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Is Fast Food Really That Unhealthy?

            In his most recent book, “Fast Food Genocide”, Dr. Joel Fuhrman investigates the effects of a fast food lifestyle on us individually and as a society.  In his definition of fast food, Dr. Fuhrman includes food served by chain restaurants and the wide range of processed foods containing added sugar, salt, and fat.  His premise is that most people are unaware that the food choices they make affect their ability to think, mental stability, attitudes, behaviors and general health.  While his views about plant-based diets have been addressed at the individual level in his previous books, this time around his goal is to explain how the foods we chose affect society.  While the book’s title does have the ring of publisher hyperbole, the statistics supporting his proposition more than live up to the title when measured in lives lost and quality of life lost.

            If interested in understanding the national debate about nutrition and in particular the appropriate role for Government as an arbiter of good nutrition, the book is a good starting place. 

            If new to Dr. Joel Fuhrman’s plant-based whole food Nutritarian concept, I recommend acquainting yourself with his approach for selecting healthy foods based on their micronutrient density per calorie.  For more about the Nutritarian approach, read “Six Basic Guidelines for the Nutritarian Diet.

            Now for a few highlights from the book that often run counter to conventional thinking.

  • Over thousands of years, humans adapted to eat a wide range of foods.  In the healthiest areas of the world, people ate mostly plant-based foods with the very healthiest consuming plant-based whole foods.  In climates where plants could not be easily grown, meat became a survival food.  For example, the Eskimos eat mostly fish.  Unfortunately, the Eskimo diet is not great for health and a long life.  In Canada, the Eskimo population has a life expectancy that’s about 12 years less than in the general population.
  • An essential part of achieving the best health and ideal weight is a diet that has a wide spectrum of nutrients without adding extra calories.  Unfortunately, we are a social species inclined to reason that if everyone else is doing something it must be ok.  A constant barrage of advertising reinforces this message.  For many, this messaging becomes an invisible force dictating their food choices.
  • Despite the billions of dollars spent seeking cures for a wide range of mental illnesses, cancers, and autoimmune diseases, lifestyle change as a preventative measure remain the best solution in most cases.  Cigarette smoking is a case in point.  It remains unlikely that a pill will be invented that keeps a person from getting lung cancer if they smoke for 40 years.  For other diseases like Alzheimer’s, lifestyle is also the likely culprit and lifestyle change will probably be the best cure that will be found.  Expect the glacially slow advances in cures for these lifestyle/age diseases to only produce incrementally improved heroic measures that typically offer on average only a few extra months in exchange for a compromised quality of life.
  • In the 1950s about 45% of adults smoked. As a result of education and public policy, today only about 19% of adults smoke.  The good news is that lifestyle improved quality of life for millions.  By comparison, smoking is a relatively small health hazard compared with fast food.  About 96% eat fast food despite the evidence that a change in lifestyle can decrease heart disease in men by 90% and in women by 92%.  Of course, heart disease is only one of many chronic conditions that can respond positively to changes in diet.
  • The problem with most fast food is not how quickly you can have it delivered and eat it.  The real problem is how fast the refined foods enter the bloodstream and the subsequent release of fat storage hormones along with the increased release of dopamine (a driver of addiction in the brain).  When the use of addictive foods is repeated, the brain responds by decreasing the number of dopamine receptors.  As a result, satisfying the addictive drive requires eating more.  This effect varies with each person depending on their propensity to addiction.
  • Baked goods containing white flour are usually devoid of many micronutrients and have almost the same glycemic load as pure white sugar.  Eating most bread, rolls, pizza, or pastries are not much different than eating candy or spoonfuls of white sugar. These high glycemic load foods are known to promote six types of cancer (colon, breast, endometrial, lung, pancreas, and prostate).
  • Food addiction is often mistaken for hunger.  In a world of plenty, most have never felt hunger.  In contrast with the far more common food addiction responses, hunger does not cause fatigue, is not painful and not uncomfortable. True hunger does turn your attention to seeking the amount of food needed to maintain a healthy weight.
  • The unfortunate trend today is for children to become hooked on fast foods from a very young age.  As a result, they reject plant-based whole foods.  Once this addictive pattern has been established, rationalizations to justify the behavior naturally follow.  The thinking process and end result are little different for food than for drug addiction.  The effects on mental health are concerning.  About one in eight adolescents can be diagnosed as clinically depressed with many more having milder forms of mood disorders and learning difficulties.
  • The use of vegetable oil is rarely necessary or nutritionally advantageous.  Refined vegetable oil adds more calories (120 calories/tablespoon) to a meal than needed to maintain a healthy weight.  With a plant-based whole food diet, no added oil is needed.  Using oil to fry is counterproductive to maintaining a healthy weight.  When you fry a vegetable in oil it no longer counts nutritionally as a vegetable.  It then qualifies as junk food.  Fruits and vegetables contain sufficient healthy fats.  However, be aware that nuts, seeds, and avocados do contain a larger amount of healthy fats which if eaten in excess can promote weight gain.
  • There are populations eating mostly plant-based whole foods that have few recorded cases of heart disease.  Typically, these people are lean despite having access to an abundance of food.  It’s actually quite difficult for a person to gain excess weight or retain excess weight when eating mostly fruits, vegetables, beans, and whole grains along with modest amounts of nuts and seeds.
  • While the Mediterranean diet is much better than the Standard American Diet (SAD), it still falls short of an optimal diet for health or weight loss.  While a step in the right direction, what passes for a Mediterranean diet by many, is a diet that still contains calorie dense non micronutrient foods like vegetable oil, flour, and animal products.  To its credit, the Mediterranean diet does emphasize tomato sauce, fruits, and vegetables.  One caution, many tomato sauces have large amounts of added sugars and fats.
  • The full potential of diet for preventing cancer is best realized by a lifetime of healthy eating with the greatest benefits accumulating when healthy eating habits begin in childhood.  Recent studies estimate that about 40% of people over the age of 40 have detectable cancer cells.  Perhaps science will eventually provide a method for eliminating these unwanted cells.  Till then, the best cancer defense is at the stage, where cancers exist at a microscopic size.  At that stage, a healthy immune system supported by a healthy diet is the best defense.
  • If you want to get healthy, join with others striving to be healthy.  Often this will require reaching beyond your immediate friends and family.  Belonging to a support group is a powerful force for change.  When you belong to a group that supports you, progress gets easier.
  • The increase in calories consumed daily per person since 1900 is shown in the table below. The trend is clear, vegetables and fruits have been replaced by high-calorie sugars, oils, and animal protein.
Food category 1900 2000
Sugar (lbs/year) 5 170
Soft drinks (gallons/year) 0 53
Oils (lbs/year) 4 74
Cheese (lbs/year) 2 30
Meats (lbs/year) 140 200
Vegetables & fruits (lbs/year) 131 11
Calories 2100 2757
  • While all foods are some combination of three essential macronutrients (fats, carbohydrates, and protein), that information alone doesn’t give much insight into the health value of the food.  The difference is because our body metabolizes whole foods differently than processed foods.  A whole food and a processed food with identical macronutrients can differ enough that one would qualify as junk food and another as optimal nutrition.  The essence of the difference is what’s left after processing.  Quality fiber is often the first casualty of food processing. Micronutrients lost in processing may include any one of 14 vitamins, 25 minerals, or 1000’s of health-promoting phytochemicals.
  • Unless highly processed, vegetables and fruits are high in micronutrients per calorie.  Among the most nutrient dense vegetables are collards, kale, cabbage, spinach, carrots, and cauliflower.  Berries and beans of all types are also high in micronutrients.
  • Anyone confused about nutrition can thank the food industry for working overtime to muddy the waters.  Studies that make the news cycle often represent a short-term comparison of two small groups that both eat unhealthy diets.  Run enough trials and one will often look more favorable.  Studies by the egg industry showing that eggs don’t increase cholesterol is a classic example.  What the highly publicized test really showed is that if you already consume the maximum amount of cholesterol your body can absorb, adding more cholesterol to the Standard American Diet (SAD) has no measurable effect.

            Perhaps, these highlights will interest you in reading more.  There is much more in Dr. Fuhrman’s book to inform you about how food affects your health, the economy, the environment, and society.

            Nancy Neighbors, MD

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Take Out is Winning the Food Wars

            Americans have typically spent about 13% of their income on food for many years.  What has changed is the proportion of the budget spent on fast food. Today, the average is 44% of a family food budget for food eaten away from home (fast food).  Among millennial households, the percentage is even higher. The percentage varies with economic times.  During recessions, the amount spent on fast food falls.  Increasingly there has been a shift from prepared food eaten out toward prepared food brought home.

            Convenience is increasingly important and now includes web delivery services and grocery stores with new offerings.  What hasn’t changed is the need to make a profit by selling more food.  This is where the consumer can be easily fooled by meals that look healthier but only use their presentation as a disguise for food science that encourages every more consumption.  Even restaurants that you would assume offer quality food must compete with their peers for your repeat business.  That repeat business comes from appealing to the taste of their customers with the most addictive and least expensive ingredients possible (salt, oil, sugar, etc.).  Few restaurants survive by featuring truly nutritious food.  Fortunately, a smart consumer can usually still find a find nutritious food hidden somewhere on the menu or by explaining to the wait staff your dietary needs.  Mentioning the phrase “dietary need” is often enough to assure attention to your special request.

By Nancy Neighbors, MD

... Dr. Neighbors provides a blend of traditional family medicine and evidence-based lifestyle medicine in Huntsville, Alabama. When indicated, lifestyle change is recommended as the first line of therapy.

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