Health Ministry admits it erred in emphasizing disease treatment over prevention

The Health Ministry has admitted for the first time that it erred over the decades by leaving the public to determine their diets and lifestyles by themselves without proactively making changes that do not require individuals to change their behaviors. Ministry director-general Moshe Bar Siman Tov conceded to The Jerusalem Post on Wednesday that as an institution, it invested the vast majority of its efforts and budgets in treating disease and too little emphasis on health promotion and disease prevention. As a result, obesity and overweight, metabolic diseases, heart disease, stroke and many other conditions that are difficult and expensive to treat have become epidemics. He said this after presiding over the first meeting of a committee he and Health Minister MK Ya'acov Litzman appointed to make recommendations to promote healthy lifestyles. Among the subjects to be discussed are legislation to promote good nutrition, limiting unhealthful components such as salt, bad fats and sugar in prepared foods; listing nutritional values in manufactured foods and in that sold in restaurants; and taxing food products with low nutritional value. Besides Bar Siman Tov, other members of the committee are Prof. Itamar Grotto, the ministry's Public Health chief; Prof. Itamar Raz, head of the National Council on Diabetes; Prof. Ront Endevelt, head of the ministry's nutrition department, Eli Gordon, director of the ministry's National Food Service; Eran Ya'acov, deputy head of the Tax Authority, Prof. Iris Shai, nutrition researcher at Ben-Gurion University's Health Sciences Faculty; and Irit Livneh, the health supervisor at the Education Ministry. While the ministry launched the Efshari Bari program a few years ago to persuade the food industry to make changes and to provide information on nutrition to the public, the director- general said that many more changes are needed in line with those carried out in other advanced countries. Finland used to have some of the highest rates of cardiac and other diseases, but it underwent a turnaround with legislation, persuasion and education. The ministry has begun to realize that the government's longtime subsidization of white bread, which is harmful to health by lacking fiber and certain nutrients, was a mistake, and that the more-expensive dark bread containing natural fiber can reduce obesity and diabetes rates. But Bar Siman Tov admitted he hadn't known that only one hospital in the country – the English Hospital in Nazareth – provides only whole wheat bread to its patients, at its own greater expense. “We are changing our concept. We used to say: 'Eat less and exercise,'” said Bar Siman Tov, but now we are taking responsibility to help the public eat right and live in a healthy manner. The public have so many choices, but they have not been free choices, because unhealthful food is everywhere and healthful food has been hard to get and more expensive. We have stressed the fact that the choices being made by the public have not been free of the influences of the food industry. But we are not at war with them; we want to cooperate with the food industry,” the director-general said. Bar Siman Tov added that the committee will not mention specific food suppliers or products, hinting at the recent direct attack by Litzman on the fast-food chain McDonald's. “We don't want people to stop eating, but they have to make changes in their diet and be more aware that a healthful diet is for everybody,” he said. Endevelt noted that when she went to school, there was only “one overweight girl” in her class, but when she encounters her daughter's class, “almost everybody seems to be overweight.” There are more than 800,000 Israelis with fatty liver disease, a potentially dangerous and even fatal condition that can be reversible if the individual eats right, exercises and loses weight in time. Prof. Itamar Raz noted that much has to be done in the Arab community, as many of those who are overweight and have metabolic diseases are Arabs living in the North and South of the country. While genetic predisposition is partly involved, poor lifestyles (including high smoking rates in men) are responsible for much morbidity. Meanwhile, Dr. Olga Raz – head of clinical nutrition in the health sciences faculty of Ariel University – said that 30 percent of Israeli children suffer from obesity or overweight due to sitting for hours in front of computer, TV and smartphone screens and eating too much and harmful food. She explained that while children for many years spent their leisure time playing ball and other physical games outdoors, thereby burning up calories, today they lock themselves in their homes, eat and get little or no exercise. This “sitting culture,” with the kitchen close by, causes youngsters to eat when they're not hungry. She advised parents to get their children out of the house, have them go on family treks and teach them to eat healthful foods. “Electronic screens serve many families as babysitters and a solution to keeping children occupied. For many parents, this is not regarded as negative, as they may consider them 'computer geniuses,'” the Ariel University nutritionist said. “It's very difficult to turn the clock back and change our lifestyles, but we should think about those things that can be changed.”

Health Ministry admits it erred in emphasizing disease treatment over prevention

“We are changing our concept. We used to say: ‘Eat less and exercise,” said Bar Siman Tov, "but now we are taking responsibility to help the public eat right and live in a healthy manner."

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