Health, Taken Seriously

I love this book. I think it should be required reading for every American.

In Defense of Food is somewhat of a follow up to Michael Pollan’s The Omnivore’s Dilemma. That book examined how our food is produced, this one examines how we should eat based upon that. It’s a harsh look at the typical Western diet–how we came to eat this way and how it is destroying our health. In a mere 200 pages, Michael Pollan lays out what’s wrong with the way we eat and how we should be eating instead.

There is so much good information in this book that I can’t resist including many excerpts:

• Together, and with some crucial help from the government, [scientists and food marketers] have convinced us of three pernicious myths: that what matters most is not the food but the “nutrient”; that because nutrients are invisible and incomprehensible to everyone but scientists, we need espert help in deciding what to eat; and that the purpose of eating is to promote a narrow concept of physical health…. If this approach to food doesn’t strike you as the least bit strange, that is probably because nutritionist thinking has become so pervasie as to be invisible. We forget that, historically, people have eaten for a great many reasons other than biological necessity. Food is also about pleasure, about community, about family and spirituality, about our relationship to the natural world, about expressing our identity. As long as humans have been taking meals together, eating has been as much about culture as it has been about biology. That eating should be foremost about bodily health is a relatively new and, I think, destructive idea–destructive not just of the pleasure of eating, which would be bad enough, but paradoxically of our health as well. Indeed, no people on earth worry more about the health consequences of their food choices than we Americans do–and no people suffer as many diet-related health problems.
• Earily in the twentieth century, an intrepid group of doctors and medical workers stationed overseas observed that wherever in the world people gave up their traditional way of eating and adopted the Western diet, there soon followed a predictible series of Western diseases, including obesity, diabetes, cardiovascular diseases, and cancer. They called these the Western diseases and, though the precise causal mechanisms were/remain uncertain, these observers had little doubt these chronic diseases shared a common etiology: the Western diet. What’s more, the traditional diets that the new Western foods displaced were strikingly diverse: Various populations thrived on diets that were what we’d call high fat, low fat, or high carb; all meat or all plant; indeed, there have been traditional diets based on just about any kind of whole food you can imagine. What this suggests is that the human animals is well adapted to a great many different diets. The Western diet, however, is not one of them.
• During the decades of the twentieth century when rates of heart disease were rising in America, Americans were actually reducing their intake of animal fats. In place of them, they consumed substantially more vegetable oils, especially in the form of margarine… Between the end of World War II and 1976, per capita consumption of animal fats from all sources dropped from 84 lbs to 71, while fats from seed oils approximately doubled. Americans appeared to be moving in the direction of a “prudent diet” and yet, paradoxically, having more heart attacks on it, not fewer.
• Here’s how Harvey Levenstein sums up the quasiscientific beliefs that have shaped American attitudes towards food for more than a century: “that taste is not a true guide to what should be eaten; that one should not simply eat what one enjoys; that the important components of foods cannot be seen or tasted, but are discernible only in scientific laboratories; and that experimental science has produced rules of nutrition which will prevent illness and encourage longevity.”
• One of the more pernicious aspects of nutritionism is that it encourages us to blame our health problems on lifestyle choices, implying that the individual bears ultimate responsibility of whatever illness befall him. It’s worth keeping in mind that a far more powerful predictor of heart disease than either diet or exercise is social class.
• We have known for a century now that there is a complex of so-called Western diseases–including obesity, diabetes, cardiovascular disease, hypertension, and a specific set of diet-related cancers–that begin almost invariably to appear soon after a people abandons its traditional diet and way of life. [Research now shows] that some of the most deletrious effects of the Western diet [can be] quickly reversed. It appears that, at least to an extent, we can rewind the tape of the nutrition transition and undo some of its damage.
• ….. a handfull of dauntless European and American medical professionals working with a wide variety of native populations around the world began noticing the almost complete absence of the chronic diseases that had become commonplace in the West. [They all] sent back much the same news. They compiled lists, many of which appeared in medical journals, of the common diseases they’d been hard pressed to find in the native populations that had treated or studied: little to no heart disease, diabetes, cancer, obesity, hypertension, or stroke; no appendicities, diverticulitis, malformed dental arches, or tooth decay; no varicose veins, ulcers, or hemorrhoids. These disorders suddenly appearsed to these researchers under a striking new light, as suggested by the name given to them by the British docor Denis Burkitt, who worked in Africa during World War II: He proposed that we call them Western diseases… Several of these researchers were on hand to witness that arrival of the Western diseases in isolated populations, typically… among “natives living more and more after the manner of the whites.” Some noted that the Western diseases followed closely on the heels of the arrival of Western foods, particularly refined flour and sugar and other kinds of “store food.”
• In 2003 the American Journal of Clinical Nutrition published an unusually nonreductionist study demonstrating that no one nutrient alone can explain the health benefits of whole-grain foods… [researchers] found that a diet rich in whole grains did in fact reduce mortality from all causes. But what was surprising was that even after adjusting for levels of dietary fiber, vitamin E, folic acid, phytic acid, iron, zinc, magnesium, and manganese in the diet (all the good things we know are in whole grains), they found an additional health benefit to eating whole grains that none of the nutrients alone or even together could explain. That is, subjects getting the same amounts of these nutrients from other sources were not as healthy as the whole-grain eaters…. Here, then, is support for an idea revolutionary by the standards of nutritionism: A whole food might be more than the sum of its nutrient parts.
• One of the most momentous changes in the American diet since 1909 (when the USDA first began keeping track) has been the increase in the percentage of calories coming from sugars, from 13% to 20%. Add to that the percentage of calories coming from carbohydrates (roughly 40%, or ten servings, nine of which are refined) and Americans are consuming a diet that is at least half sugars in one form or another–calories providing virtually nothing but energy. The energy density of these refined carbohydrates contributes to obesity in two ways. First, we consume many more calories per unit of food; the figer that’s been removed from these foods is precisely what would have made us feel full and stop eating. Also, the flash flood of glucose causes insulin levels to spike and then, once the cells have taken all that glucose out of circulation, drop precipitously, making us think we need to eat again.
• The astounding variety of foods on offer in today’s supermarkets obscures the fact that the actual number of species in the modern diet is shrinking. Thousands of plant and animal varieties have fallen out of commerce in the last century as industrial agriculture has focused its attentions on a small handful of high-yielding (and usually patented) varieties, with qualities that suited them to things like mechanical harvesting and processing… With the rise of industrial agriculture, vast monocultures of a tiny group of plants, most of them cereal grains, have replaced the diversified farms that used to feed us. A century ago, the typical Iowa farm raised more than a dozen different plant and animal species: cattle, chickens, corn, hogs, apples, hay, oats, potatoes, cherries, wheat, plums, grapes, and pears. Now it raises only two: corn and soybeans. This simplification of the agricultural landscape leads directly to the simplification of the diet, which is now to a remarkable extent dominated by–big surpise–corn and soybeans. You may not think you eat a lot of corn and soybeans, but you do: 75% of the vegetable oils in our diet ceom from soy (representing 20% of your daily calories) and more than half of the sweeteners you consume come from corn (representing around 10% of daily calories). Why corn and soy? Because these two plants are among nature’s most efficient transformers of sunlight and chemical fertilizer into carbohydrate energy (in the case of corn) and fat and protein (in the case of soy)–if you want to extract the maximum amount of macronutrients from the American farm belt, corn and soy are the crops to plant. (It helps that the government pays farmers to grow corn and soy, subsidizing every bushel they produce). Most of the corn and soy crop winds up in the feed of our food animals (simplifying their diets in unhealthy ways), but much of the rest goes into processed foods. The business model of the food industry is organized around “adding value” to cheap raw materials; its genius has been to figure out how to break these two big seeds down into their chemical building blocks and then reassemble them in myriad packaged food products. With the result that today corn contributes 554 calories a day to America’s per capita food supply and soy another 257. Add wheat (768 calories) and rice (91) and you can see there isn’t a whole lot of room left in the American stomach for any other foods.
• Today corn, soy, wheat, and rice account for 2/3 of the calories we eat. When you consider that humankind has historically consumed some 80,000 edible species, and that 3000 of these have been in widespread use, this represents a radical simplification of the human diet. Why should this concern us? Because humans are omnivores, requiring somewhere between 50 and 150 different chemcial compounds and elements in order to be healthy. It’s hard to believe we’re getting everything we need from a diet consisting largely of processed corn, soybeans, rice, and wheat.
• USDA figures show a decline in the nutrient content of the 43 crops it’s tracked since the 1950s. In one recent analysis, vitamin C declined by 20%, iron by 15%, riboflavin by 38%, calcium by 16%. Government figures from England tell a similar story: declines since the 50s of 10% or more in levels of iron, zinc, calcium, and selenium across a range of food crops. To put this in more concrete terms, you now have to eat three apples to get the same amount of iron as you would have gotten from a single 1940 apple, and you’d have to eat several more slices of bread to get your recommended daily allowance of zinc than you would have century ago. [A researcher for Worldwatch, Brian Halweil, has said] “American agriculture’s single-minded focus on increasing yields created a blind spot, where incremental erosion in the nutritional quality of our food… has largely escaped the notice of scientists, government, and consumers.” The result is the nutritional equivalent of inflation, such that we have to eat more to get the same amount of various essiential nutrients.
• Plants grown with industrial fertilizers are often nutritionally inferior to the same varieties grown in organic soils. Why this should be so is uncertain, but there are a couple hypotheses. Crops grown with chemical fertilizers grow more quickly, giving them less time and opportunity to accumulate nutrients… Also, industrial crops develop smaller and shallower root systems than organically grown plants; deeply rooted plants have access to more soil minerals…. In addition to these higher levels of minerals, organically grown crops have also been found to contain more phytochemicals–the various secondary compounds (including caratenoids and polyphenols) that plants produce in order to defend themselves from pests and diseases, many of which turn out to have important antioxidant, antiinflammatory and other beneficial effects in humans. Because plants living on organic farms aren’t sprayed with synthetic pesticides, they’re forced to defend themselves, with the result that they tend to produce 10-50% more of these valuable secondary compounds than conventionally grown plants.
• Bruce Ames, a renowned Berkeley biochemist… has found that even subtle micronutrient deficiencies–far below the levels needed to produce acute deficiency diseases–can cause damage to DNA that may lead to cancer. Studying cultured human cells, he’s found that “deficiency of vitamins C, E, B12, B6, niacin, folic acid, iron or zinc appears to mimic radiation by causing single- and double-strand DNA breaks, oxidative lesions, or both”–precursors to cancer. “This has serious implications, as half of the U.S. population may be deficient in at least one of these micronutrients.” Most of the missing micronutrients are supplied by fruits and vegetables, of which only 20% of American children and 32% of adults eat the recommended five daily servings. The cellular mechanisms Ames has identified could explain why diets rich in vegetables and fruits seem to offer some protection against certain cancers.
• A hallmark of the Western diet is food that is fast, cheap, and easy. Americans spend less than 10% of their income on food; they also spend less than a half hour a day preparing meals and little more than an hour enjoying them. For most people for most of history, gathering and preparing food has been an occupation at the very heart of daily life. Traditionally people have allocated a far greater proportion of their income to food–as they still do in several of the countries where people eat better than we do and as a consequence are healthier than we are. Here, then, is one way in which we would do well to go a little native: backward, or perhaps it is forward, to a time and place where the gathering and preparing and enjoying of food were closer to the center of a well-lived life.
• In countries where people eat a pound or more of fruits and vegetables a day, the rate of cancer is half what it is in the U.S. We also know that vegetarians are less susceptible to most Western diseases, and as a consequence live longer than the rest of us. (Though near vegetarians–so-called flexitarians–are just as healthy as vegetarians.) Exactly why this should be so is not quite as clear as the fact that it is.
• … eating meat in the tremendous quantities we do (each American now consumes an average of 200 lbs of meat a year) is probably not a good idea, especially when that meat comes from a highly industrialized food chain. Several studies point to the conclusion that the more meat there is in your diet–red meat especially–the greater your risk of heart disease and cancer. Yet studies of flexitarians suggest that small amounts of meat–less than one serving a day–don’t appear to increase one’s risk. Thomas Jefferson probably had the right idea when he recommended using meat more as a flavor principle than as a main course, treating it as a “condiment for the vegetables.”
• Is it just a coincidence that as the portion of our income spent on food has declined, spending on health care has soared? In 1960 Americans spent 17.5% of their income on food and 5.2% of national income on health care. Since then, those numbers have flipped: Spending on food has fallen to 9.9% while spending on health care has climbed to 16% of national income. I have to think that by spending a little more on healthier food we could reduce the amount we have to spend on health care.

If you’ve gotten to the end of this, you may not feel the need to read the actual book but you should. It is my current favorite!

Filed under: Book recommendation, Food and Nutrition, Organic on July 12th, 2008