Tuesday, April 24, 2012

The Heart Attack Grill Is Not The Problem

Yesterday there was another national news report about someone having a heart attack while eating at the Heart Attack Grill and while I understand the juicy and ironic lure of the story, I have to ask, is the Heart Attack Grill really the problem?   I'm quite certain heart attacks at restaurants aren't unique to burger joints.

I'm actually kind of fond of the Heart Attack Grill, because unlike virtually every other restaurant around, at least they're up front about the risks of regularly visiting. Yet I'm guessing the calories in their flatliner fries and their triple bypass burger aren't any higher than those found in their Five Guys' or Carl's Jr.'s counterparts, and that the Heart Attack Grill's Coca-Cola's pretty much the same as everyone else's as well.  And yes, as ABC's shoot from the hip Dr. Richard Besser (I'm a big fan BTW) pointed out to me yesterday, they do have an 8,000 or so calorie burger, but yet so do so many other restaurants with shock value, get-your-picture-on-the-wall-if-you-can-eat it meals.

The problem isn't inherent to the Heart Attack Grill. It's also not the other umpteen-gazillion restaurants out there. The problem is how normalized the practice of eating out has become. What was once a rare family or personal indulgence is now a regular occurrence, with more than 50% of our food dollars being spent on foods we buy outside of the home, and lord knows what percentage of the remainder being spent on reheating boxes, stirring packages together and ultimately just pretending to actually cook.

As part of our intake questionnaire in my weight management practice we ask how many prepared meals a person purchases on a weekly basis. While I haven't crunched the numbers, I'd be surprised if the average were lower than 5.

I guess what I'm getting it is that all the Heart Attack Grill is doing is meeting a demand, and that it's the demand that's broken, not the suppliers.

What I want to know is what has happened to society to lead to that increase in demand? Why don't we value home cooked meals any more? Why do we as a society utilize restaurants like our parents utilized grocery stores?

While it's impossible to finger point at specific answers to those questions up above, that doesn't mean we can't do something about them. In fact I'd argue that there's no shortage of things we can do, just that there seems to be little, if any, political or personal will to do them. Environmental problems require environmental changes. We need to change what we consider to be "normal" such that meals out again become rare treats, and that sitting around family dinner tables again becomes the norm.

So how do we do that?

Some off the top thoughts - re-prioritizing after-school activities to include at least one family shared cooked meal, turning off our electronic smart phone tethers when we leave the office, actually scheduling cooking and shopping times into our agendas, bringing home economics back to our schools, running public health campaigns vilifying purchased meals as a whole (and/or promoting actual cooking), changing crop subsidies such that places like the Grill can't serve ridiculously cheap calories, changing zoning laws to curtail the practice of fast food setting up within walking distances of schools, eliminating school and public institution based no-name fast food, instead of cities giving out free trees giving out free seeds and compost for backyard vegetable gardens, tax subsidies on fresh fruits and vegetables.......

That the Heart Attack Grill (and other restaurants) exist isn't the problem, it's the demand for their products and services that we need to change.

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  1. A young friend of mine tried to promote biking to school and learning to work in community gardens in an area with a high density of apartments in Orange County, California. Sadly some child safety groups fought her at every turn for promoting "unsafe" behavior. It seems that they saw anything with kids doing activities outside as risky. After nearly a year of hard work she simply gave up...

  2. Dr. Yoni, can you please expand upon your definition of "cooking"? I remember reading in a previous post something about "transforming raw ingredients." But here's the thing... I always thought I did a pretty good job of not eating out, my family and I rarely eat out more than once a month. But is making grilled cheese sandwiches and slicing up some apples for dinner good enough? Is that "cooking"? Because sometimes that is all I have time for, and I always considered it superior to going through some drive-thru window, but you kind of make me feel like if I'm not baking my own bread then I'm not doing it right.

    I sometimes bake potatoes in the microwave. Is that cooking? I make bean burritos from store bought tortillas, some shredded cheese and canned refried beans, which again, I always thought of as a pretty reasonable dinner when served with some steamed (frozen) veggies, but is that cooking? I use bottled spaghetti sauce, is that okay to do? I will sometimes throw a pork roast into the crock pot before leaving for work and add some bottled barbeque sauce to it when I get home and serve the resulting pulled pork sandwiches for dinner. Is that cooking?

    My husband and I both work full time to maintain our very middle class existence, have two school aged kids and I can tell you that the reason people use prepared food is because there is simply very often not time to do otherwise.

    I guess I'm asking for more specifics on what you feel are decent compromises between fast food and baking your own bread and lovingly preparing your own marinara sauce from fresh tomatoes grown in your garden. While the former is clearly a bad choice, the latter seems somewhat impossible for many.

  3. I just realized I addressed you as "Dr. Yoni", I apologize. I meant "Dr. Freedhoff".

    1. No worries - I go by both, and just "Yoni" would be fine too.

      Regarding your question, as per most of my teaching I believe in the "healthiest life you can enjoy" approach and that would apply to cooking as well.

      No doubt your grilled cheese sandwiches and apples are likely a great deal better than the fare your family would receive in a restaurant, and while there might be some benefit to home pressed tortillas, I do think everyone has to draw their own lines.

      Your compromises might not be the same as my compromises, but that doesn't make mine better, it just makes us individuals.

      If there were one thing I'd love to see all families do it would be at least one meal a week truly made from scratch, ideally made together as a family, and consumed lovingly at a table.

    2. This is the classic "perfect is the enemy of the good" dilemma. Marianne, sounds like you're doing great to me. A potato in the microwave is no different on the nutrition front than a potato in the oven. My husband and I work full-time without kids, and I make many of the same types of compromises I see you doing. It's simply not realistic for make my own BBQ sauce from locally-grown organic tomatoes. And if someone wants to get in a snit because I buy my greens pre-washed, let 'em.

      That said -- Dr. Freedhoff, my immediate reaction to "vilifying purchased meals" is no, there's no need to "vilify" things at all. I'm not going to feel overly guilty about the 1 or 2 nights a month I pick up a pizza. Vilifying foods starts sorting things into good and forbidden, and gets us into this weird mental state about food -- and onto the slippery slope Marianne describes about how homemade is enough. We all stumble through the best we can, and I'll think we'll do better coming from a place of understanding. I do think we need to change the culture to one of more home-cooked food, but I'm not sure making people feel like sinners when they're just getting off from their 2nd job and the kids are starved and crabby and they run through the fast food drive-thru.

  4. Dr. Freedhoff, I think that is an absolutely worthy goal, and something that is small, manageable and specific. And also something my family could definitely do on the weekends, we can work in almost anything on the weekends! I am hereby setting the goal of one meal made TOTALLY from scratch a week! The consuming lovingly at the table is a goal I already have down pat, we started doing that a while ago, and I can now officially report that it is a habit (although the "lovingly" part sometimes goes awry, one of our kids is a 13 year old girl, so "sullenly consumed" might be a better description some nights). I think also having the kids participate in the making of the meal is a fantastic idea, and again, as long as the goal is just one night a week, one I can completely handle. I like it!

  5. I'm a pretty new reader of this blog, but I am finding myself wholeheartedly agreeing with the posts I have read!

    I'm a busy mom of two kids. I work full-time out of the home, am taking university courses, and spend three out of five weekdays taking my kids to various activities. I do my very best to avoid eating out with them because I strongly believe in "real food" (that's what I call it at home). When we're in a pinch, like on the days we can't make it home for dinner before dance class, it's pretty easy to swing by the grocery store and but some pre-washed veggies, a tub of freshly-made hummus, and whole grain pitas. It costs about the same as a drive-thru, but it's actual food.

    We eat out as a treat. Not only because it's healthier, but also because eating out costs a ton. I have a much larger food budget if we eat in, which means I can stock up on local, organic, healthy ingredients that might otherwise be off the menu. Plus, I get to teach my kids how to shop for, cook, and eat good, whole food.

    Thanks for your post!

  6. This heart attack occurrences are so often. Just saw a documentary on youtube related to this heart attack grill victims: http://www.youtube.com/watch?v=GmOKeajYC44

  7. Dr. Freedhoff says, "I'd argue that there's no shortage of things we can do, just that there seems to be little, if any, political or personal will to do them. Environmental problems require environmental changes."

    Indeed, the food environment is a problem. In the Preface to Food for Nought Canadian biochemist Ross Hume Hall remarked, "Nourishment of the American populace has undergone a startling transformation since World War II. A highly individual system of growing and marketing food has been transformed into a gigantic, highly integrated service system in which the object is not to nourish or even to feed, but to force an ever-increasing consumption of fabricated products."

    To be sure, the people running agribusiness and food corporations are not intentionally trying to destroy the health of customers. And they don't "force" anyone to buy their products. It's just that people like the convenience of packaged snacks, prepared foods, and takeout. And because it takes years of consistently dining on such fare before symptoms of diabetes, cancer, or heart disease become detectable, each generation makes the same mistake. In fact, each generation is becoming fat and sick earlier. A quote from The Modern Nutritional Diseases by Fred and Alice Ottoboni:

    "The current relentless pressure to convert the entire population to a low-fat, high carbohydrate dietary regime seems to be driven by a curious set of circumstances. It began with an idea aimed at inducing the public to buy and eat foods that are profitable to the agricultural and food industries as opposed to foods that man was designed to eat. With judicious use of public relations, advertising, pseudo science, and political prowess, this idea has grown into a sophisticated and powerful movement that is changing eating habits throughout the world. Concurrently, the national priority aimed at the treatment of the modern nutritional diseases, rather than their prevention, has focused medical research on patentable new drugs rather than on preventive methods...The consequences are sobering. Older adults suffer premature disabilities and shortened life spans; younger adults, and even children, are increasingly affected by early signs of atherosclerosis, obesity, and type-2 diabetes. Enormous prescription drug and medical care costs have nearly reached the point of overwhelming the national budget. And tragically, a growing body of evidence suggests that the bizarre and increasingly common behavioral problems among young children and teen-agers are related to the combined effects of high sugar intakes and the virtual absence of omega-3 essential fatty acids in the American diet." http://books.google.com/books?id=wPrfdvM5V4gC&pg=PA199&lpg=PA199&dq=#v=onepage&q&f=false

    The point here is that government and health organizations did try to do something but chose (out of ignorance and for political reasons) to do the wrong thing. It's a interesting conundrum. The government determines what is considered healthful eating, relying on academia to supply the science upon which the dietary recommendations are based. Food corporations find it in their best interests to shape the content of academic instruction which affects scientific consensus. Then they formulate their products according to the governments dietary advice which they helped shape.

  8. Anonymous11:02 pm

    If I grow, pick, clean, peel, chop vegetables and add water and spices and boil until it's soup, and freeze in meal size batches...

    why is it any less healthy for big companies to grow, pick, clean, peel, chop vegetables and add water and spices and boil until it's soup and freeze in meal size batches ...

    It seems to me there should be economies of scale that would make Big Company Veg Soup cheaper than Mom's Veg Soup, and just as healthy.

    The question is - why are prepared foods so unhealthy? If I can make soup and it's ok, anybody can do it!

    1. Paulette4:37 pm

      I agree with you anonymous. The main reason I don't use canned/packaged etc soups is that they are not made the way I want to eat. - too much salt is my main issue. As well, the flavour is not all that great.
      The almighty dollar (keeping material costs as low as possible) are one reason they are not as healthy - lets face it salt is cheap. The other is consumer desire for healthy offerings - which in general is not as great as the desire for convenience.. Its tough. Companies will produce what consumers will buy - basic economics of pleasing their customers. But do they really pull out the food technology stops to make a tasty, nutritious soup, when they don't really believe that they can make it just as good without all the salt - I don't think so. I don't think they believe they can do it. After all they grew up on prepackaged food as well. Its what they know. It is their reference standard.

    2. Sadly it's not about healthy choices for big business and agriculture. It's about big profit, by any means necessary. They want to get YOU coming back, buying more and purchasing more often with the maximum amount of profit

  9. Maureen10:08 pm

    Most kids seem to walk to school in Victoria. We rarely eat out, there's too much food for slight people. It really doesn't take that long to cook a meal. And frankly, our food tastes better. Homemade can be very inexpensive. We bought a pork roast on sale and made over twenty schnitzels from it, average cost, thirteen cents each. With vegetables thrown in we estimate the cost of dinner was about fifty cents each.