Sunday, February 26, 2012
Who are we? It's an old question, often a metaphysical question, but, at this moment, I'm concerned with who we are physically. Maybe the question seemed too absurd to ask for classical philosophers living in land-based communities, eating traditional foods. For us, it is essential.
I want to know who we are so I can answer another question, equally old but newly contentious: What's for dinner? The question of diet has become genuinely partisan. I risk relationships and maybe future clientele for my restaurant by writing this. I'm not making money by doing so. I choose to broach this subject because I think it's important, because I see too much ill health in the people I care about, because I have the chutzpah to think I can help. I do not mean to cause offense in this post, though I will risk it to open the possibility of helping people live longer, healthier, happier lives.
Why has the diet question become so prominent and so charged? I see six basic reasons:
- Pandemic of obesity and related diseases.
- Pandemic of cancer.
- Yearning for agency in the midst of environmental and humanitarian catastrophes.
- Yearning for community and/or identity.
- Desire to minimize or eliminate suffering and death of sentient beings.
- Theories about our evolutionary diet.
Let's tackle these one by one, acknowledging that there will be overlap. Each will be its own post on this blog, to be followed by a final post with conclusions and recommendations. Stay tuned. For once, the new posts will be showing up pretty quickly.
Americans have gotten really fat in recent years. Others in the world are also getting fatter, though few to the same degree. America is rich, but to say that obesity is a phenomenon particular to rich countries would simply not be true. Even less accurate would be to assert that obesity correlates to consumption of fat or animal fat specifically. Indeed, the truth is almost exactly the opposite.
Obesity is a phenomenon that correlates very closely with sugar consumption, which makes perfect biological sense, as we'll soon see. Many of the world's fattest countries are sweets-loving countries in the Arab world and Latin America, regions in which the majority of the population is rather poor and where fat consumption is low. The fattest of all are the indigenous peoples of Oceania, hardly the world's rich. Meanwhile, rich Italy and France are leaner than most, and rich Japan and Singapore are among the leanest of all. The very leanest, moreover, are not the very poorest, and certainly not the most averse to saturated fat, being the more meat-loving peoples of historically pastoralist East Africa and coconut eaters in south and southeast Asia. If the correlation between affluence and obesity exists at all, it is weak, and applies only when whole countries are so poor that many people are literally starving. Finally, obesity is far from uncommon in societies with widespread malnutrition (the percentage of overweight adults is 61% in Guatemala, 57% in Jamaica, and 49% in Lesotho), and not necessarily due to maldistribution of resources.
So what makes us fat? Gary Taubes points out that we would do well to apply the principle of Ockham's Razor: the simplest explanation is usually right. So, if we can understand why obesity exists in other populations, like in Micronesia, Egypt, and Mexico, we can probably assume that it will also explain why Americans are getting fat, unless we have a truly compelling reason to believe otherwise. It's not affluence. It's not trans-fat. It's not fat. It's sugar.
France has, by far, the lowest obesity rate among Western countries, and third lowest among all rich countries, following Japan and Singapore. France has the highest consumption of total and saturated fat in Europe. It also has among the world's longest average life-spans. Italy, with lower fat consumption than France, but still higher than the rest of Europe, is also relatively lean, even with all that pasta. Egypt, much poorer than Italy or France, has the lowest per capita fat consumption in Europe or the Mediterranean basin, with one of the lowest percentages of dietary fat from animals. In other words, Egypt has long been on a low-fat diet, avoiding butter, eggs, and fatty meat, eating the sort of grain-heavy diet we in the industrialized West are being told is good for us. They have the highest percentage of overweight people in the Mediterranean region, higher than anywhere in Europe, and higher than any other large country on Earth save for the USA and Argentina (of 194 countries, Egypt is #14, Argentina #13, and the USA #9). The French eat, on average, about 170 grams of fat per day, again, the most in Europe, and more than twice the FDA guideline. Roughly two thirds of it is highly saturated animal fat, practically suicidal according to the FDA, and the highest percentage in Europe outside Scandinavia. And those Scandinavians, whose dietary fat is more animal based than that of any other country or region in the industrialized world, whose butter is both a culinary treasure and a cornerstone of their culture, are among the longest lived people on Earth, along with the fat-loving French and Italians and the Japanese.
The Japanese? Here the argument becomes nuanced. The Japanese have one of the lowest per capita intakes of dietary fat in the industrialized world. Yet they are the world's leanest rich population and among the longest lived. What other factors may contribute? For starters, one must note that Japan has among the world's best health care systems, as do the fat-loving countries in Scandinavia and Latinate Europe. One could also note that the Japanese are the world's leading eaters of fish and seaweed, nutrient and mineral rich foods whose value is beyond dispute in all nutritional circles. One could note that they are among the world's leading eaters of enzyme and probiotic rich fermented foods like miso. Perhaps most compellingly, they eat the least sugar in the industrialized world. Americans eat, per capita, 130% more sugar than the Japanese. We also eat, per capita, 119% more than the Italians, 90% more than the French, and 61% more than the Swedes.
The Japanese are clearly doing something right which indicates that it would be reductive to conclude that a high level of fat (and especially animal fat) in one's diet is essential for longevity, leanness, and good health, but Japan is an outlier from the general trend, so it would be quite absurd to assume that dietary fat, especially from animal sources, is bad for us, when the general trend shows just the opposite. It makes more sense to seek explanations for why an outlier breaks from the general trend than to reject the general trend and build a theory based on the outlier, though many arguing for low-fat diets do just that, pointing always at Japan. In the case of Japan, there is a clear and simple explanation for why it defies the general trend. The Japanese eat very little sugar. This is simple stuff.
Why pick on sugar? Sugar spikes our blood glucose level, triggering insulin, to protect us against glucose poisoning. Insulin, in addition to moderating blood glucose when it spikes, stores fatty acids in our fat cells, where they form into triglycerides, and inhibits the breakdown of those triglycerides, meaning they remain trapped in the fat cells. Simply put, the more insulin we have in our system, the more fat we store in our fat cells. And the more fat we store in our fat cells, the fatter we become. It has nothing to do with total calories. It is not a process triggered by dietary fat. Just the opposite, in fact. Dietary fat is the only source of energy that does not trigger insulin at all, for even protein does to some degree. Moreover, dietary fat lowers the glycemic index of sugary and starchy foods when they're consumed together, slowing the rate at which the carbohydrates are metabolized to blood glucose, and mitigating the need for high levels of insulin.
And it's not just how much sugar we consume but also in what form and context. We should note that Americans not only consume twice as much sugar as do the French but also that Americans consume most of that sugar in the form of soda, that is without fat, while the French consume most of their sugar in pastries laden with butter or lard (similar to the Italians and Japanese), thereby lowering the glycemic index and decreasing the need for insulin. The heavy Egyptians are even lower per capita consumers of sugar than the Japanese, yet anyone familiar with Arab society knows that the sugar they do consume is often consumed in large quantities in highly refined form in tea or candy (that is, not in food, and not with fat), and that the diet is mostly starch, in their case wheat. It's also very likely that the Egyptian and broader Arab consumption of honey, dates, raisins, and other high fructose foods that almost define their cuisine does not factor into official figures for sugar consumption, even though fructose triggers insulin to a greater degree than sucrose. So while an overly reductive analysis based on imperfect data might tend to portray Japan and Egypt as similarly low-fat, low-sugar, high-grain consuming societies, the massive disparity in their health and weight is no mystery.
Let's be rational, clear, and honest. The global facts are indisputable. Dietary fat, especially from animals, does not cause obesity, heart disease, or early death, but actually protects against them. Sugar does just the opposite. The sooner we embrace and manifest this understanding, the sooner we Americans can tackle our catastrophic levels of obesity and its related diseases and enjoy the benefits of being far leaner and healthier. If the French can do it, so can we.
Coming soon, Part 3: Yearning for agency in the midst of environmental catastrophe.
Part 2: The Pandemic of Cancer (And the Toxicity of Industrial Agriculture)
This is going to be the hardest entry to write in this series.
Cancer is a scourge, and, as we know, no one is safe. Very few of us are lucky enough to have made it this far without having lost a loved one to cancer. I have lost several. I have watched others survive cancer, usually at the cost of great suffering. The widely accepted estimate from the American Cancer Society is that one in two American men will get cancer at some point in their lives, one in three American women. At least half of those people will die of it. We must understand this: it was not always this way and it need not be this way. We must also understand that while there is a certain amount we can control through diet and other lifestyle choices, there is much else that we can control only through decisive, courageous collective action to change our culture and clean up our world.
Well, ain't that a kick in the head? But sometimes it pays to be serious, and this is one of those times.
What can we control through our personal choices? We can avoid exposing ourselves and our loved ones to many carcinogens by taking care with sourcing building materials and home furnishings, by choosing (if possible) to live in relatively less polluted places away from risk factors like high voltage power lines or Superfund sites, by being vigilant about radon, by not smoking, by using safe solvents, cleaners, and soaps, by avoiding potentially dangerous chemical additives to cosmetics like parabens, by exercising, by practicing safe sex (including oral sex, to avoid contracting HPV), and so on. But there is, perhaps, nothing more important that we can do to protect ourselves against cancer than to become hyper-vigilant about what we put into our bodies. Our food may be laced with naturally occurring or synthetic carcinogens of many kinds, and our need to fuel our bodies every day for (hopefully) many decades means that even trace amounts can accumulate to dangerous levels over time. To be unconcerned is to be reckless, which we can, maybe, excuse for the individual, but not when that individual's recklessness impacts others, particularly children. We live in a world of unprecedented toxicity and we live in an era of unprecedented confusion over nutrition. We owe it to ourselves, and are absolutely duty bound to our children, to do all we can to adapt to this new and frightening reality.
It was not always this way. Fossil records, diaries of early explorers and conquistadors, and research by modern anthropologists and doctors living among hunting-gathering peoples are consistent. Cancer was exceptionally rare in the human condition in non-agricultural societies, to the degree that it often did not exist at all. The standard challenge to this perhaps surprising fact is, “well, people barely lived to thirty in those societies.” Which is false. The fossil records, early accounts, and modern studies consistently show that many people in hunting-gathering societies lived into advanced old age, even to the century mark. If the average lifespan was not high, it was skewed by a high infant mortality rate and deaths from violent causes or infections. But those who made it out of early childhood stood a good chance of living into what we consider old age. Death from cancer, stroke, heart disease, diabetes, asthma, and the many other ailments properly called “diseases of civilization” was virtually non-existent. Even sickness, the routine colds and flus most Westerners now consider a matter of course, were virtually non-existent. Humans living in “the wild,” so to speak, or, more aptly, in an evolutionarily and biologically appropriate manner like all other “wild” beings, virtually never got sick, just like other “wild” (how about “free”?) beings. Interestingly, like free animals, free humans also never got fat but were typically muscular and lean. As noted by Gary Taubes, obesity is a phenotype that manifests only in societies with diets heavy in simple starches and sugar, which is to say, agricultural societies.
(This man from the Chagos Islands was one of the last evicted when the British expelled the entire population from their homeland to lease it to the US military. Ever heard of "Diego Garcia"? This man, very poor, and thousands of miles from the nearest gym, lived on fish and coconuts. Lots of omega-3, lots of saturated fat, very little sugar.)
Cancer exploded into human history with the advent of agriculture and the adoption of a radically new diet, a diet based on grain. With the adoption of a grain based diet, the ancient peoples of what are now Greece and Turkey lost an average of six inches in height, much of their of bone mass, and went from less than one cavity or missing tooth per person per lifetime to six. Infant and maternal mortality soared. Cancer became a normal condition, along with plagues, none of which have origins outside of agriculture. Jarrod Diamond is one of many writers to have wondered why in the world any culture would choose such a path. I explored the issue in some depth in my first post on this site. It's an important question. But, for now, we need simply note that cancer is essentially a product of the conditions of agricultural society and became epidemic in the industrial era. This is crucial, because it means that we are not doomed, as a species, to suffer this scourge. We can do something about it. One thing is to eat like our paleolithic ancestors, for we are, biologically, no different.
Before we move on to the horrors of industrial agriculture (including the socio-economic horrors that undergird it), let's take a moment to consider what our paleolithic ancestors ate, aside from more fat and protein and a lot less carbs (and virtually no sugar). They ate organs. A lot of them. In many indigenous cultures, liver and heart were eaten raw as soon as an animal was killed. These were the most prized foods, as well they should be, for they are the most nutrient dense foods on Earth. Next most prized were tongue, kidney, brain, tripe, spleen, lungs, etc. Also bone marrow and other sources of highly saturated fat. Least prized? Lean meat, like tenderloin. That often went to the dogs. If lean meat was eaten, it was eaten with plenty of fat (like in pemmican/wasna, the classic “road food” of the Plains Indians, which is half lean, half fat) and/or in fermented form. The bones, if not used just for marrow, were roasted and boiled for rich bone broths, common to a great many indigenous cultures. They ate as much seafood as they could get, and inland tribes often traded for it. They particularly valued fish roe, which was often dried and stored. Fish oil was sometimes a staple food, most notably in the Pacific Northwest, where oolichan oil was eaten at every meal. They ate deeply fermented vegetables, rich in enzymes and probiotics. They often ate raw foods, including meat. And they ate many mushrooms, rich in minerals, vitamins, mycoprotein, and, most importantly, medicinal compounds. Sound much like the SAD (Standard American Diet)? Didn't think so. In addition to eating way more fat and way less sugar, they ate many times the concentration of minerals and vitamins, and often in more bioavailable forms (i.e. with fat, since many crucial vitamins are fat soluble and largely unavailable when the body is starved of dietary fat). Malnourished people are not always skinny. But they are always at greater risk for disease, including cancer.
Back to the present. The most obvious reason why our food carries carcinogens is because we put them there, and by “we” I can mean either “we, ourselves,” or “we, our culture.” We, ourselves, put carcinogens in our food when we scorch it, when we smoke it (sad but true), when we cook it in plastic in microwaves, when we carelessly use rancid oil, when we let foods develop molds containing aflatoxins and then eat them, maybe when we use teflon, and, perhaps most of all, when we add sugar. We as a culture, spray a dizzying array of poisons onto our crops. This is insane, but it is necessitated by the myopic accounting of our system. What we call “efficiency” in this system is not actually efficiency at minimizing costs but rather at maximizing the shift in burden of those costs. I hope that made sense. It's really important. To use the terminology of economists, our system excels at externalizing costs.
When we buy industrially produced food at the supermarket, we hand over less money than we do for roughly equivalent foods at a farmers' market or organic coop. The difference is, when we pay for our organic, local foods at a farmers' market, we are actually paying a more or less appropriate price for the product, that is, the costs are internalized. When we buy industrial food, we are not necessarily thinking about the human, ecological, moral, and monetary cost of war and the military itself, which play such a crucial role in maintaining the flow of relatively (seemingly) cheap oil and other key resources, though we do, of course, pay those costs in more ways than one, some of us far more than others. That is an externalized cost. We are not often thinking of the subsidies and plain corporate welfare that create an illusion of efficiency but are, in reality, merely grand theft from the poor and middle class to the rich by way of the corporatist government. That is an externalized cost. We are not often thinking about the monumental costs of our health care industry, so much of which exists to treat ailments caused or exacerbated by industrial food (and the pollution caused by industrial food production, and by “side-effects” of the pharmaceuticals themselves). That, too, is an externalized cost. Go to Rite Aid and see how much space to given to products that either give you diabetes or keep you alive, and dependent, with diabetes. We are not often thinking about the desertification of the land and creeping foreclosure of the future through topsoil erosion, groundwater depletion, collapse of biodiversity, and toxification of the oceans (much of which is from synthetic fertilizer and pesticide runoff), costs we bear more with each day, but which will be borne far more heavily by those who come after. We are not thinking about the loss of community, culture, human dignity, and personal freedom as independent farmers are driven out and as badly underpaid and often abused migrant workers take their places in the fields, only to be scorned in the society around them. All these and more are externalized costs of industrialized agriculture. The idea that local food is too expensive is crazy. You can't even quantify the heaviest costs of industrial foods, but the lesser costs alone render it utterly beyond the reach of most of us.
And it sucks.
The trouble is, we're all forced to pay for industrial food, whether or not we take the final step of forking over a little cash at the supermarket to take it home and eat it. And when the burdens on so many people are so great, burdens so often stemming from the externalization of costs in the industrial economy, many of us will not (Americans) or cannot (the global urban poor) spend more money to buy organic, local, sustainable food, even though doing so improves our local economies, builds a safer, cleaner alternative to the industrial model, and nourishes us far better (which includes not poisoning us), reducing our future medical costs.
All that is a round-about way of explaining why industrial food is literally coated in poison, often carcinogenic poison, and why spending a little more for local, organic food not only means we get to eat clean food but means that many others will, too, for when we keep our dollars local, the local economy flourishes.
And then there is sugar. Dr. Robert Lustig has made a powerful case for why fructose (by the way, sucrose is half fructose), best known for its presence in corn syrup, but a major component of honey, agave, fruit and fruit juice, and pretty much every sugary food on Earth, is toxic. “Alcohol without the buzz,” in terms of its long-term impact on the body. Watch his talk. Check out the work. It's very good. As is the piece, inspired by that talk, written by Gary Taubes in the New York Times. Lustig asks if you would give your child a Budweiser. Since the obvious answer is no, well, what about a Coke? It will do all the same things, except the Coke will create a sugar rush instead of drunkenness. Study after study is showing that cancer feeds on sugar. We were raised in a society in which it's considered normal and nice to give our kids candies, cakes, pastries, soda, and other sweets. We poison our kids, manifesting the forward-payment of an abusive paradigm, currying short-term favor with an addictive drug, and destroying their long-term health. Dare we even ask ourselves if it's worth it? I would never and will never give candy or soda to a child and nothing more than very limited amounts of fruit, honey, or maple syrup (yes, I will let them take the occasional taste of wine, too). Too much rigidity can backfire, but that does not mean we shouldn't protect our kids. Trying to seem moderate in the midst of an insanely imbalanced food culture is not good enough.
- If it's sprayed with poison, don't eat it, don't even think about eating it, and don't let kids eat it. If you don't know for sure that it wasn't sprayed with poison, assume it was, for it's a near certainty.
- Be honest about what you can afford. A century ago, Americans spent half their income on food. Worldwide, the figure is closer to 70%. Most Americans today spend barely 10% of their incomes on food. The overwhelming majority of us can afford clean, healthy, local food without poison. Most of us, however, can't afford the inevitable health care costs of eating industrial crap.
- Don't eat sugar except in the smallest of doses, and understand that, in terms of your health, you might as well be shooting vodka. Remember that, too, with your kids. And remember that we have to protect our kids from the many misguided and/or addicted people out there who want to give them sugar. How about a nice birthday steak!
- Get plenty of micronutrients and minerals from traditional foods, including fermented foods, bone broth, organ meat, egg yolks, fish roe, etc.
If we do all we can to protect ourselves from the ravages of cancer, and do the same for our kids, it brings no guarantee of success. But that's just life. You make your kids look both ways before crossing the street, don't you? They buckle their seatbelts, right? Protecting our kids, and ourselves, is a practice of risk management. And it is a manifestation of love.
Coming soon, Part 3: Yearning for agency in the midst of environmental catastrophe.