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HOW WE CHOOSE OUR FOOD AND HOW OUR FOOD CHOOSES US ELISE LEIMOMI DELA CRUZ-TALBERT A growing body of research on eating behaviors and the industrial food system shows that our neighborhood, socioeconomic status, and ethnicity affects our diets. Looking at the contexts in which people make food choices helps to explain the unequal distribution of diet-related diseases in Hawai‘i. People often learn about health trends like the obesity and diabetes epidemics, hear that minorities and low-income populations have higher rates of these diseases , and don’t see where they fit on the graphs. Still, Hawaiians and others, friends and family, say, “I eat what I want. Don’t you think that people choose how they want to live?” Yes. We have opportunities to choose what we eat. A coworker asking the office, “so what should we eat for lunch today?” has choices. A parent planning what to cook for dinner after work has choices. A child at school, looking down at the cafeteria lunch . . . well, children often can’t be choosy. Imagine that you go with the flow of what your family and friends are eating, dine in your neighborhood, and gravitate towards the foods you see or hear about on television. How would you be eating? Depending on our mood, budget, schedule, location, nutrition needs, food that is “in season,” and our control over the menu, we all have different “choices.” I was twenty-four when a friend convinced me to try to run a mile. I thought this should be easy enough since I could run miles in high school. But after a short burst forward, my foot didn’t go as high as I expected. Breathing didn’t calm my heart the way I remembered. I started wondering, “Whose body is this?” I had to stop running, and the walk home gave me time to start thinking about why my body wasn’t listening to me. I thought about my broke and busy college phase, when I didn’t make time to cook for myself or exercise enough, and ate to cope with stress. I thought about the illnesses in my family, my mom’s cancers. I decided not to accept the unhealthy way I felt. I joined a gym, I started to choose more unprocessed foods, and I gradually lost weight. 154 PUBLIC HEALTH At first, limiting many of the foods I grew up with—saimin, rice, canned meats, many things fried to perfection, “juice,” and value meals—was the hardest. I made healthy choices more often as I began to prioritize health with my time and money and increasingly recognize healthy opportunities—like being able to find the right meal on a menu, enjoy the healthy foods that I grew up with, and share recipes that my family liked. Reflecting on my own health challenges and the health of many others in my community fueled my work and research in food and public health. Despite the many joys food brings us, we face many signs that our food systems —the ways in which most food is grown, processed, transported, eaten, and disposed of—are affecting our health, social traditions, and the environment . Food can be complicated. How can we make it easier for everyone to have access to affordable, culturally appropriate, healthy foods? What are the impacts of traditional foods and food practices and eating local on community health? How can our diets support environmental sustainability? How can diverse members of our communities feel empowered to affect their food system? Tackling these questions from a public health perspective can help us better understand the intersection between food, health, culture, and natural resources, and help us find ways to make individual and systemic changes. FEEDING THE BODY Public health data shows that for the last hundred years, the average lifespan for a person living in the United States has consistently been increasing. Facets of modernization—medical advances, the widespread availability of food, science technologies, the globalization of knowledge and goods, and our easier lifestyles—have propelled lifespan up and up. Then in 2005, the New England Journal of Medicine published research that found that the current generation of American children may be the first that would not outlive their parents.1 This research combined data on population trends for mortality rates and body mass index or BMI (a clinically defined measure of weight status) to adjust life expectancies. Many educated people had assumed life expectancy would keep rising, especially with increasing...

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