The human race has been around for thousands and thousands of years. During this time we have proven to be an ingenious species. We form complex, fulfilling, and lasting relationships with one another, have created many deep and rich literary works, have eradicated many horrendous diseases, have put a man on the moon, and have done and will continue to do countless other truly amazing things. Despite our ingenuity we epically fail when it comes to a single, biologically driven, simple task that we have been practicing for thousands of years: EATING!!
One would think that with thousands of years of practice and experience we would actually be pretty good at this; however, approximately 70% of United States adults are overweight or obese (1). Obesity is a symptom of many things including emotional distress, busy lives, and a lack of time. From a purely physiological standpoint, obesity is a symptom of caloric consumption being greater than caloric expenditure, period. Instead of focusing on this basic nutritional tenet, excess caloric consumption, our attention has been diverted elsewhere by food marketers, wannabe endocrinologists, naturalistic medicine, and yes, even physicians. Instead of focusing on reducing energy intake or increasing energy expenditure we are too often focused on remedies and causes outside of our own control.
On the New York Times bestseller list of the top 20 books on “Advice, How-To, and Miscellaneous” it is striking that 8 of the top 12 are some type of diet related books. This tells me two things, that people 1) do not know how to eat and 2) are looking for help in figuring out how to eat. The United States government tries very hard to help Americans eat better by putting out the Dietary Guidelines for Americans and the MyPlate guidelines. The problem is that < 10% of Americans are actually meeting these dietary guidelines (2). This leaves an exorbitant amount of room for self-help books to try and tell people how they should eat (and they don’t work either).
In addition, the health benefits of vitamins and minerals has largely been exaggerated and/or manipulated by the food industry. A recently published editorial in the Annals of Internal Medicine (3) reviewed several large scale scientific studies on the ability of vitamin and mineral supplementation to prevent chronic disease and concluded that vitamin and mineral supplementation studies “...consistently found null results or possible harms” of supplementation (4, 5) and in some cases actually increase the risk of death (5). I would never say that vitamins and minerals are not important to your health. Clearly they are necessary to remain alive (6). However, if vitamins and minerals were personified, there is no way they would live up to our ideals as they would surely crack under the weight of our expectations. In addition, recent research suggests that public health campaigns (such as MyPlate) aimed at promoting increased vitamin and mineral consumption may have little to no effect on reducing the risk of obesity as individuals continue to remain in a positive caloric balance despite these types of interventions (7).
Lastly, by primarily focusing on organic ingredients and sustainable agriculture (both of which are great causes and could/should be discussed at length on their own) in some cases we are sacrificing our own health. Case in point: Chipotle. While Chipotle can trumpet their cause of promoting healthful food, there is no denying that many of the items on their menu, when eaten together as in a typical visit to their restaurant, contain well over 1,000 calories or > 50% of many individual’s daily calorie requirements. The Chipotle scenario is a classic case of a self-righteous cause that may actually be detrimental to your health. I’m not saying you should never eat at Chipotle. It is possible to eat healthy there, I am raising the argument that it is just as easy to eat unhealthily at a place that touts only the best natural ingredients as it is at someplace that does not (see pictures above). Furthermore, just because the quality of the ingredients may be superior at one chain over the other, Subway versus McDonald’s for instance, there may be no difference in the total number of calories consumed at each restaurant (8).
The bottom line is, Houston, we have an eating problem and we will continue have a problem until we can refocus the eating conversation back to what matters, caloric intake and energy expenditure!
Todd M. Weber, PhD, MS, RD
- Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010. JAMA. Feb 1 2012;307(5):491-497.
- Krebs-Smith SM, Guenther PM, Subar AF, et al. Americans do not meet federal dietary recommendations. Oct 2010 J Nutr. 2010;140(10):1832-1838.
- Guallar E, Stranges S, Mulrow C, Appel LJ, Miller ER, 3rd. Enough is enough: Stop wasting money on vitamin and mineral supplements. Ann. Intern. Med. Dec 17 2013;159(12):850-851.
- Huang HY, Caballero B, Chang S, et al. The efficacy and safety of multivitamin and mineral supplement use to prevent cancer and chronic disease in adults: a systematic review for a National Institutes of Health state-of-the-science conference. Ann. Intern. Med. Sep 5 2006;145(5):372-385.
- Bjelakovic G, Nikolova D, Gluud LL, et al. Antioxidant supplements for prevention of mortality in healthy participants and patients with various diseases. Cochrane Database Syst Rev. March 14 2012.
- Hopkins, FG. Feeding experiments illustrating the importance of accessory factors in normal dietaries. J Physiol. July 15, 1912;44:425-460.
- Srinivasan CS. Can adherence to dietary guidelines address excess caloric intake? An empirical assessment for the UK. Econ Human Biol. 2013;11:574-591.
- Lesser LI, Kayekjian KC, Velasquez P, et al. Adolescent purchasing behavior at McDonald's and Subway. J Adolesc Health. 2013;53:441-445.
References for Pictures:
Dunkin Donuts Chicken Salad Sandwich: https://www.dunkindonuts.com/content/dunkindonuts/en/menu/food/sandwiches/Bakery_Sandwiches/chickensaladsandwich.html
Chipotle Burrito: http://endurancesportsflorida.com/2011/02/04/chipotle-so-good-so-salty/
Panera Napa Almond Chicken Sandwich: https://www.panerabread.com/en-us/menu-categories/sandwiches.html#napa-almond-chicken-salad-sandwich