Our marked up copy of the September issue of the journal Science includes a 37-page special section called: It Takes More Than an Apple a Day. The introduction is printed in full in the preceding link; but you have to pay for the eleven articles that follow the introduction. You can probably get a copy at your local library or order any sections that you’re especially interested in directly from Science at the link in this paragraph. Science is a high-quality refereed journal and uses common scientific jargon and technical details. It spends time, as good scientists do, documenting all references, sources, and claims.  Despite its professional style the magazine is trying hard and making strides in reaching a larger audience. It is important that more of us than only trained scientists and technical people follow what is developing in top-notch scientific circles.

I will list the articles so you can see what the titles are and decide if you’re interested.

News

• Task Force’s Prevention Advice Proves Hard to Swallow – Public Measures in Disease Prevention
• Will an Aspirin a Day Keep Cancer away? – Wondering How the Wonder Drug Works
• Tackling America’s Eating habits, One Store at a Time
• Uncertain Verdict as Vitamin D Goes On trial
• Chronic Disease Vaccines Need Shot in the Arm

Review

• Can Noncommunicable diseases Be Prevented? Lessons from Studies of Populations and Individuals?

Perspectives

• Preventing Alzheimer’s Disease
• Changing Human Behavior to Prevent Disease: The Importance of Targeting Automatic Processes
• Fetal and Early Childhood Undernutrition, Mortality, and Lifelong Health
• Double Burden of Noncommunicable and Infectious Disease in Developing Countries
• Why a Macroeconomic Perspective Is Critical to the Prevention of Noncommunicable Disease

This special section touches my public health soul; it stirs my life long desire to contribute to the improvement of the public’s health. If I’m one hundred percent honest here, I admit how powerless an individual can feel who has the desire to help solve enormous problems, even if only in some small way. Alas, I seem to always retrieve into thoughts of the image of some obscure person, out in Internet land somewhere, making improvements in their life as a result of the work that goes into our blogs. In doing that, I can motivate myself to keep trying to get the word out in ways that can impact health.

The Science article mentioned above, pulls us back into the entirety of public health; and reminds me of my years at UCLA. But I’ve chosen to focus on the areas of public health wherein I have a greater level of expertise; namely nutrition, exercise and sleep. But I thought that you might enjoy these articles to better understand the complexities that are facing public health workers; or even have a special interest in one or more of the specific sections.

The introduction to Science special section, written by four of the leading editors of Science (Caroline Ash, Paula Kiberstis, Eliot Marshall, John Travis) is worth reading, even if you don’t have time to delve into 37-pages of public health – remember that page is free in its entirety. The editors make a unambiguous case for long-term steps to be taken toward decreasing noncommunicable diseases, including: heart disease, metabolic disease, cancer, and respiratory disease which account for 60% of all deaths worldwide and 80% in low- and middle-income countries. Then they report an alarming projection; that by the year 2050 more than 100 million people will be afflicted with dementia.

Certainly it’s easy to follow that preventing these diseases is easier than treating them after people become ill. As you know, if you read this blog frequently, many of these diseases share risk factors that can be modified by lifestyle changes – the editors mention three; tobacco, processed food and physical activity. Over the decades since I received my Masters in Public Health, I’ve come face to face with the reality that changing human behavior is not an easy process to influence. I think that along with a plethora of other public health advocates, we fall into the idea that we can merely provide educational materials to people and they will change. The Science special section has an entire article dedicated to this erroneous concept.

The section called: Changing Human Behavior to Prevent Disease: The Importance of Targeting Automatic Processes. Ingrained habit patterns and cravings are the automatic processes they emphasize. The section defines the issues involved in answering why we continue health-harming behaviors (overeating, smoking, excessive alcohol consumption, and very low physical inactivity, for example) even when undesired consequences emerge. Part of the authors’ argument includes the fact that much of human behavior is automatic, cued by environmental stimuli and resulting in actions that are largely not accompanied by conscious thought. This article results in the need to help populations in controlling their environment and changing behaviors, but if you just want to focus on how your environment can either sabotage you or support your behaviors, you can read any of our articles written about environmental control. If you just want a hint of where to start, consider Willpower or Environmental Power? an article that I wrote last December 6, 2011. I have a strong belief that if the right foods are not in our immediate environment and the destructive choices are, it’s just about impossible for us to resist the bad choices and attain the health that we desire.

There is so much that can be done to reduce the probability of premature mortality caused by behaviors that have become habits. It may be difficult; and definitely will take more than one easy behavior change, like the proverbial apple a day. But we can work on designing our lives to keep us safe from poor choices and increase the likelihood of eating healthy foods most often, and getting enough exercise and sleep.