Although it’s only autumn, now is the winter of our discontent — at least for those of us who care about the potentially stunning health benefits of optimal eating, and the rather horrifying assault upon them. As I write this, evidence about profit-motivated, richly-funded alliances conspiring to undermine public health nutrition in the United States continues to mount daily. Those at all interested in lifestyle as the luminous medicine it has the capacity to be; those at all concerned for the addition of years to lives and life to years, who are other than abjectly discontent this season, simply haven’t been paying attention.
Genuine confusion about the basic care and feeding of Homo sapiens might be cause itself for some discontent, along with frustration and a sense of urgency. But our problem is far worse. We know fully enough to slash rates of chronic disease and premature death here in the U.S. and around the world, have known enough for decades, and just continue to do woefully too little with it. Every increment of delay adds to the tally of years lost needlessly from lives, life lost needlessly from years.
More than 20 years ago, McGinnis and Foege first detailed the root causes of premature death in modern culture, looking clearly past the chronic diseases that populate death certificates to the factors that underlie those diseases. Their original list of ten modifiable factors was overwhelmingly dominated by the first three, which alone accounted for some 80 percent of the annual premature death rate in the U.S. Those three factors were tobacco use, dietary pattern and physical activity.
That initial paper in the Journal of the American Medical Association constituted one of the great epiphanies, and opportunities, of modern public health: The realization that chronic diseases that constitute the great and growing plagues of the modern era are not causes, they are effects — and we know of what. That conclusion was reaffirmed when the same basic analysis was repeated a decade later and reaffirmed with almost incredible regularity and consistency in an ongoing sequence of peer-reviewed publications ever since, a veritable drumbeat, tapping out the doom of squandered opportunity again and again and again and again and again and again.
The opportunity we have been missing does not, of course, reside with acknowledging the true causes of premature death and chronic disease; it resides with addressing the cures, which themselves reside on the opposite side of the very same coin. The same literature that has indicated what factors underlie much of modern human infirmity, misery and untimely loss tells us, at times with stunning clarity, what happens when these factors are modified. The results conform to fervent hope and epidemiologic prediction alike: vitality and longevity are fostered. Chronic disease rates plummet. Premature death does not occur.
Our prowess over the forces of untimely death and infirmity is far from perfect. But it is even farther from the apparent impotence that has prevailed for decades now, stifling one of the great opportunities in the history of epidemiology. Knowledge is not power if it is not applied.
We have sufficient knowledge. Whether or not we ever suffered from confusion about the health effects of tobacco, we certainly do not now. While debate goes on about the ideal varieties, frequencies and quantities of physical activity, there is no confusion and little debate about the basic proposition: more movement is good.
As for diet, the third variable on the list, our protracted meanderings in apparent doubt, discord and befuddlement are a manufactured illusion in the service of profit over public health. The salient imperatives of eating well for health promotion and disease prevention have long been clear. Formal, authoritative recommendations for healthful eating have been more alike than not for decades, more similar than dissimilar around the world, and are now on prominent display as variants on a theme resulting in enviable longevity and vitality when practiced by whole populations, mediated by cultural traditions. Authoritative dietary guidance has always referred to real foods from nature, and has never advocated for swapping out highly-processed, high-fat junk food for highly-processed, high-carb junk food, or vice versa. The ills of excess sugar are not newly discovered; Jack LaLanne inveighed passionately against the substance some 70 years ago.
Our apparent confusion and the attendant loss of opportunity have been manufactured, in tandem with ever new varieties of junk food. Those seemingly endless varieties of junk food have been engineered to suit the nutrient preoccupation du jour and to propagate the overeating that feeds supply-side bank accounts.
It should be enough, perhaps, that we have sacrificed the human potential of several generations now on the altar of profiteering, looking on as if helpless at a tsunami of obesity and Type 2 diabetes for which we are, collectively, responsible. It should be enough to concede that even as we pretend to debate whether diets of mostly diverse plants should include fish or meat or eggs or dairy, we support sizable profits in the toaster pastry business and market multi-colored marshmallows as part of a complete breakfast. It should be enough to confront our cultural hypocrisies about health alone.
But it need not be enough, because there is more. In recent years, as the climate, the environment and biodiversity have joined human health in a hand basket on the way to you-know-where, more and more evidence has accrued that the same fundamentals of diet with the greatest potential to advance human vitality offer commensurate benefits to the planet, our fellow species and the cycling of precious, indispensable resources — notably, water.
Such are the fundamental truths. We know the common, core features of a dietary pattern conducive to human vitality and longevity. We know the overlap of dietary practices for the sake of ourselves and our loved ones that are concordant with the better destiny of the planet. We know, but we do not do — pulling up short at a barricade of special interests, profiteering, politics and the hypnotic hails of ever-present hucksters.
We have the knowledge, but knowledge is not power if not applied. And we are out of time and into desperation — seemingly calling for desperate measures. But in fact, the measures required to exit the calamitous costs of this impasse are themselves … measured.
There is no need for dietary radicalisms. Competing claims in opposing corners are part of the manufactured pseudo-confusion that prevails. The principles of healthful eating most decisively concordant with the weight of scientific evidence are the very ones most confluent with basic sense, and are moderate and thematic, providing accommodating latitude in the form of variations on the theme. The ostensibly contentious report of the 2015 Dietary Guidelines Advisory Committee in fact reaches a conclusion no more confrontational than that.
We are out of time for this nonsense. Anyone who loves a child he or she would like to see grow up in a world where adult-onset diabetes is not most often treated by pediatricians, in a world where there is food left to eat and water left to drink, in a world where polar bears still survive in the wild and neither California nor Bangladesh is under water, is out of time. Now is a time of discontent, and desperation.
Let us, then, take measures accordingly. Next month in Boston, Oldways will convene a conference of diverse experts to explore collaboratively the common ground of dietary health. Those of us participating are convinced we can find it, map it and come together there in common cause. Please take note, and take interest.
Some of us have anticipated that very hope, establishing the True Health Initiative, a new global alliance devoted to using what we know about diet, lifestyle, health and the fate of the planet — rather than propagating profits for the few, and calamitous costs for the many, in endless discord over details — to cultivate a strength only unity provides. This allows for differing perspectives on trees, even while acknowledging our common view of the forest. We welcome you to join us.
We truly know the fundamentals of healthful eating. We are out of time for pretense to the contrary. We have cause for not just discontent, but desperation with the status quo. We can, however, change it — just not by repetition of the follies that created the crisis in the first place. We need new measures, and fortuitously, rather measured measures will do: common cause, on common ground, in defense of core principles of healthful, sustainable eating held in common across generations and cultures.
Let us not be discontent or desperate any longer. Let us instead garner the strength of unity, take requisite measures and give our children the future they deserve.
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Diet, Time, Desperation and Measures originally appeared on usnews.com
