Why do we choose the food on our plates? Some of us eat traditional foods from our childhoods, our cultures, or our homelands to connect us with our history and our stories. Others of us may choose alternative menus, to change our story line or to rewrite a troubled or fraught past. In this way, “what we eat proclaims who we are,” even as it nourishes the person we are becoming in the flesh.
Yet the extreme carnivore fat shamers have no problem what so ever in singing the praises of a huge, fat riddled hunk of ribeye steak, preferably rare, and eagerly devoured as a testimony to their peak powers and dominance traits. They often mention bitcoin’s luster or their own wellness ventures if the conversation goes much past hello. I’ve often wondered if the inanimate aspect of the slab on the plate allows them to connect more deeply with their food than they can with an actual human being, who has feelings and might speak back. Better to devour both of these, and stay unaffected by the outer world’s complexities.
However, the world always intrudes. We find no sanctuary, for we tear down the very walls which we build about ourselves. If we choose the extreme course, we’re on a path to self destruction, unless we change our lives. The ancient Greeks were wise to say, “The middle path is safest and best.”
Our choice of menus, diets, or eating plans is also a form of tribal signaling, as we send out signs for others to recognize and to respond accordingly. Fat shaming is a negative form of signaling by those who overvalue outward appearances. Those whose bodies are overly generous in size need to disregard this crowd’s disgust. Instead, discovering their personal value and worth is more important so they can be proactive about their own health. To enjoy life, to live as well as possible, and to be a blessing to our family and the community, is important for each of us.
WHAT IS TRUTH?
With all the competing claims out in the world today, how can we know what is truly healthy for the long haul? Since anyone can get on the internet and make any claim they want, until someone gets hurt and the legal process shuts their scam down, how do we sort out these “Truth Claims?” The accepted way is a RCT, or randomized controlled trial, which enrolls a large number of persons and follows them over many years. This is the “gold standard” of science, rather than “I use it and it works for me, plus listen to these testimonials!” In between is the single paper, not published in a major journal, with only a small sample of 50 to 100 subjects studied for a brief period. (If someone still believes “all these truths are equal,” I may know a friend with a friend with seashore property in Arizona to sell you, but I’d recommend a lesson in logic first.)
The Lancet Public Health Journal, August 18, 2018, published a major prospective cohort study and meta-analysis of dietary carbohydrate intake and mortality. The study followed nearly 16,000 adults in 4 different US communities for 25 years and they added in published research results from 7 multinational prospective studies. They did some big number crunching, so if you want to read the whole paper, the link is at the bottom of the page. It is a real RCT study, and deserves space for commentary.
MORTALITY AND FAT SOURCE
As the wag says, “men live longer if they don’t mention the extra weight their sweet cake is carrying on her hips.” It must be true–Neil DeGrasse Tyson’s photo is connected to this quote (meme worthy, for sure!).
When my mother made meatloaf, it had breadcrumbs and an egg to bind it together. She laid two strips of bacon on top of the loaf in the pan so it would get extra flavoring. Today people wrap the entire meatloaf in two pounds of bacon before they grill it on the outdoor BBQ pit. That pork fat goes into the food we eat and stays in the arteries to clog those vessels. We might be able to live higher on the hog than our parents, but we won’t live longer, not even with a good medical plan.
LIFE EXPECTANCY AND INCOME
Fifty years has passed: we eat worse, exercise less, and we our life expectancy has quit increasing. Back in 1966, men and women could live on average to age 67 and 73. Now those numbers are 76 and 81 in 2016. Back in 1933, men could expect to live to age 61 and women to 65. At least we aren’t going back to those “really good old days” when life was harsh, medicine lacked modern advances, and sanitation was poor.
Today poverty often impacts life expectancy due to food deserts in neighborhoods, lack of health insurance, and low incomes. The wealthy live longer. The poor in some cities — big ones like New York and Los Angeles, and also quite a few smaller ones like Birmingham, Ala. — live nearly as long as their middle-class neighbors or have seen rising life expectancy in the 21st century. But in some other parts of the country, adults with the lowest incomes die on average as young as people in much poorer nations like Rwanda, and their life spans are getting shorter.
CHOOSE YOUR FAT WISELY
This Study of Dietary Carbohydrate Intake and Mortality explored how the source of fat affected deaths in the group. The more meat fat a person ate, the more it impacted their life span for the worse (table 2).
The low-carb group was split into two separate groups:
1. The plant-based low carbohydrate dietary score was associated with higher average intake of vegetables but lower fruit intake (appendix p 11).
2. By contrast, the animal-based low carbohydrate dietary score was associated with lower average intake of both fruit and vegetables (appendix pp 9, 10).
3. Both low carbohydrate diets were associated with higher fat intake in exchange for carbohydrate, although the plant-based low carbohydrate diet had higher average polyunsaturated fat and lower saturated fat intake compared with the animal-based low carbohydrate diet (appendix pp 9–11).
ANIMAL FATS VS. PLANT FATS
People choosing an animal-based diet had an overall, higher, total protein intake. Five foods differed most significantly between the highest and lowest quantiles of animal-based and plant-based low carbohydrate dietary score (appendix p 9):
1. The animal-based low carbohydrate diet had more servings per day than did higher carbohydrate diets of beef, pork, and lamb as the main dish; beef, pork, and lamb as a side dish; chicken with the skin on; chicken with the skin off; and cheese (appendix p 10).
2. The plant-based low carbohydrate diet had more servings per day of nuts, peanut butter, dark or grain breads, chocolate, and white bread than did higher carbohydrate diets (appendix p 11).
3. Both low carbohydrate diets were lower in average regular soft drink intake (appendix pp 10, 11)
DEATH BY GIANT RIBEYE STEAK
Exclusionary diets, unless for medically necessary reasons, are not the best choice. Just because we want to jump off a cliff doesn’t mean we should do this! Someone who wants to eat only white food, as my child did for a time, is going through a phase. An adult who won’t eat anything white is missing out on some food groups, or doesn’t want to spend the time learning about food. If we have time saving machines all around us, why don’t we have the time to care for our embodied selves in this spare time? Do we value our work more than the worker? This devaluation of people is a slippery slope to other ills, not only to self harm but to disparagement of others or outright hatefulness.
1. In the ARIC cohort and in meta-analysis, increased consumption of animal-based protein and fat instead of carbohydrate was associated with a significant increase in all-cause mortality (table 3). Eat more animal fat and die sooner.
2. Alternatively, increased consumption of plant-based protein and fat instead of carbohydrate was associated with a significant decrease in all-cause mortality (table 3). Trade animal fats for healthier plant fats from nuts and seeds, such as olive oil. Use in moderation.
3. The animal and plant-based findings were consistent for cardiovascular and non-cardiovascular mortality (appendix pp 3, 4). Both heart disease and other diseases are made worse by animal fats. Let’s eat leaner, greener, and add more plants into our menus.
4. Similarly, in the meta-analysis, mortality increased when animal-derived fat and protein were substituted for carbohydrate, and decreased when these substitutions were plant-based (table 3). Eating more plants would do us better.
THE SWEET SPOT
The model for carbohydrate caloric intake is about 50% of total calories per day. It seems to be a sweet spot for life expectancy. In the diabetes world, most of us work to control our blood glucose readings by diet, so many of us will reduce our carbohydrates until they’re minimal at best. We may get good readings on our glucose meter, but what about our heart health? We don’t have a home health test for this. Since people with diabetes also have high rates of heart disease, we need to think of our whole body as one interconnected system, and not focus only on one symptom. We are complex and wonderful, so finding a balance for our finely tuned instrument is important.
ALL CARBS ARE NOT EQUAL
What carbohydrates we choose are another factor. If we think a bag of potato chips is equal to a baked potato in calories and nutrition, we have another think coming. Learning to read nutrition labels might cure us of this delusion. In the meantime, avoiding the snack aisle at the grocery store can keep us from bringing this ersatz food product into our home.
In “Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association Clinical,” the trials that used polyunsaturated fat to replace saturated fat reduced the incidence of cardiovascular disease. In contrast, trials that used mainly carbohydrates to replace saturated fat did not reduce CVD.
CHOOSE CARBS WISELY
However, the types of carbohydrate-containing foods were often unspecified and typically included sugar and other refined carbohydrates to maintain energy balance. When carbohydrates from whole grains replace saturated fat, evidence from prospective observational studies indicates reduced CVD. The two best interventions for menu modification are DASH and the Mediterranean Diet.
The other way we can help keep our blood sugar in range is lifestyle modification. This is the most difficult of changes most of us have to make. Exercise, meditation, journaling, adjusting recipes, cooking meals, making menus, and setting a bedtime or wake up schedule all seems like too much at once. Of course it is! And if it were easy, everyone would be doing it, no one would blog about it, and there’d be no great 25 year long studies to tell us not to wrap two pounds of ground beef in two more pounds of fatback bacon.
Actually, Aristotle, the Ancient Greek philosopher, spoke about the “golden mean.” Moral behavior is the mean between two extremes: at one end is excess, and at the other deficiency. Find a moderate position between those two extremes, and you’ll be acting morally, or rationally. This was his goal in life.
If we were to pick only one of these lifestyle modifications per week to work on, then in the next, do another one the best we can, and do on in the following weeks. Soon we’d all be more comfortable with the routine, and all of us would be doing them all without even realizing it. This is how you sneak in your learning! Before you know it, you have a transformed life. No one waved a magic wand over you, but you grew into your grown up shoes slowly but surely.
Best wishes for a better life, with more exercise and more joy!
The Lancet Public Health Journal, August 18, 2018
Dietary Fats and Cardiovascular Disease: A Presidential Advisory From the American Heart Association | Circulation