Articles

What’s for Dinner?

Diet advice changes so fast it’s almost a full-time job to keep up with it. Avoid cholesterol; no, avoid saturated fats; no, avoid trans-fats. Avocados are bad; no, avocados are good. Wheat germ is passé; now omega 3s are de rigueur. The supermarket overwhelms us with an embarras de richesses, a confusing superabundance of choices from “organic” to low-sodium. How can we decide what to have for dinner?

Michael Pollan, the author of An Omnivore’s Dilemma, has written a new book: In Defense of Food: An Eater’s Manifesto. He argues for a simplification of diet advice. He hones it down to seven words: Eat food. Not too much. Mostly plants.

When people from traditional cultures adopt Western lifestyles, they become more likely to develop “Western diseases”: obesity, diabetes, cardiovascular diseases and cancer. Pollan blames the Western diet: processed foods, lots of meat, refined grains, chemicals, industrial production methods, monocultures, a superabundance of cheap calories from sugar and fat, and a narrowing of biological diversity. Lots of everything except vegetables, fruits and whole grains.

We realize our diet is not optimum and we are forever trying to do better, but we’re not succeeding very well. We’re overfed and undernourished. Pollan calls it the American paradox: we are obsessed with eating the right foods, yet we are getting fatter and less healthy.

We have been bamboozled by “nutritionism” – the idea that food can be reduced to a mixture of identifiable nutrients, that we can’t be trusted to eat right without scientific help, that we should choose foods to make us healthy rather than to provide pleasure (which fits right into the time-honored guilt trip that anything that feels good must be bad).

Nutrition science is notoriously fallible: it’s impossible to do an accurate controlled long-term study comparing two diets because you can’t trust people to accurately report what they eat, and you can’t hope to randomize and get adequate cooperation. Science can never be absolutely sure it has identified every nutrient important to health. We test what we can isolate and test: when we learned how to identify cholesterol we did lots of cholesterol studies. When we discovered trans-fats we did trans-fat studies. Foods have too many ingredients to test them all separately even if we knew what they all were. 35 antioxidants have been identified in thyme alone, from apigenin to ursolic acid. Even if you could test each ingredient, you couldn’t be sure combinations of ingredients don’t act in unexpected ways – turning the expression of a gene on or off, interfering with each other’s absorption, synergizing for good or bad.

The good news is

…we can enjoy thyme in the knowledge that it probably doesn’t do any harm (since people have been eating it forever), and that it might actually do some good (since people have been eating it forever), and even if it does nothing at all, we like the way it tastes.

The Lipid Hypothesis

The lipid fiasco started with the idea that a diet high in meats and dairy foods was associated with heart disease. In 1977, a congressional committee called for Americans to cut down on their consumption of red meat and dairy products. That didn’t go over well with the meat and dairy industries, so the recommendations were re-written advising us to choose foods that will reduce cholesterol and saturated fat intake. We succeeded entirely too well at getting that message across. A recent survey found that many Americans thought a no-fat diet was healthier than a low-fat diet. They didn’t realize that fat is essential to health, and that fat-soluble vitamins depend on it. We don’t get enough vitamin A and D as it is. So what did we do? We added those vitamins to processed foods.

Remember when fake foods had to be labeled “imitation”? No longer. Now they needn’t be labeled as imitation as long as they are “nutritionally equivalent” – so fats in sour cream can be replaced with hydrogenated oils or guar gum or carrageenan, and bacon bits can be replaced with soy protein without being considered fake. But they are still fake. A rose by any other name…

We substituted margarine for butter to avoid cholesterol, only to realize belatedly that the trans-fats in margarine were far more dangerous. Oops. We reduced the percentage of fat in our diets, but we ate more carbohydrates and ended up eating more total calories. Double Oops.

We’re finding that controlling fats in the diet makes very little difference in the risk of heart attacks for most people. We still recommend it for patients at high risk, but it was a mistake to try to change the diet of the whole population. We didn’t foresee all the consequences. People got fatter. We only made things worse.

The Carbohydrate Hypothesis

We needed a new villain: enter the carbohydrate hypothesis. Gary Taubes wrote Good Calories, Bad Calories to try to convince us that heart disease, obesity, cancer, diabetes, and a lot of other ills could all be blamed on refined carbohydrates. Pollan thinks Taubes left his skepticism at the door when he pinpointed one culprit. He says

Taubes is so single-minded in his demonization of the carbohydrates that he overlooks several other possible explanations for the deleterious effects of the Western diet, including deficiencies of omega-3s and micronutrients from plants. He also downplays the risks (to health as well as eating pleasure) of the high-protein Atkins diet that the carbohydrate hypothesis implies is a sound way to eat.

Organic is Not Always Better

As Pollan pointed out in his previous book, “organic” has been industrialized and hyped to make it seem better than it really is. The “organic” designation is no guarantee of freshness, quality, or safety; and in some cases it is even worse for the environment. Sometimes you’re better off buying local produce that is fresher, hasn’t required fossil fuels for long-distance transport, is grown by an environmentally conscious small farm, but isn’t technically “organic.” He recommends shopping at the farmers’ market and asking the farmer about his methods.

What to Eat

Pollan’s book ends with long lists of practical advice, such as:

• Don’t eat anything your great-grandmother wouldn’t recognize as food (non-dairy creamer?)
• Avoid food products with ingredients that are unfamiliar, unpronounceable, more than 5 in number, or that contain high-fructose corn syrup (none of these is necessarily bad in itself, but they raise red flags).
• Avoid food products that make health claims. Broccoli and tomatoes are silent. If a product needs to crow about being healthy, chances are it isn’t.
• Shop the periphery of the supermarket where the fresh food resides
• Get out of the supermarket and shop at a farmers’ market
• Eat mostly plants: more leaves than seeds
• Choose quality over quantity
• Eat until you’re no longer hungry, not until you’re full.
• Sit down to real meals with other people; eat slowly and mindfully; enjoy your food

I got a kick out of one of his recommendations. He says to be the kind of person who takes supplements – don’t actually take supplements, just be the kind of person who does (concerned and informed about health).

I don’t agree with everything Pollan says, but I endorse his 7-word formula. Only I worry that if you eat too much of one thing you may miss out on micronutrients. I’d prefer a 10 word formula: Eat a variety of foods. Not too much. Mostly plants.

Posted in: Book & movie reviews, Nutrition

Leave a Comment (11) ↓

11 thoughts on “What’s for Dinner?

  1. TsuDhoNimh says:

    Someone else said … buy food that IS an ingredient, not food that HAS ingredients.

  2. DavidCT says:

    I remember the sage words that once appeared on a sweatshirt:

    “Eat right Exercise Die anyway”.

    If you eat only for perceived health benefits and little pleasure, you may live longer or perhaps it will just feel that way.

  3. BEW says:

    “We’re finding that controlling fats in the diet makes very little difference in the risk of heart attacks for most people. We still recommend it for patients at high risk, but it was a mistake to try to change the diet of the whole population”

    Do you have any studies that you can cite that can support the above statements? There was study published in the NEJM last year that attibute 24% of the drop in deaths from heart disease from 1980 -2000 to reducing lipids by non-medical means. (Ford et al, NEJM, 2007, 356, 2388-98.

    Besides, I notice that even though you seem to believe that dietary fat makes no difference in the risk of heart attacks, you do not recommend eating a lot of red meat, milk or cheese in your recommended diet. Why is that?

  4. Jules says:

    There’s a different between diet and Diet, the one being the medical and the second being that great-bikini-bod-in-six-weeks-plan that magazines try to sell you, though, and I get the impression that Atkins (and the South beach, and whatever’s the newest media darling these days) are all about the second rather than the first.

    I think your summation of Pollan’s American Paradox overlooks one thing: the people who are obsessed with healthy and nutritious (who do things like buy organic and have gym memberships) are not the ones getting fatter and less healthy. The ones getting fatter and less healthy are mostly the poor.

    What I find most ironic about the food situation is that people assume that “natural” foods (fresh produce, basic ingredients like flour and butter) are more expensive than buying stuff in cans or out of the freezer aisle. One of the most common litanies I regularly hear is that it costs too much to eat healthy, when in fact it costs significantly less.

    I wonder if you think Pollan’s advice–eating food, not too much, mostly meat–would apply to pets as well. I feed my cats a mostly-raw diet (chicken and parts are comparatively pricey, so they get supplemented with canned food) because I think it’s better for them than something out of a bag. Almost every single vet I’ve ever spoken with has harrumphed at the thought that I, a mere mortal, should think to do better than a scientifically formulated! diet for my cats. Except I don’t see how we can say that humans need natural food, but animals don’t. They don’t feed tigers kibble at the zoo.

  5. Valiant Orange says:

    I’m surprised this blog speaks so well of the Pollan. I feel that he is on a slippery slope of anti-science. Of course like all anti-science types he relies on science when it supports his agenda. He’s fond of omega-3s, yet if nutrients derived from nutritionism is to be ignored, what’s changed that he’s not so skeptical of omega-3s?

    Much of his reasoning relies on traditional common sense is best, since you, know, science is dangerous and evil.

    He also gives far too much consideration (and reveals his influence) to groups like the Weston A Price Foundation. Okay, perhaps they have some good ideas regarding diet, I agree with some of it, but they are mired in so much woo and misinformation it’s hard to take any one thing they claim without a lot of skepticism, I sure wouldn’t cite them if I were writing a book on nutrition. I wouldn’t mention them if I were writing a serious book on anything.

    For the most part I agree with Michael Pollan on some things, however, I don’t misinterpret his approach as science-based or even entirely rational.

    He’s a writer, he writes good yarns. That’s about it.

  6. DavidCT says:

    The term “most people” is not synonymous with “almost everybody”. I don’t have the references but one could say that most people do not have to worry about sodium intake. There are about one third of the population who do. In the US that is about 100 million people. This makes is a significant concern even though “most people” don’t have to be concerned.

    With dietary lipids some people can eat anything they want. Some like myself are labile and diet makes a big difference. Then there is the last group where diet is not enough. Again dietary advise for everyone is useful for a minority.

    Restricting lipids and sodium will be very useful for many people but “most people” will have no measurable benefit. The “most people” advise ignores the large degree of individual variability and makes the effect of diet seem more powerful than it really is for the population as a whole.

    There does seem to be some progress in being able to test people to specifically determine if they can be helped by dietary change. This may lead to more meaningful advise – till then I will have to go with the 7 words.

  7. Harriet Hall says:

    BEW,

    You misread the NEJM study. The full text is available free on line at http://content.nejm.org/cgi/content/full/356/23/2388

    What it actually says is that 24% of the reduction in deaths was due to reduction of serum cholesterol, which was mostly achieved by statins and other treatments, not by changes in dietary lipids. At the same time, it showed that there was an increase in deaths attributable to increases in BMI (8%) and diabetes (10%), so one might assume that whatever changes occurred in the American diet during that period did more harm than good.

    You said “I notice that even though you seem to believe that dietary fat makes no difference in the risk of heart attacks, you do not recommend eating a lot of red meat, milk or cheese in your recommended diet. Why is that?”

    In the first place, I didn’t say dietary fat makes no difference; I said it makes only a small difference. Genetic factors make some individuals more susceptible to dietary fat while others are relatively immune.

    I recognize that it is possible to stay healthy on a diet consisting solely of meat, as long as it is eaten raw to get the vitamins that would be destroyed by cooking. There are a variety of different diets that humans have thrived on in different societies around the world and throughout history. We don’t have any strong evidence that any of those diets is superior to another.

    If you will notice, I didn’t recommend eating “a lot” of anything. My point was that we don’t have strong enough evidence to mandate wholesale diet rules, and in the absence of a sure bet, the seven words seem like a reasonable wager.

  8. Dacks says:

    Thinking of food as medicine, as the “nutritionists” do, has always unfair to do to one of life’s great pleasures. Certainly it is possible to eat an unbalanced diet, but I believe that human digestion is much more adaptable than we give credit for, as evidenced by the variety of diets that people thrive on around the world.

  9. CarolynS says:

    Pollen is essentially a “lifestyle” or cultural critic, not a scientist. He believes you should spend a lot of time cooking and eating (carefully of course), go to the farmer’s market and probably also drive a Prius, read great books and contribute to the Obama campaign and generally live like he does. Of course his work schedule and salary as a professor and his earnings as a journalist probably allow him the mental time and space to carry out these activities. I am not opposed to these lifestyle-cultural actiivities and even engage in many of them myself, but that doesn’t mean I believe that science supports them or that I need to tell other people to do the same thing. His mantra is just that, a mantra. Why not eat something your great-grandmother wouldn’t recognize as food? That might cover sushi and arugula, not just Twinkies. And apparently our recent ancestors must have adopted foodstuffs such as those sold in the supermarket today, because why else would they be available in the supermarket? You might as well just advise people to only wear clothing made of natural fibers and to sew at home rather than going to Target to buy clothes.

Comments are closed.