by Marion Nestle
Aug 8 2010

Why public health matters

I received a couple of requests to define “public health” last week from readers Anthro and MA.  As MA puts it,

Maybe…we need a definition of “public health.”  I view my health as a private matter, my food choices as a private matter, and an expression of my freedom.  To me, public health is not an individual concern, it’s a corporate (group) concern – government, schools, companies, farms, etc.  Public health includes things like properly working sewer systems, sanitation, water quality, and air quality.   Marion – can we get a definition of ‘public health’ from you, as Anthro suggested?

My definition of public health isn’t much different from mainstream definitions.  But to me, public health is a critically important expression of democracy, and the antithesis of  a “corporate” concern.  Public health approaches promote good health for everyone, not just those who can afford it or are educated enough to make appropriate choices.

A standard definition such as the one given in Wikipedia, says that public health is about promoting health and preventing disease through societal choices and efforts.   Public health deals with health at the population level, rather than at the level of individual personal responsibility, and it emphasizes prevention rather than treatment.

In my experience teaching public health nutrition, the concept of public health is sometimes hard for people to grasp, especially since populations are made up of individuals. I like to explain it this way: public health makes it easier for individuals to make healthful food choices for themselves and their families. Or to put it another way, public health makes better food choices the default.

The classic example of a public health intervention is water chlorination.  As individuals, we could all boil our own drinking water to kill harmful organisms but this requires us to have stoves, pots, and fuel, and to know how to boil water.  For many people, having to do this would be an intolerable burden and responsibility.  Instead, some societies choose to take public health measures to ensure that drinking water is safe at the tap for everyone.

Other food examples: milk Pasteurization, banning of trans fats, food labeling.

The particular example that elicited the question has to do with food safety.   We, as a society, could insist that food producers take measures to ensure that their products are free of harmful microorganisms (public health), or we could teach individuals how to manage food safety in the home or restaurants and cook foods properly (personal responsibility).

Preventing obesity is another example: We could, as a society, take measures to make it easier for people to eat more healthfully and be more active (public health) or leave it up to individuals to do this for themselves (personal responsibility). Many of the arguments about suggested public health measures to prevent obesity are about how best to balance society’s needs with individual rights.  But as I see it, the proposals aim to tweak societal choices that have already been made: which crops receive farm subsidies, for example.

An exceptionally clear example is how to avoid toxic levels of methylmercury in fish.   We can teach pregnant women to recognize which fish are high in methylmercury and hope this works well enough so they will avoid buying such fish (personal responsibility) or we could–as a society–require coal-burning power plants to scrub their emissions so mercury doesn’t get into ocean or lake waters in the first place (public health).

Obviously, both public health and individual approaches are necessary, but the overall objective of public health is to make it much, much easier for individuals to make better health choices without having to think about them.

Because public health applies to everyone, it is essentially democratic.   And that’s one of the reasons why I think it matters so much.

  • Anna

    This is a great way of explaining the difference – thanks, Marion!

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  • http://www.appetiteforprofit.com Michele Simon

    Thanks Marion for this important post. I have had difficultly explaining to students the importance of public health because it’s somewhat antithetical in our education system. Medical and law schools are geared toward an individualistic, case by case approach to problem-solving.

    Also, our American culture has been largely driven (in recent decades anyway) by a “what’s in it for me” attitude. Too many people take for granted the critical health advances we’ve made thanks to public health policies. Water sanitation and vaccination are just 2 examples, there are many more.

    And of course, the last thing food corporations want is a population-based approach, as evidenced by their individualist solutions: personal responsibility, exercise, education, are all ways to distract us from the democratic principles of public health policy.

  • Kelly

    I think it’s also important to really clarify the fact that a person’s private, personal choices still do have public impact. Someone’s personal choices about what and how they eat affects their health, which affects their medical treatments, which affects insurance, which affects the cost of insurance for everyone – just for one somewhat linked example.

    Another example would be vaccines. There’s a loud argument that vaccinations should be a private matter and choice, but the reality is that it’s a public health issue. If you don’t have enough people vaccinated to create herd immunity, disease does spread – and we’re seeing more and more examples of this, with a lot of indignant parents not understanding that if everyone exercises an option to not vaccinate, then yes, more people will get sick with more diseases that people (rather naively) thought were gone.

  • Abalone

    The broader the scope of public health, the more important it is to be judicious in its application. The more choices you take from the hands of the individual, the greater the burden to be right about what comprises “better health choices.” It’s unlikely that individuals will chafe against the powers that be for limiting their discretion to empty their own “honey pots.” But in the name of “better health choices” we have been handed greater public exposure to less healthy trans fats as a direct result of the misguided effort to save us from more healthy cholesterol and saturated fat. In the name of public health, standing advice to diabetics is to eat lots of starches and sweets. These are examples of public health as travesty.

    There are certain arenas where a centralized approach is clearly called for, such as sanitation systems. They perform a function that is clearly needed and are most effectively and efficiently performed centrally. The more public health extends itself, however, the less efficient it becomes, the more intrusive into the prerogatives of the individual, and the more risky in terms of the impact on a whole population of being wrong. There’s nothing democratic about imperious centralized control by alleged experts. And when they get it wrong, to boot, it violates not only individual rights but public health.

  • Uncle Herniation

    Abalone is right. To issue a decree that X must be the default requires you to be correct in your assumption that X does not do harm. 20 years ago, “public health” advocates would have suggested replacing margarine with trans fats. Now, some people think “public health” would be improved if we put statins in the drinking water.

    You also have to be aware of the downstream effects of any public health initiatives. If you say milk must be pasteurized, then farmers can raise cows in terribly unsanitary conditions, feed them grains and other foods that are not traditionally eaten by cows (like the brains of other cows… mad cow disease, anyone?), pump them full of antibiotics and hormones, and then sell sterilized milk to everyone.

    There’s no bacteria in my milk? Great! Too bad the cost is a bigger public health disaster than the “problem” that was fixed. This short-sightedness is far too common.

  • Uncle Herniation

    Sorry, I meant to say, 20 years ago, public health officials recommended replacing *butter* with trans fats (in margarine).

  • http://budurl.com/qgnv francesca

    i would say that the concept of “public health” is the general welfare healthwise of the population. though it shouldn’t limit itself to just the category of food. there’s sex education that falls under public health too. now i think another apt objective of a public heath department would be to create general awareness of the do’s and dont’s involved in food industries and whatnot.. PS. for more topics about healthy living you can check this one Health

  • Cathy Richards

    Thanks for the description Marion. I’ve been in public health for 21 years and still have trouble telling people what I do, and why!

  • Anthro

    I’m so glad you responded to my call for a discussion of public health, and I am equally disappointed that it seems to have gone over the heads of Abalone and Uncle H. It reminds me of people who think it is their “right” not to wear a motorcycle helmet. Yes, I agree that they are entitled to splatter themselves all over the pavement–as long as they have the personal wealth to pay for the cleanup of the mess, the medical treatment and any “collateral damage” that may occur as a result of the accident. And this would not include the grief they bring to their families, for which no dollar amount can make up.

    We cannot convince everyone of the need for adequate public health measures, and nothing is perfect, but I am grateful for the work of Nestle and Simon and all their partners in public health for working to implement and strengthen public health for ALL citizens, not just the ones who are blessed with sufficient education to know for sure what is good for them.

    Abalone, do you have a reference for diabetics being advised to eat “lots of starches and sweets”? I have never seen any such thing and it is something I have looked into a lot having been briefly Type II diabetic myself, and having a couple of Type I friends as well.

    Also, I would add that the presence of public health measures hardly stops anyone from doing as he or she pleases. Be my guest to drink from a polluted stream, eat tuna everyday, stop flushing your toilet, smoke cigarettes, don’t bother to familiarize yourself with the basics of the scientific method so that you realize that the advice given to the public is an ongoing process and will change as studies and discoveries add to the body of knowledge.

  • Roxanne Rieske

    I’ve never seen any government issued literature that promoted eating sweets and starches to manage diabetes. Excess consumption of sweets and starches aggravates the condition, which is medically well known and proven, so where did that statement come from? I agree w/ Marion on the role and definition of public health.

  • Pete

    I think what Abalone is getting at is “who decides what is healthy”? That’s the point. In the 1980s the FDA advised the public to limit fat intake with quite terrible ramifications. Did they not anticipate the corporate response with processed “fat free” foods and new chemical compounds to “replace” the fat taste? Did they forsee that refined grains would replace these fats in the western diet, which they now acknowledge plays a significant role in the rise of obesity? Even now Marion herself advocates “more plant foods, less meat”, an view with which I do not agree (through personal empirical evidence).

    The evidence of advising Diabetics to eat sweet, processed food I saw firsthand in my wifes gestational diabetes center at our hospital 2 years ago. They hand out “low glycemic” candy and even CEREAL to pregnant diabetics (called Glucerna). Packed with goodies like artificial flavor, sucromalt, fructose, GMO corn oil and soy protein isolate. Everything a growing fetus needs. The safety of soy protein has yet to be determined due to its high concentration of phytoestrogens – so give it to pregnant women?!

    The ramifications of public health policy are many. If we are not careful we can do more harm than good – which I believe we have already done. With all the corruption highlighted in Food Politics, its amazing that people are so willing to trust the government with their health.

  • Kelly

    Public health is not a facet of corporate activity, and looking at the past judging by the knowledge today is a concept known as “presentism” – and one that’s generally discouraged because it’s utterly pointless from a “should have done” standpoint. Yes, hindsight is 20/20, but that doesn’t really change the fact that we make current decisions based on best possible information.

    “Eat less butter” or “eat less red meat” does not mean “but hey, go CRAZY on whatever stuff the food corporations decide to market as an alternative” (Snackwells come to mind here). That’s where personal choice and autonomy comes into play. Anyone who heard “don’t eat so much butter” and decided that meant “go NUTS on the margarine and transfats!” made that decision on their own.

    (And that doesn’t even get into the problem of people not understanding the scientific process, or the fact that “studies suggest” doesn’t mean “WE HAVE IRREFUTABLE PROOF!”

    Does the last 30 years suggest that there is significant room for improvement of both the general education of the population, as well as making sure there are people who ‘speak’ both ‘science’ and ‘non-scientist’? Sure – but that’s hardly reason to condemn an entire field.)

  • Abalone

    @Anthro

    I tried responding to you earlier but the systems claimed my post was a duplicate. Trying again with a leaner message…

    “The American Diabetes Association (ADA) recommends that approximately 50 percent to 60 percent of total daily calorie intake should be in the form of carbohydrates. ”

    http://www.dlife.com/diabetes/information//food_and_nutrition/carb_counting.html

    Last July the ADA made significant changes. It still endorses only a high-carb diet but has acknowledged a narrow use for low-carb diets.

    http://diabeticmediterraneandiet.com/2009/07/05/ada-now-says-low-carb-diets-ok-for-overweight-type-2-diabetics/

    [Originally, the Pyramid specified up to 11 servings of bread. (I remember because I dutifully ate every last one of them, to my great detriment.) The latest official version has reduced that by a third. Small steps...]

  • MA

    Thanks for defining the term, Marion – I think it helps us all understand the perspective you are coming from. I know that I have a much better idea now.

    I think the cautionary comments about any policies being generated needing to be right are warranted, though, based on the wrongness of some of the historical advice (fats, for example). If a policy is created that affects everyone, then it should be as right as it possibly can be, and still allow as much freedom of choice as possible.

  • Roxanne Rieske

    Pete: There is a huge difference between a diet high in plant foods and one that is high in starches and sugar. MY personal empirical evidence tells me that too much meat based protein is not good for me. I have to keep it under 5 oz a day, if I eat any at all during a day. If I eat too much, I feel sluggish and tired. I need complex carbs in whole grains, beans, fruits, and veggies to keep me going. I am better able to manage my weight and energy levels this way. The bottom line here is that everyone’s nutritional needs are different, often based on body type and metabolism needs. Some need more protein, and some need more complex carbs. It’s everyone’s personal responsibility to figure out what their body’s needs are and develop an eating lifestyle that fits those needs–with their doctor’s help if necessary. The main reason I do not endorse eating meat is that 98% of mass market meat is extremely unclean and unbalanced nutritionally. The main reason a high plant-based diet should be endorsed as public health policy is that for the majority of the population, this is the type of diet/lifestyle that will work for them, which is well backed by science.

    On the subject of soy: WHOLE soy has never been a nutritional issue anywhere. Processed soy and soy protein isolate are highly suspect, and I avoid those as much as I can. There is no evidence anywhere that whole soy, which half the world has been eating for thousands of years, is a health risk to anyone. Pregnant women all over Asia consume whole soy on a daily basis, and have for generations. If there was any impact on this population and their children, we would have seen it by now.

  • Uncle Herniation

    @Anthro,

    Why the need to demean me for suggesting that public health initiatives be extremely judicious? Just because I have a different opinion than you does not mean that the issue has gone over my head. I’m completely willing to engage in a reasonable debate and offer my opinions. I don’t think anything I said was unreasonable, was it?

    Frankly, you are epitomizing an extremely dangerous attitude. You give off the impression that the “facts” you agree with are somehow sanctioned, and that people who disagree with you are just too stupid to understand the “science” you have chosen to believe. In the context of public health, it is dangerous when people who think the way you do are quick to declare that the public must be strongarmed into doing things your way, often through government legislation or initiatives that remove reasonable individual choice (e.g., fluoride in the drinking water).

    I am not arguing that public health is pointless – just the opposite. Appropriate public health initiatives, like seatbelts, motorcycle helmets, smoking, etc. appear to have a highly positive effect on society. However, I believe that some public health initiatives can inadvertently lead to a net negative effect on the public. I don’t believe that public health officials purposefully do anything to harm people, but I believe that some people have the attitude that a few years of research trumps millenia of cultural practices that have survived thousands of generations. For example, whole wheat contains numerous vitamins that, in isolation, are believed to be beneficial to human health. Therefore, public health officials advocate that people consume a diet rich in whole grains, especially whole wheat products. However, based on anthropological evidence, it is difficult, if not impossible, to find a culture in the history of the world that has lived healthfully on a predominantly wheat-based diet (http://wholehealthsource.blogspot.com/2010/03/grains-as-food-update.html). This may be due to the fact that wheat also contains a large number of anti-nutrients that interfere with the absorption of the good stuff, not to mention the fact that the gluten in wheat can be a serious gut irritant (http://www.paleonu.com/panu-weblog/2009/6/23/the-argument-against-cereal-grains.html). Those cultures who have subsisted on a grain-based diet often prepared their grains much differently than we do in our modern society (http://wholehealthsource.blogspot.com/2010/05/traditional-preparation-methods-improve.html). Yet huge corporations like General Mills, Kellogs, etc. are able to leverage well-meant public health recommendations to push highly processed grains that do not resemble anything that has ever been eaten in the history of man. Not a day goes by that I don’t see a commercial reminding people that Cheerios supposedly reduces cholesterol and fits in well with public health recommendations to eat “heart-healthy” whole grains. And not surprisingly, this may be the most unhealthy era (especially in terms of chronic disease) that man has ever experienced. Even the China Study, which supposedly offers the most concrete evidence for a plant-based diet, actually shows that wheat consumption is highly correlated with heart disease (http://rawfoodsos.com/2010/08/06/final-china-study-response-html/#sec3). But that point was left out of the original publication.

    In response to the argument that diabetics are not recommended to eat starchy foods, here is the American Diabetes Association’s diabetes food pyramid, with bread, grains, and other *starches* forming the foundation: http://www.diabetes.org/food-and-fitness/food/planning-meals/diabetes-food-pyramid.html

    Maybe I’m just an idiot and this is all above my comprehension. Or maybe we need to quit believing that we have reached the pinnacle of knowledge about food. It is extremely arrogant to think that one can just force everyone into one model and eliminate the option to consume food the way it has been consumed historically (e.g., raw milk has a much longer history of nourishing humans and other species than pasteurized milk – the reason pasteurization is beneficial is because industrial food operations are more likely to lead to infection than traditional animal husbandry).

    If you want to respond to any of my points, I’ll keep an open mind. Will you?

  • http://smartculturekitchen.blogspot.com Michael Bulger

    I hold a degree in Anthropology and I think it is important to point out the limits of anthropological theory. This is especially true of paleoanthropology. The bones of a handful of individuals who lived 70,000 years ago is not a sufficient sample size to accurately determine predominant dietary patterns.

    Many theories that are supported by different artifacts exist to consider. It’s fun and can give you great insight into how we got to where we are, but I don’t think it is something to follow religiously.

  • Uncle Herniation

    @Michael Bulger,

    Congrats on the degree, but if you’ll notice, the mention of anthropology in my comment was a very minor point that doesn’t change the overall gist of my argument.

    And if you’ll notice, I didn’t say “anthropological evidence PROVES,” I said “it is difficult, if not impossible, to find a culture in the history of the world that has lived healthfully on a predominantly wheat-based diet.” In other words, with our current state of anthropological science, we don’t have any evidence of a primarily wheat-based culture.

    Given that agriculture purportedly emerged approximately 10,000 years ago, I doubt that there were cultures 70,000 years ago subsisting primarily on Triscuits.

  • http://smartculturekitchen.blogspot.com Michael Bulger

    I noticed that. I wasn’t taking a swipe at you, and I realize I’m distracting from the point.. one little tidbit you can ignore if you’d like to stay on topic: wild ancestors of wheat, barley, etc. all existed and most likely flourished long before agriculture. These were what people domesticated. To think they wouldn’t have ‘em for a snack, or would start domesticating them before the ate them, doesn’t ring in my mind. Some think they domesticated them to attract herds of grazing animals, but IMHO there would be a lot more animal bones associated with early agricultural settlements if that was going on. We’ll never know for sure, but I think the easiest thing to imagine is they’d eat whatever was around and didn’t have any noticeably ill effects. Why am I talking about this in a public health thread?

  • Uncle Herniation

    Michael, I agree with you completely. People almost certainly ate wheat and other grains before the agricultural revolution. I’m simply saying that wheat has never been the staple crop of a healthy traditional culture.

    Just to be clear why I’m making this point: researching the effects of consuming different types of food is very difficult, especially if one’s goal is to understand the role of food in chronic disease and epigenetic phenomena. For instance, it would be essentially impossible to conduct a scientific study on the effects of a lifetime of dietary wheat consumption and the “diseases of civilization.” There are too many variables that cannot be controlled for, and as a result, there will never be able to study the effects of wheat in isolation. The best we can do is either 1) very time limited studies that still can’t control for most confounds, or 2) epidemiological studies, which can’t establish causation.

    Given these limitations, my opinion is that the best way to understand the relationship between food and health is to look backwards at human history and evolution. The foods that have been consumed as a staple for the longest period of time are those that are the least likely to produce negative health consequences. Animal fat and proteins have been demonized in the last 50 or so years, despite the fact that humans have been relying on animal products as a staple food since the dawn of homo sapiens. Something doesn’t make sense, and I’m inclined to trust history over modern science. Just for some added context, I am a Ph.D. psychology researcher in cognitive aging, so I am completely aware of the pitfalls of modern research into chronic diseases and their causes.

  • http://smartculturekitchen.blogspot.com Michael Bulger

    I think the variations in animal fat and protein quantities over time are important to point out when considering public health initiatives. One should not forget that we are making history, just as prehistoric homo sapien sapien did, in the present and with adaptation.

    Our ancestors were not necessarily more divine or enlightened, however much one might want them to be. And despite the poetics of archaeologists, they don’t speak to us through their artifacts. Imagine we were able to bring early man to the present and show him our current dietary patterns and the moderate research linking whole grains to reduced risks of CVD, T2D, and obesity. Do you think maybe he’d say, “Mmm. Humph. Whole-grain good. Me want wheat.”?

  • Uncle Herniation

    I’m not claiming that ancient humans were “divine or enlightened.” I’m claiming that the survival pressures that they faced are encoded in our genes. We eat meat in 2010 because meat was one of the foods that allowed our ancestors to survive and pass on their (meat-adapted) genes.

    Many people believe that, because grains have only been a significant source of calories for approximately 10,000 years, not enough time has elapsed for evolution to select for the ability to neutralize (or otherwise not be affected by) lectins, phytates, and gluten.

    Of course we are making history. But you can’t have it both ways. If we’re making history, then we can’t completely know the consequences of our actions. And we can’t know the future. But what we do know is where we came from and what foods sustained healthy cultures in our past.

    If we brought early man to the present and showed him moderate research linking whole grains to reduced risk of CVD, T2D, and obesity, I’m pretty sure he would say “Hrmm? What is CVD, T2D, and obesity? Me not know of these things.”

  • http://smartculturekitchen.blogspot.com Michael Bulger

    10,000 years is quite a few generations. Estimates are that celiac disease and wheat allergies effect less then 1-2% of the population. Speculative hypothesis is all I am finding as far as wheat being responsible for any other ailments. If you’ve found anything other than a fad-diet site (i.e., clinical research), I’d be interested.

  • Uncle Herniation

    This is kind of funny.

    I say: There are so many obstacles to studying the long-term and epigenetic effects of food consumption, that it is practically impossible to get accurate and reliable information. A more informative approach may be to look backwards and determine which staple foods have been associated with good health. As far as I know, wheat has never been a staple food of a healthy culture in our past.

    You say: What studies have been conducted on wheat?

    What’s next?

    Me: Aw, damn. My watch is broken!
    Michael: What time is it?

    Anyway…
    Research suggests a link between wheat (gluten) and a host of autoimmune conditions. Autoimmune dysfunction has been implicated in the “diseases of civilization,” such as diabetes, heart disease, even cancer and Alzheimer’s disease. Here are a few papers, certainly not all-inclusive. Keep in mind, I think all studies on nutrition, health, and longevity are necessarily flawed. That’s why I suggest learning more about ancestral dietary patterns to determine which foods have most successfully stood the “test of time” (not wheat).

    http://www.ncbi.nlm.nih.gov/pubmed/19758171
    http://www.ncbi.nlm.nih.gov/pubmed/18819035
    http://www.ncbi.nlm.nih.gov/pubmed/18507842
    http://www.ncbi.nlm.nih.gov/pubmed/16484508
    http://www.ncbi.nlm.nih.gov/pubmed/15093559
    http://www.ncbi.nlm.nih.gov/pubmed/14718716
    http://www.ncbi.nlm.nih.gov/pubmed/14690336
    http://www.ncbi.nlm.nih.gov/pubmed/18348715
    http://www.ncbi.nlm.nih.gov/pubmed/17007427
    http://www.ncbi.nlm.nih.gov/pubmed/3909375
    http://www.ncbi.nlm.nih.gov/pubmed/773406

  • http://smartculturekitchen.blogspot.com Michael Bulger

    It’s at least equally difficult (and in my opinion much more difficult) to determine what our ancestors actually ate. No one can measure the LDL of an unearthed skull. This is compounded by the fact that the sample sizes of of ancient populations provide little meaningful insight. You can surmise that this fellow had a knife, and we can guess he cut up meat with it, but what if the group the next grassland over were vegetarians. Why not?

    That being said, thank you very much for the links. I will check them out. (Oh, and I hope the internet is conveying the fact that I find this discussion amusing and appreciate you apparently sharing a sense of humor. The important thing is that we both be allowed to theorize and make our own dietary choices. In that, I see your point on public health. I also understand the efforts to make the public’s food environment more conducive to healthy choices.)

    P.S.- I’ve got 6:19 p.m. EST

  • Uncle Herniation

    I’ll second your comment on the positive tone of this discussion. You’ve certainly challenged me to think and present my ideas clearly. I wonder if everyone else has tuned out by now? ;)

    You are completely correct that we can’t know exactly what people ate and what their overall health was like. As you also mention, we can’t know exactly what markers such as LDL were like in ancient peoples. This is where my opinions require a more subtle explanation. I’ll try my best to make sense.

    We can’t know what our our very distant ancestors ate, but (a) we know what they *didn’t* eat, and (b) we have a good idea about the foods that were staples and the foods that were more “opportunistic.” We know that most of what we find in the grocery store were not eaten at all millions of years ago. In other words, we know that when our species evolved, Cheerios were not there to shape our evolution one way or the other. It’s pretty clear from anthropological evidence and the few modern-day hunter gatherers left on earth that our genes generally evolved with meat as a staple food. It is possible that certain groups were vegetarian, but it is likely that vegetarianism was not so prevalent that it was selected for evolutionarily. Therefore, we can safely conclude that meat passes the “test of time.” Things like grains, dairy, and certain vegetation (nightshades maybe?) could have been “opportunistic” foods, meaning that they were eaten when available, but they were not a staple prior to the agricultural revolution. Whether they pass “test of time” is unclear. 10,000 years is not a long time in terms of evolution; even today, lactase persistence is the exception to the rule throughout most of the world, and some grains (especially wheat) and nightshades are associated with autoimmune issues. But there is evidence of traditional cultures within the last 10,000 years living healthfully on a dairy or grain (though not wheat) based diet. New foods (from the past 100-200 years) do not pass the test of time.

    To try to summarize my opinion simply: if our genes evolved with relatively continuous access to a certain food, then our bodies are physiologically equipped to digest that food. If not, these foods may contain substances that our bodies recognize as toxins. Most plants use chemical defense mechanisms to survive, and humans may never have evolved a method to neutralize these chemical defenses. As a result, ingesting these mild toxins can overactivate our immune systems and lead to chronic disease (assuming the food does not cause immediate death). With grains, traditional cultures learned that by soaking and fermenting their grains, they could eliminate many of these toxins before ingestion. In contrast to plants, animals’ defense mechanisms only work when the animal is alive :)

    Assuming that is true, it doesn’t necessarily matter how healthy our ancestors were; what matters is that they ate foods that didn’t kill them for millions of years, which allowed us to develop the machinery to process these foods without negative consequences. It could be argued that we haven’t yet evolved the machinery to avoid the autoimmune issues caused by wheat, or the machinery to process highly refined carbohydrates and high fructose corn syrup.

    Getting back to the main point, public health advocates, through modern science, know that grains contain healthful vitamins. They also know about poorly-done science that suggested animal products were healthy. That led public health officials to recommend consumption of grains over animal products, a recommendation that appears to be based on a few studies over a few years, rather than looking to our past for any guidance. They focused on the potential benefits without considering the potential consequences, one of which includes the fact that the food processing industry could process, refine, and market these whole grains to the point that they bore no resemblance to traditionally-prepared grain products like injera or uttapam. Not the fault of the public health officials who recommended eating grains, but perhaps we would be healthier as a culture right now if no science-based recommendations had been made (margerine may never have replaced butter, Wonder Bread may never have replaced sourdough, sugar may have never replaced good fats, etc.

    Sorry for the length of these diatribes! I have to end by giving credit where credit is due. Much of my opinions have been influenced by the writings of Stephan Guyenet, Ph.D., at http://wholehealthsource.blogspot.com – perhaps the best resource on the web for food-related topics.

  • Uncle Herniation

    Oops, in the 6th, paragraph, I meant to write “They also know about poorly-done science that suggested animal products were UNhealthy”

  • Roxanne Rieske

    I don’t associate a whole-grain based diet with whole wheat, which I eat very little of. I do, however, eat copious amounts of brown rice, whole oats, corn, and quinoa. I have also just recently ordered my first bag of Teff, which was a staple food of the Egyptians. All of these grains have been staple foods of various civilizations, and still are for the most part. One thing we have to keep in mind when are talking of ancient diets is that these people also didn’t live very long. The average life expectancy of ancient peoples was around 38 years of age. Of course the rates of accidental deaths and deaths to disease are estimated to have been pretty high, but their lack of disease resistance could quite possibly be related to diet. A meat heavy diet lacks anti-oxidents and is low in B-vitamins and fiber–3 essential items proven to enhance health and prolong life. They could of very well have suffered from malnutrition most of their lives. Being able to survive is not a measure of the healthful quality of life. It’s often seen in famine-stricken areas that people can merely survive on one food item (like rice) for years, but they suffer nonetheless from malnutrition and disease. It’s the same concept when your main food item is meat. If that’s all you’re eating, eventually they’re are going to be consequences. And that consequence for ancient peoples could very well have been early death.

  • Roxanne Rieske

    they’re=there

    I still assert that the main reason we shouldn’t be eating meat in this country is that most of it is factory farmed, which makes it fat heavy and nutritionally unbalanced. The nutritional profiles of pastured cattle and wild game cannot compare to the feedlot crap we’re continually pushed to buy. What we find in the supermarket is NOT the food ancient peoples were eating.