With the higher standard of living, Israelis have to choose if they want junk food and immobility or a nutritious diet and regular exercise
Judy Siegel-Itzkovich interviews two experts.
By JUDY SIEGEL-ITZKOVICHTNS(photo credit: TNS)
Stroll down the aisles of a typical Israeli supermarket, and what do you see? Refrigerated salad greens; olive oil; a large variety of fresh fruits and vegetables; whole-grain breads, pasta and granola; stevia and zero-fat yogurts; bags of quinoa, seeds, nuts and dried beans; pond fish on chunks of ice; lean chicken and meat; and bottled water with whiffs of fruit.But take another look: There are also endless shelves of cola drinks and blue-or-green-colored soft drinks; smoked meats, hot dogs and pastrami; potato chips and a large variety of other salty and oily snacks; frozen burekas and puff pastries; high-fat white and yellow cheeses; artificially colored candies and cakes and cookies full of trans fats, many of them on displays near the checkout counter; white bread and rolls; and frozen pizzas with synthetic cheese.Is the Israeli diet getting healthier than it was two or three decades ago? Although Israelis are not as hefty as Americans, for example, obesity here is rising among children and adults.But never did you see so many people of all ages jogging, joining exercise clubs and marathons, going vegetarian or vegan, preferring water to soft drinks and forgoing butter, hydrogenated margarines and saturated fat.According to a recent Tufts University study that appeared in the Journal of the American Medical Association (JAMA), the average US resident is adding more whole grains, nuts and seeds to his or her diet and reducing the amount of soft drinks.Yet Americans are still overweight.The study said that while there is an improvement, Americans still eat too much processed food and sugar and too little fresh produce. Less than a third of them follow recommended dietary guidelines.What is clear is that the huge variety of food – healthful and not – presents Israeli families with clear choices.While it has become easier to be healthy for those who can afford to purchase what is good for them, there are also many ways for the socioeconomically disadvantaged to follow a healthful diet.“The standard of living here is much higher than when I immigrated from Moscow in 1973,” said Dr.
Olga Raz, a well-known expert who was chief clinical nutritionist at Tel Aviv Sourasky Medical Center and head of the nutrition department at Ariel University. Raz – who still teaches at the university, makes regular TV appearances and has a private practice following her retiring from the hospital – noted that food is everywhere and in great variety.“The more food there is, the more people tend to eat. Food that is not nutritious comes cheaply. If a fastfood place offers two hamburgers for NIS 10 and another place sells one for NIS 10, customers will naturally go for the two. Industry understands this and manufactures 1.56 kilos of chocolate-covered wafers instead of one kilo. Things are not just physiological; they are also psychological.The size of portions in restaurants grows, so you eat more. Unlike what the great Jewish sage and physician [Maimonides] advised, people don’t get up from the table before they are satiated.”In the 1970s, “almost everybody used to eat at home. Now people often go out to eat, and many times it is junk food. But why buy sandwiches to eat at work that cost NIS 35 when you can make your own at home for under NIS 10?” She counsels participants in courses she gives to buy smaller plates so that when serving the family, they will not overeat.“You have to reduce the amounts and variety of foods you serve and choose those that are more healthful.Don’t eat near the TV or computer or while busy with your smartphone.Sit down with your family to meals as many times a week as you can. If you are busy with electronic devices and screens, your brain doesn’t pay attention to whether you are still hungry or full. Don’t eat fast,” she said in an interview with The Jerusalem Post,” or you will feel as if you haven’t eaten at all.”Stress and the lack of sleep also affect what and how people eat and can lead to obesity, said Raz.“Israelis – children, teens and adults of all ages – don’t sleep enough. This causes hormonal changes and excess weight. Fatty, sweet and salty foods are addictive.”She noted that for the Jewish people, food is an important part of ritual, so we naturally have a lot of it around the house 24 hours a day.The religiously observant save the most expensive and desired (but not necessarily the most healthful) goodies for Shabbat and holidays, handing out sweets to children. If a child cries, Jews naturally tend to stick a snack into his or her mouth.EDUCATION ABOUT nutrition from the earliest possible age is vital, said Raz.“The Health Ministry is now starting to focus on specific problems, such as reducing salt or sugar in processed food. But public health nurses and nutrition experts should be talking to kids in nursery, kindergarten and elementary schools. There must be regular classes on health and nutrition there and even at the high school level. The children will take home what they learned and teach their parents. Vending machines in and near schools should not be full of junk food.”Ironically, despite all the junk food, the public in general is much more interested in achieving good health and longer lives than before, said Raz.“The media are not always providing accurate information, and the online media such as Facebook and the Internet contain a lot of misinformation,” she continued. “I don’t want the standard of living here to fall, but the public must be educated and be provided with accurate information.”Raz discounts the notion that the socioeconomically disadvantaged cannot get healthful food.“My husband and I, as new immigrants, had little money. We went to the open-air market, especially late on Fridays, and bought fruits and vegetables that remained unsold.We bought chicken wings and dried chickpeas, groats and beans. Even with little money you can eat nutritious food. People have to be taught how to shop and what it is recommended to eat.”She is perturbed about the diets of former Russian immigrants who arrived in the huge aliya wave of the 1990s.“They consume a lot of fatty meat, sausages, cheeses and cream and much less fresh produce. The men generally drink vodka and other alcohol heavily. They like sweets, and they think – even the diabetics among them – that three tablespoons of honey is a medication.”As for former immigrants from Ethiopia, they came from a country with a generally meager diet and quickly began to consume large amounts of processed sweet and salty food. They have high rates of tooth decay and diabetes. Arab women, Raz said, have high rates of diabetes, and the men high rates of smoking, which shortens their lives.The ultra-Orthodox (haredim), who usually have large families, generally have unhealthful diets. Supermarkets that specialize in this sector have large amounts of snacks and other processed foods and soft drinks in addition to the basics.“Women who have many children need special nutrition, with a lot of iron, vitamin D, vitamin B12 and other nutrients,” said Raz, whose Hebrew-language book on “the bread diet” was widely read and appreciated for its stress on whole wheat products. “The fetus in the womb needs to get the right nutrition, as do babies who breastfeed.But the mothers don’t necessarily consume what they should to give it to them.”PROF. ELLIOT Berry, the London- born expert on metabolism and nutrition, internal medicine specialist, former dean of the Hebrew University-Hadassah Braun School of Public Health and Community Medicine, has spent most of his life advocating an active life and proper nutrition for all ages.Berry’s research interests include coping with chronic disease and food insecurity, the bio-psycho-social problems of weight regulation, the Mediterranean diet and the effects of nutrition on cognitive function.He has been a visiting scientist at four prestigious foreign universities as well as head of the World Health Organization’s Center in Capacity Building in the HU Medical Faculty and worked as a consultant at the UN’s Food and Agriculture Organization in Rome. He was recently involved in a Tel Aviv University conference on Sustainable Food Systems, sponsored by the International Union of Nutrition Sciences, of which he is chairman of the Israeli branch.“Food is very enjoyable and part of our lives, but there should not be strict rules of do’s and don’ts, as people will not follow them all.There should be moderation and carrots [incentives] rather than sticks [punishment].Yet it is true, that we consume too much food. The Mediterraneans diet that is available to us because of our location – vegetables, fruits, olive oil, fish and whole grains – is tops, but because of poor education, high prices and lack of knowledge, we eat the wrong food.”“Women used to stay at home and cook traditional dishes for dinner, and families used to eat together at the table as in the 1950s Father Knows Best TV program. Thanks to washing machines and birth control, women go and work outside, and that is good. But there is a trade-off, so families eat a lot of processed food and eat together at the table much less. Screen time is a great predictor of obesity.”Berry, who is modern Orthodox, is glad that at least for Shabbat and holidays, families get together to eat.“It’s impossible to regulate nutrition.Adults must take a degree of personal responsibility for themselves and their children. Education about healthful food must begin at a young age.EVERYTHING SHOULD be in moderation and done gradually. Israelis won’t eat food whose salt has suddenly disappeared. They have to get used to it, with the cooperation of industry. He recalls a project he carried out in eastern Jerusalem kindergartens, teaching Arab children and their mothers about the importance of eating a good breakfast and more vegetables.“We succeeded in changing behavior on this, but not in spending less time in front of a screen.”A veteran wearer of pedometers who recommends that people take at least 5,000 steps a day (“I do 5,000 to 12,000 a day, on average”), Berry urges Israelis to walk more. It is not just taking exercise but part of daily life, he stressed. And while cooking reality competitions are among the most popular on TV, “we’ve lost our cooking skills. There are ads for kitchens that are always showcases, clean, neat and showing no food.”During the early years of statehood, many Israelis grew vegetables in their gardens or other plots of earth because fresh food was scarce.“Now is the time for kitchen gardens in the cities. One can even grow herbs on your windowsills. People can make their own halla with whole grains mixed with some white flour if they prefer.”He suggested that supermarkets set up “healthy aisles” where only beneficial foods are on the shelves and “healthy checkouts” where there are no sweet or salty snacks or cigarettes.There are still large gaps among Israelis in standard of living. “Having a higher standard of living does mean more or too much, food, he continued, “but the other side of the coin is that Israelis can eat better and be healthier today than decades ago and be more aware of health. We are living in exciting times for changing people’s nutrition and lifestyle.”Berry is today more optimistic about Israelis’ health than when he was dean of the school of public health in Jerusalem between 2003 and 2006.“I am encouraged when I see people of all ages walking with a water bottle in their hands.”