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Matthew J. Edlund M.D.

Diets: What We Don't Know

It's not about the food.

Neil Moralee Flickr.com
Source: Neil Moralee Flickr.com

The U.S. government has just come out with its latest dietary guidelines. Most of us won’t read them.

Many of us should.

Media attention immediately went to the cholesterol recommendations. No surprise there. That’s where “the money is,” in terms of drugs and the food industry. A few things which skipped attention you might consider are:

1. A quarter of American calories come from snacks.

2. A fifth of calories come from drinks.

3. About half of added sugars in the diet come from soft drinks.

4. People are eating less vegetables—despite reams of dietary advice to increase ingestion.

5. The government is now on the bandwagon pushing increased vitamin D in the population. Outside of getting sun on your skin, the quickest dietary source is finny fish. A tablespoon of cod liver oil contains about two hundred times what you’ll get from a bowl of yogurt.

6. There are now officially four government preferred diets—the “healthy US”, the Mediterranean, the vegetarian, and built to control high blood pressure DASH diet.

But the new dietary guidelines leave a lot of stuff out:

A. The Cholesterol religion is alive but getting modified. Despite “new” evidence that saturated fat is not bad for you (eat all the steaks and bacon you can) the government isn’t buying it. Because it’s not absorbed real well cholesterol itself is not the villain—most of our cholesterol we manufacture ourselves. Saturated fat, however, is still viewed as a big risk factor for cardiovascular disease, and through effects on weight, cancer.

So statin manufacturers can rejoice. Beef producers, a bit less so—though the “healthy US diet” includes more meat than most suggested diets.

B. Critically important variables do not appear in the guidelines. It’s clear that bacterial populations affect weight. Viral infections change weight. Timing of eating changes weight. Biological clocks—as in shift work—changes weight so much the World Health Organization wants shift work considered as a carcinogen. Whether you live near a park changes weight. How much your friends and colleagues eat changes your diet and weight. Sleep time changes weight.

It’s not about just what you eat and how you exercise. Thousands of variables affect weight and survival and need to be considered by us individually.

C. Long term survival maximizes in populations who don't eat any of the guideline diets. The longest lived population in the world—Asian American women in the US—do not follow these "standard" scripts.

Across the world what seems to matter is eating a lot of different whole foods—from lots of varying sources. The Japanese model of putting five different colors on your plate possesses merit. Colors meant different nutrients, vitamins, minerals and who knows what else affecting bacterial populations. Despite smoking like crazy the Japanese live a long time.

D. Ecology and sustainability argue for eating whole plants. Vegetarians do well overall. But so do plenty of semi-vegetarians.

Beef, however, has a huge energy and pollution footprint. Some argue that beef takes four times as much foodstuffs to produce per pound as chicken and requires huge amounts of fossil fuels. Pork also pollutes, as pigs consume lots of foods like soy that humans would generally be healthier eating directly.

Cows are flatulent. They are a surprisingly high contributor to carbon dioxide production worldwide. They look nice while driving the highway. But if the rest of the world ate the beef Americans routinely eat, we’d have a hotter planet.

Vegetarian diets can be justified by more than health criteria. They may also hold back global climate change.

Sorry, Elsie.

E. Bad Sugar. Added sugars are getting a bad rap everywhere. Unfortunately, the population does not recognize that “sugar” involves 30 different substances, all with different health and environmental effects. Sugar in whole foods, like fruit, gets far less attention. But the biggest public health concern may be that half of added sugars come from bottled and canned drinks. This is bad news for energy drinks, Coca-Cola and Pepsi.

If people want their caffeine, they can get a much healthier version through coffee or tea.

F. Diet is just one of many components of health.

That’s not how people view it. For the weight obsessed media, diet is the big health issue, followed by physical activity.

Yet what we eat is just one component of weight. The impact of social engagement and support on health (including weight) is huge. You hardly read about it. Spiritual connectedness to something larger than oneself has a big impact on health, and no place in our dietary guidelines. With 12 percent of American women between the ages of 40-59 currently diagnosed as depressed, you would think cognitive, solution based approaches to health and diet might be considered.

No, you probably won’t read about that.

The bottom line is that food and diet cannot be placed inside the general checklist approach used in guidelines and health sources. Health is a much bigger issue than what you eat. Just as diet is impacted by your friends, your work schedule, your sleep, how and when you watch TV and the relative friendliness of your gut bacteria, food is only one part of weight control.

A comprehensive approach is needed. You won’t find that in the guidelines.

Checklists work quite well for taxes, performing appendectomies and shooting planes off carrier decks. They’re just not as useful if you’re concerned about health. For the stuff that really counts—physical, mental social and spiritual being—is generally not counted.

And what they don't count counts a lot.

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About the Author

Matthew Edlund, M.D., researches rest, sleep, performance, and public health. He is the author of Healthy Without Health Insurance and The Power of Rest.