Total Pageviews

Friday, June 10, 2011

Infographic: The Cost of a Cared for Nation

Earlier this week you may have seen's fantastic Paleolithic Diet Infographic.  In keeping with the theme of the week, I wanted to share this new Health and Wealth infographic from Carrington College. Wondering about the real cost of caring for our sick nation?  Read on.

Health Care Information Technology - Infographic(Click to enlarge)
[Via: Carrington College's Health Information Technology Program]

Thursday, June 2, 2011

Dietary Guidelines and the Rise and Fall of The Food Pyramid

Re-purposed from my article at BonfireHealth

Can you think of a time when you couldn't find any food to buy or eat?  Believe it or not, a little over 100 years ago, there were a lot of people in the United States who didn't have enough to eat.  Food was not widely available.  There weren't multiple grocery stores in every town, and they certainly didn't have 24 hour convenience stores. guidelines
In 1862, the United States Department of Agriculture (USDA) was created.  From its conception, it has served two roles:  the first is to ensure a sufficient food supply by monitoring and promoting agriculture in the United States; the second is to issue dietary advice.  These two directives complemented each other nicely at the time, because nutrient deficiencies and malnutrition were prevalent health concerns.  Leading causes of death at the turn of the century were infectious diseases such as pneumonia and tuberculosis.  Roughly the same number of people died every year from diarrheal diseases as from heart disease.  The USDA began educating the public to eat more, to prevent hunger and ensure that people were getting all the nutrients and calories that were needed for health.

Eat More Versus Eat Less
Today we live in a day and age where people need to eat LESS.  Food is much more widely available, and with greater variety.  Additionally, unhealthy junk foods are available that didn't even exist 100 years ago.  Diseases that effect the majority of the population like heart disease, type II diabetes and obesity have causational roots in eating too much, especially too much of wrong foods.  The problem is that if the USDA were to encourage people to eat less, the food companies that they are supposed to be supporting would potentially sell less food.  The two roles of the USDA are in conflict with each other.  This creates a bias within the organization that has lead to questionable dietary guidelines.  Marion Nestle provides an in-depth look at this shift from "eat more" to "eat less" in her book, Food Politics: How the Food Industry Influences Nutrition and Health.  I strongly encourage you to read this book in order to better understand the food industry's influence over current dietary guidelines.  I also recommend Academy award nominated film, Food Inc. which exposes the fact that oftentimes, the food policy leaders at the USDA are former food and agriculture executives, and therefore have ulterior motives behind their policies.

Cause For Concern
The amount of food that the USDA advises that we eat is not the only concern.  There are also problems with the kinds of food that we are encouraged to eat.  Studies show that sugar, certain kinds of saturated fats and simple carbohydrates like bread and pasta are unhealthy and promote chronic diseases like heart disease, obesity and type II diabetes.  Large food corporations have opposed USDA dietary guidelines that directly convey these dietary risks.  Highlighting risks associated with eating such foods would result in less income for the producers of these foods.  Many of the people at the USDA who are responsible for editing dietary guidelines have close ties with the food industry.  For instance, high level positions at the USDA have habitually been filled by former executives of the American Meat Institute and lobbyists for the National Cattlemen's Association.  Many political players have also been employed by the grain and meat industries.  The film, Food Inc., highlights a few instances:
  • Former North Carolina State Senator, Wendell Murphy is now on the Board of Directors at Smithfield, Inc., the largest pork manufacturer in the U.S.
  • Monsanto is one of the largest agriculture companies in the US.  Margaret Miller was a Chemical Lab Supervisor at Monsanto, and then went on to become the FDA's Branch Chief.  She has maintained that position since 1989.
  • Linda Fisher was formerly the Vice President of Government and Public Affairs at Monsanto, and then went on to become the Environmental Protection Agency's Deputy Administrator.
  • Michael Taylor went from being a Monsanto client to becoming the Deputy Commissioner for Policy at the FDA, and then went to work for Monsanto as Vice President for Public Policy.
There is clearly a concern that people who have strong ties to the food industry would have trouble making unbiased decisions about our food as policy makers.

The Gap Between Research and Dietary Guidelines
The American Heart Association sponsored research on dietary fat and atherosclerosis in the 1950s and 1960s, and recommended that people reduce calories from fat in order to reduce the risk of getting heart disease.  This meant eating less factory farmed meat and less dairy.  Scientific reports from the National Academy of Science's Board of Agriculture, the Surgeon General, and the Food and Nutrition Board all echoed that eating less fat, salt and cholesterol were necessary.  Following these similar research findings, beef, whole milk and egg sales declined.  As Marion Nestle reported, The National Cattlemen's and Beef Association and the American Dairy Association were outraged and they pressed for a revision of the dietary guidelines.  Changes included "avoid too much" being changed to "choose a diet low in" and changing "choose lean meat" to "have 2 or 3 servings of meat."  The committee commented that "any food that supplies calories or nutrients should be recognized as useful in a nutritious diet."  Not only do most Americans not eat particularly nutritious diets, but statements like these put all foods on the same level as useful.  As the federal organization responsible for educating the public about nutrition, helping people learn how to distinguish more healthy foods from less healthy foods should be a main focus.  Guidelines like these only confuse the public. 

The Food Pyramid
The Food Pyramid was created in order to educate the public about what kind and how much food should be eaten every day.  The first food pyramid was set to be released in 1991.  It was blocked by the USDA Secretary because he felt it was "confusing to children."  This reason seemed so absurd that many people wondered if he was actually under pressure from the meat industry.  The Food Pyramid was certainly not thrown together, last minute.  The original Food Pyramid had been in development for 11 years.  During that time, consumer research was done on different age groups and different income levels to determine if the pyramid display was able to clearly communicate to different audiences.  It was successful in focus groups.  Marion Nestle further explains the development of the Food Pyramid:
"The 1990 Dietary Guidelines brochure incorporated the Pyramid serving numbers, thereby granting them status as official components of federal nutrition policy.  In 1990 and 1991, HNIS sent drafts of the Pyramid booklet to 36 leading nutrition experts for review, presented at 20 professional conferences, and discussed the guide with more than 20 newspaper, magazine, radio and television reporters...they met with 30 publishers to arrange substitution of the Pyramid for older guides in forthcoming texts...Furthermore, HNIS had submitted the manuscript of the Pyramid brochure to the entire USDA bureaucracy through its exhaustive review and "clearance" procedures. A committee representing ten USDA units as well as DHHS had thoroughly vetted the Pyramid; the brochure had successfully passed six levels of USDA policy review and three divisional reviews."
Marion Nestle, Food Politics.
Right before it was set to be printed and released to the public, a few news stories emerged that implied that the Pyramid suggested eating less meat.  That same weekend, the National Cattlemen's Association had their annual meeting.  They were outraged.  They, along with the National Milk Producers' Federation, demanded that the Pyramid be withdrawn.  The head of the American Meat Institute wrote a letter to the Secretary of the USDA.  And surprisingly, the Pyramid was withdrawn, citing a concern about school children's ability to understand it.  Many news stories were released, insisting that the pressure from the food industries was the real reason.  And the researchers in charge of developing the food pyramid agreed. The USDA did extensive research in the following year with school children.  They tested other graphics, such as pie charts, bowls and shopping carts.  Over $855,000 was spent on this research.  None of the other designs were found to be more effective than the Pyramid.  The press kept a close eye on the studies.  One year after it was blocked, the Pyramid was released.  However, some additional changes had been made.  The words "at least" were included before the meat and dairy servings, and the meat servings had been increased from 4-6 ounces to 5-7.  It became the most widely distributed nutrition advice ever published. Today, in Washington, a revised image for the Food Pyramid will be released. Its about time! However, I'm guessing they are still going to be suggesting people plate up lots of grains, pasteurized glasses of milk for children and that they will additionally fail to differentiate the importance of food quality and source.

A New Food Guide
After all we have learned about factory farmed meat and fish, the value of eating organic foods, and the disease-ridden consequences of eating refined sugars, grains, and processed foods, let me suggest some new nutrition advice.  This advice is not the result of lobbying and sponsorship from the food industry, and it's not influenced by politics.  It is based simply on how to become as healthy as possible and avoid chronic illness.  These guidelines have been used for thousands of years and are backed by scientific evidence.  And best of all, they are simple and easy to understand:
  • Eat vegetables!!  Eat a lot of them, eat them often, and eat many different kinds of them.
  • Eat seeds and nuts and berries.
  • Eat healthy fats with every meal.
  • Eat sustainable seafood and meat from healthy animals.
  • Supplement your diet as needed with omega-3 fatty acids to make sure you are getting all the nutrients you need to be healthy.

Bethany's Blog: An Introduction

Hello and welcome. This is my first post. And its a long time coming!

I grew up in a household brimming with health professionals.  People throwing around words like orthostatic hypotension at dinner was commonplace, even as a child.  I was blessed to be raised by parents who valued education, science, work ethic and health (or, that is to say our understanding of health at the time). Like any other kid I was given Tylenol for fevers, aspirin for headaches, and bagels for breakfast. My mother worked at Massachusetts General Hospital for 30 years, along with my brother, both as RNs.  I even worked there during college. My Dad, a pharmacist, carefully warned us against "unsafe, unregulated" non-drugs like supplements.  As I entered my twenties, more and more family members kept getting diagnosed with various diseases, most often cancer. They were treated with the most cutting edge chemo-therapies and radiation treatments at some of the best hospitals in the world, right here in Boston. My uncle almost died of colon cancer when he was 27. (He was uninsured and just recently finished paying off his medical bills 25 years later). My grandmother, my grandfather. Then a few close neighbors, some only 50 years old. My mom. My dad... Everywhere I looked, everyone was cancer-struck. These were some of the brightest health professionals I knew, and many of them were so young! Some recovered, some didn't.

I wanted to make a difference.  I entered a Master's of Science program in Drug Regulatory Affairs and Health Policy at Mass College of Pharmacy.  I aspired to work in cancer research upon completion of the program. Unfortunately, learning the ins and outs of the FDA and the history of our food and health policies made me more confused and disappointed than ever with the system. When my dad's disease began to overtake him, I was at a crossroads. I had only a flicker of faith left in our medical institutions. In our last ditch efforts we enrolled him in clinical trials. I started researching dietary advice from nutritionists. I took a leave of absence from my job at a pharmaceutical company to take care of my dad full time. When I look back on my life it is clearly divided into two sections: before my father passed and after.

I use the word "passed" loosely, almost in jest. "He passed" suggests a gentle movement from one side to the other, or some sort of unremarkable action. Death is unfortunately not as neat and tidy as it is often portrayed on TV. At 53 years old, my father died a brutal death, his body ravaged by cancer. His inner organs began breaking down, his kidneys and bowels were failing. Fluid had risen past his midsection and higher it climbed.  At the end there were days upon days of agony. He was too weak to speak or focus his eyes on us.  His body could no longer metabolize pain medication, and therefore offered no comfort. Disease seeped through the entire surface area of his body in the form of welts and puss. The last 12 hours were filled with his painful screams. The hospice nurse was overwhelmed and had to leave.  He howled and cried and we were powerless to help. It was pure terror, right up until his last breath. This is what chronic disease looks like.

Experiencing a traumatic loss like this was simultaneously the worst and best thing that ever happened to me. It was a tipping point. And had it not been so poignant, it would not have been so obvious the work that needed to be done, and I would not have been so deeply motivated.  The simple truth I learned in the coming years is that everyone must eventually die, but no one needs to die like that. Anyone who has experienced this type of loss will find it motivating.  I hope that I am able to motivate through this story so that you will not need to experience it yourself if you haven't already.

My father followed all the traditional health rules, he was not overweight, he hit the gym semi-regularly, he went to his annual checkup with his primary care physician every year.  He followed the food pyramid, wore sunscreen, and was generally an all-around disciplined person. He, himself, was a pharmacist, understood statistics and epidemiology and was always informed of the most cutting edge medical interventions. He was by all traditional accounts "healthy".  In his 40s he got lucky when he had dangerous skin cancers successfully removed from his face, twice. He eventually succumbed to prostate cancer, with a potential second primary of colon cancer, just like his brother.

The problem was that he wasn't actually healthy all those years. He just had yet to be diagnosed with his horrible disease. By the time the doctors even figured out he had cancer, it was already spreading rapidly.

Looking back there were signs and symptoms (IBS, chronic back pain, fatigue) and each was treated with medication rather than investigated.  Nutrition was not mentioned once by his physicians even after his diagnosis, even as a last ditch effort at the end. Misinformation and misunderstanding are rampant, even among the majority of health professionals. Our institutions have failed us.

After my Dad's death I set out to find a better way. I found the beginnings of that better way a little more than two years ago in my health coach, Dr Stephen Franson. He began to educate me about my evolutionary roots, the paleo diet, the ten pillars of fitness, spinal health, behavioral science, human potential and much more.  Since that time I have been completely submerged in the full-time study of these concepts, many of which are being wonderfully fleshed out on various online platforms. I am thankful for Robb Wolf, Matt LaLonde, Chris Kresser, Dr Jesse Davis, Dr Paul Kratka, Dr Stephen Franson, Dr Nick Araza, Mark Sisson and more who have helped educate so many people, including myself.  I'm thankful for Bonfire Health and for Crossfit. I'm thankful for the Paleo blogging community including John Durant and Melissa McEwan for engaging and challenging us. And I'm thankful for the open-source platforms for discussion in the Paleo subculture, specifically PaleoHacks and now, because they keep us honest and open in our educational quests. In fact, it was Patrik who motivated me to finally start this blog and to write this post, in hopes he will select me to attend the sold-out Ancestral Health Symposium.  If selected I will humbly and gratefully attend and report back in detail, here! But even if I'm not selected, I will blog here.  I will question, I will research, I will test and I will inform others.(But I really really hope that I am!!)

Defining health as the absence of a disease diagnosis is a huge deficiency perpetuated by the medical community. In my experience so far, if you are compelling, people listen.  And with the right tools and the right information, people's lives can be transformed.  I now endeavor to do everything in my power to take daily steps towards to optimal health. This is the bar I have set for myself and the bar which I believe will change the world. Questions still remain unanswered, and the answers we do have are not set in stone, but we are constantly learning and constantly discovering, and as a group we need to be constantly educating ourselves and others. We need to approach health differently.  We have to shift the paradigm, and we have to do it together.

Thank you for reading and stay tuned!