Our Great National Eating Disorder
Red Flags
Doctor enters exam room, patient sits expectantly on exam table.
“Hello, Mr. Marley. We need to talk about your test results.”
“Sure, Doc, tell me the good news.”
“You’re not going to like the news. Your blood sugar is 168, which means that you have diabetes. Your cholesterol is 245, your triglycerides are 220 and your HDL cholesterol is 32. Your blood pressure is 150/98. You are 30 pounds overweight. The chances are 80% that you will die of a heart attack or stroke and you will live 12 years less than you might otherwise. You will need to be on at least 5 or 6 medicines for the rest of your life. And your health care costs just went from $2,500 per year to $15,000 per year.”
“Okay, now tell me the bad news. Jesus, how can that be? I live and eat like everybody else that I know.”
“I understand. I hear the same thing all the time. Let’s talk about what you need to do.”
So goes a familiar story.
In my medical practice, I have recognized a change in the nature of the health problems of my patients. Diabetes and its complications of heart disease, stroke, vascular disease, and kidney disease have become the most prevalent disorders. That is not to say that these were not relatively common problems before. But these problems have now become epidemic. It has become clear that the primary cause of this epidemic is our “Western diet.” This led me to investigate what we know about our diet and its effects on health – and then to discover the other issues that make our current food production and eating habits not only dangerous to our health directly, but dangerous to us indirectly through the environmental effects, the social effects, the security effects, the moral issues and the lack of sustainability of the status quo of food production. Our food is cheap and easy up front but costly in the long calculation.
The Western Diet
The “Western diet” is characterized by an abundance of refined and processed grains, red and processed meats, fried foods, lots of cheap added calories of sugar and fat - lots of everything - except fruits, vegetables, and whole grains. This dietary habitat has developed slowly through a process of industrialization of our food production and through the rise of fast and convenient foods. Not so many years ago, food was produced by small farmers growing diverse crops with multiple livestock populations. In the name of efficiency – of both production and profits - we have evolved a system of huge monocultures of grains (mainly corn, soybeans, and wheat) and large concentrated livestock operations (concentrated animal feeding operations, or CAFOs), fueled by the aforementioned grains as feed for the animals. Goodbye Mr. and Mrs. Family Farmer; hello ADM, Cargill, National, and Tyson.
In our past and in other countries meals were eaten differently, also. They were prepared and cooked from whole foods and eaten at a table with others, usually family. Today, most meals are eaten in a rush, microwaved, from a drive through, in the car, alone, and anywhere but a table. Goodbye “Mom, what’s for dinner?” and hello McDonalds(supersize that?), Wendy’s (biggie fries?), and Pizza Hut (extra cheese in the crust?).
The Nutritionists
On the heels of these changes emerged the nutrition scientists, much hyped and now much maligned, who were on the hunt for the nutrient that was killing us or the nutrient that would save us – with little success. The only success of the nutrition scientists, unintended, has been to create mass confusion for American eaters. We read one day that fats are bad, and the next that they can be good, and then that some are good and some are bad. We have gone through the high carb craze, and now the low carb craze. Supplements of vitamin E, vitamin C, vitamin A, and even yogurt enemas have had their day in the sun, only to be discredited.
We have been easily influenced by nutrition scientists in the U.S. since, as a nation of immigrants, we do not have a traditional, cultural diet. Rather than eating foods in combinations and quantities found to be healthful and culturally satisfying by our ancient ancestors, we have found ourselves confused and look to science to tell us what to eat. But nutrition science is reductionist and fatally flawed. Nutrients taken out of the context of the food, out of the context of the diet, and out of the context of the lifestyle do not have the same health effects as otherwise. The nutritionists cannot see into the soul of a carrot, to quote the author Michael Pollan. Single nutrient science misses the complexity involved in the most holy of processes in our bodies and in our world ; that is, our sustenance by the fruits of the soil of the earth.
But there is one fact that we and the scientists can state without reservation: the Western diet is a cause of the most deadly diseases that we suffer. These diseases are commonly called (appropriately) the “Western diseases.” They include the aforementioned diabetes, heart disease (mainly coronary artery disease), stroke, other obesity related diseases, and cancers. The fact of this relationship of diet and disease is observed by the fact that any person who moves from another country and culture and adopts this diet quickly develops the same (or greater) risk of these diseases, many of which are rare in his native country. It has been observed that a return to the country of origin and to previous dietary habits returns the immigrant to his native state of health.
Interesting is the so called “French Paradox.” The French eat foods that are high in fat content and calories. But they eat foods that are not so heavily processed, in smaller amounts, more slowly and socially, and they do not eat between meals. They don’t seem to worry too much about nutrients but are overall much slimmer and healthier than Americans. We have our own “American Paradox.” We are obsessed with nutrition science and follow the latest health diet fads, yet we are obese and sick as a nation. We are the most overfed and undernourished people in the world. And, unfortunately for the people of the world, more and more of them are migrating toward our dietary habits.
S-I-C-K in the USA
Two thirds of Americans are overweight or obese; a quarter of us have metabolic syndrome; 54 million have prediabetes; and the incidence of type 2 diabetes has risen 5% annually since 1990, going from 4% to 7.7% of the adult population- nearly 20 million Americans. Diabetes is a major risk factor for heart attack and stroke with 80% of diabetics dying of one of those diseases. Diabetes is now the #1 cause of both blindness and kidney failure in this country. A diagnosis of diabetes subtracts twelve years from a life and costs $15,000 a year in health care (compared to $2,500 in non-diabetics). Big numbers, which increasingly drive an already financially suffocating health care system over the proverbial cliff.
The incidence of diabetes and vascular disease is a serious problem for our adult population, but it is a potential disaster for our children. If current circumstances continue, one in three children born since 2000 will develop diabetes in their lifetime, with the attendant risks of cardiovascular and other diseases and premature death – caused mainly by the foods we provide them. This is the first generation who may expect to have a shorter lifespan than their parents.
Added to the toxicity of the refined, concentrated calories in our diet are the pharmaceuticals used in livestock production. Because of the crowded, unhygienic living circumstances of livestock in concentrated animal feeding operations (CAFO’s), they must be given massive doses of antibiotics to keep them from getting sick and spreading contagion amongst their fellow feedlot mates before they reach slaughter weight and age – a bottom line issue for the industrial meat producers. 70 % of antibiotics used in the U.S. are given to animals in CAFOs – an alarming statistic. This practice is a major contributor to the development of resistant bacteria causing human disease. Many experts think that our current problem with MRSA (resistant Staph bacteria) is caused by this excessive use of antibiotics in food animals. Another concern is the unknown human effects of these antibiotics, as well as the synthetic growth hormone they are fed, in the flesh of the animals that we eat and the milk that we drink.
Why does this diet make us sick? There are many possibilities. The excessive calories (we take in at least 300 more a day than we did in 1980) contribute to obesity which then leads to the metabolic problems of excessive abdominal adipose (the metabolic syndrome). The refining of grains takes most of the nutrients out, leaving just empty calories. We simply refine all the nutrition out of food. These simple, refined carbohydrates are rapidly absorbed through the GI tract, have immediate effects on blood sugar and overwhelm the endocrine/insulin system of the body, ultimately leading to failure of that system and diabetes.
With the change from grass feeding of livestock to corn feeding (in CAFOs), the nature of the fats in the flesh of the animals has changed from a ratio of predominance of omega 3’s over omega 6 fatty acids in grass fed animals to a marked predominance of omega 6’s over omega 3’s in corn fed livestock. Even eggs follow this pattern of change in grass/natural vs. corn feeding of the laying hens. It is recognized that omega 3 fatty acids have beneficial, anti-inflammatory effects and other beneficial effects on cell membranes, while omega 6’s are believed to be pro-inflammatory. This may be the major change in the nutritional makeup of our industrialized food (if you believe in that sort of thing).If one is looking for a “theory of everything” in nutrition, this could be it.
Another postulate is that the food that we eat, derived directly or indirectly from corn (through the flesh of animals fed corn) lacks many trace nutrients due to the depletion of micronutrients in the overused soil used to grow the corn. It may be that one or some of these trace nutrients are critical for health. Some even speculate that we may overeat because our bodies are trying in vain to get these nutrients from our food, prompting us to eat more in that craving for nutritional content. This could be tied to another theory: what we are eating is less important that what we are not eating – that is, vegetables, fruits and whole grains.
Food production and the environment
Our current system of food production is energy intensive. No wonder, as the system was built on the foundation of cheap fossil fuels. But the days of bargain prices for fuels are finished and the hidden costs to our environment of the burning of those fuels are now being felt. Pay it forward is over – we now have to pay as we go, and also pay for our past “conveniences.”
The average distance that the food on your plate travelled is 1500 miles – a result of our centralized production of foods and our non-seasonal eating habits. Want strawberries and tomatoes at Christmas? No problem – just ship them in from Mexico, California – wherever it is warm. Charge to our children the freight (carbon emissions, wasted fuels, damage to infrastructure). The food industry burns a fifth of all the petroleum consumed in the United States. With this long distance transportation of foods, we put more fossil fuels in our refrigerators than we do in our cars.
The current “scientific” methods for industrial farming are to deplete the soil of its nutrients, growing vast monoculture crops of corn, soybeans, and wheat (heavily government subsidized) while replacing only nitrogen, phosphorus, and potassium fertilizer and using excessive pesticides to make the plants grow next season. This leaves a soil depleted of all micronutrients and producing foods likewise depleted of nutrition. And where do these fertilizers and pesticides, produced from fossil fuels, go? They go “away.” But where is “away?” They poison the drainage system of the land, the underground water, waterways, and ultimately the streams and rivers and are dumped into the ocean. Likewise, the huge rivers of fecal waste from CAFOs ultimately meet other flowing waters. A result of this is “dead water” where nothing can grow due to high concentrations of nitrogen in the water. We have observed this phenomenon recently in the reported “dead zones” of river deltas and gulfs around the world, most intimately in the Gulf of Mexico. There is a huge area at the mouth of the Mississippi River where fish cannot grow due to the depletion of oxygen caused by industrial farming runoff.
Who wants to eat alone – or - one is the loneliest number
The act of eating should be a communal experience. It is historically a time for families and friends to gather together to share experience and conversation. Our meals have become more solitary. Twenty percent of our meals are eaten in a car. We eat as a means of sustenance, like the animals, and miss the intimacy of the shared experience. We eat in a hurry, standing, in front of a television, rarely at a table. Maybe our food is eaten quickly because it doesn’t warrant being savored in its current state - highly processed and with multiple foreign flavor additives and little true natural fresh taste or nutritional value.
Studies have shown that a result of families eating together at a table is better nutrition for children, less obesity and fewer drug and alcohol problems in the young. The table is where you can teach your children good eating habits and the art of conversation and civility. Does anyone notice that missing today?
The pleasures of the table consist of “the considered sensations born of the various circumstances of fact, things, and persons accompanying the meal” and comprise “one of the brightest fruits of civilization” quoting the British writer Brillat-Savarin. “Each meal that we share together at a table recapitulates the evolution from nature to culture, as we pass from satisfying our animal appetites in semi-silence to the lofting of conversational balloons,” as Michael Pollan states in his book “The Omnivore’s Dilemma.”
The Demise of the Farming Community
Once, this country was a great quilt of small farming communities. These were vibrant townships with vigorous trade in goods and services driven by the small farm economy. My own community of birth was one of these. The town square was a bustling place on Saturdays and a place of repose on Sundays. Townspeople had great civic spirit and pride. Now, that community, like many of its sister communities, is a shell of its former self, just hoping that some heavy industry will come in to take advantage of jobless desperation. The downtown is a commercial dead zone. Economic salvation is seen in the Trojan horse of Wal-Mart, locating a superstore on the edge of town and driving the final nail in the social and economic coffin of the community. This is a story duplicated ad nauseum across the U.S., and a great tragedy in this story is that our government has been an accessory to the devastation. By subsidizing corn (with most of the subsidy going to huge corporations) and subsidizing cheap fuels (through military excursions and payoffs to corrupt petrocracies), and by imposing ominous and economically ruinous regulations on our smaller farming operations (regulations aimed at controlling the unsanitary and dangerous practices of the huge corporate producers, and that should not apply to the small producers) they have undercut the economic viability of the smaller farmer and therefore helped destroy these small communities.
A visiting Op-Ed piece written by a small farmer in the New York Times recently described how he was being fined by the government for growing vegetables on land that had been designated as a subsidized soybean field. How much sense does that make?
Cynics will say that is just progress, the nature of free markets. I say that these communities and these people, the core of our country (and interestingly enough, fighting in wars for this country at the highest per capita rates) were sold out by our government to the more rewarding (for the politician) corporate interests. This is our great societal loss. Kentucky writer Wendell Berry has been telling us this for many years. Nobody was listening.
Insecurity
When food is so cheap and readily available, we feel that the party can never end. Eat, drink and be merry. But hidden behind the façade of this bounty is the vulnerability of our food supply.
Any slowing of the flow of oil out of the Middle East leads to higher gas prices, which is then directly reflected in prices of food at the market. The fuel intensive nature of our production system would make a severe disruption of the oil flow (such as a terrorist attack on the Saudi oil fields or a wider Middle Eastern war) lead to our inability to produce and transport food around the country and an actual crisis of food availability. Obesity would likely not be our main concern in that situation; survival would. Local and regional production of food gives us security, as it is somewhat insulated from these oil price and availability problems.
The most authoritarian and antidemocratic governments in the world are in control of oil production and are corrupted by their oil revenue: Saudi Arabia, Russia, Iran, Venezuela, Sudan. World instability is directly tied to oil. Some say that we could be in for perpetual resource wars. Our dependence on oil creates vast military costs, in blood and treasure, required for the defense of the continuous flow of the oil to this country. Like an addict, we ask for more, more, more; and our pushers accommodate us to their great financial and geopolitical benefit.
Our centralized food supply is vulnerable to direct adulteration by someone meaning to do harm to American citizens – specifically terrorists. Decentralized production and distribution of food is much more secure.
Contagion in the form of bacteria or viruses is much more likely in large concentrated animal operations. Mad Cow disease , E.Coli 0:157 and Salmonella are a result of large industrial farm practices. Just recently we have seen a massive withdrawal of beef from the market due to the neglectful practices of large beef producers. They were processing for ground beef “downed cattle,” cattle that had difficulty standing or walking, which could be a sign of Mad Cow Disease.
Feeling better about that cheeseburger now?
Don’t Look, Ethel
The practices of concentrated animal feeding operations are fairly well known, but little discussed. Most of us shut our eyes when the images of livestock treatment are displayed. We “can’t handle the truth” as Colonel Jessep so famously stated in “A Few Good Men.” And most of us cannot. But the truth is that if we look closely at the way livestock are raised and processed in this system, we would have a hard time accepting them as food: cattle kept in crowded feed lots, wading in their own feces, fed corn (to the point of illness) and antibiotics and hormones until they are prodded down a chute to slaughter ; spent dairy cattle (comprising 70% of your ground beef) too weak to walk and dragged off trucks, with ropes around their hooves, to the slaughterhouse; chickens raised five in a small cage, cages stacked several layers high with open bottoms and feces raining on the birds at lower levels, unable to move, their beaks cut off with a hot knife to prevent them pecking each other to death in these crowded, filthy conditions; hogs raised in similar crowded and unhygienic conditions and taken to slaughter, sometimes with ineffective killing methods resulting in the pigs being dumped alive and squealing into boiling water vats intended remove their hair by scalding. Enough, you say?
It need not be that way. There are methods of animal husbandry that are more natural and humane and that result in safer and higher quality food. The up- front increased cost of these methods would be recouped in the avoidance of the hidden costs of the industrial methods. These animals’ natural diet is not corn; in fact, corn makes them sick. If the animals were not slaughtered fairly youthfully, they would quickly die of internal diseases as a result of the corn diet.
Grasses are the natural diet for a cow. Chickens and pigs eat grass and other plants, insects, larvae, and pigs are omnivores, eating even animal flesh. They can be raised in circumstances with some respect for their natural being and the sacrifice they are making. And this can be done economically if regulators will differentiate a mass production industrial farm from a safer small operation.
I believe that there is no moral reason that we cannot eat other animals - It is their natural place in the food chain to be food - they are prey animals. But the way that we care for the animals in their lives and the methods of slaughter make all the difference. This is a moral imperative.
Escape from the Western Diet
So, you say, what do we eat? How do we change our habits?
Here, I borrow heavily from the writer Michael Pollan. In his excellent book, “In Defense of Food: An Eater’s Manifesto” Pollan states the following, very simply: EAT FOOD. NOT TOO MUCH. MOSTLY PLANTS. Simple wisdom. He further offers some of the following recommendations:
1) Don’t eat anything that your great-great-great grandmother wouldn’t recognize as food.
She would recognize a carrot or an apple – she would not recognize Go-gurt or Hot Pockets.
2) Avoid food products containing ingredients that are a)unfamiliar, b)unpronounceable, c)more than five in number, or that include d)high fructose corn syrup.
3) Shop the periphery of the grocery store (produce, dairy, meats, whole grain breads). Avoid the center aisles of the store (refined grains, added fats and sugars, highly processed and packaged).
4) Avoid food products that make health claims.
First, they are boxed or packaged and therefore likely highly processed and nutritionally empty rather than a whole food; Second, the “nutrition” has likely been added as a solitary ingredient (recommended by the nutritionists, remember) and probably has no health value in that state.
5) Eat mostly plants. Especially leaves. Let colors be your guide. Nature gave foods multiple colors for a reason. Suffice it to say that if you eat a “multicolorful” diet of produce, you are going a long way toward good health. Eat more leaves and fewer seeds – likely the most beneficial nutrients are usually in the leaves.
6) Pay more, eat less. Americans spend less than 10% of our income on food. That is less than at any time in our history and less than any other country in the world. We have found room in our budgets for many new services and products that were not even available a few years ago –computers, cell phones, cable, internet service, ipods – so why can’t we find room for better food? In all other purchases we equate price with quality – why not food?
7) Buy locally produced foods. Get out of the supermarket whenever possible. Shop the farmer’s market or local food co-op. You will eat foods that are in season and at the peak of their flavor and nutritional value. The only way that you can have some comfort in knowing the way that your food is grown and produced is to know personally who is producing it.
8) Prepare your own food. Eating a healthy diet means, generally, cooking your own food using whole ingredients. It doesn’t sound easy, but it is what it is. And there are many satisfactions in the process. TV cooking shows are very popular these days, but there is little cooking going on in homes. Cooking has become mainly a spectator sport.
9) Do all your eating at a table and try not to eat alone. You will eat less and enjoy it more.
10) You are what what you eat eats, too. Grass fed and finished livestock beats corn fed every time. More omega 3 fatty acids and fewer omega 6, more micronutrients.
11) Eat more like the Italians, or the French, or the Japanese, or the Indians, or the Greeks – but don’t look for a magic bullet in the traditional diets – we could fall into the same trap as the nutritionists. Eat moderate portions, don’t go for seconds, don’t eat snacks.
12) Relax, eat slowly, enjoy and savor your food, your family, your friends. Eating can and should be one of the great pleasures in our lives; not a source of worry or guilt.
A New Paradigm
We are entering a post industrial phase in our society. We find that more and better are synonymous no longer. There was a time, in the not so distant past, when they were. But now we often find that more is actually harmful and unsustainable. And nowhere is that more apparent than in our food and eating habits.
The enabler of the centralized production of food and other products has been cheap and plentiful oil. That situation no longer exists. And even if it did, the other problems of our current arrangement make it imperative that we seek an alternative.
Changing our food system and eating habits is one of the few circumstances where a decision that improves our health also improves the environment, our society, our community, our security, and our satisfactions.
As Wendell Berry famously stated, eating is an agricultural act. When we choose what we eat, we are making a decision with multiple implications. We are making a personal health choice that affects not only us but our loved ones and our society at large. We are making a choice to support industrial agriculture, including the crimes and misdemeanors of that system, or we choose to support local and regional farmers and our local economy. We choose the methods and the dangers of CAFOs, or we choose safer meats and a clearer conscience. We choose a secure local and regional food economy or we choose to be hostage to the dictators of the oil supply.
I have discussed many negatives here. But there is great hope and possibility for change – and we can all participate. There is a movement now toward local, healthy, and sustainable food. Farmers Markets and local food co-ops are appearing in communities all over the country – and thriving.
Here in Glasgow and Barren County we have a wonderful opportunity arising. The Green Market Co-op is organizing and hoping to open a store here within the year. This will be a locally owned store selling locally and regionally produced foods. It will provide easy access to the most healthy foods that you can buy. And the farmer gets more profit as he avoids the corporate processors and middle men who siphon off much of the food dollar. Plus, a dollar spent in the Green Market gets circulated back into the local economy, rather than being sent to Bentonville, Arkansas at midnight.
Well grown and raised food with great nutritional value and taste with proceeds and profits circulating back into the local economy – win, win, win.
Many writers on the national scene, including Michael Pollan and Bill McKibben, suggest that Kentucky is perfectly situated to be a leader in regional food production. We have an infrastructure of existing small farms which previously grew tobacco and are now looking for alternative crops. The lay of the land in our state and the climate is excellent for growing produce and for grass farming cattle and other livestock. The abolition of disincentives for small farmers could put Kentucky in the forefront of this movement nationally.
I am not suggesting that we boycott or abandon existing supermarkets and products. I suggest that we make more informed choices in our purchases. The one thing that big box retailers and corporations understand is money; and if they are making less, they will adjust to the demands of the consumer. But I also suggest that we look deeper at the way that we approach food. Eating is a political act, also, and we should remain vigilant to what our government does in farm policy, specifically policies that are favorable to ADM, Cargill, Tyson, National Beef and other mega-corporations and harmful to our small farmers. Our government subsidizes high fructose corn syrup – they don’t subsidize carrots.
Eat well and live a long and happy life. Enjoy your food. Taste it again.
We vote with our forks. Make an informed vote.
See you at the polls.
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