Tag: #healthyfoodforhealthcare

One of the earlier elements that drew me to “the magical microbiome” was that both of my sons have food allergies, which I never had to endure, but which puts them squarely in the mainstream for the past 15 years or so (one has an all-too-common peanut and tree-nut allergy; both are allergic to mollusks). Both, by the way, were born by c-section, so they “missed out” on the transfer of natural microbiota that occurs with natural birth (I shared a link about that in last week’s post.) I also have inflammatory arthritis – an autoimmune disorder – so that threw a little lighter fluid on the charcoal, too.

As for our own ability to control, or at least influence, our microbiomes, diet is a key factor (see Sections 4 – 10 in the linked article). To be fair, so are other facets of lifestyle, such as smoking and exercise, but since I post about food’s impact on health, I’m going to stay focused there. While there is still a need for much further study, so far it is clear that diet has a significant effect, and specific nutrients and compounds have greater and lesser impacts, promoting or suppressing either the levels or functions of certain organisms. There are also suggestions (same article linked above) that a greater variety of beneficial microbiota is linked with improved immune function and overall health.

I promised last week that I’d share some more practical information about things that can promote a healthier microbiome. First, it’s important, in order to get everyone on the same page, that I define a couple of key terms.

Probiotics vs. Prebiotics

I think it’s a fairly safe bet that you’ve heard the term “probiotic;” and I’d wager 50/50 odds that, with the increase in awareness of the importance of “gut health” as many call it, you may have heard the term “prebiotic” as well. But do you really know what they are, what the difference is, and why each one is important?

First, their definitions, according to the International Scientific Association for Probiotics and Prebiotics (ISAPP):

A “prebiotic” is a substrate that is selectively utilized by host microorganisms conferring a health benefit; and,

A “probiotic” is live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.

So, prebiotics are, essentially, foods that our bodies can’t necessarily fully break down on their own, but which feed beneficial microorganisms (I’ll share some examples of these in a minute) and thus promote their presence and function, while probiotics are the beneficial organisms themselves. Each is important, and neither stands effectively on its own.

Prebiotics. . . Yummm . . .        

You probably think I’m kidding with that heading, but I’m not. Many foods containing key prebiotic compounds fall on my list of “things I love to eat,” and maybe they’re on yours, too. This, by the way, is not an exhaustive list by any means, but it will get you started!

Chicory root is the runaway winner for food with the highest concentration of prebiotic compounds content by weight (in this case, the compound is called inulin), at 64.6%. It gets processed into prebiotic supplements and fiber supplements all over the place, but given how I feel about supplements, I’m not inclined to go there. It’s barely a food, but I’m including it anyway. The most common way to consume it is roasted, ground, and made into a beverage. It can be a coffee substitute, or added in equal parts to coffee when brewing (New Orleans-style); however, the volume consumed in that manner is relatively low, so realistically, though its prebiotic concentration is high, the amounts one would be likely to consume on a daily basis probably bring it about level with the rest of the foods on this list. Acacia powder has a higher concentration of prebiotic compounds, but it’s not an actual food, so it’s off my list.

Other prebiotic-containing foods include Jerusalem artichoke, a.k.a. sunchoke; dandelion greens; garlic; leek; onion (I can barely cook anything that doesn’t have at least one, if not all 3 of these members of the allium family at its base); asparagus; wheat bran; wheat flour; banana; cocoa (unsweetened!!); cruciferous veggies (broccoli; cauliflower; kale; brussels sprouts); legumes; unrefined barley; oats; apples; flax seed; jicama root; seaweed. If you have no idea what some of these things are or how to eat them, don’t worry – I was in the same boat with a few of them too, and below I’ll tell you where you can learn more about them, including sources for a whole bunch of recipes.

Beware the Probiotic Craze

No matter what, it just seems that we’re doomed in this culture (sorry – no pun intended, but now that it’s on the page, I’m going with it) to seeking a magic bullet for everything, and we are obsessed with breaking everything down into components to try to figure out that one mystical thing that’s creating a benefit; for example, the compound resveratrol in red wine. Remember when everyone went nuts over that for a while? God knows how many $ millions were, and still may be, being made off resveratrol supplements, and just about every other discovery of the latest “miracle compound.” Unfortunately, it has never been, and never will be that simple, and it will always be the case that our bodies are much better at synthesizing all the beneficial elements (vitamins, minerals, fats, proteins, etc.) of *real food* rather than processed supplements.

Therefore, we shouldn’t all go crazy running to the supplements aisle for the latest probiotic concoction, expecting some kind of health miracle, most especially if we aren’t making other lifestyle & diet changes to support it. Nor should we fall into the marketing trap of spending a ton on specially engineered probiotic foods. Humans have been making things like sauerkraut, kimchi, and yogurt for thousands of years. Over-engineering and over-marketing them doesn’t make them any better. It just makes them more expensive.

. . . But They *Can* Still be Helpful

As I mentioned briefly in my post last week, however, there are some cases where studies have shown that probiotics do confer meaningful benefits, and more studies are underway for various others. So far, probiotic supplements have been shown to have benefits:

1. When taken to offset the side effects of antibiotic treatment;
2. In preterm infants, to prevent the development of necrotizing enterocolitis, which is otherwise not well-understood, but is often fatal;
3. To help relieve the symptoms of Irritable Bowel Syndrome (IBS).

In addition, there’s enough anecdotal evidence for benefits from regular consumption of probiotic foods (mostly fermented foods) that further studies continue, and in the meantime, consuming them isn’t harmful, provided the benefits aren’t offset through the addition of sweeteners and other unnecessary additives.

Some Probiotic Goodies

Some examples of fermented foods & beverages (I’ve already mentioned a few above): yogurt (be sure it has live, active cultures and best to go with plain. Add your own fruit, and, if you must, sweetener, but really, try to wean yourself off that stuff. Cut it out for a couple of weeks and before you know it, you’ll wonder how it ever owned you like it did); sauerkraut; miso; kimchi; kombucha; fresh, sour pickles and other pickled vegetables; tempeh (as long as you don’t cook it too long/at temps that are too high and kill the active cultures); natto (made from fermented soybeans – I’ve never tried it); kefir; traditional buttermilk (not cultured).

It’s easy to add these things into your diet. For things like kimchi and sauerkraut, go easy at first if you aren’t used to them – maybe just a tablespoon or 2 along with a meal to add a little zing. My experience is that it can take a couple of weeks for your body to acclimate to what, in some cases, may be new strains of beneficial microbes. . .

Getting Practical

One of the first books I read on this subject was The Microbiome Diet by Raphael Kellman, M.D. As I mentioned last week, weight loss was not my quest. Self-education, and just maybe, a practical solution for some of the health challenges I and my family were experiencing, was the goal. I’ve included the link to the book on Amazon here because I still think it’s a great primer on the microbiome: what it is, why it’s important, and how to keep it “healthy.” That was where I first learned about prebiotic foods, and as the title of the book promises, a guided approach to incorporating them, and a microbiome-supporting diet, into your life, including recipes galore.

You can choose to follow the stepped diet in his book if you really want to go hardcore, but you can, I believe, still derive a lot of benefit even if you don’t pull out all the stops. He also markets a line of probiotic supplements; he tells you himself in the book that you don’t need them, but claims that you get a bigger bang for your dietary buck if you do. I’m skeptical of anything that requires me to spend exorbitant amounts of money on supplements, but since he doesn’t require it, he gets a pass.

Other Resources

A quick google search for “prebiotic recipes” or “probiotic eating” should yield a pretty sizable collection of sources to review for recipes and eating ideas. Here are a few good ones: MakeSauerkraut!; Paleo Hacks Gut Health Recipes; Clean Eating.

Anything you do to incorporate more of the foods that support the microbiome is likely to be helpful, as long as you aren’t drowning out the benefits with processed garbage and too much sweet stuff. It works for me. Just ask my arthritic elbow.

Happy Food Friday!

I admit it. I’m a fat-lover.

I am a meat lover. To be even more specific, I am a fat-loving meat lover. Fat has always made me happy. And so far, it seems to also be keeping me healthy, which isn’t something I’m sure would work for everyone. (I have a theory about diets in general and why there is no single “best” or healthiest diet that is the right one for every person – I’ll post about that sometime in the not-too-distant future).

Full disclosure though, I am also a vegetable-lover, so perhaps that’s my nutritional saving grace – who knows? The only vegetable I’ve ever tried that I didn’t like was okra. Bitter greens, like mustard, dandelion, broccoli rabe? Bring ‘em on. Brussels sprouts? I can hardly get enough. I’m crazy about kale; cuckoo for kimchee (technically a fermented vegetable, I know – I’ll do a post about fermented foods sometime in the future, too). But nothing makes me drool more than a well-seasoned ribeye, freshly sizzling off the grill, and the near-swoon of anticipation I feel slicing into that first, beautiful, melty piece of salt & peppered fat.

True story, just to put a needle-sharp point on my borderline obsession: we, like millions of others, had a ham for Easter this year. Because we were a small crowd, I got a quarter ham, bone-in. Until the end of the day, when I was cleaning up and putting away the leftovers, I had not considered a truly wondrous thing: in order to have a “bone-in” quarter ham, the bone would have to be cut, too. And, there, as I lifted the ham by its partial shank bone to nestle it into a storage container, I spied it. Shimmering unctuously at me from the cocoon of that split shank was that grail of fat-lovers everywhere: the *marrow.* I stopped dead in my cleanup tracks, gasped at my fortune, then proceeded to scoop and slurp up every last molecule of it. Yes. I LOVE fat. (If that just grossed you out, my apologies. On the other hand, if you have a leaning toward fat and you’ve never experienced the sublime joy that is marrow, go forth and find yourself a great restaurant that serves osso bucco. Your life may never be quite the same again).

But I’m not mindless about it.

With all of that said, I have to share something else that has grown to be a part of my life and routine, though I must admit that I’m not always able to follow this perfectly: when I buy any kind of animal protein (meat, poultry, eggs, fish, even dairy products), I spend the time to find, and the extra money to buy (though often to buy reduced quantities of) products which are grass-fed, pasture-raised, free-range, wild-caught, hormone- and antibiotic-free, etc. I don’t do this because I’m a food snob or an animal rights activist. I do this because I believe that animals raised eating the foods *they* were meant to eat (cattle eating grasses & hay, as opposed to grains, soy meal, and God-knows what else; chickens tapping around and eating insects, seeds, and worms; etc.), and in surroundings they were meant to inhabit (cattle in fields, rather than crammed into muddy, manure-filled pens; ditto for chickens or pigs, or even fish) are inherently healthier themselves, and by logical progression, their meat is also healthier when we consume it.

Grass-fed, free-range: really healthier?

This is borne out by studies of cattle fed grass diets versus grain diets. The concentrations of, for example, healthier omega 3 fatty acids are consistently higher in grass-fed than in grain-fed beef. While omega 6 fatty acid concentrations don’t seem to change significantly with the different diets, as I noted a couple of weeks ago in my
Step Away From the Canola post, we should be after ratios of omega 6: omega 3 more in the range of 4:1 or lower (ideally, 1:1), whereas now, our typical ratios are sky-high (15:1 or higher). Grass-fed beef provides a better ratio. It also has higher concentrations of antioxidant enzymes, among other benefits. While grass-fed and free-range animals do tend to have lower overall fat content and slightly different flavor profiles, I’ve been perfectly happy with the fat they do have, and have grown accustomed to the flavor profile.

I also think there’s something to be said for “happier” animals in terms of the eventual healthfulness of their meat: in the same way that elevated stress hormones are known to have deleterious effects on humans and our propensity for all sorts of disease, animals under chronic stress respond similarly. Keep subjecting them to stressful situations; drive up their stress hormones and, not surprisingly, you will decrease the quality of their meat.

But what about the environment?

Finally, I return to one of the areas I said I’d focus on at the outset of writing this blog a few months ago, and a huge reason I buy carefully: environmental impact. The production of animal protein, no matter what, has a larger carbon footprint than the production of most plant products (though that does start getting more iffy with some monoculture crops, many of which are produced for what? Animal feed. But I digress). However, the negative environmental impact of grass-fed/pasture-raised/free-range meat production is significantly lower than high-intensity “factory farming” techniques. There’s a great book about this called Farmageddon: The True Cost of Cheap Meat, by Philip Lymber with Isabel Oakeshott, which, despite the alarmist title, does a very balanced job of laying out the horrific environmental impacts of factory farming, along with a very solid argument for how, despite broad belief to the contrary, expanding global populations do *not* demand more such intensive farming techniques. You can find a good overview and review of the book here on The Guardian.

Our choices, our future.

It’s critical that we all understand the absolute power we wield to shape our own futures, whether carnivore or vegan, not only by how we eat, but by how we spend our money. We’re seeing more food retailers adding organic options to their shelves, and many manufacturers shifting to non-GMO ingredients. They aren’t doing that just for yuks or out of a sense of environmental stewardship or social justice. They’re doing it because of consumer demand. That demand, my friends, begins and ends with you and me.

Think your doctor is the right person to ask about your diet? Think again.

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If you only read and absorb two sentences here, make it these two: PLEASE STOP THINKING REFINED SEED AND VEGETABLE OILS ARE HEALTHY. THEY’RE REALLY *NOT*; AS A MATTER OF FACT, THEY’RE HARMFUL AT THE RATES WE’RE CONSUMING THEM. Let me call them out right up front: soybean, canola (a.k.a. rapeseed), corn, cottonseed, sunflower, safflower, grapeseed, peanut; anything calling itself “vegetable oil,” margarine or other butter-like spreads. This may not be news to you. If it is, though, or you keep finding yourself hypnotized by the “healthy” marketing BS that accompanies these products, keep reading.

A well-cited editorial in the British Medical Journal (“BMJ”) from March of 2014 spells out a lot of the evidence. I don’t want to go too science-geek on you with this, so I’m going to attempt to share a few of the reasons in a way that will hopefully keep your eyes from glazing over (but I’ll include citations so you can explore more deeply if you’d like).

Fact # 1: “Vegetable” and Seed Oils are High in Omega-6 Fatty Acids

Our bodies *need* omega-6 fatty acids, and cannot produce them on their own. Why, then, would consuming omega-6 be a problem? In short, it’s the old “too much of a good thing” conundrum. The presence of omega-6 competes in the cells with omega-3, also an essential fatty acid that our bodies can’t produce on their own. We should be after a ratio of omega-6 to omega-3 of less than 4:1. Estimates of the ratio in the western diet are now at least 15:1; by some estimates, in the U.S., it may be as high at 25:1 for some people. Processed foods are *full* of it, which is a big part of the problem. You can get omega 6’s naturally from seeds (e.g. sunflower or pumpkin); certain nuts (pistachios – yay! – and pine nuts, a.k.a. pignolis); acai berries. You should probably stop there.

This out-of-whack ratio is bad news. According to a 2002 abstract on the website for the National Center for Biotechnology Information, too-high omega-6 to omega-3 ratios “promote the pathogenesis of many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases.” To get more specific, various studies have linked high ratios to (thanks to this article on paleoleap.com for this list and citations):

• Cognitive decline (Alzheimer’s, dementia, etc.)
• Breast cancer
• Cardiovascular disease (although recent trials have put a damper on the initial enthusiasm, there still is a link; it’s just not as big as researchers initially thought)
• Depression and other mood disorders
• Gut problems and gut flora dysfunction
• Insulin resistance and diabetes
• Obesity
• Arthritis

As far as I’m concerned (maybe you, too, at this point), just the above info is enough to put me completely off these oils. If you want to come with me as I pile on, though, keep reading.

Fact # 2: Most Vegetable and Seed Oils Marketed as “Healthy” are Heavily Industrially Processed

Did you know: “Crisco” was the catchy name they came up with for “crystallized cottonseed oil” when it was first created? (Because in the late 1800’s Procter & Gamble, who’d been using cottonseed oil in the manufacture of candles and soap, discovered they could partially hydrogenate the oil and it resembled lard. *Resembled* lard. Let that sink in for just a second. An oil from the seeds of a plant that we would never consider to be a food source – cotton – was something that resembled lard. What the heck? Why not try it out in cooking?!?) So P&G tested this product, which resembled lard, and found that it worked in the kitchen, and decided to market it as a lard replacement. Good. Lord.

Now that it’s pretty common knowledge that hydrogenated oils should be avoided, we’ve shifted to liquid oils. But while oils like olive, coconut, and avocado can be fairly easily produced by cold-pressing the seeds of the fruits/nuts they come from, the process to extract the oils from, for example, rapeseeds (i.e. refining), borders on the nearly mind-numbing (with attribution and thanks to this piece on thankyourbody.com for this edgy if admittedly over-simplified description):

“Step 1: Find some “canola seeds.” Oh wait, they don’t exist. Canola oil is actually made from a hybrid version of the rapeseed… most likely genetically modified and heavily treated with pesticides.

Step 2: Heat the rapeseeds at unnaturally high temperatures so that they oxidize and are rancid before you ever buy them.

Step 3: Process with a petroleum solvent to extract the oils.

Step 4: Heat some more and add some acid to remove any nasty wax solids that formed during the first processing.

Step 5: Treat the oil with more chemicals to improve the color.

Step 6: Deodorize the oil to mask the horrific smell from the chemical processing.”

I could stop there, but, one more, to help to hopefully drive the nail into the vegetable and seed oil coffin for you.

Fact # 3: Industrially Processed (“Refined”) Vegetable and Seed Oils are Chemically Unstable and Easily Oxidized

To me, this might actually be the scariest one.

Not only are these oils likely compromised during production (as noted above in “Step 2”), exposing them to air, light, and heat adds insult to injury. This happens because of the molecular structure of these “polyunsaturated” oils. Why does oxidation matter? Oxidation, like omega-6 fatty acids, is essential in the body. Oxidation creates free radicals, which, when limited to what is needed by the body to turn food into energy, is fine. Too many free radicals roaming around in the body, though, is not a good thing. This article does an amazing job of describing why, so I’m going to steal some of it for you here (emphasis added by me): “once free radicals are formed, a chain reaction can occur. The first free radical pulls an electron from a molecule, which destabilizes the molecule and turns *it* into a free radical. That molecule then takes an electron from another molecule, destabilizing *it* and turning *it* into a free radical. This domino effect can eventually disrupt and damage the whole cell.

“The free radical chain reaction may lead to broken cell membranes, which can alter what enters and exits the cell, according to the Harvard School of Public Health. The chain reaction may change the structure of a lipid, making it more likely to become trapped in an artery. The damaged molecules may mutate and grow tumors. Or, the cascading damage may change DNA code.”

Still gonna hang onto that bottle of Wesson or canola oil? If yes, I hope you move it out to the garage with the WD-40.

So, I finished the book. If you missed last week’s post, “the book” is The Big Fat Surprise, by Nina Teicholz. Another week of messed-up sleep patterns has transpired, with me staying up too late reading something I couldn’t put down, despite the fact that what I was reading was, at nearly every turn of the page, leaving me with that “train wreck, can’t-look-away” sensation. Every few minutes, I found myself groaning with irritation; sometimes, genuinely seething with anger, and, on several occasions, really craving a sizzling, well-seasoned ribeye, though that’s not all that unusual for me anyway.

If you read this book, which, if you’re interested in food, nutrition, and health, I recommend you do, you may ultimately find it difficult to ever think anything BUT critically about advice coming out of organizations like the American Heart Association, and, quite frankly, the USDA, among many others. It’s a story of good intentions run amok, triggered when heart disease began cranking up at an alarming rate back in the post-WWII days and the medical and scientific communities were scrambling to try to figure out why.

The book is about 500 pages long. Of that 500 pages, 20 pages are dedicated to post-chapter citations; fully 80 pages to the author’s extensive notes when she quotes people or makes otherwise un-cited statements; 58 pages are bibliography. I’m telling you all of that because when you understand what she’s done with this book, given our collective “knowledge” of what constitutes a “healthy” diet, drummed into us for our entire lives, it’s otherwise going to be impossible for you to not be skeptical. The science-geek in me truly appreciates that 158-or-so pages. This isn’t the interpretation of someone who started writing with an axe to grind or an agenda to support.

It may not surprise some of you to read that we (meaning Americans – hundreds of millions of us, and then, eventually, much of the rest of the world) have been subjected, for well-over 50 years, to something like a giant, macro-version of helicopter parenting. A hypothesis was formed in the pressure and heat of that post-war heart disease ramp-up; tiny sample sizes and highly flawed data sets then became the bedrock of the idea that saturated fats were the cause of obesity and heart disease; myths about serum cholesterol levels and how they were supposedly impacted by foods containing cholesterol became fact; the fallacy of a low-fat diet as the way to health insinuated itself in our brains (with the help of the above-mentioned entities, to name just a couple of the offenders). Because we’ve been told by so many authorities (our collective surrogate helicopter parents: the government, the American Heart Association, our own doctors!) for so long that we should be following the tenets of a low fat (or, more recently, Mediterranean-style) diet, it never occurred to most of us that perhaps the whole substrate of that advice might be sitting on a huge fault line.

The punch line of the book is essentially in 4 parts:

1) Saturated fats are not the unhealthy villains they’ve been painted to be for over 5 decades; further, saturated fats are the only foods known to raise “good” HDL-cholesterol levels (there’s a lot more in the book about cholesterol and how it functions, which was highly enlightening);

2) A low-fat diet, in most cases, reduces the HDL cholesterol levels in the blood, which is not a good thing to do. While it may also reduce the “bad” LDL cholesterol, that isn’t necessarily a high-impact effect when it comes to heart disease, and LDL cholesterol is actually more complicated than a single number, with “subfractions” consisting of denser and lighter particles. The dense particles are more strongly correlated with risk of heart disease, so even if you have a low LDL number, if your LDL is made up mostly of the denser particles, you can still be at risk of heart disease (and oh, by the way, saturated fats tend to cause the lighter LDL particles to increase);

3) In our quest to replace saturated fats with supposedly “healthy” fats (i.e. polyunsaturated vegetable and seed oils: canola, corn, soybean, etc., etc.), we’ve created a silent, and growing monster, and not just when those oils are hydrogenated. As a matter of fact, what we’re doing now that hydrogenation has become mostly taboo, is using these vegetable and seed oils in their liquid form for cooking and frying. Unfortunately, these oils, because of their chemical makeup, oxidize easily, and this oxidization accelerates when the oils are heated. I’ll get more into why that matters in a future post (bringing me full-circle to where I was 2 weeks ago), but I’ll give you a teaser, in the form of a quote from the book (page 279, if you decide to read it), by Gerald McNeill, a vice president at “Loders Croklaan, which is one of the country’s largest suppliers of edible oil:” “As those oils are heated, you’re creating toxic oxidative breakdown products. One of those products is a compound called an aldehyde, which interferes with DNA. Another is formaldehyde, which is extremely toxic.”

4) If we want to zero in on more likely sources of chronic disease, consistent evidence has been out there since the 1920s that sugar and carbohydrates are the more probable culprits. Chapter 10 of the book goes into the evidence and the science behind this in convincing depth.

Several questions I want to get into in the coming weeks: how big food and edible oil companies and industry groups contribute to the problem; why our doctors don’t seem to know any of this and continue to espouse low fat diets; how and why huge, influential entities like the American Heart Association became, and remain, shills for low fat eating (and, alarmingly, vegetable and seed oils); why you should strongly consider the impact of vegetable oils on your health; why the USDA still hasn’t changed dietary guidelines; the list goes on.

Oh, the places we’ll go . . .!!

Happy Food Friday. . .!?

that articleI had been planning to post today about the myth and legend of the healthfulness of vegetable oils (I know – how much more compelling a subject could there possibly be?!? I figure if you’re reading these Food Friday posts, though, you might have some interest in understanding food/health myths, too). However, when I write about things like this, I want my points to actually have a basis in fact. I therefore began doing additional research, and I ended up going off on a fascinating, if sometimes blood-boiling tangent.

My vegetable oil research last weekend led me to a book I’m now reading that was published a few years ago, with a title I utterly love: “The Big Fat Surprise.” It’s written by Nina Teicholz, an investigative journalist whose credits include reporting for National Public Radio and writing for numerous publications including Gourmet magazine and The Economist. If you’re interested in the links between food and health, this book is a must-read, and despite the fact that she’s sifting through a virtual mountain of research and historical records, it’s written in such a way that it’s hard to put down – rare, in my experience, for non-fiction. It’s screwed up my entire sleep pattern this week, and this post is later than usual today because I spent far more time lost in reading over the past several days than in writing!

The author, who is decidedly not someone with any proverbial skin in the game of either the food or the healthcare industry, spent 9 years meticulously researching the nutrition science and research behind the “known” links between saturated fat and poor health  (cholesterol, heart disease, obesity, cancer), which was prompted by an article on trans fats her editor at Gourmet asked her to write (that article was published in June of 2004). The article was written about a year after the FDA announced that, starting in 2006, food manufacturers would be required to print information about trans fats on their labels. The book was published in 2014.

As she was researching and writing the Gourmet article, the question she was attempting to answer was “why.” Why, when research for more than 30 years had been indicating that trans fats were possibly far worse for health than saturated fats (which were the demon-children of the diet and nutrition world from the 1960s onward, and still are, according to many doctors), was further study not aggressively pursued? She was able to scratch the surface of an answer in the article, but the matter required a lot more digging –  in essence, meta-research (research on the research – especially about the methods that were followed in the various studies that were supposedly the foundation of what became incontrovertible dietary recommendations for the U.S. for several decades). It’s that meta-research which underlies The Big Fat Surprise.

I’m only about 1/3 of the way through the book as I’m writing this post, but what I’m reading certainly has my hackles up so far, as one might expect upon becoming enlightened about being lied to for most of one’s life, regarding genuinely life-altering things. I’m going to try to finish reading it before next Friday, by which point I should have enough rant-worthy material to keep us all going for quite some time.

Happy Food Friday!

A while ago I came across a whitepaper that decimated a notion I’d harbored for a long time: that farm subsidies were a key enabler behind our national problem with obesity, and, therefore, many chronic, preventable health conditions. It seemed to be a logical (if factually flawed and highly simplified) flow: subsidies encourage overproduction of certain commodities, especially corn and soy, which, because they’re so abundantly over-produced, end up as meaningless livestock feed and unhealthy fillers in processed foods; processed foods, made mostly from these unhealthy ingredients, end up being significantly cheaper than healthier whole foods, encouraging over-consumption.

It turns out that the very first part of that flow – the part where subsidies encourage overproduction –presented the surprising (to me anyway) flaw in my logic. This whitepaper isn’t new – it came out in 2011. I’m sure it was widely discussed in food policy advocacy circles at the time. Sadly, from what I have seen, the policy changes advocated in the paper (which appear to be based in quite a deep and sound body of evidence) have yet to take root.

I haven’t been able to do further research (yet) into why it is that we haven’t made any significant strides on the food policy front, but I have a few hypotheses: 1) Disengagement. As I’ve surmised in prior posts, the long-term negative health impacts of poor eating habits simply aren’t particularly evident, usually until it’s too late, so most people just aren’t paying attention – they have bigger fish to fry (so to speak!) in their lives, or so they think. It’s a little like engaging with our democracy – we take it for granted until things get too painful for us, then we start writing our Congressmen. Maybe. 2) Food policy is a double-whammy. Not only is its importance not evident enough to enough people, it also does get into politics. Changing policy requires changing minds at the legislative level, a challenge for even the most fired-up consumers, especially in light of the lobbying power of 3) “Big Food.” The whitepaper makes a clear point in its third finding: “The food industry has been the main driver of commodity policy, not farmers.” The evidence shows that “the deregulation of commodity markets – not subsidies – has had a significant impact on the price of commodities. Deregulation also has provided benefits and incentives to the food industry, including processors, marketers and retailers, and is one of a number of contributing factors impacting the availability of high-calorie processed foods in the marketplace.”

The paper is very much worth the read if you’re even remotely interested in addressing public health issues and the cost of healthcare. If you don’t have the time for the full 13 pages of content, there’s also this issue brief that distills it all down to 3 pages.

The impact of blaming subsidies also tends to demonize farmers, which I suspect most of us don’t want to do. There’s been a definite resurgence of small, local farms in various places around the country in the past decade, but it’s incredibly difficult for them to make a consistent living from growing things we can actually eat (as opposed to mass production of the commodity crops noted above), and it’s especially difficult for them to price their products at levels that lower-income households (who are disproportionately impacted by those pesky preventable chronic diseases) can justify spending. What if there were a way we could incentivize farmers to go back to growing actual food, in places that are relatively local to most of us, and make real, fresh, healthy food accessible and affordable to everyone?? The paper concludes with a short list of recommendations for policy solutions:

• Engaging in the long-term campaign to reform commodity policies;
• Increasing consumption of fruits and vegetables, whole grains and other healthy foods;
• Expanding the supply of healthy foods by helping farmers diversify their production and supply local and regional markets with healthy food;
• Building the infrastructure needed to better link farmers and consumers and aid in the delivery of healthy foods.

We can keep burying our heads in the sand and ignoring this problem, arguing over “healthcare reform” that’s focused only on treating symptoms, or we can focus on things that will make us, our children, and our grandchildren truly healthier.

There are many organizations out there who are doing this work at national, state, and local levels, and they are always delighted to have extra voices and resources to help. The two who collaborated on the whitepaper, Food and Water Watch (www.foodandwaterwatch.org) and The Public Health Institute (www.phi.org) are great places to start, but nearly every state and major city also have food policy organizations addressing things at more local levels if you’re so inclined. (There’s a wonderful one in the Hartford, CT area for which I served as a board member for 6 years, Hartford Food System (www.hartfordfood.org)). Their work and the work of their counterparts around the country will make you smile. Check them out.

Happy Food Friday!

Why is it that we can so easily recognize the importance of understanding and structuring policy regarding the dangerous addictive properties of opioids, but we have such a hard time recognizing the importance of understanding and structuring policy regarding food, which, in many cases, plays along the same addictive pathways in the brain?

There are numerous studies showing that certain foods (sugar, for example), can be at least as addictive, if not more so, than cocaine or heroin, activating the same receptors in our brains as the drugs. (This article is a great read, and provides links to a few such studies if you’re so inclined. There’s also this study regarding highly processed foods and “food addiction”). Some studies suggest that the impact of sugar on those receptors could be even *stronger* than the impact of cocaine.

We’re enraged to the point of proverbial torches and pitchforks at the pharmaceutical companies who produced and marketed opioids literally to death. (According to the latest figures – January 2019 – from the National Institute on Drug Abuse, approximately 130 people die from opioid overdoses each day – over 47,000 per year).

Yet, with the clear links between poor diet and chronic preventable disease (mentioned in my Food Friday blog last week) and related deaths, which number approximately 1.4 *million* annually in the US (I had to go to a few different sources on the CDC website to compile this number, but roughly, it’s comprised of 600,000 deaths per year each from heart disease and cancer; 140,000 from stroke, and 80,000 from diabetes), up to 40% of which are preventable (much higher, actually, for Type 2 diabetes), where’s the outrage? Where are the lawsuits?? What are we thinking???

I find it fascinating how we humans (especially we freedom-loving Americans) rationalize things like this, and how outraged many people become at the suggestion of policy (such as consumption-based taxes) that can begin to shape longer-term, truly beneficial changes in our food and beverage habits. We cling to them like a tattered blankie from childhood, assigning all sorts of mythic autonomy to our “rights” about our choices for what we eat and drink, and, in the process, choose a clear path to disease, premature death, and billions and billions of dollars in healthcare spending that are truly avoidable. We *all* then pay the price in higher costs of “delivery” and upward-spiraling insurance premiums. And then we punish the providers by continuing to squeeze them to deliver an ever-increasing volume and quality of services at lower and lower cost. It really pisses me off.

As it stands, in 2017, $3.5 *trillion* was spent on healthcare in the U.S., representing 17.9% of GDP. In 1970, in inflation-adjusted dollars, we spent $400 billion, which represented 6.9% of that year’s GDP. The rate of healthcare spending has been increasing at a considerably steeper rate since the late 1990s, and even though it’s slowed down somewhat in the past couple of years (as of the date of the latest Peterson-Kaiser Health System Tracker), the links between preventable chronic disease, death, and dietary choices remain.

We need to get more aware of what’s influencing our “decisions” (our own brains’ pleasure receptors gone wild; willful and active ignorance by food manufacturers as they continue to produce and heavily market products with addictive ingredients – remember the tobacco industry 40 and 50 years ago? Yeah, that. But with your FOOD.) We need to stop acting like petulant children, stamping our feet and declaring in effect, “it’s my body and I’ll eat what I want to.” We need grow up and instead, plant our feet firmly in the soil of true self-worth (as opposed to misguided notions of self-determination masquerading as “choices” we think we want to make) and start taking seriously our own roles in our individual and collective health.

Rant over. Happy (Food) Friday!

Call me (still) crazy, but back about 10 years ago when people were fighting like cats and dogs over the  Affordable Care Act and political liberals and conservatives largely fell into nice, neat lines on either “side” of the debate, I, who consider myself to be largely a social liberal and a fiscal moderate, was trying to invent a completely different line whenever the issue came up in conversation. That line invoked my deep and pretty much unrelenting conviction that when you’re dealing with any significant, systemic issue, you do yourself (and any impacted constituents – in the case of healthcare, that’s more or less all of us who aren’t super-wealthy) a huge disservice by only addressing symptoms. Rather, analysis of, and solutions for, the root cause(s) of an issue are the path to a longer-term, more effective answer.

In this case, the “symptom” was (is) the skyrocketing costs of healthcare (duh!), which, per the main focus of the ACA, would be addressed by a turning of the regulatory screws, mostly on providers and payers. My point (then, and still) was that we already knew at the time, and we have an even greater body of evidence now, that there are a few *significant* drivers behind healthcare costs in this country. One of those drivers is spending on chronic preventable diseases (which also impacts some of the other major levers of spending, including “service price and intensity,” a significant proportion of which is driven by increasing costs of pharmaceuticals and acute interventions to *treat* the chronic preventable diseases).

My essential argument is this: we’ll *never* rein in the costs of healthcare if all we focus on is the cost of delivery of healthcare. We need to get serious (as serious as a heart attack, maybe?) about making the deeper changes we need to make as individuals, a country, and as a culture that will influence our collective health. And I’ll be the first to admit that diet isn’t the only issue, but it’s my soapbox, and I’ll focus on food if I want to, because it’s a big one.

Here are some sobering statistics from the Centers for Disease Control and Prevention (a.k.a. the CDC – though this language is quoted from “The Nutrition Source” on the website of Harvard’s T.H. Chan School of Public Health):

• Chronic diseases are the leading causes of death and disability.
• 70% of annual deaths are due to chronic diseases.
• These *preventable* (emphasis added) conditions not only compromise quality of life, they add to rising health care costs—*75% of our health care dollars are devoted to treat these diseases* (emphasis added, again).
• Among adults ages 20 to 74, diabetes remains the leading cause of kidney failure, blindness, and non-traumatic lower-extremity amputations.

“Chronic diseases —*including heart disease, stroke, diabetes, and cancer* (emphasis added)— account for some of the most common health problems in the United States . . . yet many of these chronic diseases are preventable, as they’re linked to poor diet and lifestyle choices including tobacco use, excessive alcohol consumption, and inadequate physical activity.” Let me repeat: 75% of our health care dollars are devoted to treat these diseases.

This isn’t simply about making changes to our diets, though. There’s an entire undercurrent (more like a riptide) of culture that needs to evolve as well, and I’ll be talking more about that in future entries, but allow me close this post with one simple example, as this particular policy is certain to whip up controversy wherever it’s proposed: a tax on beverages with added sugar. People invariably FREAK. OUT. over this (though I think it’s a freak-out that in large part is manufactured by political action/interest groups representing beverage manufacturers, whose “ads” on the horror of the idea are intended to sow discontent). But this is what I mean when I talk about the riptide of culture, and I’ll come back to that next time.

Cheers for now, and happy (Food) Friday!