, everyone around me is an expert on the ways in which grass-fed beef metabolizes in my body and how that impacts insulin production and why that’s better for me than a bowl of fresh fruit (hypothetically, of course). I’m sorry but I don’t care how many four-paragraph articles someone read about certain ways of eating in that month’s edition of the health magazine to which they subscribe. That doesn’t cut it when it comes to my health - and it especially doesn’t cut it when it comes to my daughter’s health. Similar to medical advice, I’m prone to rely on objective experts who ground their advice in high-quality science. Here’s a fun/terrifying fact: anyone can call themselves a nutritionist. There are certifications, of course, but they’re not required and no agency is regulating the quality or safety of nutrition advice. I bring this up to highlight the fact that super unqualified people are already spreading misinformation and influencing the dietary patterns of large groups of people unchecked. Search the hashtag #nutrition or #nutritionist on any social media platform and you’ll see what I mean. Even if I thought nutrition education was the solution to the diet-related disease epidemic, I would still be highly skeptical about who was doing the educating and the actual quality of said education. In addition to junk-science aplenty, when it comes to nutrition education, the opportunity for major conflicts of interest are enormous. Those conflicts of interest already exist at the policy-level (USDA being responsible for both agricultural production and nutrition advice, not a good match), and fighting that battle is difficult beyond measure as it is. Industry-funded “nutritionists” have long been manipulating the behavior of individuals, and it’s getting much worse. The food industry has capitalized on the rise of “influencers” - foregoing already unreliable nutrition experts in favor of online celebrities “educating” their followers on the benefits of whatever hashtag Keto product they’re selling. Going door-to-door, or more likely screen-to-screen, trying to undo the damage of that advice is nearly impossible. Advocacy, on the other hand, provides us the opportunity to campaign for stronger regulations around nutrition-science and industry-influence, as well as the policies born from those two things. Thus, improving the quality (and truthfulness) of nutrition education as well as our community food environments. Win-win. In closing, once again, I want to clarify I’m not advocating we stop trying to educate people about healthy habits and good nutrition - and all that entails (shopping, cooking, etc...) Not by a long shot. What I am hoping you get out of this is that education alone is not enough, and by-and-large we’re not doing enough to address the systems that promote unhealthy behaviors. It’s hard to educate our way around systems that work against us - which is why I hope you’ll join us in advocating for a better, more supportive, health-centered food system. Audrey Lawson-Sanchez is the founder and executive director of Balanced. She lives in Kansas City with her daughter, husband, and admittedly too many pets. ___________________________ To get involved advocating for a healthier food system in your community, download the Balanced Community Advocacy Guide and sign up for 1:1 training with our team of professional advocates. Not ready to run a campaign but want to support our work? Share our work with your networks and/or make a donation today!

In this two-part series, I’m sharing five reasons I’ve come to believe we can’t educate our way out of the current diet-related disease crisis. In Part One I'm sharing the top two reasons, and in Part Two I’ll share the other three. Let me preface what I’m about to say with this: I used to be a teacher. Then, I taught teachers. Then, I was one of the first in the country to be certified as a Real Time Teacher Coach. Then, I worked as the Vice President of Education for a major international nonprofit. So, I understand the value of education, the value of coaching, and the art and science of behavior change. In fact, it’s one of the things I’m most passionate about. And it’s exactly because of that understanding that I no longer believe individual education is the most effective way to transform the way most people eat or our food system. To be clear, it is still an absolute non-negotiable part of the solution. But the most effective or singular solution? Not any more. So what’s my money on? Advocacy. Institutional and political advocacy. Here's why... 1. The system in which people make decisions matters just as much as the decisions people make. Nutrition education, at its core, is about helping people make decisions. Improving peoples’ knowledge and skills and influencing their mindsets and beliefs is all in service to healthier decision making. The fact remains: people cannot make healthier decisions if those decisions literally do not exist - or they’re inaccessible to them for whatever reason (cost, geography, convenience, etc). Even if some of us have been able to overcome similar barriers within our own food environments, given what we know about the standard American dietary pattern, it’s clear those barriers are still overwhelmingly limiting to most. Trying to convince or shame or influence or even educate individuals as a means to change their behavior within a system that actively works against those efforts is not only ineffective, it is damaging to both that individual and the cause. The individual, no matter how committed in theory, will experience frustration and “failure” in reality. Frustrations and failures that, over time, may result in them giving up entirely. Or worse still, doubling down on poor nutrition habits because they (often rightfully) see change as an impossibility. If we want to see more people making healthier nutrition choices, we have to make those choices convenient, affordable, and accessible to more people. Having good intentions to eat well — a product of good nutrition education — is irrelevant if access to healthier foods is limited or the barriers are too great to reasonably overcome. 2. The scale of the problem is so, so massive. I’ll avoid going on about current nutrition and diet-related disease public health stats because they’re already listed in basically every other blog post I’ve written and plastered all over our social media, but here’s what I’ll say about this: the size and scope of our country’s diet-related disease epidemic is incomprehensibly large. You and/or every single person you know is affected in some way by preventable, chronic, and deadly diseases linked to the imbalance of health-promoting (too few) to disease-causing (too many) products in our food system. Heart disease. Stroke. Hypertension. Type-2 diabetes. Breast cancer. Colon cancer. Prostate cancer. High cholesterol. All diet-related — or dare I say food-system related — diseases. Try to find someone who isn’t currently experiencing one or more of those and/or find a person who doesn't know someone who is. The odds are against you. Food-system/diet-related disease: Is the #1 cause of death in our country Accounts for 90% of all health-care costs Directly affects 117 million American adults What other public health epidemic is as far reaching and destructive? The sheer magnitude of this issue makes it nearly impossible for individual education alone to help enough people. Instead of playing whack-a-mole with individual consumers, trying to change one while others with the same unhealthy habits pop up all around, we have to strike at the root of the problem. Industries and government agencies have, for too long, designed nutrition and regulatory policies that favor business at the expense of individual health. And frankly, in order to even begin addressing the enormous consequences of those failed policies, practices, and systems, we must address those policies, practices, and systems head-on. As an example, all the individual consumer-level education in the world won’t change the Federal Nutrition Standards for school food that allow fruit juice to count as a serving of fruit or processed meats to be served daily - and no nutrition educator (or program) has the capacity to educate the 30 million children who eat school food every day. But our collective advocacy does have the power to demand improved nutrition standards, which in turn, determine what is fed to those same 30 million children each day. For high impact outcomes, we must engage in high-impact advocacy. Advocacy that reshapes policies and systems. Read more in part two.

Great question. The answer is almost as intuitive as it sounds, honestly. Balanced menus are about making sure more of our meals are more in line with leading evidence-based nutrition science more of the time. Wait, do you mean vegan? No. What about whole-food plant-based? No. So, paleo? Negative. Hmmm, I’ve heard things about the Keto diet. Definitely not. Balanced menus aren’t about one specific diet or ideology. Sure, there are camps on all sides of the nutrition debate that champion one diet over another - and no matter how much we yell at each other in the comments section about how right one diet is, different beliefs and behaviors are sure to persist. Even if there was a major, global consensus about a singular way to eat, the unfortunate thing about rigid, unyielding nutrition advice is this: even the most precise, undeniable science and its accompanying meal plans won’t work for everyone. This is true for so many complex reasons not the least of which are accessibility and food environments, cost, culture, knowledge, cooking skills, competing priorities, confusion, food industry-influenced misinformation campaigns, and geography. Just to name a few. Many well-intentioned people believe that information and education are enough to change the lifelong dietary patterns of others - likely because education and information is what changed their own eating habits. While this is certainly true for some, this belief oversimplifies the complex nature of behavior change and the particularly sensitive relationship many people have with their food. That’s why, even though we each have our own beliefs about what we consider healthiest and the scientific consensus is increasingly pointing toward heavily plant-based diets, here at Balanced we aren't on a mission to convince individuals what they should be eating or how to feed their families. We're here to advocate for food system changes that are reasonable, feasible, and sustainable at a large scale. We advocate for something slightly less strict than any one type of diet. Something slightly more realistic. Something a bit more balanced if you will. Given the current dietary patterns of most Americans, wherein over 57% of our diets are made up of ultra-processed food products, we’re consuming at least 50% meat, eggs, and dairy than recommended, and 97% of us are fiber deficient, that balance is going to look like more plant-proteins, fruits, vegetables, and whole grains in place of some animal-source proteins and junk food products. It’s just that simple. For our diets to get truly balanced, our menus and community institutions have to do the same. This means taking a hard look at the foods our families are being served and demanding better on the whole. To be clear, championing for balanced menus isn’t some covert mission to take away choice and shove kale down anyone’s throat - quite the opposite in fact! Although kale is delicious. Balanced menus are about real choice. And choice depends on having a diversity of options and access to foods of substantial nutritional value. So if we're being honest with ourselves, asking someone to choose between pepperoni pizza and chicken nuggets isn’t choice at all. It’s just more of the same thing. And clearly more of the same (unhealthy) thing isn’t balanced at all. ___________________ Audrey Lawson-Sanchez is the founder and executive director of Balanced. She lives in Kansas City with her daughter, husband, and admittedly too many pets. Balanced is a 501(c) nonprofit organization. We depend on the generous donations of our supporters to keep our work going strong. If you value our content or our work, please consider a donation of any size. Make sure to sign up for our newsletter and share our page with your networks.

At Balanced, we often say, “If it matters to the food industry [Big Food], it matters to us.” Why? Because our advocacy is only effective when it improves the lives of the people most affected by the issue. The food industry knows this, too. Big Food’s success depends on capitalizing on the people it can most easily and readily exploit. Either via marketing or by creating captive audiences. That is, by drumming up customers based on the promotion of a product, by the convenience or cost of that product, or by virtue of customers having no other choice but that product. As an industry, food companies are smart. They’ve done the math and they know where the purchasing power lives. They know that marketing their products to, for example, a mom of two children will result in more of their product purchased than if they market that same product to an individual only feeding themselves. After all, feeding a family requires more food than feeding one person alone. By that logic, the food industry also knows that feeding five hundred kids a day - via an institution like a school - is a lot more profitable than feeding a family. It's not a coincidence two of the food industry's biggest targets are parents and institutions. So what does all that have to with Balanced? Everything (and more!) Because we know how much the food industry invests in manipulating and influencing the purchasing patterns of parents with absolute disregard for the health of families, our advocacy is designed to empower and amplify the voices of parents who know their families deserve better. Because we know the degree to which the food industry attempts to influence nutrition policy and infiltrate our community institutions, our work is rooted in giving children and families meaningful choice via healthier menus and nutrition policies. Our work is not about convincing parents to adopt one specific diet over another. Unlike the food industry, we don't have an agenda to sell one product or ideology. Our only goal is to bring balance back to our food system and environments in a way that restores the health and longevity of our families. Unlike the food industry, that matters to us. It seems the only thing that matters to the food industry is making the most money possible by targeting children and parents, as well as the institutions that serve them. Keeping parents and institutions as customers so matters to the food industry it’s willing to invest billions of dollars in marketing and promoting disease-linked junk food products each year. They're so threatened by the fact parents and institutions would serve healthier meals if those meals were more convenient and affordable, food companies buy up shelf space, mass produce cheap food, and lobby for loosened nutrition regulations - in an effort to keep menus (and thus profit) stacked in their favor. Major food companies have spent decades deliberately shaping our food environments so that their products are overrepresented in the everyday places our families shop and eat. They understand when their food products are our only option, our only choice is to buy them; which is how our food environments came to be so distorted and public health so devastated. We could look at the whole situation cynically and assume given the enormous wealth and influence we’re up against that righting this ship is a battle we can’t win. That Big Food has us beat and our families are destined to suffer the consequences of lifelong poor nutrition. That we are powerless. Or we could see the food industry for what it really is: an industry of manipulative cowards terrified of our collective power. Food companies deeply understand the degree to which parents, when armed with the right tools and supports, can turn entire institutions and systems upside down. All that hard work cornering parents and institutions? That doesn’t mean the food industry has the upper hand. It means the food industry understands the enormous power of parents. It means that without the deceit and manipulation, Big Food knows it wouldn’t survive. Major food companies know how dangerous informed parents are to their bottom lines. The food industry knows there is nothing more powerful than parents on a mission to save the lives of their children and protect the health of their families. They know parents are relentless, unyielding, and capable of changing the world. They know parents have high expectations for the community institutions that serve our families and they know we're willing to hold those institutions accountable for the wellbeing of our loved ones. That’s why parents matter to the food industry, and that's why they matter to us.

The Advocacy team at Balanced has had the privilege of being able to work with some incredible and dedicated parent advocates, and we wanted to take the time to spotlight their hard work to show our appreciation and to give others some insight into what it’s like to be a Balanced advocate. Today we’re spotlighting Sean Lishansky, a parent of two young children in Fairfax County, Virginia, who is leading campaign efforts in the county’s school district of nearly 200,000 students. Fairfax County is lucky to have such a dedicated community member championing a healthier food system for its students and future leaders. Here’s what Sean has to say: Why is this cause important to you? When I was 10 years old, my cholesterol was 195. I ate a lot of fast food, but lunch at school certainly didn’t help either. By high school, it ballooned to 230 and I had chest pain almost every night, so my doctor gave me an EKG. He talked to me about being put on cholesterol medicine, but he said once you start it, you are generally on it for life, so since I was so young he wanted to wait and see. A few years later, I took a health class in college and watched a video of open-heart surgery, learned about inflammation in your body and learned about why you should eat your veggies. The professor was amazing, and his message was “let food be thy medicine.” I went plant-based pretty much overnight and felt like a new person two weeks later. I got my cholesterol checked the next year, and it was down to 102. And now 12 years later, all of my blood work is better than it was in high school—HDL, LDL, triglycerides, blood pressure—and everything dropped to the bottom of the normal range right away. I now have a 3- and 1-year-old who will be entering FCPS schools very soon, and I just want what’s best for them. Kids in elementary school are at the mercy of their cafeterias during the school day. If known carcinogens like bacon aren’t offered to them at breakfast, they won’t eat known carcinogens. If foods that are known to clog our arteries and cause a buildup of plaque aren’t offered to them at lunch, then our kids’ hearts will stay healthy. It is that simple—and it’s our job to protect them! What do you think is the biggest challenge of menu advocacy? Unfortunately, there are so many mega-rich food groups donating millions of dollars to politicians and lobbyists to fight scientists’ concerns about harmful ingredients in our food. I was Googling how big food companies are fighting food labeling and so many common-sense regulations that would protect us, and it took me down a horrifying rabbit hole. I was looking into a candy lobbying group that has spent millions to ensure they can keep using food dyes like red 40 and yellow 5. The entire board of the lobbying group was made up of all the CEOs of the biggest candy companies using these dyes, which have caused kidney tumors and immune system issues in mice and a host of issues in kids. I truly believe they know they are hurting our kids but only care about their profits, and it’s so infuriating. What do you hope your campaign will accomplish in Fairfax County Public Schools? My hope is for FCPS to lead the way and offer the healthiest school meals in the country. I want us to be number 1. That’s the ultimate goal. I hope one day the food we serve is so healthy and delicious that everyone else around the country strives to be like us, and our Food and Nutrition Services department flies around the country showing other districts how to get there. What would the ideal menu look like to you? I want to see more beans, lentils, chickpeas, whole grains, vegetables—you can make the most amazing meals and sauces with just whole foods. My kids love mac and plant “cheese,” for example. For the cheese sauce, I put cooked potatoes and carrots in a blender with tahini, nutritional yeast, apple cider vinegar and garlic powder, and top it off with a sunflower seed crumb topping. Fairfax County’s amazing food staff can easily do this, on site and fresh every day, but they have to be given the tools and resources to be able to nourish our kids’ bodies and help them thrive! What advice would you give to someone thinking about getting involved in advocacy with Balanced? I read about other school districts, like Santa Barbara and New York City, voting to ban processed meats and other unhealthy foods in schools, and then I came across Balanced, which had already analyzed the menus of the 25 largest school districts, giving Fairfax County a “C,” due to an overemphasis on health-harming foods and Group 1 carcinogens. I learned that another parent was already in touch with Balanced and was putting together a team of volunteers to lead a healthy menu campaign in our district, with Balanced’s complete support. I was so relieved to find that there was an organization out there that was able to help us. We now have bi-weekly video meetings with two Balanced staff members, and they are absolutely incredible, leading the way on our campaign based on our input and concerns! I am so excited to work with the district’s staff to show them our proposals to make the menus healthier, and I know it will be a win-win for everyone! ----- Check out the work Sean is doing in Fairfax County here. Want to lead a campaign in your area? We’re here to help! Get started by downloading the free Advocacy Guide today and we’ll be in touch. Sarah is the Advocacy Coordinator at Balanced. Driven by her belief that health depends on a food system that cares about people, she is passionate about helping community advocates lead effective healthy-menu campaigns in schools, hospitals, and other critical institutions. You can reach her here: sarahl@balanced.org

At Balanced, our central ask of school districts is that they enrich their menus by adding nutrient-dense plant-based proteins and produce in place of the standard (typically processed) animal source proteins and other less healthy items. Ideally, we’d like to see a 15 to 20 percent shift in this direction. Pretty reasonable, wouldn’t you say? It might even appear so simplistic that it’s hard to believe a change that subtle could possibly make kids’ diets demonstrably healthier. For a school offering 25 conventional lunch entrées a week, meeting our 20 percent target would require replacing four or five of those with a plant protein-based option. From the student perspective, let’s imagine that a 20 percent change leads to the replacement of just one conventional lunch per week with a plant-rich alternative. One meal doesn’t seems very significant, so how much can a 20 percent shift toward plant-rich entrées really affect a student’s nutrient intakes over a week? To answer this question our team dug into some real-life breakfast and lunch menus being served in an actual high school. To ensure our analysis was realistic and fair, we were careful to select complete, reimbursable meals for one week as determined by FNS standards and guidelines. We then used the nutrition facts information provided by the food service department to calculate average daily nutrient intakes. Table 1 shows those values for each day and meal. Next, we replaced the least healthy lunch entrée of the week, bacon cheeseburger nachos, with a plant protein entrée, a veggie hummus wrap. The nachos were included as part of Tuesday lunch, highlighted in yellow in Table 1. The nutrient content of Tuesday’s lunch with the veggie wrap and without the nachos is given in Table 2. Let’s compare the two Tuesday lunch entrées. (Table 3) Excluding other lunch components, the nachos alone contained 45 grams of fat, 13 of which came from saturated fat. That’s almost an entire day’s limit for saturated fat in just one entrée. The nachos alone also contained 127 milligrams of cholesterol, 60 percent more cholesterol than a Big Mac! The sodium content of the nachos, 1412 milligrams, almost reaches the American Heart Association’s recommended daily limit of 1500 milligrams for individuals at risk of heart disease, and with the other lunch components’ sodium content added, the entire meal exceeds this limit. Sadly, many high schoolers already are at risk for heart disease, and it is because they are being served these kinds of meals day after day. Lastly, the nacho entrée contained a mere two grams of fiber. Compared to the nachos, the veggie hummus wrap entrée contained 17 grams of total fat, only 3.7 of which were saturated. Because the wrap contains no animal products, the cholesterol is zero milligrams, and the sodium is just one-fourth that of the complete nacho lunch. Most impressively, the fiber content of the wrap is 13 times that of the nachos at a whopping 26.1 grams. As shown in Table 2, thanks to this one simple plant-based swap, the daily average nutrient content over one week changed significantly and favorably. Average daily intakes of total fat, saturated fat, and cholesterol each fell by approximately 15 percent. Average sodium intake fell ten percent, and average fiber intake increased by 40 percent. This menu change, though seemingly small and simplistic, had a relatively large impact on the average nutrient intakes of a hypothetical student over one week. That is the transformative power of a 20 percent shift away from processed, heavy meals toward hearty, plant-rich meals. In a similar nutrient analysis using a different high school’s breakfast and lunch menus, we replaced two conventional lunch entrées in one week with plant-based alternatives, which yielded the following changes in average daily nutrient intakes: 16% reduction in total fat 30% reduction in saturated fat 18% reduction in sodium 30% reduction in cholesterol 75% increase in dietary fiber As expected, the benefits only deepen when we consume even more plant-forward and plant-based meals. But the benefits can only be derived when those options are actually on the menus in the institutions we rely on for food. This is why we act with such urgency and drive to advocate for healthier, more balanced food environments on campuses where young palates develop, in hospitals where food has the potential to heal, and in our office buildings where we spend half of our waking hours. While it may not seem like it in the short-term because diet-related disease and chronic illness develop over time, this is proof that every single meal matters. Help us show institutional food service teams in your area that a solution this simple and impactful is one worth making. Share this information with key decision makers, forward our food service tools to the right people, or lead a campaign where you live. Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org ___________________ Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

This week, the EAT-Lancet Commission released its first report outlining a set of universal, evidence-based benchmarks for the global food system, which it describes as urgently requiring a “radical transformation.” According to the report, an international effort to meet these targets is needed to effectively combat both crises of health and climate, which are intrinsically linked through food production and consumption. In fact, the report names food “the single strongest lever” humanity has for restoring public health and environmental stability. The Commission—which brought together 37 experts in nutrition, agriculture, and political and environmental sciences from 16 different countries—concluded that, in order to safely and healthfully nourish 10 billion people by 2050, we must, in the aggregate, reduce meat and sugar consumption by more than 50% and double our intakes of healthy foods, such as vegetables, fruits, legumes, nuts, and whole grains. For those who follow our work at Balanced, this conclusion should come as no surprise. Nor should it surprise anyone that food industries are attempting to do damage control by publishing reactionary screeds deriding the work of international experts. The report’s findings bolster the argument that consumption-side, systems-level changes toward balanced, plant-rich diets are desperately needed to mitigate and reverse today’s dire health crises. And the time to take action is now. If you’re not sure where to start or need some inspiration, we’ve put together three ways you can get involved today. Lead or join a campaign As the liaison between consumers and food manufacturers, critical community institutions have the unique ability to create food environments in which healthy dietary choices are easier to make for the people they serve. By starting or joining a campaign for balanced menus in your local institutions, you help demonstrate and foster demand for healthier, plant-rich meal options that will promote health of the people who rely on those facilities. When balanced food environments and healthy choices become part of the norm, more individuals will choose to eat for health. Because institutions rarely make decisions in line with evidence-based nutrition on their own, we must hold them accountable and show them that these changes are both essential and viable. Contact your state and local elected officials In light of the EAT-Lancet report, now is an excellent time to remind your elected officials who they work for. Let your state and local politicians know that you agree with the conclusions in the report, that they should read it if they have not done so, and that they have the responsibility to create legislation that addresses the realities described therein. If you need some help knowing what to say, here's a simple sample script (say that three times fast!): I'm writing to share my strong endorsement of the recommendations made in the newly released Eat-Lancet report. I encourage you to read it if you have not already, and move quickly to design or endorse policies that make public health and sustainability a priority for our community. In line with the changes many states, cities, and communities have already made in this direction, now is the perfect time to make the changes necessary to ensure a healthy future for all your constituents. You have the power to make a difference and I'm eager to see the healthy changes you help make happen in our community. Municipal governments have already begun making health and sustainability commitments through the adoption of city-wide nutrition standards that apply to government-run facilities. Several cities have adopted or are considering adopting the Good Food Purchasing Program. Similarly, Brooklyn Borough President Eric Adams is pushing for a stronger pro-health stance within the NYC Food Standards, advocated for Meatless Mondays in 15 Brooklyn schools, and helped start a pilot program to treat and prevent chronic disease through diet. The updates to the food standards would include deeper reductions in saturated fat- and cholesterol-containing foods, in alignment with the best nutrition science evidence. Spread the word, lead by example Accountability doesn’t always have to start from the top-down. Ultimately, movements are made up of individuals who take the first step to make changes in their own lives and their own homes. Spreading the word by sharing the work of credible nutrition advocates on social media and educating friends and family are powerful ways to make an immediate impact. Potential allies to public health advocacy are everywhere. Seriously, who doesn’t want healthier families?! It may surprise you which friends and family members will lend their support and join in your advocacy efforts, they might just be waiting for someone like you to speak up! If you need hands-on resources to help you get started, check out the Reducetarian Foundation. With it's cookbook, summit, and online resources, the Reducetarian Foundation is focused on helping individuals make realistic dietary changes that have a big impact. And as always, the team at Balanced is ready and willing to answer questions and help you get a jumpstart on your advocacy. ______________ Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org Please donate to support Balanced's ongoing advocacy and outreach.

The hardest job of a nutrition advocate is getting people to appreciate the full gravity of our nation’s truly grim health crises. Not surprisingly, I’ve found that the more embedded into “business as usual” a crisis is, the more denial and despair people will express in reaction to the facts. The enormity of the avoidable suffering can be overwhelming to reflect on, especially when the solutions require disrupting the status quo of an entire system. And in a world awash in personal strife, clarity and the mere ability to take reasoned action often feel like luxuries. But, despite how we may feel, whether anxious or apathetic, the facts and realities remain and continue to worsen. That said, honesty and awareness also sow the seeds of motivation to do something, which in turn is necessary to effect positive change. So, ahead of describing the urgency of the situation, I want to reassure you that, collectively, we are not helpless, and change requires that more of us be willing to take a path of greater resistance. Action is the remedy not only to our malaise but also to the health crises in question. And while each of us is facing challenges in our own lives, the diet-related illnesses we experience as individuals share a common origin in our destructive, profit-driven food system. People deserve to be educated and, maybe, more importantly, inspired to take concrete measures against the erosion of our autonomy over the food environment and over our collective health and wellbeing. Let’s begin with a bird’s eye view of the state of America’s health. According to the Centers for Disease Control, fully six in ten adults, or about 117 million people, suffer at least one diet-related disease, and four in ten adults suffer two or more. These diseases are largely preventable — some even reversible — and include cardiovascular disease, cancers, and diabetes, among others. To be clear, these diseases are our nation’s deadliest killers. And, as a common denominator, poor diet is the leading cause of illness, disability, and premature death. The toll is sobering: nearly 700,000 Americans die every year from diet-related disease. Which begs the question, when an issue this massive impacts nearly every single family in the country, why don't more people care? For many, it’s easy to read the words “cardiovascular disease” and “cancer” and feel no visceral reaction. For instance, it’s unlikely that the first thing you think about when you hear the word “diabetes” is blindness, limb amputation, or death. These maladies, on paper, seem too distant and abstract to apply to us. And yet, an average American’s lifetime risk for developing cancer is more than one in three — not much better than a coin toss. The lifetime risk of dying from cancer is an alarming one in five. Chemotherapy, often the first treatment cancer patients receive, is not only excruciating to endure for many, but, sadly, contributes a mere 2% to all cancer survival in the United States. It is not nearly as effective at saving lives as preventive dietary measures, which have the added benefit of greatly reducing the need for such a grueling treatment to begin with. But it gets worse. Longevity in the United States has been on the decline for the last three years. While the opioid crisis explains much of the decline, the fall in women’s life expectancy is largely due to women dying at younger ages from the usual diet-related diseases, particularly heart disease. In fact, for both men and women, the death rates have gone up from multiple diet-related illnesses, including diabetes, stroke, and Alzheimer’s. Heart disease remains our number one killer, and advances in modern medicine are no longer improving the survival rate from it. For many years, rising life expectancy belied the fact that we were only growing sicker and living with more disability for longer periods of time. But now, it appears as though we’ve hit a wall with our pharmacological and surgical Band-Aids as decades-long positive longevity trends reverse. Most regrettably, children’s health is on the decline. Between 2000 and 2009, the prevalence of type 2 diabetes in children ages ten to 19 increased by over 30%. In case it bears repeating, diabetes is a leading cause of death in the United States. Childhood obesity, which quadruples the risk of type 2 diabetes before age 25, is still on the rise in 2018. Thirty-five percent of children ages two to 19 are overweight while about 20% are obese. Disturbingly, the largest increases in obesity prevalence were seen among two- to five-year-olds. And while diabetes is deadly, it’s not even the deadliest chronic illness associated with obesity. Thus, it’s obvious why public health researchers are concerned that today’s generation of youth will experience worse health and shorter lifespans than their parents did. The exploitation of human susceptibility for pecuniary gain by the food industry is nowhere more brazen than in its assault on our youth. Children in 1995 were already consuming five times as much fast food as children in 1977, and today, the clustering of fast-food establishments around schools has been linked with lower diet quality and a greater odds of overweight and obesity among students. Franchises and food service companies are increasingly edging their way into school cafeterias, and many lunch items resemble typical fast-food fare. What’s more, children are mercilessly targeted by food industry advertisements both in and out of school, ensuring that highly palatable, disease-promoting foods remain entrenched in our culture and our national palate. Diet-related disease touches all segments of our population and transgresses race, class, and sex. However, health disparities along lines of ethnicity, income, and education level make poor diet not just a public health issue, but a social justice issue, too. Sixty to 70% of youth with diabetes come from low-income households; these proportions are higher among children of color. Unhealthy food environments and food apartheid play a heightened role in disease development and further entrench a cycle of disenfranchisement as poor nutritional status impacts academic performance, results in greater health expenses, and may lead to fewer opportunities for socioeconomic advancement. Our food and healthcare systems are atrocities that continue to go under-addressed by those who hold the most power to fix them. Time and again, they give us the same excuses: the necessary measures aren’t feasible, affordable, profitable, reasonable, or easy. We are told that health is an individual problem — that a quadruple bypass is routine and normal, but replacing processed meats with plant proteins in school and hospital meals is somehow extreme. Yet, no fewer than one in three Americans experience negative outcomes associated with poor nutrition. When over one hundred million people are involved, can we really afford to continue blaming individuals? At what point do we hold the system accountable? Over a day, a year, or a lifetime, the foods we are able to access, prepare, and consume determine whether we are protecting or risking our short- and long-term health. Diet’s potent, intimate impact on the body needs much greater appreciation from school administrators, healthcare professionals, parents, legislators, business leaders, and every-day people. When more individuals come to this awareness and begin taking collective action against the entities causing and abetting these crises, the better our chances will be of restoring public health and reducing needless human suffering. Together, let us resolve to make 2019 the year in which we no longer sit idly by as hundreds of thousands die and millions more languish in poor health as a direct result of America’s industry-dominated, disease-promoting food system. ______________ Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org Please donate to support Balanced's ongoing advocacy and outreach.

In December of 2018, TIME magazine published an article titled "Are Eggs Healthy? Here's What the Experts Say." Unfortunately, what the article failed to do was look critically at the science and/or interview any "expert" whose opinion was different from "Eggs are totally, absolutely, unequivocally, all the way healthy. No doubt. Believe me. I'm an expert." What the article succeeded at doing, however, was lying to consumers about the true healthfulness of eggs. Likely, in concert with the egg industry. Below, Balanced's Manager of Institutional Outreach and Support, and nutrition and food policy professional, Maddy, responds to the TIME article. For some years, there has been a push by the egg industry to exonerate the “humble egg”—a phrase I borrow from a recent TIME magazine article in which the breakfast staple was heavy-handedly lauded. It appears that, in the court of public opinion, the defense’s strategy is to paint this disease-linked food as a wholesome, if banal, source of nutrients that has been unjustly defamed. The article in question fails to critically examine the nutrition science literature on eggs, cholesterol, and saturated fat. It features quotes from just two dietitians (both of whom have their own personal online brands), and from those interviews, the article concludes by the third paragraph that “[n]utrition experts agree” that eggs are “healthy.” It’s not terribly difficult to find dietitians or other healthcare professionals with dissenting viewpoints, but the opposing arguments from that group of equally qualified experts found no representation in the article whatsoever. Indeed, if the egg-loving experts find eggs healthy, their opinion contrasts with federal laws and a Supreme Court decision explicitly prohibiting the marketing of eggs as healthy or safe. It would appear that scientific and popular publications, grasping for novelty, have failed in their duties as gatekeepers against poorly designed, industry-backed research. Given that overstimulated consumers of media are relentlessly bombarded with conflicting nutrition information, it is easy to see how a jaded reader might simply choose the side that validates her or his comfortable, but unhealthy, dietary choices. As a result, the average egg-eating consumer may read the TIME article and determine that the nutritiousness of eggs is both absolute and unquestionable. If somebody wants to eat eggs, that’s their prerogative. However, at the very least, consumers should be well informed with all the information, not just cherry-picked factoids. Here, I will interrogate the article’s stance and provide an alternative perspective. The first dietitian quoted in the article states that eggs are “very healthy” because they contain “13 essential vitamins and minerals” and are a “high-quality protein” source. But neither of those qualities in and of themselves makes eggs a de facto healthy food. Extrapolating from reductive facts can be dangerous because it does not take into account the impact of the whole food on the body. For example, poisonous mushrooms and plants undoubtedly contain essential vitamins and minerals, but that fact alone doesn’t make them edible or safe to eat. Similarly, eggs may very well contain vitamins, minerals, and all nine essential amino acids, but they also contain choline, phosphatidylcholine, and L-carnitine—all of which are converted by gut bacteria into trimethylamine-N-oxide, also known as TMAO. Just as poisonous plants are unhealthy because of their toxins, eggs are unhealthy because they stimulate production of TMAO, which actively participates in the development of atherosclerosis. The “high-quality protein” argument deserves an extra rebuttal. The average American ingests far more protein than is needed. School-aged children consume three to four times as much protein as is required, and adults consume approximately twice as much as they need. Excess dietary protein is generally converted into and stored as body fat when we meet our minimum carbohydrate needs, which we easily surpass. It therefore seems silly to speak of protein as though we are a protein-deficient population. The second dietitian quoted in the article continues in the same vein as the first and touts the lutein and zeaxanthin content of eggs. A quick Google search will reveal that the best sources of both of these antioxidants are green leafy vegetables, squash, peas, carrots, pistachios, and many cruciferous vegetables. None of these plants contribute to atherosclerosis and, in fact, can help lower blood cholesterol thanks to their fiber content. Both dietitians allude to studies that appear to de-link dietary cholesterol and fat from blood cholesterol levels, but they provide no specific sources. The article does link to a study conducted with Finnish men—not exactly a generalizable population, I should add. This study concludes that neither egg consumption nor dietary cholesterol is associated with greater risk for coronary artery disease. However, researchers classified “low” egg intake as less than 19 grams per day and “low” cholesterol intake as less than 321 milligrams per day, and the average intakes among the “low” egg and cholesterol consumption groups were 11 g and 267 mg, respectively. An astute observer will note that a cholesterol intake of 267 mg per day is objectively high—too high to be honestly labeled “low.” The upper limit of daily cholesterol intake is 300 mg for those without high LDL cholesterol and 200 mg for those with high LDL cholesterol (including one-third of American adults). Even though the average individual in the “low egg consumption” group only ate one-sixth of an egg on average per day (about 35 mg of cholesterol), the chances are high that this individual still ingested too much cholesterol from other sources. So, it’s not surprising at all, given these egregious misclassifications, that no significant differences were found between low, moderate, and high consumers of eggs and cholesterol with respect to their risk for coronary artery disease. I haven’t even mentioned the study’s numerous limitations detailed by its authors in the paper’s discussion section. All flaws taken into account, the conclusions drawn from this study are simply untenable. And it is very often on flimsy, poorly designed, and incorrectly interpreted science that the purported healthfulness of eggs is based. The scientific community established decades ago that eggs should be restricted in our diets if we want to protect our hearts, but the appeal of novel, seemingly contradictory findings is strong. Couple that with the food industry’s infiltration into academic research through the funding of studies and donations to universities, and we’re left with distorted, paradoxical facts that the average science journalist probably isn’t equipped to demystify. This apparent lack of a final verdict on the healthfulness of eggs is all the egg industry needs to keep us buying, and suffering the consequences of consuming, its products. Madeline is the Institutional Outreach and Support Manager at Balanced. She holds a B.S. and M.S. in Nutrition from the Univ. of Texas and Tufts, respectively. As a nutrition expert, she advocates for more plant-based dining options in critical institutions with the aim of building healthier food environments and fostering better public health outcomes. You can reach her here: madelineb@balanced.org ___________________ Balanced is a nonprofit organization providing the tools, resources, and supports for everyday people to advocate for healthier menus in their community institutions. Please support Balanced's mission with a donation of any size today.

For a long time, New Year’s Resolutions have been pitched as independent endeavors. They’re sold as this sort of pull-yourself-up-by-your-bootstraps and change your life scenario. And it’s a romantic idea, isn’t it? Somehow, miraculously on January 1st, every single person will suddenly have the skills, knowledge, and mindsets necessary to be their best selves. Just because they want it bad enough. Romantic, yes. Realistic, no. It’s not that a few folks won’t have some sustained success with their resolutions in the new year — but compared to the number of people who make resolutions — the number of successes will be nominal. And the reason why is pretty simple. Why you ask? Why won’t I suddenly only crave kale and quinoa? Why won’t I be motivated to rearrange my entire life to get to the gym 20 minutes away 6 mornings a week? Why won’t I be able to avoid the pint of ice cream in my freezer after a stressful day at work? Because most resolutions are predicated on willpower or some overnight behavior change “hack” — and as disappointing as this may be — those hacks are not the best way to initiate sustained change. Although they do make super-awesome listicles. If you’ve tried to get sober or eat healthier in the past, you know the best chance you have at success is to remove all alcohol/drugs/junk food/etc… from your house. It’s nearly impossible to get sober with a bottle of wine sitting a few feet away or choose an apple over potato chips when you’re hungry. More and more, we’re understanding the ways in which environment plays a role in behavior change. We’re also realizing that willpower has less and less to do with success than we used to believe. The person who changes their diet? Doesn’t usually do so with a fridge full of junk. They change their food environment at home. They throw out temptations and stock their cupboards with healthy food. The person who exercises more? Likely does so by making exercising easier at home vs. joining a gym and then quitting a few weeks later. When resistance to healthier habits is lowered, and the environment makes it easier to make healthier choices, people are more likely to choose healthier options than if their decision was contingent on willpower alone. Knowing this, it begs the question: why aren’t we doing more to make the environments in which we live, work, learn, and heal healthier? Instead of individually setting out to change our own behaviors based on a flawed understanding of behavior change and willpower, why haven’t we yet banded together to demand healthier offices, schools, and hospitals for ourselves and our families? Instead of beating ourselves up for struggling to follow through on our resolutions, why aren’t we concerned with why those resolutions are so difficult to keep? Instead of blaming ourselves for not being “strong enough to resist” the abundance of unhealthy food surrounding us, we should be questioning why unhealthy food is the only thing surrounding us! Why aren’t we asking the corporations and institutions serving our families to put our health first and make healthy living easier? We want to eat healthier at work, but the only options around are vending machines, drive-throughs, or greasy office cafeteria food? Recipe for feeling terrible. We want to “tackle childhood obesity,” but we expect our children to turn down chicken nuggets and opt for the salad bar in the lunch room? Not happening. We want triple-bypass patients to go home and eat vegetables at every meal, but serve them sausage, hash-browns, and eggs in the hospital? Setting people up for failure. With our New Year’s Resolutions looming just on the horizon, now is the perfect time for us to come together and demand better from the places that serve us and our families. We can use our individual energies to change very little about our own lives, OR we can harness our current optimism to change the environments that actually shape our behavior. In 2019, our collective resolution should be to make healthy meals the default option in our offices, schools, and hospitals — not a reward for the few with the strongest willpower.

“Maybe the way you’re going about this is wrong,” a colleague in a similar industry said to me after reviewing Balanced’s School Scorecard. “Maybe you should be more collaborative and less combative.” Maybe (although, to be fair, we reached out to every single school district on the list before publishing the scores in an attempt to be collaborative) Or maybe, I’m staring down the barrel of a public health crisis that is on track to kill another 700,000 people in the US again this year. An epidemic that is close to all but ensuring this generation of kids won’t live as long as their parents. A problem that denies people their opportunity to heal and develop healthy habits. Or maybe I’m just fighting like hell to fix a food system that has yet to be swayed solely through collaboration. Maybe. Here’s the thing about accountability: it’s uncomfortable. It should be. It has to be. Without discomfort, there is rarely growth. Sure, collaboration feels better. Trust me, I would love to collaborate more with key decision makers. 100% open to it. Would welcome it with open arms. Entirely prepared to do it should the opportunity arise. And I absolutely believe collaboration is a critical element of success, but so are unrelenting high expectations. The truth is, I don’t enjoy the parts of my job that result in angry phone calls and biting emails. That doesn’t feel good. But I’m less concerned with what feels good and more concerned with what does good. At Balanced, when we talk about accountability, we aren’t talking about making people uncomfortable for no reason. We’re talking about raising the expectations for what we deserve and what we’re capable of. We’re talking about literally saving lives. Imagine looking at your newborn baby and saying to them, “In 30 years, you’re going to begin experiencing a bevy of completely preventable diet-related diseases because I didn’t want to make someone uncomfortable at their job.” For me at least, as a mother, it’s a moral imperative that I speak up. Not only on behalf of my child, but for all children. Just because diet-related diseases develop and progress more slowly than other epidemics does not mean the impact and suffering are any less real or acute. Heart disease, diabetes, cancer, and other diet-related diseases rob families of time with their loved ones, and can make the lives of the people we love (or ourselves) more difficult and painful. Fortunately, diet-related disease is nearly always preventable. But we can only do so much within our homes to safeguard our families from heart disease, diabetes, hypertension, cancer, etc… Until more of our food environments are balanced and reflective of a system that values our health, we will struggle to turn the tide on the leading cause of disease, disability, and premature death in the US. So, maybe I’m too mean, forthright, or unyielding. Or maybe I’m just unafraid to believe we deserve better.