America in 2013 is a fat, sick nation. By now we’re all familiar with the dismal headlines that seem to make the rounds among national news media every couple of months:
“Two-thirds of U.S. adults overweight or obese”
“Diabetes cases soar at alarming rate”
And how about this particularly alarming forecast:
“Experts predict more parents will outlive their children”
Yes, despite the fact that Mexico recently bumped us out of the top spot on the World’s Fattest Nations list, despite the decades-old advice from government and other “experts” urging us to eat less and exercise more and despite the fact that drugs and technology are keeping us alive longer, it’s clear that what we’ve been doing just isn’t working. If you’re still in denial, take a walk down the street in most any city in America.
In the face of it all, I see reason for optimism. I think we’re finally starting to get it. We’re asking the right questions, taking more responsibility for our own health and challenging the conventional wisdom. The Internet affords us unprecedented access to a wealth of information that can be helpful in making decisions about our health (along with some really, really bad and potentially dangerous information that we have to be on the lookout for). We’re also seeing growing interest in the fields of integrative medicine and epigenetics, shifting the conversation about disease to prevention and focusing on environmental factors such as diet, behavior, stress, and toxins. And there’s an increasing segment of the population who have decided to take control of the only thing we have complete power over – what we put in our bodies. I call them Informed Eaters and they are the inspiration for my blog.
So, what’s informed eating all about? Well, I can tell you what it’s not about. It’s not a diet (at least not in the modern-day sense of the word), it’s not about counting calories or deprivation. It’s not about the latest “superfood” or miracle supplement. It’s also not about big muscles or six-pack abs (although those are common “side effects”!). Likewise, it’s not about being skinny, which, by the way, isn’t necessarily healthy, as skinny people still get heart disease, cancer and diabetes too. In a nutshell, it’s applying common sense to dietary decisions. It’s about doing (mostly) the things that are known to reduce our disease risk and as few as possible of the things known to increase it. It’s about broadening the discussion beyond the generic, overly-simplistic and failed recommendations that mainstream authorities continue to regurgitate.
Apparently, blog readers like lists. I’ve always been a big fan of bullet points and bold letters myself, so I thought I’d mark my official entry into the blogosphere with a list of my own. Though the source of motivation often varies, informed eaters are a passionate bunch who share a number of traits that help them succeed in navigating an oft-confusing nutritional landscape and improving their physical and emotional well-being in the process. Here’s what makes them tick:
This is the foundation of it all, the core principle. Informed eaters believe that what they eat impacts their health. How could it not? Food is the stuff that we put inside our bodies all throughout the day, each and every day. Though it’s easy to lose sight of this, food doesn’t just go in one end and out the other. It makes a few stops along the way. It’s thought that 80-85% of our immune system is in our stomach. Starches and sugars – more abundant in the standard American diet than ever before – are known to fuel pathogens in the gut. The fact is, we have 10 times more bacteria in our bodies than normal cells. This is equivalent to 5 pounds! When our gut flora is imbalanced in favor of bad bacteria, we set the stage for illness. Fermented foods and probiotic supplements are strategies that help crowd out the harmful bugs. This is just one mechanism through which disease gains a foothold but clearly diet plays a role. Just look at Asian countries, where fermented foods such as kimchi and miso are widely consumed and disease rates are much lower.
Growing research even links gut health to a variety of mental illnesses. As it turns out, most neurotransmitters are produced in the gut, including 95% of our body’s supply of seratonin! For this reason, researchers have referred to the GI lining as the “second brain” and are studying gut health for possible treatments for everything from ADHD to autism. There’s even a nerve, the vagus, that runs from the brain to the abdomen. Diabetes inflicts damage on the vagus nerve, causing gastrointestinal issues. What do we know about diabetes? It’s almost entirely preventable- and reversible- with proper nutrition. Diet strikes again!
Informed eaters consider preventative medicine one of the keys to longevity. They don’t want to wait around to get sick. They understand that it’s much easier to keep illness at bay than to hope to be able to treat it once it appears. To that end, informed eaters are proactive in doing the things in our control to stave off disease. And there is so much that we do have control over. Informed eaters don’t throw their hands in the air, wave the white flag, surrendering to the perceived inevitability of our genetic predispositions. Informed eaters understand that genes do not act in isolation; they need to be activated or turned on and this is where diet and lifestyle come in. Research shows, for example, that factors such as deficiencies in B-vitamins, found in leafy greens, and exposure to bisphenol-A (BPA), found in the lining of canned foods, can negatively alter gene expression. This is where we have complete control. As they say, nobody ever ate anything by accident.
A recent analysis by the Institute of Health Metrics and Evaluation found that poor diet is the leading cause of “disease burden” in the U.S., responsible for more premature deaths than smoking. Studies out of the Harvard University School of Public Health have shown that we could prevent about 82 percent of heart attacks, nearly 70 percent of strokes, more than 90 percent of diabetes, and at least 70 percent of colon cancer, with the proper dietary choices. (In comparison, the most effective drugs can reduce heart attacks by about 20 or 30 percent!) We know, and have known for quite some time, that there are compounds in certain vegetables, for example, that cause cancer cells to commit suicide, minerals that prevent abnormal heart rhythms and herbs that help normalize blood sugar. As a matter of fact, hundreds of prescription drugs used today are based on plant compounds.
For informed eaters, diet matters and this continues to be confirmed, not only through a growing body of scientific research, but also in our own lives, based on improvements in more direct measures of personal health, such as blood results, weight loss, energy and mood.
Informed eaters approach food differently than others. They understand that, from an evolutionary perspective, the whole reason we even have a sense of hunger is to satisfy the need for nutrients. For the informed eater, food is- first and foremost- a source of sustenance, nourishment and fuel, things we’re just not going to get if our diet consists mostly of processed junk. Specific nutrients are needed for optimal health and when deficiencies are allowed to take hold, we invite disease. No, one cookie certainly won’t kill you (though, is it ever really only one cookie?). But when informed eaters see a plate of cookies, for example, we think to ourselves, Dude, where’s the nutrition? Sure that first bite might taste good for the two seconds that it takes for our taste buds to process it, but then what? What comes along for the ride with that momentary pleasure?
Digestion starts in the mouth and an entire cascade of biological, metabolic and hormonal processes is initiated, including a spike in blood sugar, in response to which your pancreas releases a flood of insulin (insulin release literally begins the moment you start thinking about those cookies!). Insulin’s job is to remove sugar from the blood, as it is toxic and seen as a biological emergency. Ideally, the sugar will be taken in by your muscle cells and stored as glycogen for future use but, unfortunately, your glycogen storage capacity is limited, so where does the excess glucose go? It floats around the bloodstream, some gets stored as fat, some clogs the arteries and raises your triglyceride levels (that’s right – it’s sugar that increases triglycerides, NOT fat!) Later, when you start feeling sluggish because of the sugar crash, what will you be reaching for? Not broccoli and salmon, but more sugar. Brain scans reveal that sugar affects the same region of the brain as heroin and cocaine. In fact, a drug used to fight opioid addiction is now be studied as an anti-obesity treatment. And that’s not all. A serving of sugar has been shown in studies to increases the production of free radicals and impair immunity for at least 5 hours after consumption. And, as if that weren’t enough sugar leaches calcium from the bones. But, perhaps most frightening of all, sugar feeds tumors. We’ve known of this potential since Otto Warburg hypothesized it in 1924 and now we have MRI scans to prove it.
Our bodies produce thousands of cancer cells each day, and though most won’t make it past the initiation stage, we certainly don’t want to give them the extra fuel needed to progress, especially since there’s not one biochemical reaction that requires added sugar from our diets. Our bodies can produce the small amount of glucose it needs from amino acids.
According to Dr. Lewis Cantley, Director of the Cancer Center at of Beth Israel Deaconess Medical Center in Boston:
“If you happen to have a tumor that has insulin receptors on it, then it will get stimulated to take up the glucose that’s in the bloodstream,” he adds. “So rather than going to the fat or to the muscle, the glucose now goes into the tumor, and the tumor uses it to grow.”
This may explain why the overweight and obese have a greater cancer risk. For years, doctors around the world have successfully used a ketogenic (high-fat, low-carb) diet to starve cancer cells, though in the U.S. such treatment protocols often go under-the-radar or are seen as “radical”, despite the fact that we have the 7th highest cancer rate in the world. We can learn a lot about by studying how other countries approach disease treatment and prevention but we have to look for this information ourselves. Sadly, many of us have the attitude that, “if it was important, I would have heard about it.”
Cantley told the New York Times Magazine earlier this year, “Sugar scares me.” He studies this stuff for a living and based on what he’s seen under the microscope and in patients, he has decided to give up sugar. Fortunately, alternative flours and sweeteners exist and they don’t exhibit any of the same disease-promoting properties as sugar. That’s right, we can create desserts that not only are not bad for us, but actually have health benefits. There are dozens and dozens of recipe sites focusing on grain-free (remember, grains are just long chains of sugars that break down into glucose in the body) and sugar-free baking.
Knowing that chronic, systemic inflammation is the primary cause of most degenerative disease, informed eaters focus on avoiding inflammatory foods, such as trans fats and Omega-6 fatty acids, opting instead for those that block this process. Does this mean food has to be boring and bland? Quite the contrary. When you choose real, unadulterated food and let the natural flavors come through, there’s nothing in a can, box or package that can come close. Does it require some extra effort, time and money? Perhaps in some cases, and informed eaters have concluded it’s worth it. No matter the schedule or the financial constraints, though, there’s almost always a way to make a dietary decision a more informed one. Informed eaters often choose to make sacrifices elsewhere in their budget, recognizing that we only get one body.
Because informed eaters focus on nutrients, we reject robotic eating patterns, like rolling out of bed the second we awake and running to the kitchen for a bowl of cereal with skim milk and a glass of O.J. (the quintessential American breakfast), just as depicted in the TV commercials. And because we didn’t start the day with all that sugar and the ensuing insulin spike-crash cycle, we’ll be able to walk past the donuts (can you think of a “food” with less nutritional value than fried cake?) in the break room mid-morning without feeling an urge to grab one just because they’re there and everyone else in the office has helped themselves. And on our commute home we won’t be reaching for that bag of pretzels because we just can’t make it those 45 minutes until supper. Nope, what we’re after is the stuff that makes the body run the way it’s supposed to. When you focus on that, you don’t crave the other stuff and when you start reaping the benefits of whole-body nutrition, it gets easier and easier to resist. Passing on the empty calories and cheap filler becomes almost second-nature. We replace the old, unhealthy eating patterns and habits with more informed behaviors.
Informed eaters envision a constant battle taking place inside our bodies between our immune system and a barrage of pathogens. It’s widely accepted that oxidative stress and inflammation are the two primary causes of degenerative disease. There are foods that promote those processes and foods that fight them. For the informed eater, the choice is clear.
3. Skepticism. Informed eaters are not cynics but we’ve seen over and over how the so-called experts have steered us in the wrong direction when it comes to what we should and shouldn’t be eating. Often, they rely on incomplete and questionable science, make recommendations based only on observational rather than controlled studies and ignore data that may not conform with their own long-held views. The history of dietary recommendations in this country is a story rife with elements of politics, ego, money and the bias that they engender. It makes for an interesting read but is beyond the scope of this post.
One of the most prominent examples of dietary misinformation is the vilification of saturated fat and dietary cholesterol. Mounds of research have exonerated these two vital components of a healthy diet, yet there are millions of people out there who won’t eat an egg, one of the most nutritious foods on the planet and there are doctors still spewing this nonsense. It hasn’t been explained to them, for example, that dietary cholesterol and blood cholesterol (the kind your doctor measures) are two different things and that the process is self-regulating, meaning that if you consume less cholesterol, your body just makes more. In one day, your liver produces up to 10 times the cholesterol in an egg. This overblown and unrealistic fear means patients are unaware that we’d die without cholesterol, that it’s contained in every cell and is the parent molecule of every hormone in the body. We know now that cardiovascular health goes way beyond “good” and “bad” cholesterol and that it’s actually the particle type, size and number that matters most, yet most primary care physicians don’t test for these, unless we demand them or go elsewhere, as informed eaters are wont to do.
Dissenting voices in nutrition research are often muffled, others are fearful of coming forward at all and when they do they their words are sometimes buried, like these from Dr. William Castelli, former Director of the long-running Framingham Heart Study, which has been identifying risk factors of cardiovascular disease since 1948:
“Most of what we know about the effects of diet factors, particularly the saturation of fat and cholesterol , on serum lipid parameters derives from metabolic ward-type studies. Alas, such findings, within a cohort studied over time have been disappointing, indeed the findings have been contradictory. For example, in Framingham, Mass, the more saturated fat one ate, the more cholesterol one ate, the more calories one ate, the lower the person’s serum cholesterol.”
Others in the field have been forced into a complete reversal of positions, most notably Walter Willett from Harvard who, after years of collecting egg on his face, flip-flopped on his past dietary recommendations.
“Fat is not the problem,” he told the Los Angeles Times in 2010.
Here’s more from Willett on health and diet from an interview with Frontline on PBS:
“Unfortunately, as a physician back in the 1980s, I was telling people that they should replace butter with margarine because it was cholesterol free, and professional organizations like the American Heart Association were telling us as physicians that we should be promoting this. In reality, there was never any evidence that these margarines, that were high in trans fat, were any better than butter, and as it turned out, they were actually far worse than butter.”
We can trace the American obesity epidemic and our accompanying health decline to about the time that these same experts told us to cut the fat from our diets. We listened. And during that time we became the fattest people on Earth. That strategy backfired, wouldn’t you say? Mainstream dietary wisdom is often rooted in basic theories which sound plausible in a textbook and seem to tie everything together in a nice, tidy way but don’t play out very well in the real world. Humans are not theories.
“When we began our studies back in the late 1970s, we expected that we would find a relationship between, say, fat intake and breast cancer, because that was almost an accepted relationship. But as the data started coming in over the years, we just did not find any higher risk of breast cancer among women who consume more fat in the diet. And the same was true for colon cancer and for heart attacks and risk of type 2 diabetes. In fact, the percentage of calories from fat in a diet has not been related to any important health outcome.”
Informed eaters recognize that the landscape of nutrition education in this country is littered with misinformation, confusion and outright lies. Informed eaters wonder how, for example, a food – grain – that didn’t exist for 99% of human history, came to make up the bulk of our diets. We ask why, for example, diabetics – who suffer from a disease of carbohydrate metabolism – are told by the “experts” at American Diabetes Association via their own doctors, that it’s perfectly fine for them to consume the same amounts of carbs as those without the disease (“just dial it into your glucose meter and pop your meds!”) Hey, ADA: there’s no human physiological need for carbs, unlike fat and protein, which we would die without!
This stuff is most irritating when it comes from respected sources but no less disturbing when the peddler is one driven purely by profit. Informed eaters approach the notion of “healthy” products and services with an inherent distrust, as the industry is replete with unscrupulous marketers trying to capitalize on emerging nutrition trends, shady supplement companies, TV infomercial charlatans and various other Johnny-come-latelies purporting to be go-to sources of medical wisdom.
Sometimes the B.S. is of the government-sanctioned variety. Informed eaters have a visceral reaction at the sight of what I call “impostor” health foods, like cereals with dozens of hard-to-pronunce ingredients, masquerading as something that must be good for our bodies because the buzz word “antioxidant” is splashed across the colorful box.
WHOLE GRAIN WHEAT, SUGAR, RICE, CHICORY ROOT FIBER, MIXED BERRY FLAVORED CLUSTERS (ROLLED OATS, SUGAR, OAT FIBER, CORN BRAN,CORN SYRUP, WHEAT STARCH, HONEY, YELLOW CORN FLOUR, CORN CEREAL, CANOLA OIL, NATURAL AND ARTIFICIAL FLAVORS,FRUCTOOLIGOSACCHARIDES, MODIFIED CORN STARCH, SOYBEAN OIL, SALT, CARAMEL COLOR, MALT EXTRACT, STRAWBERRY POWDER, CITRIC ACID, GLYCERIN, BHT [PRESERVATIVE], RED #40, BLUE #2, CELLULOSE GUM, GREEN #3, BLUE #1, RED #40 LAKE, BLUE #2 LAKE), MODIFIED WHEAT STARCH, SOLUBLE CORN FIBER, MALT FLAVORING, SALT, ROLLED OATS, FRACTIONATED PALM KERNEL OIL, INULIN, OAT FIBER, NONFAT DRY MILK,CORN BRAN, MODIFIED CORN STARCH, GLYCERIN, WHEAT STARCH, CORN SYRUP, HONEY, APPLE PUREE CONCENTRATE, YELLOW CORN FLOUR, STRAWBERRIES, BLUEBERRIES, VITAMIN A PALMITATE, NATURAL AND ARTIFICIAL FLAVORS, KIWI JUICE CONCENTRATE, WHEY, MONOGLYCERIDES, SOY LECITHIN, CORN STARCH, NONFAT YOGURT POWDER (HEAT TREATED AFTER CULTURING), CANOLA OIL, INVERT SUGAR, STRAWBERRY JUICE CONCENTRATE, ASCORBIC ACID (VITAMIN C), CINNAMON, FRUCTOOLIGOSACCHARIDES, RED RASPBERRY JUICE CONCENTRATE, GUAR GUM, BLUEBERRY JUICE CONCENTRATE, NIACINAMIDE, MALT EXTRACT, CARAMEL COLOR, CITRIC ACID, VITAMIN D, ALPHA TOCOPHEROL ACETATE (VITAMIN E), BHT (PRESERVATIVE), PYRIDOXINE HYDROCHLORIDE (VITAMIN B6), RIBOFLAVIN (VITAMIN B2), THIAMIN HYDROCHLORIDE (VITAMIN B1), BETA CAROTENE (SOURCE OF VITAMIN A), FOLIC ACID, VITAMIN B12.
Does it make it less bad because they’ve “fortified” the cereal with some of the vitamins that were stripped away during the extensive processing? I’m sure there are “experts” who think so.
As informed eaters, we are infuriated by a Food and Drug Administration whose labeling laws allow for this. Of course, this is the same FDA that only inspects 1% of the food that enters the country and engages in pay-to-play schemes with pharmaceutical companies to fast-track drug applications, all the while making it increasingly difficult for Americans to buy raw milk and natural herbal remedies that have been used safely for thousands of years (in contrast to prescription medications, which kill an American every 19 minutes).
Informed eaters prefer to do their own research and we demand evidence. You can usually find a study that says whatever you want it to say but informed eaters look for a consensus -scientific and anecdotal- among those who have first-hand experience and no stake in the outcome, one way or the other. It’s called credibility. We don’t blindly accept and follow recommendations simply because they seem to make sense, like the notion that a calorie is a calorie. If that were true, we wouldn’t have an obesity epidemic. Americans are very good at counting calories. In fact, we’re obsessed with it because the need for it is drilled into our heads from an early age. Can you really tell me that 100 calories worth of almonds behaves the same way in the body as a 100-calorie “snack pack” of whoopie pie?
A recent poll of 17 medical schools revealed that students received less than 10 hours of nutrition education during the entire duration of their schooling. The survey also found that only 38% of the schools polled required the minimum hours recommended by the National Academy of Sciences and nearly 90% of instructors thought more nutrition education is needed.
Why such little focus? Not to sound like a conspiracy theorist but preventing illness through diet isn’t very profitable.
A 2009 Harvard University study revealed that 84% of doctors had some relationship with the pharmaceutical industry. Additionally, nearly two thirds of physicians accept drug samples and 70 percent take food and beverage incentives from drug companies. The same study also showed that fourteen percent of doctors accept cash payments for services.
A couple of years ago, Dr. Beatrice Golomb, Associate Professor of Medicine at University of California, San Diego, presented data showing that the pharmaceutical industry spent $18.5 billion per year promoting their drugs to doctors. It’s no wonder that docs are so quick to reach for the prescription pad at the mere mention of even the slightest form of physical discomfort, for which there are often well-established natural methods of treatment involving dietary or behavior modifications.
A far-too-prevalent example is that of heartburn and the use of acid blockers, which are notoriously over-prescribed –as early as infancy! An informed eater thinks to him/herself, “Hmmm…don’t we have humans have stomach acid for a reason? Is suppressing it really such a good idea?” Proton pump inhibitors are one of the most profitable categories of drugs but the increased risk of osteoporosis and pneumonia, as well as the potential for interference with other medications is well-documented. Informed eaters prefer to work with their body rather than against it and, in the case of acid reflux, may choose to address the source of the problem with proven, safe and natural remedies such as digestive enzymes and deglycyrrhizinated licorice or by eliminating the dietary and lifestyle triggers. Sometimes medication is warranted but to not even consider that diet plays a role sure seems foolish to an informed eater.
Informed eaters know their bodies. They’re aware of how certain foods make them feel and make changes as needed. They don’t shrug off seemingly minor annoyances as being part of life. They know that everything has a cause and they seek to identify and deal with the source. We all know people who always seem to be suffering from something. Year-round they’ve got the sniffles, maybe a dry cough, frequent headaches and they just can’t seem to muster the energy to make it to the gym after work. They keep Tums in their pocket and Advil in the top drawer. Perhaps they’ve gotten used to all this and have come to accept it. Informed eaters know that this cannot possibly be what Mother Nature had in mind for us.
Awareness also refers to a familiarity with the ingredients that comprise the food we eat, along with their source and method and degree of processing. Informed eaters keep their finger on the pulse of the ever-changing nutrition landscape, making an effort to stay abreast of emerging issues for instance, such as the GMO labeling controversy and the fluoride debate (it’s amazing that this is still a debate; the evidence is clear about its effects on brain development). This goes beyond reading labels and doing Internet searches. It might mean subscriptions to journals and newsletters and sharing information via social media and Meet Up events. Whatever the means, informed eaters are hungry for information – accurate information – to help improve (and extend) our lives. We weigh the evidence, compare data, and consider the source and their potential motive. Only then can we make an informed decision.
If you’re still reading this you might feel overwhelmed. It might seem as if there is so much to sift through and factor into our dietary decisions. Yes, there’s quite a bit of minutiae to focus on if we choose to but it’s important that informed eaters be able to take a step back at times to see the bigger picture. It’s not about one meal or one isolated nutrient, but rather the cumulative effect of all the dietary decisions we make over time. Informed eaters don’t stress about every bite and we resist the obsessive mentality that comes with traditional dieting. We still let our kids go trick-or-treating and celebrate birthdays, we too enjoy dining out and yes, we do shop at “regular” grocery stores. Chronic disease develops over the course of many years so informed eaters don’t beat themselves up over an encounter with an item from the “forbidden” list like say a Jenny Craiger or Weight Watcher may. (Although, to be honest, we just don’t really crave stuff that makes us feel like crap after.)
Keeping things in perspective also means realizing that there’s more to life than what is or isn’t on our plates. Yes, we make an effort to do the things that we believe will improve our quality of life but we don’t want to be defined by those decisions. Of course, all of life’s other pleasures are more enjoyable if you’re not dealing with illness but the stress that comes from feeling overwhelmed by our dietary choices certainly doesn’t do our bodies any good. Likewise, informed eaters reject an “us vs. them” mentality. We may be passionate about our philosophy but we’re not interested in mocking, scolding or condescending. We care what others eat only to the extent that we don’t want to see anybody get sick if they don’t have to. To that end, we share what we know and leave it up to the individual to make decisions about his or her own body. We call out public health authorities and those in positions of power when they spew lies and misinformation, but we see no point in publicly humiliating the guy at the next table for asking for more rolls. The hope, of course, is that after learning what those rolls do in the body, that same guy might make a more informed decision. But if not, so be it. We can all eat at the same table!
I think that’s enough for now. Leave a comment and let me know what other topics you’d like to read about.