End the Diet Debate
We already know what to do
The knowledge I gained from a science education and 20 years of experience as a nutritionist is of little value in a culture where people want quick fixes and everyone is an expert. In 2018, the diet and weight loss industry was worth $72 billion. That’s nearly equal to the U.S. federal budget for the Environmental Protection Agency, NASA, conservation of natural resources and the National Parks, the National Science Foundation, and the Department of Energy combined.
Americans are desperate for help and willing to try anything. I appreciate why people are drawn to the latest and greatest, especially when [insert diet] (paleo, intermittent fasting, keto, low-glycemic, gluten-free, local, vegan, other) is working for someone they know and have reason to trust. The sense of community and support that comes with following a particular diet can be very helpful.
The medical community has little to offer in the way of effective and lasting help. The U.S. model for healthcare is based on illness and disease. In many cases, my patients can’t use their health insurance for nutrition therapy until they’re sick. We spend zero on prevention and few medical professionals have the depth of knowledge, and skill required in nutrition science to be helpful.
Heart disease and cancer remain the top two killers in the U.S., with diabetes, stroke, and hypertension in the top ten. We move so little, research labs now study the effects of being sedentary on the human body and brain. A lack of walkable, bikeable, and safe communities contributes greatly, as does the war on public transportation.
A majority of institutional foodservice operations are flat out harmful. Our childcare centers, schools, prisons, and hospitals, serve meals that make us sick and keep us sick. Mental health care programs often serve food that prevents patients’ guts from healing, very likely impairing their body’s ability to make the chemicals they need to recover. The day food and nutrition services were expected to generate revenue, was the day things went terribly wrong.
Time, energy, and money spent trying to combat the food and beverage industry is an utter waste. The food and beverage industry has never been about nutrition, wellbeing or food. It’s about sales. Let that be very clear.
Time and energy spent circumventing the current state of politics to repair the Farm Bill? Yes. Honest and effective policy is desperately needed, but we are past that. The political will required to affect change is non-existent. For the optimist, I point you to well-conceived policy recommendations on food as medicine from the Friedman School of Nutrition Science and Policy at Tufts University. This document describes policy change that would make our entire food system more sustainable, nutritious, and fair. It also addresses military readiness, healthcare costs, and social disparity. Tufts will be presenting their solutions at the 50th Anniversary of the White House Conference on Food, Nutrition, and Health on October 3–4, 2019.
Americans do more, try more, and spend more on health and fitness with disheartening results. We condemn the obese for eating cheeseburgers and believe thinness and health are synonymous. We blame individuals even though our environment and culture cause harm. Our ability to cast shame is epic. Dieting as an intervention for weight loss is an abysmal failure. It is well understood that human biology works against weight loss efforts. Yet, we continue to espouse personal responsibility knowing health is not determined by size or appearance, or one cheeseburger. If you think this, you’re part of the problem.
To all of this, I call bullshit.
I say please stop spending excessive amounts of time thinking about your body, food, and exercise. Please stop listening to everyone else talk about their latest diet, exercise program, or how much they loathe their own body. Please don’t spend your hard-earned money on the next thing. Please stop consuming toxic media. Please stop being unkind to yourselves and others.
Please stop discussing, debating, and researching the optimal human diet. We already know what it is. What is most important, and this is well researched, is the pattern of your dietary choices over time. This has been observed in Seventh Day Adventists, Okinawans, Sardinians, people from the Mediterranean, and those who follow the DASH diet (Dietary Approaches to Stop Hypertension) in the United States. They are variations on a theme.
Seventh Day Adventists are primarily vegetarian and avoid processed foods. Okinawans include nutrient-rich starches like legumes and sweet potatoes with a high carbohydrate to protein ratio. Sardinians include plenty of legumes, goat’s milk, and cheese made from grass-fed sheep. The Mediterranean diet includes plant fats (nuts and oils) and fish, as well as pasta and bread. The DASH diet is low in sodium and emphasizes vegetables, fruits, low-fat dairy foods, and moderate amounts of whole grains, fish, poultry, and nuts.
There is more nuance and depth to each diet and culture than described here, but they share two important things. Meat is served as an accent or not at all, and vegetables are consumed in abundance. These groups share other beneficial behaviors like rich social connections, gardening and walking, adequate sleep, and relaxation. Combined, these are powerful antecedents to living well and eating well that requires no further debate.
Instead, do three things.
Eat your vegetables. There are no weight-loss diets, popular health diets, or evidenced-based recommendations by national health organizations that do not include eating an abundance of vegetables. There should be no comments to the contrary. Half a plate twice per day. Get them in however you can from the sources most available to you. Frozen works just as well as fresh. That’s it. The rest is noise.
Cook at home. This will not be easy. This requires opting out of 60 hour work weeks for some. For others, it means learning new skills. For others still, it will require banding together as friends and family to make eating at home more possible. Some of us live with very difficult circumstances, work 2 or 3 jobs, or provide care for loved ones on top of everything else. Do your best.
Eat real, whole food which I define as food grown and harvested as it was intended and anything prepared with a few simple ingredients. Whole real food is loaded with the kind of nutrition and live microorganisms human beings thrive on. By default, this results in the avoidance of preservatives, dyes, gums, excess sodium, trans fat, and products otherwise devoid of nutrition. I refer to the latter as not food.
Lastly, approach food and nutrition with a sense of curiosity, flexibility, and compassion. There is no such thing as perfect eating. In fact, it’s contraindicated for health and wellbeing. Dieting, over-exercising, and excessive worry are distractions that prevent you from spending time on the things that matter most to you.
Spend an appropriate amount of time and energy attending to self-care. Yes, plan and prepare nutritious meals. Move your body in a way that brings you joy and fitness. When eating or exercise becomes a source of stress and anxiety, this may be a sign that something else needs attention. If this describes you, please seek the advice of a therapist or medical professional experienced in this area.
Is eating this way and cooking at home possible? I mostly hear it isn’t.
The ability to grow and access safe and nourishing food remains an issue of social justice. Growing food in a way that restores the land, keeps water clean, and nourishes people is daunting, leaving many farmers broke and without health insurance. Accessing that food can be just as difficult.
But on these points, I have hope.
