Medical
Writer
America’s
“vast nutritional experiment” has failed. It began in the late 1970s with a new
diet that vilified fat—red meat, eggs, cheese, butter, and whole milk.
Ostensibly designed to protect people from heart disease, which was mistakenly
attributed to fat, the fat calories were to be replaced with calories from
breads, grains, and cereals—in other words, carbohydrates.
The
result? The prevalence of adult obesity has more than doubled while diabetes
has increased nearly fivefold. Obesity has also dramatically increased among
children.
Cut the clutter,
not the cake
Knowledge
could help. Knowledge is disseminated through education, which empowers us to
make healthy decisions that produce positive change. But what are the facts?
Where’s the nutrition science? Where’s the knowledge?
Month
after month new diet and nutrition books achieve best seller status. The
information about what we should eat or not eat is endless. You might think
there’s a best approach—one that is supported by science and clinical research.
Follow the reasoning and all will be well. But that’s not the case.
When
it comes to diet and nutrition, not enough scientific evidence exists and
what’s available is often contradictory or too weak to refute extreme “theories.”
What’s touted as fact one month is disparaged the next. The scientific vacuum
is filled with advice from pundits, authors, celebrities, sports figures, and
YouTube “vloggers.” In the midst of this noise, people continue to gain weight
and lose their health. It’s a wellness and disease crisis, and it has a name.
“Syndrome X,” or metabolic syndrome
Obesity
is related to several cardiovascular risk factors collectively known as the
metabolic syndrome. The metabolic syndrome increases your risk for developing:
- Coronary heart disease
- Stroke
- Type 2 diabetes
- Cancer
- Alzheimer’s disease
The
combined costs associated with these 5 conditions amount to $1 billion of
healthcare spending and 4,000 deaths every
day!
What went wrong?
It’s
a complex issue. The answer to “what went wrong” may not yet be definitive
(more on that later), but simply put, Americans didn’t replace “fats” with
healthy alternatives. We replaced fat with carbohydrates. As it turns out, the
recommended increased intake of carbohydrates that America has enthusiastically
swallowed may be causing the “diabesity” epidemic.
The
problem with carbohydrates is that the body’s digestive and metabolic machinery
doesn’t distinguish between bread, corn, and candy. It all turns to sugar in
your blood. Sugar, as we are learning, is toxic.
When
fats were replaced with carbohydrates, we removed what turns out to be at least
a neutral macronutrient (in terms of disease-causing potential) with one that
is toxic and less filling. Because carbohydrates don’t satisfy us like fat does,
we eat more—more sugar and more calories.
Over a period of 40 years (1970 to 2010), American’s consumption has changed:
- 42% more calories from flour and cereal
- 23% more calories over all
Why did the
experiment fail?
In
his book The Omnivore’s Dilemma: A
Natural History of Four Meals, Michael Pollan advises, “Eat food. Mostly
plants. Not too much.” That’s probably good advice. I try to follow it. But the
scientist in me wants more. I want a strong hypothesis tested in well-thought-out
experiments, a theory based on robust, unequivocal results that withstand peer
review and, maybe in the end, solid advice. I’m dumbfounded that this isn’t the
case.
Back
to the question of what went wrong. America’s nutritional experiment failed
because it was not based on science, but on associations and suppositions
rather than irrefutable conclusions drawn from data generated by good science.
We
need good science to provide the facts that will be the basis of education
initiatives for the population at large and for patients already trying to cope
with chronic health conditions.
What’s next?
Answers.
We must combine top-notch nutritional science with robust clinical research.
That’s where the Nutrition Science Initiative (NuSI.org) comes in. It’s a
nonprofit effort that is willing to take the financial and technical risks that
are necessary to find the answers to “What should we eat?” Three clinical
trials are already underway.
Once
we have answers, we can educate and empower people, who will for the first time
make decisions about what they eat based on fact.