March 23, 2009 -- We Americans suffer a national eating disorder: our unhealthy obsession with healthy eating.
That's the diagnosis delivered by food author Michael Pollan in a lecture given last week to an overflow crowd of CDC scientists.
As part of an effort to bring new ideas to the national debate on food issues, the CDC invited Pollan -- a harsh critic of U.S. food policies -- to address CDC researchers and to meet with leaders of the federal agency.
"The French paradox is that they have better heart health than we do despite being a cheese-eating, wine-swilling, fois-gras-gobbling people," Pollan said. "The American paradox is we are a people who worry unreasonably about dietary health yet have the worst diet in the world."
In various parts of the world, Pollan noted, necessity has forced human beings to adapt to all kinds of diets.
"The Masai subsist on cattle blood and meat and milk and little else. Native Americans subsist on beans and maize. And the Inuit in Greenland subsist on whale blubber and a little bit of lichen," he said. "The irony is, the one diet we have invented for ourselves -- the Western diet -- is the one that makes us sick."
Snowballing rates of obesity, diabetes, and heart disease in the U.S. can be traced to our unhealthy diet. So how do we change?
7 Words & 7 Rules for Eating
Pollan says everything he's learned about food and health can be summed up in seven words: "Eat food, not too much, mostly plants."
Probably the first two words are most important. "Eat food" means to eat real food -- vegetables, fruits, whole grains, and, yes, fish and meat -- and to avoid what Pollan calls "edible food-like substances."
- Don't eat anything your great grandmother wouldn't recognize as food. "When you pick up that box of portable yogurt tubes, or eat something with 15 ingredients you can't pronounce, ask yourself, "What are those things doing there?" Pollan says.
- Don’t eat anything with more than five ingredients, or ingredients you can't pronounce.
- Stay out of the middle of the supermarket; shop on the perimeter of the store. Real food tends to be on the outer edge of the store near the loading docks, where it can be replaced with fresh foods when it goes bad.
- Don't eat anything that won't eventually rot. "There are exceptions -- honey -- but as a rule, things like Twinkies that never go bad aren't food," Pollan says.
- It is not just what you eat but how you eat. "Always leave the table a little hungry," Pollan says. "Many cultures have rules that you stop eating before you are full. In Japan, they say eat until you are four-fifths full. Islamic culture has a similar rule, and in German culture they say, 'Tie off the sack before it's full.'"
- Families traditionally ate together, around a table and not a TV, at regular meal times. It's a good tradition. Enjoy meals with the people you love. "Remember when eating between meals felt wrong?" Pollan asks.
- Don't buy food where you buy your gasoline. In the U.S., 20% of food is eaten in the car.
Is this good advice? Janet Collins, PhD, director of the National Center for Chronic Disease Prevention and Health Promotion, is one of the CDC officials who met with Pollan.
Collins agrees with Pollan that advice from health experts has to be simplified. And she loves the suggestions he makes.
"Some of the changes in our environment are the reasons behind our obesity epidemic," Collins tells WebMD. "Pollan's advice to eat at the table with your family and not the TV is excellent. And portions: During our grandmothers' era, plates were smaller. If you took the portions that filled their plates and put them on ours, it wouldn't look like much to eat."
Eat Foods, Not Nutrients
Pollan, author of In Defense of Food: An Eater's Manifesto and The Omnivore's Dilemma: A Natural History of Four Meals, is professor of science and environmental journalism at the University of California, Berkeley.
Pollan says that where we've gone wrong is by focusing on the invisible nutrients in foods instead of on foods themselves. He calls this "nutritionism" -- an ideology that's lost track of the science on which it was based.
It's good for scientists to look at why carrots are good for us, and to explore the possible benefits of, say, substance X found in a carrot.
What happens next is well-meaning experts tell us we should eat more foods with substance X. But the next thing you know, the food industry is selling us a food enriched with substance X. We may not know whether substance X, when not in a carrot, is good or bad for us. And we may be so impressed with the new substance-X-filled product that we buy it and eat it -- even though it may have unhealthy ingredients, such as high-fructose corn syrup and salt.
Pollan identifies four myths behind this kind of thinking:
- Myth #1: Food is a delivery vehicle for nutrients. What really matters isn't broccoli but its fiber and antioxidants. If we get that right, we get our diet right. Foods kind of get in the way.
- Myth #2: We need experts to tell us how to eat. Nutrients are invisible and mysterious. "It is a little like religion," Pollan said. "If a powerful entity is invisible, you need a priesthood to mediate your relation with food."
- Myth #3: The whole point of eating is to maintain and promote bodily health. "You are either improving or ruining your health when you eat -- that is a very American idea," Pollan says. "But there are many other reasons to eat food: pleasure, social community, identity, and ritual. Health is not the only thing going on on our plates."
- Myth #4: There are evil foods and good foods. "At any given time there is an evil nutrient we try to drive like Satan from the food supply -- first it was saturated fats, then it was trans fat," Pollan says. "Then there is the evil nutrient's doppelganger, the blessed nutrient. If we get enough of that we, will be healthy and maybe live forever. It's funny through history how the good and bad guys keep changing."
Pollan remembers that when fats were declared to be evil, his mother switched the family to stick margarine. His grandmother predicted that some day stick margarine would be the evil food. Today, we know that margarine was made with trans fats.
The trouble with the whole notion of "evil' and "blessed" ingredients is that they help the food industry sell us processed foods that are free of the evil thing or full of the blessed one. We buy them, not realizing they may contain many other ingredients that aren't good for us.
Collins agrees with Pollan's central theme that whole foods are vastly better for us than are processed foods. But our food system makes it hard for many Americans to get whole foods.
"If our food system made more whole foods at lower cost and made them more available, that would help with our public health," Collins says. "We need full-service groceries in urban centers, where people can get to them. Unfortunately, urban centers are getting filled with fast food stores and liquor stores. Pollan's rules are good, and it is one thing to eat by his rules, but making our environment such that people can live by the rules is not always easy."
Will the CDC be pushing for these kinds of changes? Yes, suggested Anne Haddix, chief policy officer at the CDC's Office of Strategy and Innovation, during the panel discussion following Pollan's remarks to the CDC.
"How we go forward on this will take some very different types of thinking than we have done in the past," Haddix said. "We have an opening we have not had for years. ... Of the federal agencies trying to address food issues, CDC is uniquely positioned. We have to step out as leaders. ... Now is the time to ramp up our efforts and reach out to people who make us uncomfortable and go for it."