Wednesday, January 31, 2007

The Dogma of Nutritionism - Eat Less Meat

The blogosphere has been buzzing the last few days over seven words:

Eat food. Not too much. Mostly plants.

Those seven little words start Michael Pollan's essay, Unhappy Meals, in the New York Times magazine (from Sunday). As Pollan sums it up at the start, "That, more or less, is the short answer to the supposedly incredibly complicated and confusing question of what we humans should eat in order to be maximally healthy."

Somehow as he meandered from his brillant assessment on the rise of "nutritionism" - "an ideology" - influencing nutrition - "the science" - he too fell for it; fell for the belief that animal protein is a dietary demon that must be limited, if not eliminated if we are to get back on track to reach an optimum diet, thus maximize our health.

Intersperced throughout the essay are a number of not-too-subtle reminders that animal protein, especially meat, is taking up too much space on our plates.

He tells us we we knew this decades ago when the McGovern Senate Subcommittee first drafted dietary guidelines that included the statement to “reduce consumption of meat," that was compromised in an effort to appease industry to read “Choose meats, poultry and fish that will reduce saturated-fat intake.”

He continues to explain to us that the Gary Taubes article, What if it's All been a Big Fat Lie, was a "revisionist" accounting of what really happened in our diet since the implementation of the compromised dietary recommendations; cites T. Colin Campbell and Walter Willet as two researchers in agreement with the view that "the culprit nutrient in meat and dairy is the animal protein itself", thus we should eat less meat.

He then ties it all neatly up with "But people worried about their health needn’t wait for scientists to settle this question before deciding that it might be wise to eat more plants and less meat. This is of course precisely what the McGovern committee was trying to tell us."

He includes a number of convincing arguements to make the case against animal protein:

We just heaped a bunch more carbs onto our plates, obscuring perhaps, but not replacing, the expanding chunk of animal protein squatting in the center.

Of course thanks to the low-fat fad (inspired by the very same reductionist fat hypothesis), it is entirely possible to reduce your intake of saturated fat without significantly reducing your consumption of animal protein: just drink the low-fat milk and order the skinless chicken breast or the turkey bacon.

Thomas Jefferson was on to something when he advised treating meat more as a flavoring than a food.

Even the beginner student of nutritionism will immediately spot several flaws: the focus was on “fat,” rather than on any particular food, like meat or dairy. So women could comply simply by switching to lower-fat animal products.

And then, in a plea to convince us to return to our ecological and cultural relationship with food and eating, and reduce our consumption of meat, Pollan suggests we "Eat more like the French. Or the Japanese. Or the Italians. Or the Greeks. Confounding factors aside, people who eat according to the rules of a traditional food culture are generally healthier than we are. Any traditional diet will do: if it weren’t a healthy diet, the people who follow it wouldn’t still be around. True, food cultures are embedded in societies and economies and ecologies, and some of them travel better than others: Inuit not so well as Italian. In borrowing from a food culture, pay attention to how a culture eats, as well as to what it eats... Let culture be your guide, not science."

With all of this taken together then, it's difficult to wrap my head around his advice to "Eat more like the French. Or the Japanese. Or the Italians. Or the Greeks... Let culture be your guide, not science;" especially when he takes a huge leap of faith to explain the French Paradox by suggesting, "it may not be the dietary nutrients that keep the French healthy (lots of saturated fat and alcohol?!) so much as the dietary habits: small portions, no seconds or snacking, communal meals — and the serious pleasure taken in eating. (Worrying about diet can’t possibly be good for you.)"

So while I agree with his recommendations to eat real food (not processed, packaged, unknown generations ago foodstuff) and not too much, I'm baffled by his indictment of animal foods and his strong words against eating meat - especially when he then holds up four countries as somehow traditionally superior to our own because their dietary pattern is real food, not too much and mostly plant-based food.

The problem with that is the data doesn't align with the dogma which holds the traditional dietary patterns in Japan and the Mediterranean are plant-based, rich with "good fats," and naturally limits consumption of meat and animal foods.

What does the data tell us? Let's use the data from a source considered accurate for worldwide production and consumption data - the Food and Agriculture Organization (FAO) of the United Nations. Let's start with some basics:

United States 77.85-years Obesity 33% Smokers 17%
France 79.73-years Obesity 9.4% Smokers 27%
Italy 79.81-years Obesity 8.5% Smokers 24%
Greece 79.24-years Obesity 22% Smokers 35%
Japan 81.25-years Obesity 3.2% Smokers 30%

Gosh, maybe staying thin and smoking makes you live longer?

No, I don't think that's what Pollan was thinking when he suggested we eat like any of the above countries! No, the implication is they consume a healthier diet - specifically with more plant foods and less animal protein and animal fat.

The big question is, do they?

Well, not exactly.

Of all the countries, we actually eat the least amount of protein as a percentage of calories with 12.2% of our total calories provided by protein. Italy consumes 12.4% of their calories from protein; Greece 12.7%; France 12.9%; and Japan 13.2%.

But wait, percentage of calories is often misleading since it doesn't tell us the absolute gram intake and if they're eating less calories than we are, then even with higher percentage of protein, they're likely eating less protein....right?

Wrong.

With the exception of Japan, who consumes 92g protein daily, with a total calorie intake of 2768-calories daily (2003), here is how the absolute intake stacks up for the countries Pollan implies eat less animal protein and therefore infers is the reason they have less heart disease (2003 data):

United States - Protein 115g daily, 3754-calories/day
Italy - Protein 115g daily, 3675-calories/day
France - Protein 117g daily, 3623-calories/day
Greece - Protein 117g daily, 3666-calories/day

Wait, wait, wait - that's total protein! What about animal protein? Surely if these countries consume plant-based diets, the majority of their protein will be from plant-based sources and little will come from animal foods, right?

Well, let's look at that data:

United States - animal protein 66g daily (57% of total protein)
Italy - animal protein 62g daily (54% of total protein)
France - animal protein 76g daily (65% of total protein)
Greece - animal protein 63g daily (54% of total protein)
Japan - animal protein 52g daily (57% of total protein)

So, from our country to each Pollan asserts has a better dietary pattern, we find adequate intake of protein and a majority of that protein is from animal foods.

Something then is making us fatter than them - could it really be that we're eating too much fat?

Probably not:

United States - total fat 155g daily - 37% of calories
Italy - total fat 156g daily - 38.2% of calories
France - total fat 168g daily - 42% of calories
Greece - total fat 145g daily - 35.5% of calories
Japan - total fat 86g daily - 28% of calories

OK, so with the exception of Japan, these countries consume a "high fat" diet, not the mythical "low-fat" diet we're told they eat.

Perhaps then, the problem with our diet goes a bit deeper - maybe it really is the animal fats, the "bad" saturated fats we're told we should limit and avoid if possible.

Oops, there goes another assumption...

United States - animal fat 72g daily, 46% of fat calories
Italy - animal fat 71g daily, 46% of fat calories
France - animal fat 106g daily, 63% of fat calories
Greece - animal fat 57g daily, 40% of fat calories
Japan - animal fat 35g daily, 40% of fat calories

Surely death from heart disease must be highly correlated with their protein or fat consumption?

It has to be there somewhere - we're told repeatedly if we eat too much animal foods we're going to increase our risk for heart disease! So, again, what does the data say?

I'll let the numbers speak:

United States - 106.5/100,000 die from heart disease each year
Italy - 65.2/100,000
France - 39.8/100,000
Greece - 68.8/100,000
Japan - 30/100,000

So it seems if we're looking to reduce the risk of heart disease, it's an all-or-nothing proposition when it comes to protein and fat - France and Japan are very similar for rates of death from heart disease, but their diets are radically different; France consumes a high fat, high saturated fat diet, rich with protein and animal protein; Japan consumes a lower fat diet, lower in saturated fat, but still 40% of their fat calories from animal source, and their diet is rich with protein and animal protein as a percentage of their calories.

Hey, let's add to the confusion - both countries also have the highest percentage of the population that smokes - in France 27% smoke, in Japan 30.3% smoke!

So is the best advice to take up smoking and eat eather a low-fat with less than 30% total fat or eat a high-fat diet withmore than 40% of calories from fat and eat lots of animal protein while you're at it?

No, but unlike Pollan's subtle and not-so-subtle implication that the diets he suggests we follow do not include much meat or animal protein, the data clearly shows that protein is an essential part of these diets; the Japanese consume 57% of their total protein from animal protein sources, the French consume 65% of their total protein from animal protein sources.

Surely something is protecting these populations for heart disease; surely it's something we or they eat or do that the other doesn't.

What can start to explain how these countries eat better, live longer and die less from heart disease?

It's not the fat, it's not the protein, it's not the animal fat and it's not the animal protein.

Heck, it's not even their smoking or drinking habits.

What is it then?

I don't know - but the one glaring difference in our diets isn't our protein or fat - it's our consumption of sugar.

As a nation, we consume almost twice as much added sugars - 657-calories a day, 17.5% of total calories - than the next closest country, France (383-calories/day 10.5% of calories).

Our sugar consumption is significantly higher than all the countries - Italy 302-calories/day 8.2% of calories; Greece 332-calories/day 9% of calories; Japan 271-caloires/day 9.8% of calories.

Pollan got sucked into the dogmatic belief that meat is the problem in our diet because he didn't do his homework - he accepted the version of the "healthy diet" as espoused by those trying, desperately, to convince us to eat less meat and animal foods and adopt a plant-based diet; accepted a "healthy diet" means eating less meat and animal foods.

Problem is, the data tells us something different - it tells us the real, tangible, measurable difference between us and them is our consumption of added sugars.

Eat real food, not too much, limit the added sugars!

Bon Appetit!

13 comments:

  1. Anonymous9:44 AM

    You had it right until you got to sugar. Scientists studied sugars and obesity for more than 50 years trying to find a link and couldn't. In fact, the thinnest people eat the most sugars in obesity studies.

    And the U.S. also eats FAR less sugar than countries; almost half that of Brazil, Mexico and Australia; and much less than the UK, Thailand and Russia.

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  2. FAO Data for added sugars/sweeteners:

    USA - 657-calories/day
    Brazil - 550-calories/day
    Mexico - 472-calories/day
    UK - 400-calories/day
    Thailand - 320-calories/day
    Russia - 410-calories/day

    Heart disease death data is known for the following countries and compares to the US 106.5/100,000:

    Australia - 110/100,000
    UK - 122/100,000

    Obesity rates are published for the following countries, and compare with the USA 33%:

    Mexico - 24.2%
    Australia - 21.7%
    UK - 23%

    Hope this information is useful!

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  3. Anonymous10:30 AM

    This illustrates why population-based data is only good for hypothesis generation...nothing more. Too many confounding variables to draw firm conclusions.

    e.g. skinny people burn the most calories, hence they can eat all the sugar they want. You gotta be able to control for activity...hard to do in populations. Averages actually mean very little.

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  4. Anonymous10:47 AM

    The other problem is that FAO data specifically notes that these are estimations based upon food production data, not actual dietary consumption. And the US produces and exports an enormous amount of food to other countries that are not included in much of this data. They also note that every country compiles their data a little differently, making comparisons faulty. That's why you have to look at individuals and there is no correlations between obesity and sugars or any health problem other than caries mostly if sugars are in sticky forms such as raisins. The bottom line that people need to realize, is that obesity is not about eating any particular way. Fat and thin eat the same.

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  5. While the FAO data isn't perfect, it is the best estimates available for a worldwide snapshot of dietary patterns by country. It certainly doesn't represent what any one individual in a country eats - I know that for sure, I don't eat more than 600-calories a day from added sugar!

    That said, the spreadsheets I pulled from the FAO were food balance sheets, compiled by taking Production, Imports, Stock Variations, Exports, Manufacturing, Waste and other +/- to arrive at an estimated food quantity available and then consumption data - Calories available, calories from plant-based foods and animal foods; total protein, protein from both types; total fat, fat from both types; and then a detailed listing of each food group and the calories/protein/fat provided by each.

    The FAO data does show consistency with published survey data from the literature - for example, Japan has increased fats and protein in their diet since the 1960's to now include about 28% of their calories from fat. The FAO is consistent with this finding. Another example - the Japanese consume (it's estimated) 1/3 of all the fish/seafood available - in looking at the FAO data, they do consume much more fish/seafood than other countries...so again, there is a synergy between the FAO data and the published literature.

    Is it perfect? Nope. But it is a good dataset IMO.

    The bottom line that people need to realize, is that obesity is not about eating any particular way.

    I agree that there is no optimal macronutrient ratio to strive for - that is no perfect fat:carb:protein ratio that will guarantee health and well-being. There is alot more to eating than any one macronutrient being good or bad.

    What I do think the data bears out is the quality of the diet consumed matters - and that the consumption of essential nutrients is critical.

    Fat and thin eat the same.

    Health is more important in my view than overall body weight. A thin person can be as unhealthy as an obese person; an overweight individual may be in better health than a normal-weight person.

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  6. Anonymous1:06 PM

    I agree that epidemiology is not science or anything close. Could I point out that a leading Cholesterol Skeptic, Dr Malcolm Kendrick believes that chronic stress has a large part to play in the development of CHD.
    He has written many amusing and provoking essays on diet, they can be found at http://www.thincs.org/Malcolm.index.htm I shan't try to paraphrase him, he's too good a writer to deserve that treatment.

    Regards,
    Neil

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  7. Anonymous4:12 PM

    Actually sugar isn't good for anyone.It doesn't matter if you are skinny or otherwise.Everyone accepts that sugar rots your teeth.It also rots everything else inside you & just because it can take almost a life time to do so doesn't make it safe or okay to eat. Sugar is the main reason for cellular break down in the body & cancerous cells love the stuff.

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  8. Anonymous4:56 PM

    here here!!
    Susan

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  9. Limiting sugar is one of the best things we can do for our health as if we get enough protein, carbs, and healthy fats we should be fine.

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  10. Anonymous6:38 PM

    Great post! You truly have a gift for sifting through numbers, statistics and studies to arrive at accurate conclusions - rather than agenda driven disinformation. You're an articulate voice of reason in a sea of nutritional ignorance. Keep up the good work!

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  11. Anonymous11:59 AM

    I think Pollan's caution to reduce meat consumption is due to the fact that he's writing for U.S. readers, the vast majority of whom get their meat from very poor quality industrial farm sources. Based on "The Omnivore's Dilemma" and additional reading, I only buy my animal protein from pastured/free-range sources now (farmers' markets). This has had the effect of cutting my consumption of animal protein by at least 50%. Poor quality animal protein is just not worth the risk to my health to me.

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  12. I have to wonder sometimes just how much of the anti-meat propaganda has to do with fears over ecological issues such as global warming and water pollution - I've seen several articles recently that make mention of how much cattle flatulance increases greenhouse gases, and how run-off from dairy farms affect the ecological balance in the Chesapeake Bay.

    Then of course there's the whole argument about how much more pasture land it takes to graze cattle than it takes to grow corn/wheat/soybeans, and how too much of the grain that's being grown is being used to feed cattle instead of people (starving children in africa, that sort of thing).

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