by Michael GregerĀ
Research in human nutrition over the past four decades has led to many discoveries as well as a comprehensive understanding of the exact mechanisms behind how food nutrients affect our bodies. However, the āprevalence of epidemics of diet-related chronic diseases, especially obesity, type 2 diabetes, osteoporosis, cardiovascular diseases, and cancers, dramatically increases worldwide each year.ā Why hasnāt all this intricate knowledge translated into improvements in public health?
Perhaps it has to do with our entire philosophy of nutrition called reductionism, where everything is broken down into its constituent parts; food is reduced to a collection of single compounds with supposed single effects.
āThe reductionist approach has traditionally been and continues today as the dominant approach in nutrition research.ā For example, did you know that mechanistically, thereās a chemical in ginger root that down-regulates phorbol myristate acetate-induced phosphorylation of ERK1/2 and JNK MAP kinases? Thatās actually pretty cool, but not while millions of people continue to die of diet-related disease.
We already know that three quarters of chronic disease riskāādiabetes, heart attacks, stroke, and cancerācan be eliminated if everyone followed four simple practices: not smoking, not being obese, getting a half hour of exercise a day, and eating a healthier diet, defined as more fruit, veggies, whole grains, and less meat.
Think what that could mean in terms of the human costs. We already know enough to save millions of lives. So, shouldnāt our efforts be spent implementing these changes before another dollar is spent on research such as figuring out whether there is some grape skin extract that can lower cholesterol in zebra fish or even trying to find out whether there are whole foods that can do the same? Why spend taxpayer dollars clogging the arteries of striped minnows by feeding them a high cholesterol diet to see whether hawthorn leaves and flowers have the potential to help?
Even if they did, and even if it worked in people too, wouldnāt it be better to simply not clog our arteries in the first place?
This dramatic drop in risk and increase in healthy life years through preventive nutrition need not involve superfoods or herbal extracts or fancy nutritional supplementsājust healthier eating.
When Hippocrates supposedly said, āLet food be your medicine and medicine be your food,ā he ādid not mean that foods are drugs, but rather, that the best way to remain in good health is to maintain a healthy diet.ā (Note: Hippocrates probably never actually said thatābut itās a great sentiment anyway!)
The historical attitude of the field of nutrition, however, may be best summed up by the phrase, āEat what you want after you eat what you should.ā In other words, eat whatever you want as long as you get your vitamins and minerals. This mindset is epitomised by breakfast cereals, which often provide double-digit vitamins and minerals. But the road to health is not paved with Coke plus vitamins and minerals. This reductionistic attitude āis good for the food industry but not actually good for human health.ā Why not? Well, if food is good only for a few nutrients, then you can get away with selling vitamin-fortified Twinkies.
We need to shift from the concept of merely getting adequate nutrition to getting optimal nutrition. That is, we shouldnāt just aim to avoid scurvy, but we should promote health and minimise our risk of developing degenerative diseases.
Bringing things down to their molecular components works for drug development, for example, discovering all the vitamins and curing deficiency diseases. In the field of nutrition however, āthe reductionist approach is beginning to reach its limits.ā
We discovered all the vitamins more than a half-century ago. When is the last time you heard of someone coming down with scurvy, pellagra, or kwashiorkor, the classic deficiency syndromes? What about the diseases of dietary excess: heart disease, diabetes, obesity, and hypertension? Ever heard of anyone with any of those? Of course we have. Yet we continue to have this deficiency mindset when it comes to nutrition.
When someone tries to reduce their consumption of meat, why is āwhere are you going to get your protein?ā the first question they get asked, rather than āif you start eating like that, where are you going to get your heart disease?ā The same deficiency mindset led to the emergence of a multibillion-dollar supplement industry. What about a daily multivitamin just āas āinsuranceā against nutrient deficiency?ā Better insurance would be just to eat healthy food.
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