Thursday, September 4, 2014

Are You What You Eat?

Gene Lysko
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.

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