THE PERILS OF PLENTY

Americans who were taking in less than 2,000 calories daily at the end of the eighteenth century were swallowing over 3,000 toward the end of the twentieth century – and by 1995 more tha

THE PERILS OF PLENTY

These same forces – improvements in transportation, preservation, and distribution – liberating Americans from seasonality also con-tinued to free them from the dictates of regional geography

Harvey Levenstein (1993) 1

IT IS WORTH REPEATING that many of the breakthroughs in nutritional science paradoxically occurred during the depression years of food riots, soup kitchens, and breadlines, where the hungry in the cities shoved aside dogs and cats to get at the contents of garbage cans, and rural folks ate wild roots and plants These were years when morbidity and mortality rates caused by pellagra, scurvy, and rickets were rising alarmingly, and bowleg-gedness continued to be a common sight 2

Needless to say, it was not a time for experimenting with foreign foods, nor were the food-rationed war years that followed Despite rationing, however, Americans ate better than ever during the war although this did not prevent the “experts” from touching off a brief episode of vitamin hys-teria, beginning in 1943 when the Food and Nutrition Board erroneously told Americans – now back to work with plenty of money to spend – that

their diets were dangerously defi cient in many of the chief nutrients Such

foolishness only underscores the fact that the functions and chemistry of vitamins and minerals were still poorly understood So did proposals for widespread vitamin supplementation, with bread, cereals, milk, and oleo-margarine all fortifi ed during the war It was a vita-mania pot that Adel Davis would continue to stir in ensuing decades with her recommenda-tions for an excessive, even dangerous, vitamin intake 3 By 1994, vitamin supplements constituted a four billion dollar industry 4

Backyard barbeques came into vogue in the 1950s By 1995, 77 percent

of American households had at least one grill generally presided over by males who, at fi rst limited themselves to charring hunks of meat, slabs of ribs, chicken parts, or, less ambitiously, hot dogs and burgers 5 It was men who bought the barbequing cookbooks that began appearing in the fi f-ties, and some became sophisticated cooks who promoted themselves to the indoor kitchen Frequently more culinarily adventuresome than their wives, many led their families into foreign cooking

By the 1960s dark clouds had once again built up on the health horizon, even as Americans were congratulating themselves on being the best-fed people in the world In 1953, University of Minnesota physiologist Ancel Keys had ominously correlated high rates of coronary heart disease with high intakes of animal fats, 6 and in the United States coronary artery dis-ease ( CAD ) rates had spiraled upward with CAD death rates rising from

180 to over 200 per 100,000 by the early 1960s 7

There were also cancer concerns Worries about cancer-causing additives

in foods prompted a 1958 amendment to the Food, Drug, and Cosmetic Act of 1938, which forbade the use of additives that had not been used long enough to be “generally recognized as safe” ( GRAS) At the behest of Congressman James J Delaney, an amendment was inserted that became a controversial clause (the Delaney Clause), which stated that if any amount

of an additive was shown to produce cancer in humans or in test animals then no amount of the additive could be used Needless to say, food pro-cessors were not amused by the joke that everything seems to give mice cancer, and they correctly pointed out that humankind would not be here

if low levels of carcinogens could not be tolerated Paracelsus, a Renais-sance physician, wrote a long time ago that all substances were poisons and

it was the dose that mattered; an important truth, but no Congressman wants to be known as voting for cancer 8

If the apparent upsurge of these chronic diseases did not give Americans enough to fret about, they also found themselves battling obesity in a way they never had before “Plenty” was multiplying By the late 1960s, the average output of meat per breeding animal was double that of the 1920s; the average Wisconsin dairy cow was yielding ten quarts of milk a day instead of the six it had provided in 1940; and the average farm acre was producing seventy bushels of corn, up from twenty-fi ve in 1916 9

Paradoxically, however, while many wrestled with the problem of too much to eat, others were not getting enough The Field Foundation report

entitled Hunger U.S.A and the television documentary Hunger in America,

both released in 1968, touched off President Nixon’s “war on hunger” as well as a debate over the methodology used by hunger studies 10 Yet, despite the “war” there seems little doubt that food insuffi ciency remains a chronic problem for some 35 million Americans During the fi rst four years of the new century hunger was either present in or a threat to about 12.6 million American families (a bit over 11 percent of U.S households) Obviously, this has nothing to do with food shortages But it has everything to do with poverty caused by joblessness, the cost of housing and other basic needs, and a welfare system that does not put up a safety net 11 Some defenders

of the system, however, take a perverse delight in pointing out that obesity

is more pervasive among the poor than among the affl uent, brushing aside that the poor feed disproportionately on cheap and fatty fast foods 12

In the 1940s, obesity was defi ned as “overfatness,” implying that one could be overweight but not “over-fat.” But in the following decades such niceties were tossed overboard – people had become suffi ciently concerned about their waistlines that sales of low-calorie and diet products skyrock-eted and books on weight control became best sellers In 1962, 40 percent

of American families were using low-calorie or diet products on a regular basis; by 1972 the percentage had jumped to 70 13

There was good reason for concern Over the past two centuries the fat intake of those on a western diet had risen fi ve times, while their sugar intake had leaped fi fteen times Americans who were taking in less than 2,000 calories daily at the end of the eighteenth century were swallowing over 3,000 toward the end of the twentieth century – and by 1995 more than half of them had achieved the “ideal” weight of an earlier America, when slimness was regarded as a sign of ill-health and products, like Groves Tasteless Chill Tonic, promised to add “much admired heft to the fi gure” by making children and adults “as fat as pigs.” 14

By the beginning of the twenty-fi rst century, there was such plenty that

a mean of almost 4,000 calories was available on a daily basis for every man, woman, and child in the nation (up from 3,700 in 1990), represent-ing over a third more than the caloric RDA for men and over twice that for women.15 Moreover, the calories in question have increasingly come from highly processed calorie-dense foods, which means that they reach the stomach in such a compact form that we generally get more of them than

we need before ever feeling comfortably full 16 For the sake of comparison, unprocessed plant foods such as cereals, pulses, potatoes, vegetables, and

fruits comprise around 61 percent of the calories consumed in Crete, and

74 percent of those in Greece But in the United States only 37 percent of energy is derived from these unprocessed foods 17

These are some of the reasons behind the so-called “obesity epidemic” that has ambushed the nation, and yet another, some say, is that food is too cheap for our own good In 1965, Americans spent an average of 18.5 percent of their income for food – down from 24.4 percent in 1955 This represented the lowest percentage ever, as well as the lowest in the world – a situation that has not changed 18

Paradoxically then, life-giving food has become life-threatening and not just for Americans The World Health Organizations’ ( WHO) fears that the obesity epidemic would be globalized during the fi rst part of the

twenty-fi rst century were realized in the very twenty-fi rst year of that century when it was reported that the number of overweight people in the world had reached

a bit over a billion, matching almost exactly another billion that are badly nourished and underweight 19

Westerners, of course, are in the “globeisity” vanguard with America, the United Kingdom, Russia, and Germany all having overweight majorities that seem to be getting heavier by the day, thanks to an energy intake that far exceeds output 20 Hunter-gatherers expended great amounts of energy

in fi nding their food; farmers did the same in growing theirs Modern Westerners, by contrast, although metabolically still hunter-gatherers, use little more energy in food acquisition than it takes to push a cart around a supermarket and open their wallets at the checkout counter

Caloric needs used to be based, in part, on occupation-related energy expenditures, but today’s labor-saving machinery has sharply reduced occupational caloric requirements, just as automobiles and elevators have reduced those previously needed for walking and climbing Television and computers lure us even further into physical inactivity, and the conse-quences of a growing gap between energy intake and energy output have become terribly evident in the onset of the so-called “chronic” diseases that beset us – coronary artery disease, adult onset diabetes, high blood pres-sure, and cancer 21

The following unsettling numbers lurk behind these modern killers Between 1988 and 1991, one-third of America’s population was weight; by 1995 estimates indicated that around 55 percent were over-weight, and if the young were excluded then 63 percent of men and 55 percent of women over the age of 25 were either overweight or obese

In 1999, according to an article in The Journal of the American Medical

Association, 21 percent of male and 27 percent of female Americans were

not just overweight but obese, and obesity was killing upwards of 300,000 U.S citizens annually 22 In 2001, 65 percent of all Americans were over-weight, double the percentage of a few decades earlier, and then in the

spring of 2004, USAToday told travelers that diet and physical inactivity

were doing in 400,000 Americans annually and that obesity was edging out tobacco use as the nation’s number one killer In 2005, the promised revi-sions to the Food Guide Pyramid corrected its earlier silence on exercise by urging that people exercise between 30 and 90 minutes every day 23

Such numbers also lie behind businesses like the weight-loss industry, already doing 5 billion dollars worth of business in 1990 Good for that business, too, was a 1996 Harris Poll report that 74 percent of Americans aged

28 and older perceived themselves to be overweight 24 If these perceptions seem high, it is a fact that since the 1980s the number of extremely obese Americans has quadrupled despite “low-carb” diets, Slimfast, Richard Sim-mons, and jazzercise This has given new meaning to the term “personal expansionism” which has stimulated the clothing industry (in 1985 the most common size for women’s sportswear was an 8; in 2003 it was a 14); health-delivery systems (around 250,000 operations to help obese people lose weight are performed annually, and demand for obesity surgeons is skyrocketing); and Medicare, which has tossed its old policy that obesity

is not a disease in the wastebasket (thus opening the door to millions of claims for stomach surgery and diet programs) It is also responsible for such novel enterprises as the construction of larger and sturdier couches, chairs, and toilet seats, the manufacture of seat-belt extenders for airlines, extra-wide umbrellas, bathroom scales that can weigh people up to 1,000 pounds, and the production of super-sized caskets with cemeteries offering super-sized plots

A search for substitute foods and ingredients may have originated for reasons other than weight loss, but it has been spurred on by the current dietary dilemma Margarine, the fi rst successful substitute food, has been commercially produced in America since 1873 as an inexpensive alterna-tive to butter, although not without bitter opposition from dairy farmers who, at one point, demanded that margarine be dyed purple to discour-age its purchase Unlike butter, margarine lacked vitamins A and D, so that, after the vitamins were discovered, it became obligatory for marga-rine manufacturers to add these vitamins 25 By the 1950s, margarine was

viewed by the health-conscious not just as a low cost, but also as a low fat alternative to butter Subsequently, however, doubts emerged about its healthiness

Margarine is made from those unsaturated vegetable oils praised by nutritionists The trouble is that in margarine-making the oils are hydro-genated to give them the consistency of butter It is a process that satu-rates some of the fat; and worse, it creates trans-fatty acids, shown in the 1990s to raise levels of low-density lipoproteins (the bad cholesterol) and

to lower levels of high-density lipoproteins (the good cholesterol) Marga-rine consumers, therefore, were apparently increasing their risk of a heart attack – substantially so in the estimation of some 26

Health considerations also drove the search for a sugar substitute Sac-charin was the fi rst to enter the market at the beginning of the twentieth century But in 1977, saccharin was shown to be carcinogenic in rats, and the FDA tried to get it banned under the Delaney Clause Congress, how-ever, enacted a moratorium on the ban (which was renewed several times), and in 1991 the FDA withdrew its ban proposal so that saccharin contin-ues to be used in America as well as in more than ninety other countries Aspartame, FDA- approved in 1981 for table use, with only four calories per gram, made possible the wildly successful Diet Coke in 1982 and subse-quently became the sweetener of choice for 80 percent of the diet soft drink industry It is also employed in a range of foods from fruit juices to yogurt products U.S aspartame production accounts for about 80 percent of the global market and is added to over 5,000 products in more than 90 coun-tries 27 These are consumed by most everybody so that a recent campaign of internet terrorism which claimed that aspartame caused multiple sclerosis, Alzheimer’s, Parkinson’s, and a host of other illnesses scared the daylights out of many But there was not an ounce of truth in the allegations

In addition, there are numerous other artifi cial sweeteners (called low-calorie or non-caloric because the word “artifi cial” has an ominous ring to it) either on the market, waiting for FDA approval, or still the focus of research Yet, importantly, low calorie sweeteners have not even shown up

as a ripple in the obesity tide because they clearly have not replaced

calor-ic sweeteners Rather, Amercalor-ican sugar consumption has steadily increased despite the use of artifi cial sweeteners, as has world consumption In 2004, however, the WHO managed to hammer out an agreement among the world’s health ministers that sugar consumption be limited, without the sugar industry destroying it 28

Fat substitutes are suspected of precipitating similar unanticipated con-sequences by increasing the nation’s appetite for high-fat foods These include “carbohydrate” substitutes like Oatrim, protein- based substitutes such as Simplesse, and synthetic fat substitutes, with Olestra a notable example But in addition to concerns about unintended consequences, there are other unresolved issues of safety and nutrition, notable among them the risk of allergenicity and gastrointestinal distress 29 Fat substitutes are nothing new, and there are many of them on today’s market, but to date, despite considerable publicity, none have proven to be an unqualifi ed success – the bonanza that fake fat manufacturers are shooting for

Dietary fi ber rests on even shakier ground Although long known as a stimulant for colonic activity, this non-food was pretty well dismissed by medicine as “roughage” until the 1970s Then suddenly it became a “mira-cle” preventive of diabetes (by lowering glucose levels), colorectal cancer (by bulking up stools), and heart disease (by reducing cholesterol) 30

By the 1990s, however, voices questioning the effi cacy of fi ber were being heard It was not at all clear that fi ber had much, if any, effect on glucose; lots and lots of fi ber– (and calorie-) fi lled foods like cereals and legumes were required to have much of an effect on cholesterol; some

fi ber-containing cereals like oats were high in calcium (associated with cor-onary artery disease by a European study group); 31 and no optimal intake

of fi ber had been determined 32 Perhaps, if fi ber had been taken more seri-ously as a displacement for fats and other foods by making one feel full, it might have helped slow the obesity epidemic Yet, fi ber by itself contains

no nutrients, and heavy fi ber intakes deprive the body of nutrient-rich foodstuffs In the anxiety to shed pounds it was frequently forgotten that the body does have a requirement for dietary fat, in no small part because fatty acids participate in every aspect of cellular life 33

Fiber has always had champions, like John Harvey Kellogg, who believed that meat eating was overstimulating and chided “modern people” for the lack of fi ber in their diet; and recent writers continue to insist that a lack of dietary fi ber is behind various “Western” diseases 34 Certainly, the nation’s

10 million or so vegetarians are convinced that a vegetable diet sustains health and prevents disease, and many believe it is of moral importance

as well 35 The American vegetarian legions, which have increased dramati-cally since the 1960s, represent the tail end of a long line of vegetarians stretching back to Pythagoras, the Greek natural philosopher who founded

a sixth-centuryBCE religious community based on vegetarianism 36

Animal welfare was at the root of early vegetarianism, but medicine also had something to do with its rationale Some practitioners feared that meat turned putrid after it was consumed (just as it did when not con-sumed fast enough) which, in turn, brought on ill health, or a nasty dis-position, or both Others felt that undercooked meat could be a curse all

by itself Illustrative was the blood-drenched French Revolution and the tyranny of Napoleon, said in England to be the natural result of a French appetite for rare meat 37

Despite the popularity of vegetarianism however, most people, both historically and today, have been underwhelmed by arguments for veg-etarianism, in some instances, because of apparently confounding con-tradictions For example, despite a heavy meat and fat diet the Eskimos remained remarkably free of the chronic “Western” diseases so long as they continued with their traditional regimen 38 But when that regimen became “Westernized” – with high doses of saturated fats, sugar, and car-bohydrates – Alaskan natives began to develop “Western” affl ictions such

as obesity, diabetes, hypertension, and heart disease 39

Other evidence that meat is far from harmful to human health emerged from a widely-publicized experiment Two Western volunteers ate a ratio of two pounds of raw, lean meat to one half-pound of raw fat for a year – and nothing else Both individuals not only survived, but thrived, and one of the two volunteers was judged to be in better health at the end of the experi-ment than when it began, suggesting, of course, that Western diets may not be all that good for Westerners either 40 In a similar vein, a study of the Masai of Tanganyika, who consume almost exclusively the meat, blood, and milk of their cattle, turned up no arteriosclerotic disease, purportedly caused by artery-clogging cholesterol 41

Pacifi c Islanders are in a health predicament similar to that of the Eski-mos They, too, have developed extremely high rates of diabetes mellitus II

as well as hypertension after the adoption of a “Western” diet 42 It appears, then, that food globalization can be positively harmful to people – especially those who just yesterday were healthy hunters and gatherers This, in turn, brings up some questions about what actually constitutes good nutrition, and other questions regarding nutritional adaptation

The United States government has wrestled with questions about the constituents of good nutrition since 1941, when the Food and Nutrition Board of the U.S National Research Council established a dietary standard called Recommended Dietary Allowances ( RDA ) Revised continually, the

RDA is the U.S nutritional guide, and about forty other countries have also established similar national dietary standards 43 Then, more recently,

in 1992 the USDA established a Food Guide Pyramid to visually depict the amounts of the various foods that make for a balanced diet, the pyramid that was updated in 2005 It puts oils at the top (use sparingly), and bread, pasta, rice, and other cereals at the base (6–11 servings daily) 44 Meat, fi sh, and poultry, along with dairy products, are right under the oils, but two to three servings from each of the two categories are recommended 45

Next came food labeling – this in the wake of a fl ood of false and mis-leading health claims about foods, which brought a regulatory crackdown in

1994 Despite howls of fi nancial pain from the food industry, nutrition label-ing was made mandatory to let consumers know the macro- and micronutri-ents contained in the products they buy, and especially the levels of calories, carbohydrates, fats, sodium, and cholesterol 46 Labeling, however, is tricky because manufacturers can take advantage of the labels to misrepresent their products, so that many assertions remain unblushingly misleading 47 A good example is “low-fat” or “nonfat” claims for products, which might lead consumers to believe they are slimming But, as a rule, sugar simply replaces the fat, and the calorie count remains high Another familiar ploy is ground beef labeled – say – 80 percent lean, which implies that it is low in fat Yet, what if the label read “20 percent fat” and went on to inform the consumer that a three and a half ounce hamburger patty with 20 percent fat delivers

260 calories, 70 percent of these from fat? 48 Conversely, a lack of labeling can also be dangerous and, until 2006, manufacturers were not required to list the trans fats contained in their products – trans fats or partially dehydro-genated oils that are understood to elevate the risk of heart disease

The Food Guide Pyramid and labeling requirements clearly represent governmental responses to the nation’s obesity epidemic But from the beginning, the Food Guide Pyramid has been under attack In part this was because powerful food lobbies such as the National Cattlemen’s Asso-ciation, the National Milk Producers’ Federation, and the National Pork Producers Council had a hand in molding it 49 But it was also the result of carelessness In the 1992 food pyramid, for example, milk and ice cream were placed in the same category with lentils and bologna; and olive oil and butter with wheat bread and doughnuts 50 Another problem was the

1992 pyramid did not take into consideration people’s age, gender, weight, and exercise patterns, (although this has been corrected to some extent in the 2005 revision)

Then there are deeper objections Cereal-grains and dairy products have been basic food groups only for the past 500 generations, and some suspect that this has not been enough time for the human body to make all the necessary genetic adjustments to these “new-fangled” foods 51 Our hunter-gatherer ancestors rarely, if ever, ate from either group, but did take in considerable fats The Food Guide Pyramid, however, encourages the con-sumption of much in the way of refi ned carbohydrates and dairy products and makes all fats, including oils and even fi sh oils, seem dangerous But

in light of the disastrous nutritional experience of recent hunter-gatherers such as Eskimos, Pacifi c Islanders, and the Arctic Inuit, who have switched

to a “recommended” diet, the question arises of exactly who is supposed to benefi t from such nutritional guidance? 52

The recommendations promote the consumption of a mixed diet of food groups such as cereals, fruits and vegetables, meat and fi sh, and dairy products, even though the Inuit (and the Eskimos and Pacifi c Islanders and most people in the world) are lactose intolerant – meaning that they cannot digest many of the recommended dairy products 53 The traditional Inuit diet consisted almost entirely of caribou, whale, and seal meat, fi sh, birds, eggs, and meat from other land mammals that could be killed, such

as muskoxen ( Ovibos moschatus) The latter coexisted with mammoths

and mastodons, but was hunted so relentlessly by humans for its hides and meat that it was near extinction by the turn of the nineteenth cen-tury Clearly meat was the most important part of the Inuit diet But the mixed diet tries to steer consumers away from too much meat, lest they develop cardiovascular disease The Inuit, however, were virtually free of this affl iction, along with renal disease, hypertension, and diabetes as are other contemporary foraging peoples 54

If the Inuit diet was high in protein and fat, it was extremely low in carbohydrate-containing foods – cereals, fruits, and vegetables – yet the Pyramid recommends that foods high in carbohydrates be consumed in abundance In short, the Inuit diet is practically a mirror-opposite of the Food Guide Pyramid recommendations But, like the Eskimos, the Inuit had remarkably good health until they began to eat what the rest of us eat.55 Nor is this a recent phenomenon Long ago colonists in New Eng-land reported that their Indian neighbors remained healthy so long as they continued to eat those foods they were accustomed to 56

This has been labeled the “New World Syndrome” because those who made the rugged journey across the Bering Straits into an icebound New