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Comment by bettercaust | Hacker News Reader

I'm going to reply here to both comments.

I didn't contest the relationship between regular exercise and health. The questions I raised were: what evidence is there that [malnutrition] is a significant contributor to infectious disease in countries like the US? What evidence is there that an otherwise healthy immune system could be "boosted" with proper nutrition and elimination of environmental toxins to the point that it would have a meaningful impact on infectious disease?

I agree with all of these solutions for encouraging regular exercise, and I'm open to the solutions for encouraging healthier nutrition.

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The most clear example of this in the US is obesity. It correlates extremely negatively with basically every disease in existence, in every single way (susceptibility, severity, outcomes, recovery, etc) and is driven by malnutrition.

Solutions are not difficult to find for this specific manifestation of malnutrition. The primary issue is crap foods and cola which enable one to consume far more calories than you'd even be able to if eating a comparable amount of healthy food. For instance 2400 calories is 15 100g (cooked size) chicken breast servings. Or it's less than 2 McDonalds Big Breakfasts.

Not difficult to find? Maybe, maybe not. Effective public health solutions for obesity for which there is political will to implement them seem difficult to find to me. At the individual level, if you can manage to cut out ultra-processed food, exercise a few times a week, and get any comorbid medical conditions treated you're probably in the clear. All that is to say, it is relatively easy to identify at least some of the determinants of obesity for solutions.

I don't agree there at all. Our society has become so screwed up with unhealthful practices that there's low hanging fruit all over the place. For instance don't offer soft drinks, junk food, "sports drinks", etc. at public schools or allow vending machines for such. Offer water, milk, naturally non-caffeinated teas, and so on. Vending snacks could include things like wasabi peas and other extremely low calorie + high flavor type items.

Another thing is to remove the ability to purchase junk foods and cola with government food assistance. There's an extreme inverse correlation between obesity and income (hah.. imagine people of a couple hundred years ago hearing that) and so steps like this could actually have a tremendously positive overall impact on overall social health and wellbeing. This is even more true when you consider that twinkies and cokes are being bought on strictly limited budgets which means that much less money (and now more) for healthy foods.

I thought we were talking about public health interventions. How would "don't offer soft drinks, junk food, etc." be implemented? Are you going to propose a law or regulation that bans offering those things?

There's merit to the government food assistance (SNAP in the US) idea, though if you're trying to ban "junk food" from SNAP you're going to run into definition issues. Banning things like Twinkies and cola from SNAP is one thing, but "junk food" may also include ready-made ultra-processed food depending on your definition, and that may be the only type of food typical SNAP recipients can use (e.g. homeless who do not have access to cooking, people who live in food deserts). There is also a valid concern about micromanaging the food people eat, because SNAP recipients are normal humans and we tend to give normal humans leeway to indulge in a treat every now and then.

A lot of the malnutrition of students is driven by money. For instance Coca Cola has contracts with a massive chunk of all US school districts. And schools are obviously signing those with complete disregard for the health of their student in exchange for money. But because money is the motivation, this can just as easily be fixed by executive order (amongst a million other ways). Cut Federal funding to schools that sell soft drinks or other sorts of unhealthy products to children and Coke will disappear pretty much overnight.

Food deserts are largely irrelevant. Things like rice, beans, canned goods, and other such products are widely available and provide sufficient nutrition. There is also online food ordering (from Amazon etc) that allows payment with things like SNAP. And the sort of products we're talking about are not "treats", and should not be seen that way. They are highly addictive and harmful trash that, in the future will almost certainly be completely banned, certainly in anything like their current formulations.

I remember thinking it couldn't be true when the local schools first put in soda machines. Yes, banning the sale of soda and junk food in taxpayer-funded schools is an obvious, easy way to improve health. It would get major pushback from school boards which would cry about the lost funds, but they're always doing that anyway.

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