Michael Pollan, journalism professor and author, begins his provokingly-titled essay (”Unhappy Meals: How nutritional science has ruined the way we eat“) in today’s NY Times Magazine with a pithy summary of what people should eat:
Eat food. Not too much. Mostly plants. . .That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy. . . a couple more details to flesh out the advice. Like: A little meat won’t kill you, though it’s better approached as a side dish than as a main. And you’re much better off eating whole fresh foods than processed food products.
Certainly sound advice.
The essay’s thesis is that nutritional science has both confused and misguided consumers to eat in unhealthy ways, that “nutritionism” has taken over food in society’s discussion on eating.
Let’s take a look at some of the essay’s main points:
1. The focus shifted in the 1970s and 1980s from food to nutrients.
Pollan notes how a Senate Select Committee on Nutrition held hearings in 1977 and found that heart disease rates had soared since World War II in the U.S., and that other cultures that ate traditional diets based largely on plants had very low rates of chronic disease. Yet, thanks to lobbying by the meat and dairy industries, the original committee recommendation (”reduce consumption of meat”) was instead replaced by, “Choose meats, poultry and fish that will reduce saturated-fat intake.”
Pollan criticizes this compromise, the focus on politically-unconnected nutrition science terms like “saturated-fat,” and the subsequent development of “the official new dietary language” (e.g., polyunsaturated, cholesterol, monounsaturated, carbohydrate, fiber, polyphenols, amino acids, carotenes, etc.):
Henceforth, government dietary guidelines would shun plain talk about whole foods, each of which has its trade association on Capitol Hill, and would instead arrive clothed in scientific euphemism and speaking of nutrients, entities that few Americans really understood but that lack powerful lobbies in Washington.
Comment: Fair enough. Political interference in food policy exists, is bad, and leads to government food recommendations that aren’t always in the best interest of individuals. No argument there. Marion Nestle, a nutrition professor and author, covers this topic in depth in her book, “Food Politics.” However, is nutrition science (understanding how nutritional components may affect physiology and the potential risk for disease) the culprit? Or, is it the application of nutrition science in the political sphere that is flawed? I’d argue it’s the latter.
2. The assumption that the key to understanding food is the nutrient (an ideology Pollan calls “nutritionism”) is flawed. It creates a situation where consumers are dependent on scientists (and journalists who present their ideas to the general population) to explain these mysterious, hidden nutrients, in order to understand what to eat.
Comment: If the media did a better job of understanding the science and presenting its implications to consumers, perhaps there would be less confusion. Sensationalist headlines and storylines sell. The fact is that different nutritional components of foods can affect health in both positive and negative ways. Can scientific studies and results be skewed by both the people conducting the research and the people presenting the information to the general public? Sure. But is that a good reason to not seek out a better understanding of how different nutrients may affect our health?
3. A weakness of nutritionist ideology is that it has trouble discerning qualitative distinctions between foods. Food manufacturers exploit this when designing and marketing foods.
[Foods] through the nutritionists’ lens become mere delivery systems for varying quantities of fats and proteins and whatever other nutrients are on their scope. Similarly, any qualitative distinctions between processed foods and whole foods disappear when your focus is on quantifying the nutrients they contain (or, more precisely, the known nutrients).
This is a great boon for manufacturers of processed food, and it helps explain why they have been so happy to get with the nutritionism program.
By comparison, the typical real food has more trouble competing under the rules of nutritionism. . .The fate of each whole food rises and falls with every change in the nutritional weather, while the processed foods are simply reformulated.
Comment: Food manufacturers gaming the system by enhancing nutritionally poor food choices with added nutrients isn’t a “nutritionist ideology,” it’s a “food manufacturist ideology.” No knowledgeable, ethical nutritionist would suggest to eat such artificially enhanced foods. The focus is on emphasizing whole, unprocessed foods. Pollan uses the term “nutritionists” as a proxy for food manufacturer product developers and marketers. I think many clinical nutritionists who work with patients to help them to understand how to make healthier food choices and prevent/treat chronic disease would strongly disagree with that terminology and grouping.
4. Nutrition science and policy recommendations haven’t been sound.
Pollan states:
Oddly, America got really fat on its new low-fat diet — indeed, many date the current obesity and diabetes epidemic to the late 1970s, when Americans began binging on carbohydrates, ostensibly as a way to avoid the evils of fat …
… While it is true that Americans post-1977 did begin binging on carbs, and that fat as a percentage of total calories in the American diet declined, we never did in fact cut down on our consumption of fat. Meat consumption actually climbed. We just heaped a bunch more carbs onto our plates, obscuring perhaps, but not replacing, the expanding chunk of animal protein squatting in the center.
Pollan claims these consumer actions are the fault of “nutritionism”:
How did that happen? I would submit that the ideology of nutritionism deserves as much of the blame as the carbohydrates themselves do — that and human nature. By framing dietary advice in terms of good and bad nutrients, and by burying the recommendation that we should eat less of any particular food, it was easy for the take-home message of the 1977 and 1982 dietary guidelines to be simplified as follows: Eat more low-fat foods. And that is what we did. We’re always happy to receive a dispensation to eat more of something (with the possible exception of oat bran), and one of the things nutritionism reliably gives us is some such dispensation: low-fat cookies then, low-carb beer now.
Comment: I agree that it’s a mistake to emphasize one aspect of diet (e.g., low-fat, low-carb) as a panacea. As Pollan notes, though, human nature plays a big role. With the advent of inexpensive, high-calorie foods, and food manufacturers designing foods to fit the latest fad, consumers are going to likely eat more of whatever is deemed “healthy.” However, a knowledgeable, ethical nutritionist isn’t going to push a dietary fad as a foundational approach to eating, and certainly wouldn’t be reluctant to encourage eating less of certain foods. Again, Pollan seems to group all nutritionists, government food policy designers, and food manufacturers under one umbrella — definitely an unfair characterization.
5. Nutrition science is flawed because it only looks at one nutrient and nutrients in foods are synergistic.
Most nutritional science involves studying one nutrient at a time, an approach that even nutritionists who do it will tell you is deeply flawed. “The problem with nutrient-by-nutrient nutrition science,” points out Marion Nestle, the New York University nutritionist, “is that it takes the nutrient out of the context of food, the food out of the context of diet and the diet out of the context of lifestyle.”
If nutritional scientists know this, why do they do it anyway? Because a nutrient bias is built into the way science is done: scientists need individual variables they can isolate.
Comment: Of course the relationships between nutrients in foods are complex and interdependent. But does that mean that it’s useless to conduct research looking at the effects of changing intake levels of individual nutrients? There are confounding variables in nearly every study in any area of scientific research. Does that mean we shouldn’t conduct research in those areas, too? The fact is that well-designed nutrition science studies can help researchers (and the media and consumers) to better understand how different intake levels of nutrients may impact the risk of developing and/or treating various diseases and conditions. Whether those study results are presented and interpreted properly is a different story — and a function of the parties in the information chain.
6. People who take supplements aren’t healthier because of the supplements, but instead because they are better-educated, more-affluent, and take a greater interest in their personal health.
People who take supplements are healthier than the population at large, but their health probably has nothing whatsoever to do with the supplements they take — which recent studies have suggested are worthless. Supplement-takers are better-educated, more-affluent people who, almost by definition, take a greater-than-normal interest in personal health — confounding factors that probably account for their superior health.
Comment: This claim is both sensationalist and unsupported. That’s the entire quote above. There is no evidence presented in Pollan’s essay to expand upon what he’s said. It’s the kind of thing one would expect to hear on The O’Reilly Factor. The unnamed “recent studies” he cites suggesting some supplements are “worthless” not only represent a very small percentage of the overall body of research, but several of the studies likely alluded to have also been debunked for poor research design and analysis.
It’s funny, but when a study suggests supplementing with a particular nutrient is not helpful, the media touts it as the gospel truth. But when a study suggesting the same nutrient is helpful in a particular condition, the media either ignores it or heavily qualifies the finding. That double-standard probably has nothing to do with the amount of money that pharmaceutical companies spend on media advertising.
7. Nutrition advice hasn’t made us healthier.
But what about the elephant in the room — the Western diet? It might be useful, in the midst of our deepening confusion about nutrition, to review what we do know about diet and health. What we know is that people who eat the way we do in America today suffer much higher rates of cancer, heart disease, diabetes and obesity than people eating more traditional diets. (Four of the 10 leading killers in America are linked to diet.) Further, we know that simply by moving to America, people from nations with low rates of these “diseases of affluence” will quickly acquire them. Nutritionism by and large takes the Western diet as a given, seeking to moderate its most deleterious effects by isolating the bad nutrients in it — things like fat, sugar, salt — and encouraging the public and the food industry to limit them. But after several decades of nutrient-based health advice, rates of cancer and heart disease in the U.S. have declined only slightly (mortality from heart disease is down since the ’50s, but this is mainly because of improved treatment), and rates of obesity and diabetes have soared.
No one likes to admit that his or her best efforts at understanding and solving a problem have actually made the problem worse, but that’s exactly what has happened in the case of nutritionism. Scientists operating with the best of intentions, using the best tools at their disposal, have taught us to look at food in a way that has diminished our pleasure in eating it while doing little or nothing to improve our health.
Comment: I agree that the average Western diet is poor and pales in nutritional quality in comparison to a traditional, whole foods diet. And I also agree that the focus on individual diet characteristics (e.g., low-salt, low-fat, high-protein) has in general been convenient from a marketing standpoint, but less than helpful in improving health outcomes. I think human nature and the convenience factor are primarily to blame, though.
Suggesting that nutrition science has taught us little or nothing about how to improve our health is simply ridiculous. I’d argue that much has been learned, little has been applied, and still more has been misinterpreted. Pollan notes disease rates remain high after years of nutrition advice. Yet, he knows as well as anyone that such advice is often ignored by consumers or co-opted by industry to market questionable food choices. And that’s nutrition science’s fault?
8. Four large-scale changes have altered our relationship with food.
A. From Whole Foods to Refined. “The case of corn points up one of the key features of the modern diet: a shift toward increasingly refined foods, especially carbohydrates. Call it applied reductionism.”
B. From Complexity to Simplicity. “Chemical fertilizers simplify the chemistry of the soil, which in turn appears to simplify the chemistry of the food grown in that soil. . . Processing foods depletes them of many nutrients, a few of which are then added back in through “fortification”. . . The astounding variety of foods on offer in the modern supermarket obscures the fact that the actual number of species in the modern diet is shrinking. For reasons of economics, the food industry prefers to tease its myriad processed offerings from a tiny group of plant species, corn and soybeans chief among them. Today, a mere four crops [corn, soybeans, wheat and rice] account for two-thirds of the calories humans eat.”
C. From Leaves to Seeds. “[W]e’re eating a lot more seeds and a lot fewer leaves, a tectonic dietary shift the full implications of which we are just beginning to glimpse. If I may borrow the nutritionist’s reductionist vocabulary for a moment, there are a host of critical micronutrients that are harder to get from a diet of refined seeds than from a diet of leaves.
D. From Food Culture to Food Science. “The sheer novelty and glamour of the Western diet, with its 17,000 new food products introduced every year, and the marketing muscle used to sell these products, has overwhelmed the force of tradition and left us where we now find ourselves: relying on science and journalism and marketing to help us decide questions about what to eat. Nutritionism, which arose to help us better deal with the problems of the Western diet, has largely been co-opted by it, used by the industry to sell more food and to undermine the authority of traditional ways of eating.”
Comment: Each of these changes are legitimate risks to better health, but are they a function of nutrition science or food economics? I’d argue it’s the latter. Refined foods sell. The number of crops are minimized for efficiency purposes. Grains (seeds) are easily stored and traded. New products appeal to consumers’ desire for novelty and variety. Nutrition science, as Pollan notes, was co-opted by industry to sell more food. Does that make nutrition science itself a bad thing? I don’t think so.
9. Accepting fast food as our food culture is financially not an option.
It might be argued that, at this point in history, we should simply accept that fast food is our food culture. Over time, people will get used to eating this way and our health will improve. But for natural selection to help populations adapt to the Western diet, we’d have to be prepared to let those whom it sickens die. That’s not what we’re doing. Rather, we’re turning to the health-care industry to help us “adapt.” Medicine is learning how to keep alive the people whom the Western diet is making sick. It’s gotten good at extending the lives of people with heart disease, and now it’s working on obesity and diabetes. Capitalism is itself marvelously adaptive, able to turn the problems it creates into lucrative business opportunities: diet pills, heart-bypass operations, insulin pumps, bariatric surgery. But while fast food may be good business for the health-care industry, surely the cost to society — estimated at more than $200 billion a year in diet-related health-care costs — is unsustainable.
Comment: Couldn’t agree more. It’s not sustainable. I’d argue, though, that helping people understand nutrition, not in a reductionist sense, but in a holisitc sense, is critically important. Just telling people to eat a more traditional, whole foods diet, given all the existing processed, convenient food choices that predominate the marketplace, will be confusing to many people who haven’t had good food consumption role models. Pollan acknowledges this issue in his first dietary rule of thumb below.
10. Suggested rules of thumb
A. Eat food. Though in our current state of confusion, this is much easier said than done. So try this: Don’t eat anything your great-great-grandmother wouldn’t recognize as food. (Sorry, but at this point Moms are as confused as the rest of us, which is why we have to go back a couple of generations, to a time before the advent of modern food products.)
Comment: Makes sense.
B. Avoid even those food products that come bearing health claims. They’re apt to be heavily processed, and the claims are often dubious at best.
Comment: Yep.
C. Especially avoid food products containing ingredients that are a) unfamiliar, b) unpronounceable c) more than five in number — or that contain high-fructose corn syrup.None of these characteristics are necessarily harmful in and of themselves, but all of them are reliable markers for foods that have been highly processed.
Comment: Second that.
D. Get out of the supermarket whenever possible. You won’t find any high-fructose corn syrup at the farmer’s market; you also won’t find food harvested long ago and far away. What you will find are fresh whole foods picked at the peak of nutritional quality. Precisely the kind of food your great-great-grandmother would have recognized as food.
Comment: Excellent idea if you have access to a farmers market and can afford to get food there.
E. Pay more, eat less. There’s no escaping the fact that better food — measured by taste or nutritional quality (which often correspond) — costs more, because it has been grown or raised less intensively and with more care. Not everyone can afford to eat well in America, which is shameful, but most of us can: Americans spend, on average, less than 10 percent of their income on food, down from 24 percent in 1947, and less than the citizens of any other nation. And those of us who can afford to eat well should.
“Eat less” is the most unwelcome advice of all, but in fact the scientific case for eating a lot less than we currently do is compelling.
Comment: Definitely agreed on the “eat less” part. The “pay more” part is more difficult. This isn’t 1947. While food costs are way down, education and health care expenses are way up, while wage growth has slowed. For those who can afford to buy better quality foods, that’s great. But one doesn’t have to shop at farmers markets and expensive grocers to eat healthy.
F. Eat mostly plants, especially leaves.
Comment: No arguments there.
G. Eat more like the French. Or the Japanese. Or the Italians. Or the Greeks. Confounding factors aside, people who eat according to the rules of a traditional food culture are generally healthier than we are. Any traditional diet will do: if it weren’t a healthy diet, the people who follow it wouldn’t still be around.
Comment: Uh-huh.
H. Cook. And if you can, plant a garden.
Comment: Ideal and definitely a goal to shoot for, but not as realistic for households with two working parents and kids. There are some healthy packaged food alternatives out there that can help to make things easier (e.g., as found at Trader Joe’s).
I. Eat like an omnivore.
Comment: Ok, but a well-designed vegetarian diet can work, too.
CONCLUSION
Overall, I agree with many of Pollan’s points. The emphasis on whole foods and traditional diets makes a lot sense. Where I primarily disagree with him is with his blanket anti-nutrition science approach. Much has been learned through nutrition science that can be applied to help prevent and treat chronic disease. The fact that food manufacturers have co-opted nutrition science to market products and influence food buying habits doesn’t make nutrition science itself a bad thing. Using nutrition science to better understand how nutrients (which form the primary basis for cell function and thus life) affect our health and influence our risk for developing disease is both a worthwhile and necessary cause.
Two of the most important steps you can take for good long-term health are to:
$50 trillion. That’s the Government Accountability Office’s (GAO) estimated present value of the financial promises the federal government has made over the next 75 years. Medicare obligations represent more than $32 trillion of that amount, and have increased more than three-fold since 2000.
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