We’re all familiar with the images of donut-munching Americans staggering from one fast-food restaurant to another. Fewer people in the Netherlands are overweight, but if we continue on the path we are on, we will soon be a second America. That is Nynke van der Zijl’s great fear. That is why the Haarlem GP has a mission: to support people as best as possible in their attempt to live a healthy life. She asks the new government to help with this.
‘Dear new government’
With the elections approaching, NH publishes a story every day from a North Hollander who wrote a letter to the new government at our request. What do residents from different corners of our province hope or expect from the new national government?
Nynke has just finished a quick but responsible lunch between appointments with patients: brown bread, salad, an egg and some fruit. Although she also has her excesses, she generally eats healthy. It was instilled in her from a young age. Although her father was also a general practitioner, he played no role in this. “Eating healthy was not a theme: you just did it.”
Norge
“I come from Norg, a small village in Drenthe. The basic principle was that we ate healthy. That meant: a brown sandwich with us to school and an apple or an orange. When we came home, we were welcome to have a cookie with tea. But it wasn’t as exuberant as it is today. Moreover, we moved a lot more. It wasn’t that healthy living was a theme: it just went the way it went.”
“A pill may temporarily solve your knee pain, but not the underlying problem.”
“It was only during my GP training that so many people came to me with obesity-related complaints that I thought: I have to do something about that. Because with a pill you may temporarily solve the pain in the knee, but not the underlying problem. The lifestyle of people is not really part of the study of medicine.”
“I only discovered how to approach this when I became a lifestyle doctor and joined Nutrition Leeft, a foundation where we help people with a chronic illness through a lifestyle that is about exercise, relaxation, sleep and meaning. That’s what eighty percent of my consultations are now about.”
Bad sleeping
“Of course, as a student I often made unhealthy choices. I really do! And I still do. That is fine, but nowadays it is made too easy for us to make too many unhealthy choices. As a general practitioner, it is my job to to make it clear to the patient that his or her lifestyle plays a role in the complaints. In addition, I also have a motivating role. It goes further than saying: you have to eat three peppers. If people sleep poorly or suffer from stress, it has no effect It makes so much sense to just pay attention to the diet.”
“Of course I also snitch every now and then, I’m not a saint!”
“As far as that lifestyle is concerned, it’s about feeling good about what you do. That sometimes involves snapping. I recently did that when we walked Sint Maarten. I’m not a saint either! You have to be yourself in everything what you eat, just ask yourself: am I feeding myself or am I filling myself? That’s fine if you fill yourself up, but then enjoy it.'”
Conflict
“Indeed, it is quite a battle that you face as a GP. It is necessary that we receive some support from the government. So excise duties on fruit and vegetables must be reduced. As long as a bag of chips is cheaper than a kilo of apples, we have We have a problem. Isn’t it ridiculous that I am offered an extra large Twix at the gas pump? Or take the marketing behind the crompouce that has now been put on the market. It is all made far too tempting. Commercialism makes it seem as if gingerbread is a healthy snack. That’s nonsense! There are five cubes of sugar in a slice. Ridiculous.”
Children
“It’s really difficult for children. They get sweets as comfort. They don’t know any better. Schools play an important role in this. I noticed a while ago that the treats are getting bigger and bigger in my children’s classroom. Why? Treats are definitely not necessary. not to consist of three parts! Then we will really go in the direction of America.”
Fat shaming
“What I would like to say: let’s be careful about overweight people fatshaming. The fact is that the pattern maintains itself. So if your body is a bit less healthy and is more in fat storage mode, you will actually be hungrier and more tired. As a general practitioner you first have to help someone get started in order to give them some wind. It is very complex, otherwise the problem would not be so big.”
Read the letter that Nynke van der Zijl wrote to the new government below:
Dear new government,
As a general practitioner, in this letter I focus on the content of healthcare policy and what I expect from it. As you are undoubtedly aware, the number of overweight people is increasing exponentially. This is because we are, as my esteemed colleague professor psychiatrist Hoenders calls it, participating in a major lifestyle experiment.
If we look at where we come from before the industrial revolution and compare that with our current living environment and relate that to our genetic profile, it is not surprising that obesity is currently the number one public disease. Where we used to have to work for our food and there were periods of scarcity, nowadays processed food is available everywhere around us and our living environment is designed in such a way that we have to move as little as possible. Our genetic profile is not adapted to this. We efficiently store the excess sugars consumed as fat, so that we have sufficient reserves in the event of possible scarcity. You may be wondering what you can do about it. In my opinion that is a lot. Below are a number of feasible recommendations.
The prices of healthy food are significantly higher than the prices of fast food/processed food. So reduce the tax on fruit and vegetables and make healthy food financially feasible for a much larger audience. Make sure there are no more offers next to the cash register that tempt people to buy cheap ‘snack bars.’
Ensure that young people start exercising more by offering more sports hours at school. Support campaigns from, for example, the Arts & Lifestyle Association that aim to inform a large group of people about a healthy lifestyle that has a proven positive effect on health. Support local initiatives of walking groups or, as I recently heard, a walker race to get people moving.
Today’s society focuses on the individual, while we need each other to deal with all the challenges that exist. People relax by spending time with each other. We also learn from each other, not only from friends but also from our parents and older people in society. We used to ask our mother or grandmother what to do if a child had a fever, but nowadays we call the doctor. We have become further removed from the natural dying process.
Today’s society, where we are on 24/7, causes stress for many people. This has an adverse effect on health. There is a great need for control, both for the individual and for the umbrella organizations. This control manifests itself in distrust and more and more rules. If we could reverse this and work based on trust and connection, this would reduce the administrative burden and free up more time for much-needed direct patient care. People must be able to connect with each other again instead of becoming lonely.
It is necessary that we appreciate our elderly again, that we learn from them and that they have a place where they can gather. The same applies to our young people: give them the space to develop and give them the space to make themselves useful. If you are valued and you are part of a community, you are less likely to enter the criminal circuit.
Another important point that I am very surprised about is the policy regarding vaping. Why do manufacturers have the opportunity to sell their stock of flavored vapes until January 1, 2024?! We know this is attractive to young people. We know that vaping reduces the risk of smoking in the long run. The industry knows this too and that is exactly why it was developed. The smoke-free generation is going up in smoke.
Finally, I believe that the takeover of general practices by commercial investors should be restricted.
Nynke van der Zijl
Letter to the government from Haarlem GP Nynke van der Zijl – NH News