Wednesday, April 29, 2015

Nutrition, diet, and health


There’s a LOT of noise in the area of diet and nutrition so there’s no doubt that it’s hard to know what to believe and how to proceed in our lives.  And so I think that many people have reached a point where they don’t have much trust in the latest nutritional advice to come along.  And for good reason as we all know that there’s a multitude of diet books out there, mostly useless gimmicks meant to sell books and diet programs: i.e. just the latest nutritional fad.  And so I think that a lot of people get to a point where they don’t pay much attention to it anymore and just accept the conventional wisdom as propagated by the mainstream dietitians, government agencies and most of academia.  Unfortunately that also means that people are so jaded that they are reluctant or unable to accept the real truth when it comes along.  

I know that was me until some while ago, mostly because I didn’t have a particular problem with my weight (though I had certainly added a bit more fat around the middle).  But I saw this great (and controversial) NY Times article from 2002 (unfortunately I didn’t see it back then) and it really sparked my interest and got me looking into diet/nutrition. It’s long, but it’s well worth reading:

What If It's All Been a Big Fat Lie?  - Gary Taubes

And a couple more recent, and very good, articles from the same author:
What Makes You Fat: Too Many Calories, or the Wrong Carbohydrates? – Scientific American
Why Nutrition Is So Confusing – NY Times


I started to look into the whole topic and really immersed myself in it, fascinated by what has happened in the science and what recommendations should be forthcoming vs. what the conventional wisdom is (eat low fat, plenty of grains, low saturated fat, little meat, “heart healthy” vegetable oils, etc.).

For most of my adult life I had mostly followed the conventional wisdom about eating a low fat diet, low in sweets, etc.  You know the drill: chicken breasts, little or no beef, few eggs, trim the fat obsessively, etc.  I didn't have any particular problem with weight or other diet-related health problems and so I didn't really question it. 

Clearly a lot of people have struggled with their weight, even while trying mightily to adhere to that guidance.  And they've often been looked down upon (quite likely very unfairly) as being undisciplined and lazy. (We really need to get the moralizing out of this.)  One part of Gary Taubes’ hypothesis is that because we haven’t fully appreciated the role of hormones (especially insulin, but also leptin, ghrelin, glucagon, and others) in our metabolism, we may have had this causal relationship backwards.  Just maybe, people aren’t fat because they eat too much and they’re lazy, they eat too much and they’re lazy because they’re fat.  I know, that’s hard to get your head around, but read his work and you’ll see where he’s coming from (if this is news to you, of course).  It really changes your viewpoint on this whole thing.


It’s understandably very hard for people to go against the conventional wisdom and the “authorities” (from registered dietitians and health advocacy organizations like the Am Heart Assoc., to govt agencies), but the evidence shows that they have been very wrong about their advice.  How can that be?  Why would they do such a thing?  There’s a whole host of reasons: scientific and statistical error, greed & corruption, stubborn refusal to change due to the fact that they simply don’t want to admit they’ve been so wrong for so long, ideological reasons, etc.

There’s a lot of resistance (typical of big, lumbering bureaucracies) in academia, government, and the big health organizations (e.g. American Heart Assoc., Amer Diabetes Assoc.) to giving up the idea that we should eat a low fat diet, high in carbs, especially grains. Even as the actual science (and our collective societal experience) has shown this to be a very flawed and detrimental approach. Top 11 Biggest Lies of Mainstream Nutrition
 
One of the biggest points of contention has been about what the macronutrient (fat, protein, and carbohydrate) makeup of our diet should be.  I think that the evidence shows that there’s a pretty wide range of appropriate carb intake for different people, based on activity levels, individual variation in genetic expression, and factors we don’t even know about or understand properly.  Most people could probably benefit from cutting back their carbs significantly; particularly from refined grains (especially wheat) and, of course, sugar.  The fat (and cholesterol) phobia (and irrational moralizing about eating fats) that has been instilled in us over the last 40+ years has driven us to eat far too much carbohydrate on the whole, especially from highly refined grains like wheat and corn; and of course sugar.  

I now follow a lowish carb diet (depends on how you define it, of course). I don't actually track carbs (though I did track for a bit at first to get a feel for what I was eating) but I’d say probably around 100-150 per day on average, though I don’t really know for sure.  I started out keeping it down at about 50-75 gms/day.  I wasn’t a big sugar/junk food eater before, so mostly it was a matter of dropping cereal and pasta from my diet and very little potatoes, rice etc. during that time.  I dropped 20 lbs (190 to 170) in a few months without trying and without much exercise and definitely no additional exercise.  Honestly, I wasn’t even thinking about losing weight and certainly wasn’t restricting my food intake (at least not consciously).  Apparently that’s a common experience when people do this.  Not that I had a lot to lose, but it was noticeably from my waistline (almost 2 inches).  Then I started experimenting with adding some starchy foods back in (as outlined below).

Our focus is really on eating “real food” (an admittedly nebulous term): no processed, packaged food, no so-called vegetable oils (i.e. seed oils; corn, soybean, canola, etc.), very little added sugars (no, we don’t eat all those cakes and cookies that Jill makes :-) ), almost no grains, especially wheat (with the occasional exception of a homemade pizza!). 

This is a darned good run down of what we avoid: 20 Foods That Are Bad For Your Health (Love that website; real good, solid info.)  I try not to get dogmatic about it.  But I also don’t really miss anything I’m not eating, so it’s really not hard.  There’s lots of good food that’s good for you.  And truly occasional treats aren’t the problem.  The problem is when those occasions come daily!  :-)

So we’re focusing mostly on avoiding what are often referred to as the big three modern nutritional “evils”: refined grains, sugar, and industrial seed oils.  The latter’s harm is very much overlooked, to say the least, as we continue to get the message that they are “heart healthy”; a grave mistake, as the science actually shows that they create inflammatory conditions in our body leading to many types of disease.  Instead, for cooking we use coconut oil; animal fats, like lard, beef tallow and butter; and sometimes olive oil.  And olive oil & avocado oil for non-cooking uses, like salad dressings.

We get beef in bulk (trying to eat “nose to tail”, especially liver; and making homemade broth from extra bones we get), eggs, and milk all straight from local small farms. And we also eat store-bought chicken & pork (working on getting from better sources), and fish.  We eat lots of veggies (especially greens & some homegrown), including starchy root veggies like potatoes, sweet potatoes, carrots, rutabaga, parsnips, beets, etc., which is where the bulk of our carbs come from (plus some rice once in a while).  And some fruit and nuts.  Oh, and I should mention homemade fermented foods, like yogurt, kefir, kombucha, and sauerkraut and assorted other veggies.  Great stuff to aid the intestinal microbiota - and nutritious, of course.  I eat a bit of dark chocolate (85% plus) once in a while too.

It’s very much in line with the diet laid out here: The Perfect Health Diet, although it’s not that I just picked up the book and went right to this diet.  I had been doing a lot of research and exploration and had ended up pretty close to this, and then after reading the book it all pretty much fell into place for me.  They have a great book that explains it all: Perfect Health Diet.  I highly recommend it. It’s NOT a faddish, quick weight loss diet book.  You can read a description at that link.  Lots of good, well-grounded (referenced) science that is still not too technical; so very accessible to the layman.  And the web site is a great wealth of information as well. 

As with much of the really good work that’s been done in the area of nutrition, they were not primarily trained in that area but are very smart people who came to it after experiencing serious nutritional problems themselves.  So they remained open-minded and not heavily biased by the (highly flawed) conventional wisdom as taught in most higher education and adhered to by almost all licensed dietitians (they’re held hostage to it by the sclerotic govt guidelines & licensing requirements). 

I think that maybe the biggest thing people probably have to overcome (other than dropping their bread/pasta/sugar habit) is the cognitive dissonance that comes from going against a conventional wisdom that is very fat-phobic (especially re: saturated fats).  We’ve been truly indoctrinated into the idea that fat makes us fat, and that sat fat “clogs” our arteries.  I think the science pretty convincingly shows that these things - just - aren’t - true.  And if you’re going to drop the proportion of carbs in your diet you really have to increase the fats (only 3 macronutrients: fat, protein, carbs).  You can only eat a limited amount of protein in a pretty strict range, and our protein intake is very well regulated by our appetites; though many people no doubt need to improve the quality of the protein they’re eating (as with their whole diet).

And then there’s the flawed “A Calorie Is a Calorie mantra.
7 Common Calorie Myths We Should All Stop Believing
9 More Calorie Myths We Should All Stop Believing
 
And finally, though I realize that it’s still hotly debated, I disagree with the demonization of red meat that seems to be largely driven more by ideology than science; with the caveat that concentrated animal feeding operations where cattle are fed an unnatural diet of only grains and not forage is a problem, for the nutritional value of our food, and the cattle’s well-being, which aren’t mutually exclusive; same for dairy.  And there are probably some problems with many processed meats, but we shouldn’t conflate those with good, fresh, healthy beef/bison, pork, etc.

I could go on and on (I know, I already have). :-)  I aim to keep learning and maintain an open mind. 

Here are some websites/blogs and books I recommend to anybody interested:
http://perfecthealthdiet.com/
www.marksdailyapple.com/ 
http://authoritynutrition.com/
http://chriskresser.com/
https://intensivedietarymanagement.com/  
http://www.fathead-movie.com/
http://www.gnolls.org/index/
http://eathropology.com/
http://rawfoodsos.com/
http://eatingacademy.com/start-here

Books: 
The Perfect Health Diet 
Why We Get Fat: And What to Do About It (review)
The Big Fat Surprise: Why Butter, Meat & Cheese Belong in a Healthy Diet (review)
Death by Food Pyramid (review)
The Art and Science of Low Carbohydrate Living (review)
Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet andHealth
Real Food: What to Eat and Why