Pulling off this rescue is going to be a big challenge. In her last blog post, my wife Joyce, Dr. Grandma, rejoiced greatly in the publication of an article in the Journal of the American Medical Association (JAMA). This article confirmed her central message, and that of others, in advocating strongly a return to foods, rather than individual nutrients. “Nutritionism”, as food writer Michael Pollen, Dr. Grandma, and others have called it, has many negative effects. One of them is in creating dietary guidelines based on individual nutrients, making it difficult to translate them back to foods. The Harvard scientists writing in JAMA spoke out against new government guideline and in favor of returning the dialogue back to foods instead of nutrients. The confusing obscurity fostered by nutritionism has been a detriment to ordinary people in deciding what to eat. While Dr. Grandma has been thrilled with the JAMA publication, it has struck me as long overdue, quite ironic, and that despite this article, it is still going to be a long and difficult battle.
The JAMA article seems to me a belated response by respected and distinguished scientists to a problem, which their kind has permitted to develop over a period of many years. That is part of the irony. Scientists have been party to this state of affairs. A minority of them has spoken out against it from the first, but most have gone along with the confusing doubletalk that economic and political pressures have enshrined in government agencies and professional organizations. Nutritionism permits ambiguous, compromising messages, designed to quiet down the political might of Big Food, leaving the confused public easy prey to education through advertising – hyping nutritionally inferior processed products. These products are highly profitable, with ample margins to permit vast advertising expenditures. Along with everywhere available access to these processed products with long shelf lives, the result is the mass consumption of fake, fattening fudes that have deeply damaged our public health. The relaxation of regulations against artificial and adulterated foods has been permitted by governmental bodies that were supposed to protect us from this sort of thing. The majority voice of scientists has gone along with it.
Let me quote one of the minority voices -- the words of Joan Gussow, a Columbia University nutritionist who served on a panel assembled by the National Academy of Sciences in 1982 to advise on the link between diet and cancer. Gussow and a few others argued against the focus on nutrients rather than whole foods. She pointed out correctly that the research studies showing a link between diet and cancer were based on the intake of whole foods, not individual nutrients. But in frustration she saw the report written “…as though it was the vitamin C in the citrus or the beta-carotene in the vegetables that was responsible for the effect (reducing cancer). I kept changing the language to talk about ‘foods that contain vitamin C’ and ‘foods that contain carotenes.’ Because how do you know it’s not one of the other things in carrots or the broccoli? There are hundreds of carotenes. But the biochemists had their answer: ‘you can’t do a trial on broccoli.’” This quote comes from a lucid account of the history and nature of Nutritionism written by investigative journalist and food champion Michael Pollen. The quote is found on Page 26 of In Defense of Food: An Eater's Manifesto, which was published in 2007, three years before the recent article by the Harvard Professors. It is clear that these writers of the important JAMA article are also in the minority, since they make bold to publish their own defense of foods vs nutrients in a challenge to new government proposals.
The Harvard authors Mozaffarian and Ludwig give a useful two-paragraph background to the historical events that led up to what we are calling the fallacy of Nutritionism. Not having the same page limits as they did, Michael Pollan greatly elaborated on the key historical events, from the 1800’s to the present. He traced the early uses of the reductionist fallacy of nutritionism from the “father of modern nutritional science”, the great German scientist Justin Liebig. “Having cracked the mystery of human nutrition, Liebig…concocted the first baby formula, consisting of cow’s milk, wheat flour, malted flour, and potassium bicarbonate…But the post-Liebig consensus that science now pretty much knew what was going on in food didn’t last long. Doctors began to notice than many of the babies fed exclusively on Liebig’s formula failed to thrive.” Vitamins had not even been discovered at that time. Once they were, the Nutritionist mentality, which had only been slightly dented by common sense and the effects on real babies, took courage again. This has led to the concoction of wave after wave of baby formulas, with mixed results (see Wikipedia article on Infant Formula.)
Pollan singles out several crucial events in the rise of nutritionism during the last century, before the explosion of obesity and diabetes. I have already mentioned the National Academy of Sciences Panel, which published their influential results in 1982. Liebig was one of the founders of organic chemistry and is really responsible for modern methods of teaching chemistry, so the biochemists on the National Academy panel were his intellectual heirs. His wildly unwarranted reductionism to the big three macronutrients, fats, proteins, and carbohydrates, should have led to substantial embarrassment when his concoctions didn’t prove nutritious. Now again in 1982 Liebig’s intellectual descendents in biochemistry committed themselves and the country to a deeper dip into a similar reductionist fallacy. Micronutrients surely will prove to be all that matters, even if Liebig was wrong about the all-sufficiency of the macronutrients. His reputation came off well despite his reductionist fallacy. The majority of scientists on the 1982 panel made sure that the Academy of Sciences backed what we now call Nutritionism. But these scientists were only lagging the politicians by five years.
Another crucial event occurred in January 1977 when nutrients rather than foods won the battle of words in the vocabulary of diet. The Senate Select Committee on Nutrition and Human Needs stumbled their way into this debacle. The committee was chaired by South Dakota senator George McGovern (A three-term senator and later democratic presidential candidate). In Pollan’s words (pg 23) “the committee issued a fairly straight-forward set of dietary guidelines, calling on Americans to cut down on their consumption of red meat and dairy products. Within weeks a firestorm of criticism, emanating chiefly from the red meat and dairy industries, engulfed the committee, and Senator McGovern…was forced to beat a retreat. The committee’s recommendations were hastily rewritten. Plain talk about actual foodstuffs – the committee had advised Americans to ‘reduce consumption of meat’ – was replaced by artful compromise: ‘choose meats, poultry, and fish that will reduce saturated fat intake’.”
Pollan continues with this compelling story: “The linguistic capitulation did nothing to rescue McGovern from his blunder. “ (He lost in the very next election). “…sending an unmistakable warning to anyone who would challenge the American diet, and in particular the big chunk of animal protein squatting in the middle of its plate. Henceforth, government dietary guidelines would shun plan talk about whole foods…”.
I have quoted a bit more than we usually do, both to give you an earlier example of this argument that pre-dated the JAMA article, and to give you some idea about Pollan’s excellent investigative work, and his interesting and delightful language. There is so much in his writing that we simply encourage you to purchase In Defense of Food: An Eater's Manifesto, and/or his short follow-up book Food Rules: An Eater's Manual. This book makes it easy to tell the difference between food and what he calls Food-Like Substances. We call these concoctions “fude”. Our word rhymes with rude and crude and goes nicely in the phrase “fake, fattening fudes”. My Full Cost Accounting blogs, Part 1 and 2 give the argument at a top level for how government and Big Food have created fudes. Understanding nutritionism explains how fudes have been foisted on the American public at great profit to Big Food and great cost to our pocketbooks and to public health.
If you haven’t already read them, you might want to examine Grandma’s blogs on this subject. Most recent is Nutritionism: Using a Single Player instead of the Entire Team. Or you could just search this site using the word “Nutritionism to find a handful of articles and a definition in the GrandmaPedia. Dr. Grandma has stood up for Food as along as I have known her. She has long practiced what she preaches, using it in reclaiming me from overweight and diabetes, then she has tried to promote these principles through founding Dr. Grandma’s Whole Grain Foods Company and teaching and explaining about making whole foods delicious as well as nutritious.
Don’t get me wrong about the JAMA article. Like Dr. Grandma, I am personally very pleased that two distinguished Harvard MD’s who also have PhD’s related to public health have made such a clear statement. Their message may be slightly belated, but they are clear about removing the ambiguity and the compromise. They are clear about the research and theory that ties certain foods to good health and certain others to chronic illnesses. Their commentary, Dietary Guidelines for the 21st Century – A Time for Food is not the report of narrow research findings but a broad synthesis with strong policy recommendations. It is no coincidence that their commentary comes at a time when public comment has been requested by the USDA in response to its new version of their Dietary Guidelines and Food Pyramid. You can read the interesting public comments by going to this USDA site and clicking on “View Written Comments.”
Reading some of these myself, and looking at the Dietary Guidelines, they have a lot of really good well written and well documented advice. The graphic food pyramid is where the problems still lie. As the JAMA article states, it still lumps processed grains and pastas together with whole grains, and still puts sweets, with good and less good oils together at the pinnacle, In what one would normally think is the next most honored position comes meats and dairy, rather than being at the bottom or in some kind of tail. You have to read the words to get the best of these guidelines, and realize that the pyramid itself is still the product of Nutritionism compromising nutritional truth to protect vested interests.
Despite this positive development from scientists who are still in the minority, I have hopes that the public will rise up and choose foods over fudes. We will have to do this despite the fog of nutritionism, which has so effectively disguised fudes as healthy because they contain a few added vitamins or other popular nutrients. There are commendable steps forward from scientists and government agencies. But it is still going to be a long battle.