Guide To Lifestyle Health Part 2.1: Nutrition Background

For introducing my basics on lifestyle medicine, I started with exercise because it seems to be a little less controversial. Working out makes you feel good immediately and in reality, it’s the “easier” component of healthy living. Diet, on the other hand, can be pure torture (if done flagrantly.) I think to really understand why your diet mistakes happen/how to fix them, we must first understand how we got here in the first place.

Why is eating well so difficult? Why is it so hard to resist overeating, or to choose leafy greens over deep fried oreos? During 99% of the time humans have been on earth, food has been scarce. Survivors were those able to 1) find food 2) eat that food quickly and save it as fat for a rainy day 3) thrive without eating again for weeks. Now imagine starving, and stumbling upon a walnut tree-  a very dense source of calories, with a wild lettuce patch next to it.  It takes a lot of work in eating/digesting that lettuce to get enough calories to last you a few weeks. So screw it, bye lettuce, now GORGE ON THOSE WALNUTS BEFORE YOU DIE OF MALNUTRITION. [If you’ve taken an anthropology class, this might remind you of the Dobe Ju/’hoansi tribe foraging for mangogo nuts. For a brief summary on this modern-day hunter gatherer tribe, from whom we have much to learn, read here.

Over the years this was of huge benefit; both a learned and natural selection trait, our bodies adapted to crave and seek out foods of the highest caloric density. This was all well and fine until the agricultural revolution and the subsequent rapid development of the “food industry” that quickly transitioned us from starving and dead, to alive but chronically ill.  This was particularly apparent in certain populations who had a very rapid transition from paleolithic to western influence of food abundance [Neelson’s Thrifty Gene hypothesis is a must-read and far ahead of its time] having an impressively quick onset of type II diabetes and other obesity related disease.  We now live in a world of excess through which we must carefully navigate and instill self control all while battling our primitive brain stems impulsively telling our higher cortex to just GET OVER IT AND EAT THE ENTIRE BOX OF GIRL SCOUT COOKIES.

Don’t get me wrong- I’m not saying that we’d be better off living in a time where starvation was a common occurrence. Duh, of course not. In fact, I don’t glorify the paleolithic era at all; to think that humans 10,000 years ago lived in a utopia setting with a daily catch of wild salmon with a side of freshly picked berries and vegetables is totally ridiculous.  It was likely treacherous with people dying of famine and tragic accidents, worried about the simple act of survival. For the great majority of persons today in an industrialized society, caloric scarcity is hardly ever a concern and what a wonderful thing to not worry if you’ll have a next meal. Even in the homeless population whom we assume are starving, the prevalence of being obese is 32.3% compared to the prevalence of underweight (1. 6%)!! [reference: The Hunger-Obesity Paradox: Obesity in the Homless. Koh]  I’m here to simply highlight that we now have the great burden of chronic disease that could be greatly improved with consistent lifestyle (and most importantly, diet) modification. 

Once food abundance was a thing, and physical activity declined, the incidence of cardiovascular disease, diabetes, and obesity skyrocketed. Researchers and doctors started delving into finding an explanation for these troublesome public health concerns.  Most notable is the Seven Countries Study completed by Ancel Keys that sparked a multi-decade trend of low-fat low-cholesterol product development.  Unfortunately what the public extrapolated from this study was NOT the presence of high fruit/vegetable content being associated with prolonged life but rather the lower amount of animal fats/cholesterol, which was then extrapolated even more to include ALL fats as a cause for poor health. The conclusions in this original study was further supported by more basic science studies suggesting the role of cholesterol in fatty plaque development and eventually coronary artery disease, and before you know it the American Heart Association is making strong recommendations for low fat dietary guidelines.  This was literally GOLD to food production companies. You now have an entire population worried about how much fat they’re consuming, thus triggering development for thousands of low-fat processed products, slap a label of “healthy” on there and call it a million dollar day. What Dr. Keys, other scientists of his time and the AHA intended to do was convince us to eat this:

But thanks to food companies praying on the health conscious minds, we got trapped into eating THIS:

Dr. Keys’ study came to a recent head of controversy, as new data along the way debunks the public and food industry interpretation that a low fat diet is the key to health. We have a recent TIME article retracting their original disposition from the 1970′s regarding this topic, now taking the viewpoint to EAT MORE FAT, 

all while STILL missing the overall point that a balanced diet with your plate brimming in fruits and vegetables and natural fats and whole food carbohydrates and not eating bullshit products stripped of any nutritional value is actually how we will improve disease burden. But we are stuck with extremes. You’ve got doctors still stuck in the outdated recommendations of low fat diets, and you’ve got new-age “health coaches” recommending keto diets and maple syrup cleanses. You’ve got raw vegans literally disgusted by the fact that you would dare feed your child a piece of chicken, and there’s paleo dieters freaking out that you’d recommend oatmeal as part of a balanced diet. The food industry exploded first, which triggered an equal and opposite reaction from the health industry, which then triggered the food industry to respond with new products that would sell to those people, and back and forth we go.  

All this evolution and food industry and health and fitness movement brings us to the current scenario: navigating our way through battling primitive desire versus wanting to live well in a grocery store full of “health foods,” “normal foods” and “non-foods.” There are just so many choices, temptations, and avenues of poor advice that it makes sense why we’ve been so unsuccessful in eating well as a population. So the first key tip in changing your diet for the better is to relax and cut yourself some slack. Look what you’re up against! You are not a glutton, you are not a lost cause, and most importantly, you don’t have to be miserable while eating well. After this, the simplest advice is to eat (mostly) foods that are natural products of the earth.  Outside of the grocery store, these foods have no monetary gain if you eat them or not. They’re not backed by a corporate company trying to promote trendy health claims to get you hooked. They literally exist for nourishment. Once you take this approach, along with sprinkling in some extremely delicious treats that are intertwined with our culture & customs, your body will feel better and do better. This is all easier said than done, but we’ll talk about that more in my next post :-)

All my love,

Shanny, D.O.