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by Manya Goldstein
December 11,
2018
from
Medium Website
Photo by Joshua Rawson-Harris
on Unsplash
Our modern food landscape is spectacular, isn't it?
Walk into the
average grocery store, and it appears as if you've entered food
nirvana. The aisles overflow with a dizzying array of items, from
Oreos and Cheez-its to Kashi and Greek yogurt.
The products call out
from their home on the shelves, singing masterfully-tailored appeals
to entice each kind of consumer.
Some might be captured by the
mouthwatering packaging, others by the impressive health claims… and
for a number of us, it's simply the memory of a taste we just need
to experience again.
There was a time, not too long ago, when the food we ate did not
come in a package.
Labels were non-existent, as were the complex
ingredient lists we're accustomed to today. We simply cooked and ate
real food. Yet those days are gone, replaced by the industrial food
complex that has embedded itself into the very fabric of American
life.
Our processed food products
- our chips and granola bars and
hummus packs - are just so convenient, so affordable and so
pleasurable that most people can't imagine life without them.
More than
60 percent of the American diet consists of highly
processed foods - foods that have been taken apart and put back
together again with various combinations of,
sugar, salt, oil and
additives...
It's no surprise that
junk food and frozen dinners fall
into this category, but many innocent-looking kitchen staples do as
well.
For instance, the majority of industrially-produced breads are
intricate concoctions of,
-
refined grains
-
sugars
-
emulcifiers
-
dough
conditioners
-
preservatives...
Oh, and we can't forget the
synthetic vitamins added back in to make up for the nutrients
stripped away during processing.
Two years ago, I didn't think twice about what I ate. Taste and
convenience guided my food choices above all else.
Like most
Americans, I thought orange juice and granola bars were healthy.
In
fact, I really knew nothing about nutrition except the adage that
fruits and vegetables are good for you. And why would I think twice
about food? I felt fine. No one ever told me to eat differently...
And
besides, everyone else was doing the exact same thing...
Quite simply, I was in for a rude awakening.
Just one month after I
entered college, I came down with a host of frightening symptoms
that began with near-fainting spells and progressed into a slow
breakdown of my autonomic nervous system.
This is the system
responsible for basically everything our bodies do without our
conscious control: heart rate, digestion, breathing, temperature
regulation… you name it.
I was diagnosed with Postural Orthostatic
Tachycardia Syndrome (POTS), a condition characterized by an
excessive jump in heart rate upon standing that really just means
your autonomic nervous system can't regulate circulation (and
usually many other of its necessary jobs).
The independence coveted by the average college kid took on an
entirely new meaning for me. I travelled from doctor to doctor
desperately trying to get my symptoms under control. Most offered me
a handful of drugs, which I gladly accepted.
The more knowledgeable
ones told me to increase my salt and fluid intake to expand blood
volume, exercise to improve vascular tone and buy compression
garments to help circulation.
But nothing worked. I hit rock bottom
the summer after my freshman year when I began having week-long
crashes of total nervous system shutdown.
I couldn't stand, walk,
breathe well, digest or even think. I felt like a half-conscious
shell of my former self, and no one knew what to do.
By the time a family friend recommended I see a holistic specialist,
I was willing to try anything. I walked through the clinic doors
with no idea what to expect and soon found myself standing in an
entirely new world of knowledge.
The specialist spoke about the body
as an interconnected system, influenced by everything from the food
we eat to the lifestyle we lead…
Wait, what? Back up a second. Our food choices can't really matter
that much, I thought.
I mean, c'mon, it's just food. And besides, I have a nervous system
problem. The doctors gave me a diagnosis; they say its chronic. I'm
just trying to control my symptoms a little better.
That's the end
of the story.
Looking back, this was a completely normal response for someone
growing up in conventional American society, eating conventional
American food and seeing conventional American
doctors.
No one talks
about the environmental factors that influence disease, most notably
the chronic conditions that dominate today's health landscape.
We
treat illness as an isolated problem with a corresponding
black-and-white solution.
"You have depression? Here is an
anti-depressant. You have Crohn's? Your immune system is
overactive. We'll have to control it with immuno-suppressants."
With chronic conditions ranging from asthma to allergies to
arthritis, there's rarely any talk of,
"Why is this happening?" and
certainly no discussion of "How can we reverse it?"
Therefore, it is only natural to react with disbelief
- and often
rejection - when introduced to this entirely new paradigm of
thinking about disease.
And that's just what I did.
It took me a solid six months of seeing the holistic specialist to
accept the fact that my everyday food choices directly affect my
health.
When people would ask me about POTS, I told them about the
holistic approach I was pursuing.
"I mean it makes sense that our
food and environment affect us," I would say.
But for a long time,
this was a half-hearted declaration, one that I did not entirely
understand or believe myself.
Even once I started researching for this project, it took me months
to internalize that food has well-established links to the leading
chronic diseases plaguing society, diseases like,
-
heart disease
-
cancer
-
Alzheimer
-
diabetes,
...that are responsible for
7 out of
10 deaths in America - and worldwide according to a
new Lancet
study.
The study was published ahead of a Sept. 27 meeting at the United
Nations General Assembly, which brought 500 experts together to
discuss the chronic disease epidemic.
Speakers repeatedly called for
action, declaring that 41 million people die each year from
preventable conditions.
In fact, research shows that diet is the
top risk factor for
mortality in our country...
What?! I simply couldn't believe that this was the case. Why don't
more people know how much food matters? Why don't doctors talk about
it? And most importantly, why aren't we doing anything to fix it?
But let's not get ahead of ourselves with too many questions.
I'd
like to return to the grocery store to unpack what's really wrong
with all of the processed food I grew up with - the food that simply
seemed too tasty and convenient to live without.
Part I - Unpacking Processed Food
So what's really wrong with processed food? I mean c'mon, it's just
food. It can't be that bad (i.e. Please don't take away my Oreos!)
The sad answer to that question is, well, almost everything...
Let's start at the very beginning with an ingredient so prized by
the food industry that they add it to
74 percent of their products.
It's something that practically symbolizes childhood, something so
soothing and sweet that we can always rely on it when we need a
friend.
Yup, you guessed it. It's sugar.
Sugar is magical - not only to children but to the food industry as
well. We all know that sugar makes things sweet. But did you know
that sugar can
enhance the flavor of savory foods? It can also
retain moisture, improve texture and act as a preservative, among a
number of other impressive feats.
The classic line is that sugar is "empty calories," but an
increasing number of experts are arguing that sugar's calories are
far from empty.
"Sugar is metabolized in the liver virtually identically to
alcohol," said Dr. Robert Lustig, a neuro-endocrinologist and
professor of pediatrics at the University of California San
Francisco.
Wait. Sugar is the same as alcohol...?!
We know alcohol is bad. We
would never give alcohol to kids, but we give sugar to them all the
time thinking it is harmless. How could this possibly be true?
We'll get there, but first we need a brief biochemistry lesson to
explain the sugar hypothesis.
Sugar is a type of carbohydrate called sucrose. Sucrose is made up
of two components:
glucose and fructose.
When we eat sugar, it gets
broken down into these two components. With me so far?
Great, so the glucose can be metabolized by all organs. That's all
that's important for now. The fructose, on the other hand, must be
processed by the liver.
Now, the liver can handle fructose in small
doses, such as the fructose that trickles in from a fiber-packed
orange. But the concentrated hit of fructose from sugar simply
overwhelms its capabilities.
The liver metabolizes as much as it
can, but it has no choice to convert the rest to fat. The fat builds
up around the liver, which impairs its functioning and leads to
insulin resistance.
It also gets transported out into the blood,
increasing visceral fat (the fat in our abdominal cavity) and our
cardiovascular risk.
Collectively, this cycle is known as
metabolic
syndrome, and it sets us up for a multitude of problems - including
those previously confined to adulthood.
"There are two
diseases that children never got before: Type II diabetes and
fatty liver disease," Lustig said. "Prior to 1975, those two
diseases were the diseases of aging and the diseases of alcohol.
Now kids get them."
How exactly do children get the diseases of alcohol without
consuming alcohol?
According to Robert Lustig, the answer is clear:
sugar...
The sugar hypothesis states that sugar causes insulin resistance,
which many experts believe lies at the heart of our chronic disease
epidemic.
Insulin is the fat-storage hormone released when we
consume carbohydrates. It pulls glucose out of the blood and into
our cells, keeping our blood sugar stable.
When we stop responding
to insulin, it sets off a cascade of detrimental consequences
throughout our bodies.
"We have an epidemic of insulin resistance, and it manifests itself
as obesity and diabetes and heart disease and cancer and Alzheimer's
and strokes.
This is the paradigmatic disease of Western diets and
lifestyles," said Gary Taubes, an investigative science journalist
and author of 'The Case Against Sugar.'
Lustig and Gary Taubes are among a new school of experts working to
combat the message that "a calorie is a calorie."
According to this
logic, obesity and related conditions such as diabetes stem from an
energy balance problem: too many calories in, not enough calories
out.
The food industry loves to promote the calorie hypothesis to
mitigate criticism. (In Lustig's words, "Don't blame our calories;
go blame somebody else's calories.")
However, the notion also
remains entrenched in the professional realm of nutrition.
"The world is full of
'scientists' who clearly believe a calorie is a calorie. I'd say
99 percent of the community thinks that it's all about energy
balance. " Taubes said.
"Clearly, the energy balance
story was the sugar industry's best friend - the gift that keeps on
giving. But had the scientists done their job, they would have
just dealt with it."
In their argument against the calorie hypothesis, Lustig and Taubes
explain that calories are metabolized differently in the body
depending on where they come from, and certain calories can make you
sick regardless of whether you are overweight.
In fact, up to
40
percent of normal-weight people have metabolic dysfunction, and 20
percent of obese people are healthy.
"What really bothers
me is that I majored in nutrition and food science in college
back in the 1970s, and I knew about nutritional biochemistry and
that different foods were metabolized in the body differently," Lustig said.
"Then I went to
medical school, where they beat it out of me.
They said,
'It's only about
calories'.
I actually practiced
that way for the first 20 years of my career, and then I started
doing the research to show that that actually isn't true."
As it turns out, not all calories are created equal
- and it appears
sugar may be the most harmful.
"Sugar's not
dangerous because of its calories or because it makes you fat.
Sugar is dangerous because it's sugar. It's not nutrition. When
consumed in excess, it's a toxin. And it's addictive," Lustig
writes in his latest book, 'The
Hacking of the American Mind.'
Sugar In the Brain
People may joke that they're addicted to chocolate or other sweets,
but there is actually research to back it up.
Photo by frankie cordoba
on Unsplash
When we eat sugar, it activates the brain's reward system and causes
dopamine - the pleasure neurotransmitter - to rise.
Neuroscientist
Dr. Nicole Avena explains that it's normal for dopamine to be
released when we eat new foods; it's an evolutionary mechanism that
helps us pay extra attention to determine if a food is safe.
However, the dopamine response should subside after repeated
exposure to the food.
Sugar, on the other hand, plays by different rules.
"Dopamine is released
in response to a sugar binge even when sugar is no longer a
novel food. It is as if the brain starts to treat sugar like a
drug," Avena writes in her book, 'Why Diets Fail,'
co-authored by John Talbott.
The biochemical reaction is so strong, it may be almost impossible
to resist sugar's call.
Rats will run
across an electric grid to
reach M&M's. They will even choose
sugar over cocaine when they are
already hooked on the powerful stimulant.
In its natural form, sugar is not addictive. Besides, it only exists
naturally bound up with fiber in fruits and some vegetables or as
honey guarded by bees.
As Lustig and his colleagues
put it,
"Nature made sugar
hard to get; man made it easy."
Only after sugar is refined does its addictive potential become
fully actualized, not unlike other drugs.
"Indeed, when sugar cane is crushed and drained of all its liquid
contents, boiled down to a syrup, shaken and then stripped of all
its vitamins, minerals and molasses, we are left with pure white
crystals.
This extraction and refinement process is similar to that
of other addictive white crystals, that is, cocaine from the coca
leaf, and opium from the poppy seed/pod," Dr. James DiNicolantonio
and colleagues write in a 2017 paper, 'Sugar
addiction: Is it real?'
And like these other "white crystals," we can build up tolerance to
sugar as our
dopamine receptors downregulate, requiring more input
to feel the same reward.
So that one piece of chocolate really might
not be enough.
Given sugar's addictive properties, some experts argue that it might
be almost impossible to moderate our intake.
"Trying to consume sugar in moderation, however it's defined, in a
world in which substantial sugar consumption is the norm and
virtually unavoidable, is likely to be no more successful for some
of us than trying to smoke cigarettes in moderation - just a few a
day, rather than a whole pack," Taubes
writes in The Guardian.
Safety First
But let's put sugar's addictive potential aside for a moment. How
much sugar is safe to eat?
Though the American Heart Association is not always known to give
the best dietary advice due to conflicts of interest - don't worry,
we'll get to them later - their sugar limits are a good place to
start.
The
AHA recommends that men consume no more than 9 teaspoons of
added sugar per day, and women consume no more than 6 teaspoons. For
children, the range is 3-6 teaspoons depending on their size.
Let's put that in perspective...
A 12-ounce can of Coke contains 39
grams of sugar, which is equivalent to 9.75 teaspoons. So if you
have a standard-sized soda, you're already over your daily
allotment. Don't even think about that Big Gulp.
Sugar is listed on nutrition labels as grams, but seriously who can
visualize that?! To convert grams to teaspoons, simply divide by
four.
And remember, sugar is added to 74 percent of processed foods, even
products marketed as healthy.
For instance, Tazo's organic chai latte contains 6 teaspoons of
added sugar. Perhaps you'd like to enjoy it with a serving of
Chobani strawberry greek yogurt, which has 4.5 teaspoons of its own.
It may sound like a healthy snack, but you'd already be well over
your daily limit. Sugar sure adds up fast, no?
In middle school, I used to trade my Oreos for a friend's LUNA
bar - not for health reasons per se, but I thought the protein bars
were healthy enough that they became my lunch staple for the next
five years.
It turns out that LUNA bars contain the same amount of
sugar as three Oreos. I should have just kept the cookies.
Perhaps the most surprising fact:
12 ounces of orange juice is
equivalent to over 8 teaspoons of added sugar even though all of the
sugar is natural.
Why? Juice lacks the essential fiber that eases
sugar's bombardment of the liver.
Food manufacturers excel at disguising sugar in their products.
There are
at least 61 names for sugar, from rice malt to dextrose to
dehydrated cane juice.
Why go to all this trouble? Because
ingredients lists are sorted by weight.
Even if consumers don't
understand how sugar affects their biochemistry, they might become
wary if sugar is the first ingredient.
To add to the confusion, manufacturers were not required to list
added sugars or their percent daily value on nutrition labels in
America until this year. The sugar industry naturally wasn't
thrilled with the decision, claiming it was based on "inadequate
scientific evidence."
Many products still do not feature the updated
labels, and it's no mystery why companies are stalling.
When we combine misleading packaging with sugar's addictive
potential - and its ubiquity in food products - it's no wonder that
the average American
consumes 19.5 teaspoons of sugar per day,
nearly 300 percent more than we should.
The Woes of Refining
Though sugar is a big problem in the world of processed food (some
would argue the biggest problem), there are many other areas of
concern worth our attention.
Photo by Kai Pilger
on Unsplash
Highly refined grains serve as the foundation of most processed food
items.
Not only does the refining process improve the shelf life of
products, it also enhances texture and appearance (think of white
bread). In doing so, however, it strips grains of essential fiber
and nutrients.
Food manufacturers are well aware of this, and so they add a handful
of synthetic B vitamins and iron back in
after processing.
In fact,
the USDA tells consumers,
"Check the ingredient
list on refined grain products to make sure that the word
'enriched' is included in the grain name."
The problem is that food is more than a few vitamins thrown
together.
"A whole food is a matrix of all these compounds and nutrients and
minerals and vitamins - thousands of substances that interact with
each other," said Kristin Lawless, a journalist and nutrition
consultant who recently published 'Formerly Known as Food.'
"If you add a
synthetic vitamin to, say, refined white flour, it is not going
to be as readily absorbed by the body or utilized in the same
way as if you ate the whole grain."
The loss of fiber in the refining process is perhaps even more
problematic because it cannot be added back in (though that doesn't
stop
some food companies from trying).
There are two primary types of fiber: soluble and insoluble.
As Lustig explains in his 2013 book
"Fat Chance," the two work together
to form a "gelatinous barrier" along our gut to slow the absorption
of food.
Just like the fiber in fruit slows the rate of fructose
hitting our liver, it also delays the absorption of glucose, which
in turn lowers our body's insulin response.
By regularly consuming
refined carbohydrates, we put our bodies on an insulin roller
coaster and set ourselves up for cravings, weight gain and metabolic
distress.
(Experts debate whether the primary driver of metabolic dysfunction
is sugar or sugar plus other refined carbohydrates. Clearly, more
research must be done, but our best bet for now is to limit both.)
But fiber is crucial for another reason: to feed our gut bacteria.
Our gastrointestinal tract houses trillions of microorganisms that
are collectively known as the "gut microbiota." They play a critical
role in maintaining our health, one that researchers are just
beginning to understand.
What we do know is that low bacterial
diversity has links to a range of health problems from autoimmune
diseases to inflammatory conditions, as Dr. Ana Valdes and
colleagues
outline in the British Medical Journal.
We also know that
a flourishing, diverse gut microbiota requires fiber.
Low-fiber
diets have been shown to reduce species diversity, which can
potentially worsen
from generation to generation.
"Fiber is probably the single most important factor driving the microbiota and health," said Maria Gloria Dominguez-Bello, a Rutgers
University professor of microbiome and health and fellow of the
American Academy of Microbiology.
"If we don't eat
enough fiber, we starve our gut microbes."
When we starve our gut microbes, many bacterial populations die off
and we're left with lower species diversity.
But it gets worse - the
microbes that do remain must eat their only available source of
food: our intestinal lining.
"When you starve the colon, the only microbes that can survive are
those that attach to our epithelium and feed on us, including mucus
degraders," Dominguez-Bello said.
The
mucus-protected epithelium serves as an important barrier to
keep our bacteria away from the intestinal wall.
When
mucus-degrading bacteria start feasting on it, our immune system
goes on hyperdrive, resulting in chronic inflammation that can also
contribute to the progression of disease.
If we don't feed our body right, it will quite literally eat us.
The bottom line is that:
However, our processed food landscape gives us the illusion of
diversity.
Grocery stores are filled with countless variations of
breads, pastas, snacks and desserts.
Though they appear different on
the outside, these products are largely variations of the same raw
materials dominated by corn, soy, wheat, sugar and vegetable oils.
"All of these foods are chemically similar, but sensorally they are
not," Dominguez-Bello said.
In other words, our senses tell us that we are eating a variety of
foods.
It appears as if our options are endless when we walk through
the grocery store aisles. But at the end of the day, it is all an
illusion - one that the food industry excels at creating.
Greasy Business
Apart from sugar and refined grains, vegetable oils represent
another fundamental pillar of the processed food industry. For
years, we've been told that vegetable oils are a healthier choice
than saturated fat, which was said to cause heart disease.
Though we
now know that saturated fat has
no connection to cardiovascular
risk, the dogma became so embedded in the public health community
that it is still echoed to this day. (Don't worry, we'll fully
examine the fat debacle later on.)
Vegetable oils are highly processed oils extracted from seeds such
as corn, rapeseed, sunflower and, most notably, soybeans.
According
to food author Michael Pollan, 75 percent of the vegetable oils we
consume are derived from soy.
But making vegetable oils is no easy task. Seeds are quite different
than olives which "ooze with oil," as Melanie Warner writes in
"Pandora's Lunchbox."
In fact, she refers to soybean oil as a
"complex, high tech product" before outlining the lengthy process it
entails.
To extract the oil, manufacturers use a harsh chemical solvent known
as hexane. (Indeed, Warner explains that it is so harsh, factories
must be explosion proof.) The oil is then treated with more
chemicals, bleached and deodorized at 500° degrees.
But that's the
short version...
As Warner writes:
"At long last, after multiple rounds of heating,
chemical treating, centrifuging, filtering, washing, and vacuuming,
the soybean oil - clear, odorless, nearly nutrient-free - is edible,
ready to be pumped into eight-thousand-gallon tanker trucks and
shipped off to customers across the food industry."
This process results in a highly unstable oil, which was not very
stable to begin with since it is a polyunsaturated fat.
From a
chemistry perspective, polyunsaturated fats oxidize much faster than
saturated or monounsaturated fats since they contain multiple double
bonds.
"Each bond provides an additional opportunity for the fatty acid to
react with the air, so the oils oxidize - and go bad quickly,"
science journalist Nina Teicholz writes in 'The Big Fat Surprise.'
Alright, so we know that vegetable oils are quite fragile, to say
the least.
What happens when we add heat to the mix?
According to
researchers, the picture gets ugly very quickly.
"Heat degrades polyunsaturated fatty acids to toxic compounds," De
Montfort University professor Martin Grootveld and colleagues state
in
a report published in Foodservice Research International.
According to the report, the toxic oxidation products may lead to a
number of problems ranging from birth defects to cancer.
In restaurants, oxidation products emitted from the fryers' mist
build up as "thick gunk" on all cold surfaces, Teicholz writes. The
toxic compounds are so unstable, she says worker uniforms have been
known to "spontaneously combust" in the dryer.
Vegetable oils don't seem so innocent after all.
As if that's not enough, this processed food staple poses another
problem:
they throw off our omega-3 to omega-6 balance.
Omega-3 and omega-6 are essential fatty acids that have historically
existed in a 1:1 ratio. The ratio is
now 20:1 or higher thanks to
changes in diet, most notably our increased consumption of vegetable
oils rich in omega-6 fats.
But why does this matter?
Experts say that a skewed fatty acid ratio
can promote inflammation throughout our bodies.
"The imbalance between these two types of fatty acids will push us
toward a pro-inflammatory state," said Todd Robinson, a naturopathic
doctor and owner of Wellness Working Group.
He explains that a diet filled with whole foods
- like fish and
vegetables and nuts - tends to be omega-3 rich, whereas the standard
American processed food diet tends to be omega-3 poor.
At the same
time, our modern diet provides a hefty dose of omega-6's, pushing
our ratio toward the pro-inflammatory side.
"As with most areas in biologic systems, it's about the balance,"
Robinson said.
"We are supposed to
mount an inflammatory response if we get injured; that's part of
how our body heals. The problem is chronic, unchecked
inflammation, which contributes to conditions like heart disease
and dementia and diabetes.
If people eat a diet
that helps their bodies maintain a natural inflammatory balance,
they are going to be healthier in the long run."
Adding or Subtracting?
Whenever I make a passing comment about food safety, I almost always
receive a variation of this response:
"Oh, I'm not worried, I'm sure
there are regulations."
Unfortunately, our sense of security turns
out to be misplaced.
There are over 10,000 substances directly or indirectly added to our
food, according to
a 2011 report led by chemical engineer
Thomas Neltner.
Direct food additives include everything from emulsifiers
and preservatives to colors and flavorings.
The food industry relies
on them to keep products fresh, consistent and appealing to both our
eyes and taste buds. Indirect additives are the substances that come
into contact with our food during processing and packaging, such as
plastics and lubricating oils.
They do not have to be listed on
labels, though they can leach into food.
Photo by NeONBRAND
on Unsplash
Most people are unaware that the Food and Drug Administration does
not perform safety testing.
Rather, the companies themselves are
responsible for assessing the safety of their products.
"The manufacturers are the ones doing the safety testing in their
own laboratories with their own hired scientists," journalist and
nutrition consultant Kristin Lawless said.
To top it off, the system is entirely voluntary.
If companies don't
want to notify the FDA about their ingredients, they have no legal
obligation to do so.
"The chief problem with the food-additive self-regulation is that it
provides no incentive for either the industry or the government to
do - or even to review - the difficult and often expensive studies
that might result in bad news," Warner writes in 'Pandora's
Lunchbox.'
So when researchers dug deeper into the data on food additives, it's
no surprise the results were concerning.
One evaluation found that
most additives in our food supply have not been adequately tested
for safety.
"Almost two-thirds of chemical additives appear to have been
declared safe for use in food without the benefit of being fed to an
animal in a controlled toxicology study," the researchers state
in a
2013 paper published in Reproductive Toxicology.
Even if all food additives were properly tested for safety, it still
doesn't take into consideration cumulative or synergistic effects.
We rarely consume additives in isolation; rather, we receive a
diverse chemical cocktail when we eat processed foods. According to
the American Academy of Pediatrics,
chemical exposures can interact
with each other and interfere with similar biological pathways.
Therefore, it is crucial for regulators to take these considerations
into account.
So far, we've examined a number of problems with processed
food - from the sugar to the lack of fiber and nutrients, from the
vegetable oils to the chemical additives.
Still, one question
remains:
Part II - Processed Food Takeover
Given the thousands of products in our grocery stores, it might be
hard to believe that processed food is a relatively new phenomenon.
Its story goes back to the early 1900s, but it didn't truly take off
until post-World War II when the food industry began persuading
women to forgo traditional cooking.
"The food industry launched this huge campaign to get women to bring
their products into the home," Lawless said.
"They were marketed
as 'liberation for women!' and 'freedom from the kitchen'!"
In "Pandora's Lunchbox," Warner describes how the industry's
advertising tactics were not immediately successful. Yet within a
decade, their "exhortations to abandon the kitchen" took hold and
industrial food started to change our entire way of eating.
"They became part of a family tradition in place of traditional
whole-food cooking," Lawless said. "The industry embedded their
products into the culture, into the home and made them
completely normalized."
As technology expanded, traditional marketing gave way to more
advanced tactics to further embed industrial food into our lives.
In his exposé "Salt, Sugar, Fat," Michael Moss outlines how today's
food manufacturers capitalize on the latest science to enhance the
appeal of their products.
He describes how companies hire
highly-trained food scientists to calculate the "bliss point" of
sugar and manufacture the perfect "mouth feel" to optimize the "crave-ability" of their products. (They avoid the term
"addictive"
like the plague.)
Moss writes:
"[The products] are knowingly designed
- engineered is
the better word - to maximize their allure. Their packaging is
tailored to excite our kids.
Their advertising
uses every psychological trick to overcome any logical arguments
we might have for passing the product by. Their taste is so
powerful, we remember it from the last time we walked down the
aisle and succumbed, snatching them up.
And above all, their
formulas are calculated and perfected by scientists who know
very well what they are doing."
Photo by Fancycrave
on Unsplash
Surprisingly, federal policies also helped to facilitate the
takeover of processed food by subsidizing the food industry's main
ingredients - most notably, corn and soy.
"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,"
Michael Pollan writes in his 2008 book, 'In Defense of Food.'
We've already mentioned that 75 percent of our vegetable oils come
from soy, but so do a myriad of food additives from thickeners to
stabilizers (think of soy lecithin that is found in most
chocolates).
Along the same token, Pollan writes that more than half
of our sweeteners come from corn.
Corn can also be broken down into
its own bundle of additives including emulsifiers, flavorings and
even synthetic vitamins.
"Products infused with corn and soy additives line our grocery and
pantry shelves - breakfast cereals, baked goods, candy, frozen
desserts, ketchup, dressings and sauces are a few household
favorites," researchers
write in a 2013 U.S. Public Interest
Research Group report.
The report states that crop subsidies favor
"junk food production"
over fruits and vegetables, which receive only one percent of
federal payments.
To illustrate, the authors directly compared
apples to a timeless American processed food item:
the Twinkie.
"Of the 37
ingredients in a Twinkie, taxpayers subsidize at least 17,
including corn syrup, high fructose corn syrup, vegetable
shortening and cornstarch."
If the money had gone directly to taxpayers, the authors calculated
that the apple subsidies would enable each person to buy half an
apple each year.
Yet they could afford almost 20 Twinkies with their
junk food subsidies.
"Rather than reflecting our nation's established health priorities,
these subsidies mirror a pattern of special interest influence. With
childhood obesity rates worryingly high, this use of taxpayer
dollars thwarts common sense.
Almost any other conceivable use would
be a wiser investment," the report concludes.
Yet despite all of these factors, we have to dig a bit deeper to
fully understand the takeover of processed food.
Besides, doctors
and public health officials should have eventually caught onto the
health risks and started speaking out against the food industry and
federal policies.
Why didn't this happen?
Industry and Institutions
The food industry has not only managed to embed itself into
consumers' lives but into the professional health realm as well.
The Academy of Nutrition and Dietetics (AND) is the world's largest
association of nutrition professionals.
They claim to be,
"committed
to improving the nation's health and advancing the profession of
dietetics through research, education and advocacy."
However,
according to
a 2013 report by public health lawyer
Michele Simons,
the AND boasts nearly 40 food industry sponsors that include,
-
Coca-Cola
-
PepsiCo
-
Kellogg
-
Mars
-
General Mills
The industry sponsors run many programs, including continuing
education courses for dietitians.
The problem is that the food
industry is not,
"in the education business," as Simon puts it.
"It's in the selling-more-food business."
Therefore, companies hire seemingly credible experts to teach biased
material that supports their aims. Simons described a Coca-Cola
webinar taught by a Harvard professor who attempted to neutralize
concerns about sugar, calling them "urban myths."
Hershey sponsored another continuing education opportunity that
brought nutrition professionals to their Pennsylvania headquarters
for a full-day workshop.
"To cover up the fact that nutrition professionals were visiting a
candy store, the event was called 'From Nature to Nutrition: A
Hands-on Exploration of Natural Cocoa from the Bean to Health
Benefits,' and was listed in the program as 'Planned with Academy
Partner: Hershey Center for Health & Nutrition'," Simons writes.
The AND's deep corporate ties are perhaps best illustrated at the
organization's annual expo.
Though more than 300 vendors attend the
event, Simon says junk food companies dominate the floor.
"It's a truly surreal experience just to walk into the expo hall,"
she writes.
"You know it's
supposed to be a nutrition conference and yet it feels like a
food industry event. Junk food expo is really the best
descriptor."
Industry even influences science itself.
Science journalist Nina Teicholz explained to me how the food and pharmaceutical industries
fund university scientists and departments, underwrite scholarships,
endow chairs, sponsor conferences… and the list goes on.
"It's pretty much endless," she said.
In her research, Teicholz has found that the largest influence comes
from the vegetable oil industry.
In fact, there has only been one
conference dedicated to the potential harms of vegetable oils,
despite the mounting evidence against them, because no one will
sponsor the topic.
"If there is no conference to bring people together, if there are no
conversations, there is no air for an idea to breathe and grow," she
said.
What's more, the vegetable oil industry practically launched the
American Heart Association (AHA) itself.
Teicholz said the office of
cardiologists remained small and underfunded until 1948. (Besides,
cardiology was a new profession since heart disease had been quite
rare until a few decades before.)
She explained how Procter &
Gamble, the inventor of vegetable oils, changed everything when they
chose the AHA to be the beneficiary of their popular radio contest.
"The American Heart
Association, in their official biography, writes that millions
of dollars flowed into their coffers and they were transformed
practically overnight into the national powerhouse that they are
today, opening offices across the country and really becoming a
force in public health," Teicholz said.
Procter & Gamble continued to support the association (along with
many other food giants).
Then in 1961, the AHA became the first
group in the world to recommend that we limit saturated fat and
cholesterol - and consume vegetable oils instead.
Photo by José Ignacio Pompé
on Unsplash
Teicholz emphasizes that we should not solely blame industry for
this very misguided nutrition advice.
Rather, our demonization of
fat stems from scientists who fervently believed it drives heart
disease.
It all began in the 1950s when University of Minnesota physiologist
Ancel Keys drew a simple line of causation from the fat we eat to
the cholesterol in our blood to heart disease, thus becoming the
father of the diet-heart hypothesis.
"This connect-the-dot
exercise in 1952 was the acorn that grew into the giant oak tree
of our mistrust of fat today," Teicholz writes in
her book 'Big Fat Surprise.'
Keys' hypothesis was just an idea, yet it became accepted as truth
before being properly tested in clinical trials.
Once the diet-heart
hypothesis became institutionalized by the American Heart
Association and the National Institute of Health, Teicholz said it
became almost impossible to change.
"Scientific institutionalization is almost an oxymoron," she said.
"Science requires
that one be self-doubting, nimble, able to change according to
new scientific observations. Institutions require just the
opposite: they require constancy to not lose the faith of the
public."
So despite the fact that billions of dollars of research over the
following decades could not prove the diet-heart hypothesis, it
remained entrenched in dietary policy and the minds of countless
scientists.
"The idea, like DNA,
has been carried from one generation to the next of scientists
who have committed their entire careers to those beliefs," Teicholz said.
"The critics were
silenced, and the next generation of researchers learned to
self-censor."
The U.S. dietary guidelines still recommend that we limit saturated
fat and consume vegetable oils instead.
They backed away from their
caps on cholesterol in 2015 but issued no announcement to inform the
public.
"This was one of the
pillars of dietary advice for the last 60 years, and they
dropped it by a single sentence in a nearly 400-page document
without any explanation," Teicholz said.
Teicholz explained that the U.S. dietary guidelines are enormously
powerful since they serve as the backbone of our country's nutrition
policy.
They dictate what is included in all federally-funded food
programs, such as school lunches and military rations.
They also are
downloaded by healthcare professionals, societies, hospitals and
clinics across the country, forming the basis of their dietary
recommendations.
"The guidelines are a
more powerful lever on what Americans eat than any other single
document in the country," Teicholz said.
Therefore, if any document should be based on the best possible
evidence, devoid of all scientific and industry bias, it should be
our dietary guidelines.
However, experts say this is not the case.
"Unfortunately, the current and past U.S. dietary guidelines
represent a nearly evidence-free zone,"
writes Dr. Steven Nissen,
chairman of cardiovascular medicine at the Cleveland Clinic in Ohio.
Experts like Nissen and Teicholz argue the guidelines are based on
weak observational data, not high-quality randomized controlled
trials that form the gold standard of scientific research.
"There is nothing evidence-based
- that is, based on rigorous
clinical trials - in the guidelines. It's all based on weak
epidemiological data, in many cases contradicted by more
rigorous science," Teicholz explained in an email.
Given that our top dietary recommendations are rooted in poor
science, it is any wonder that our population is so unhealthy - and
so confused about what to eat?
Part III: Missing the Mark in Treating Chronic Disease
Chronic diseases utterly overwhelm our medical system, accounting
for
86 percent of healthcare spending.
Sixty percent of adults have
one chronic disease, while over 40 percent suffer from multiple
conditions. Simply stating we have a chronic disease epidemic feels
like an understatement.
Hold up. We live in the 21st century, an era of cutting-edge science
and medicine.
Shouldn't we be able to stem the tide of illness?
Why
is the chronic disease epidemic just getting worse?
Quite simply, conventional medicine lacks the tools for the job.
The conventional medical framework looks something like this: you go
to the doctor with a complaint. The doctor listens to your symptoms
and prescribes a medication, usually
within a 15-minute window.
"This is what we're trained to do during medical school," said Dr.
Beth Frates, a Harvard Medical School professor and expert in
lifestyle medicine.
"It's comfortable and
reliable, and it's what the patient is expecting."
The problem is that while medications might help control the
symptoms of chronic conditions, they do nothing to reverse their
progress. Hence, chronic diseases - ranging from heart disease and
diabetes to Alzheimer's and cancer - account for
7 out of 10 deaths
in our country.
This is a tragic state of affairs, given that these conditions are
largely preventable.
Beth Frates said researchers debate what percentage
of chronic diseases could be avoided, but she believes it falls
somewhere around 80 percent.
"The number is debatable in terms of how much of chronic disease is
preventable, but what is not debatable is that changing your
lifestyle can treat - and in some cases, even reverse - your
disease."
This is an extraordinary concept, one that I didn't believe myself
when introduced to it for the first time.
I thought that if we can
truly prevent and even treat disease through lifestyle changes,
surely more people would know about it. It took several months of
sustained dialogue with a holistic practitioner for me to start
shifting my rigid mindset, a mindset I had developed over 20 years
of living a conventional American life.
To truly understand the power of lifestyle medicine, we need to take
a brief look at the developing field of epigenetics. Epigenetics
explains how environmental factors can influence gene expression and
thus have profound implications for our health.
In other words, we are not merely our genetic code.
We are the
totality of our everyday life choices - from the realm of food and
exercise to sleep and stress - that turn on or off our genes.
Frates says we must teach patients that their genes are not their
destiny. Just because your parents had heart disease or diabetes
does not mean you are doomed to the same fate.
She believes doctors
must explain the impact of our lifestyle choices and empower
patients to take control over their health.
"We need to focus the majority of our attention on the possibility
of beating disease with prescriptions for exercise, nutrition, sleep
and stress management," she said.
So why don't doctors talk about lifestyle factors?
There are a
number of reasons, from lack of training and time to the very
incentive structure of our healthcare system.
Still, many doctors
feel that patients simply don't want to hear it.
"A lot of physicians don't believe that patients will actually
change. In my experience, many of them have a defeatist attitude, so
they feel as though they're wasting their time if they talk with
patients about lifestyle," said Todd Robinson, a naturopathic doctor
and owner of Wellness Working Group.
Changing habits takes work. It's much easier to pop a pill.
At the
end of my first neurology appointment, the doctor asked how I felt
about being diagnosed with POTS. I said I felt fine…as long as there
was a medication to take.
We live in a quick-fix culture, and sometimes the quick fixes appear
to work. However, it has become clear that we cannot medicate our
way out of the chronic disease epidemic.
Lifestyle medicine is not only more effective than conventional
methods for treating many chronic diseases, it is also incredibly
empowering. When I learned that I could take action to help me feel
better, it was a turning point in my condition.
I realized that I
did not have to surrender my life to the whims of the doctor or the
disease. I could take control.
"Clients feel empowered by natural medicine," Robinson said.
"That empowerment in and of itself is medicinal."
But in order to successfully change their lifestyles, people need
more guidance than a 15-minute appointment allows.
It's not enough
for a doctor to say,
"You need to work on your diet and incorporate
some exercise and stress reduction into your day."
Most patients
require a greater degree of support.
"The work I do with my clients has shown me that people need a lot
more to effectively make changes. They need more information, more
guidance, they need more ongoing support if there is going to be any
real change," Robinson said.
It is crucial to note that not all chronic diseases can be treated
by lifestyle measures alone.
Todd Robinson, who specializes in cancer
treatment, believes in an integrative approach that unites the best
of both conventional and natural medicine.
He explained that natural
approaches are gentler and less potent than conventional treatments;
therefore, stronger interventions are sometimes necessary.
That
being said, he does not want to minimize the impact of lifestyle on
our health.
"I have seen people reduce or eliminate their need for some
medications - for hypertension, diabetes, dyslipidemia, rheumatoid
arthritis, etc. - through diet and lifestyle change," Robinson said.
"The impact of
lifestyle on all disease is profound, even cancer."
Frates says that most of the research on reversing chronic disease
centers around diabetes and heart disease.
While the data is less
substantial for other conditions, many doctors describe patients
dramatically improving after switching to a non-processed, whole
foods diet.
"I cannot tell you
how many stories I get from people who changed their diet and
tell me their eczema has gone away, or their allergies have gone
away, or their GI distress has gone away, or their irritable
bowel has gone away," Lustig said.
***
Now that we have a deeper understanding of why diet matters, let's
return to the world of processed food.
What can we do to safeguard
our wellbeing and ensure that we don't wind up as just another
chronic disease statistic?
In practical terms, the answer is simple:
Eat real food...
Banish as
much processed food as you can from your kitchen.
Learn to cook
delicious meals from real ingredients, not those found in a package
or box.
Photo by Brooke Lark
on Unsplash
Yet while our individual choices yield tremendous power, it will
take much more to fully transform our food environment.
-
What about
the countless Americans who do not have access to fresh fruits and
vegetables?
-
Or the children who never learned how to cook and so
are - as Dr. Robert Lustig puts it - hostage to the food industry
for their entire lives?
-
Or the millions of individuals fed
inaccurate nutrition advice thanks to bad science and bad
journalism?
There have been many solutions tossed around the public health
community:
-
remove subsidies for commodity crops like soy and corn
(and
perhaps subsidize produce)
-
regulate food marketing
-
tax sugary
drinks
-
get junk food out of schools and hospitals
-
teach kids how
to cook in home economics courses,
…and the list goes on.
In short, transforming our food environment will require a complete
system-wide overhaul.
It will require us to start prioritizing
health over profit, placing long-term considerations over short-term
gain. It will require doctors to start discussing food and patients
to really listen.
It will require that we return to our kitchens,
rediscovering the joy of preparing wholesome meals for ourselves and
our families.
But while all of these political and cultural considerations can
threaten to overwhelm us with their complexity,
-
we can take solace
in the fact that we have power
-
we don't have to wait for the
government or industry or society to turn around
-
we can take
control over our health each and everyday,
...with the basic decisions
of what we eat for breakfast, lunch and dinner...
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