I’m Shouting Halleluiah! Cheers! Hurray! And Yippee!

August 25, 2010 in Blog Recipes, Diabetic Menu Item, Foodland, Mediterranean, Nutrition by Joyce Bunderson

In Proverbs 17: 22 it says: A merry heart doeth good like a medicine; I’m writing this post on Friday the 13th and my heart has been singing for two days. In all honesty I’ve had many a despairing thought that this day would never come. But despair no more!  In The Journal of the American Medical Association (JAMA) on August 11, 2010, two medical doctors with doctoral degrees in public health have published commentary on principles that I have been waiting for more than a decade to be acknowledged. So why am I rejoicing? It is that two highly respected public health Harvard physician/professors (Dariush Mozaffarian and David S. Ludwig) have published a statement in JAMA, arguably the most prestigious medical journal in the U.S., if not the world, saying in clear and simple English that there is a need for a new approach to nutrition education.

The authors discuss how we got to the point of focusing on nutrients not on foods, which presently afflict the nutritional information, education and goals for the public. They even address the concept of the inadequacy of using RDAs (Recommended Daily Allowances – those numbers on the labels of packaged foods).  I’ve felt for so very long that few, very few people have any idea of how much fat, cholesterol, fiber, salt or calories they are actually consuming. The authors say, “Few individuals can accurately gauge daily consumption of calories, fats, cholesterol, fiber, or salt.” We have some hope of judging portions of entire foods or dishes, but little hope of judging portions of abstract categories like these. Salt is the only one in this list that we can see, and even for salt, most of the salt we eat is invisible now days, dissolved in the processed substances we buy.

I especially enjoy the author’s critique of those who design the Dietary Guidelines combining foods with “widely divergent physiologic effects” like “brown rice, white bread, apples” into a single group. They continue with another example of foods “based upon protein content (chicken, fish, beans, nuts) despite demonstrably different health effects.”

The article points out that, “In contrast with discrete nutrients, specific foods and dietary patterns substantially affect chronic disease risk ….” If you read this blog very often, you can guess how happy this paragraph makes me. You know that I write and write to help our readers learn precepts of a Mediterranean-style of eating. Mozaffarian and Ludwig are writing about this style of eating, without using the term we use. They say, “Fruits, vegetables, whole grains, and nuts are consistently associated with lower risk of disease. Fish consumption reduces risk of cardiac mortality, belying categorization with other protein sources.”

The FDA Food Pyramid has been under revision and its new 5th version has been out for public comment.  This was one impetus for the publication of this article. This highly public critique in the influential JAMA journal makes it clear that the government is boxed in between what the scientists independent from the food companies say, and what the food companies’ scientists and lobbyists can influence.  Getting your processed food listed in the same slice of the new pyramid as an acceptable alternative is worth millions in sales. This leads to a food pyramid that contains many compromises.

On the other side of the coin, Mozaffarian and Ludwig say, “processed meats, packaged and fast foods, and sugar-sweetened beverages increase chronic disease risk.” Note: please see my numerous posts on this subject. Yet another comment that they made, will likely become scripture to me, is one that involves the complex synergistic contributions from the many aspects and nutrients that are found in foods. I’ve repeatedly alluded to this concept in the Dr. Grandma’s posts, including the one on nutritionism.

They make the point that “healthy eating patterns share many characteristics, emphasizing whole or minimally processed foods and vegetable oils, with few highly processed foods or sugary beverages. Such diets are also naturally lower in salt, trans fat, saturated fat, refined carbohydrates, and added sugars; are higher in unsaturated fats, fiber, antioxidants, minerals, and photochemicals; and are more satiating. Thus, a focus on foods increases the likelihood of consuming more healthy nutrients and fewer calories and decreasing chronic disease risk, whereas the opposite has arguably occurred through decades of nutrient-focused guidelines.”

Mozaffarian and Ludwig go on to describe how the food processors market refined products with an “aura of healthiness but without actual health benefits.” More music to my ears! Maybe one of the reasons that I like these guys so much is that they can throw in a bit of sarcasm. They explain how “whole-milk yogurt” is in the same category with “donuts and French Fries”; “sautéed vegetables and tuna canned in vegetable oil” are in the same group as “processed cheese spread and pretzels”; and “fresh fruits and vegetables are grouped with trimmed beef and fat-free mayonnaise”.

I very rarely do so much quoting but this JAMA article has too many good ones to miss, “Taking the nutrient approach to self-serving extremes, the food industry "fortifies" highly processed foods, like refined cereals and sugar-sweetened beverages, with selected micronutrients and re-characterizes them as nutritious. These marketing ploys provide little public health benefit and could potentially produce harm.” This issue has been fodder for my blogs – see Tomato Favor Instead of Tomato, Hummm? and Nutritionism: Using s Single Player instead of the Entire Team.

The authors conclude their article with statements saying that the “nutrient-focused approach “contributes to confusion, distracts from more effective strategies, and promotes marketing and consumption of processed products that nominally meet selected nutrient cut points but undermine overall dietary quality.”  They go as far as saying that “the greater the focus on nutrients, the less healthful foods have become.”

The authors say that their approach may seem radical, but it actually represents a return to more traditional, time-tested ways of eating. “Modern nutritional science now provides substantial evidence for how foods and food-based patterns affect health, guiding the design of more effective approaches for the prevention of chronic disease.” These two gentlemen know about chronic disease, they study and teach cardiology, diabetes care, epidemiology and weight management. I’ve never met, Mozaffarian and Ludwig, and probably never will; but they have become my heroes; I also like Dr. Walter Willett, who I periodically quote, but now my hero group is growing. I so honor these two physicians for taking the time and effort to draw this very deep line in the sand. I do not believe that I am over-optimistic; I believe that their commentary is a seminal piece that nutrition educators and leaders in the field of nutrition will ‘wake up’ and notice.

Frankly this article almost brought tears; tears of joy. I recognized this issue so long ago, and have written about it since I started blogging, but I’ve felt somewhat alienated by traditional public health nutrition. I’ve also felt absolutely powerless against the mega business of food manufacturing. I don’t receive any pay for writing the newsletter or the blog for Dr. Grandma’s; it’s our ‘give back’ gift to the public. I’d have to say that it’s been, at times, fairly discouraging to be the little person, against the enormous machine that designs the Dietary Guidelines and those that produce the profitable overly processed foods that are not yet ruled out by the guidelines, yet the frequent unhealthy choice of millions. I, have, however, a renewed hope that more prestigious professors, physicians, researchers, dietitians, nutritionists and so on, will see the light and stop endorsing the merit of this glut of processed foods. Food Inc. is selling us down the river of poor health with their profitable concoctions: foods, impoverished of natural nutrients through processing, and with cheap added junk, bearing scientific-sounding nutrient names.

My Easy Whole Wheat Apricot Almond Cobbler is a yummy dessert using whole grains, oil olive, apricots and other real food.