Got a health question? Ask the nutritionist!

Because food policy guidelines and medical direction clearly aren't working.

By now we all know our food should be our medicine, but we continue to turn to doctors and pharmacopoeia with our health woes, outsourcing our power over our own health and wellness. We’ve been sold the ideology that pills and creams and injections and surgeries can solve most of what ails us.

Clearly, it’s not working. Despite our best medical tech - all our devices, all our drugs, all our seemingly free (in Canada) healthcare services and advances in how they’re delivered - we in the West (and arguably the world) are unhealthier today than at any point in our collective history.

We won’t get into lifespan analysis in this essay. Instead let’s talk about life quality, aka health. And our lack of it.

>42% of Americans today are obese ¹. Statistics Canada reports that two out of every three adults in Canada are now overweight or obese and the proportion of obese children has nearly tripled in the last 25 years. By 2030, it’s estimated that Canada will have over 1.1 million children who are obese ². Obesity is linked to numerous health complications and diseases, including the big 3: diabetes ³, cardiovascular diseases ⁴, and cancers ⁵ ⁶. It’s no stretch to say that obesity is a leading cause of death and preventable disease worldwide ⁷ . If nothing changes, the cost of obesity alone on the various public healthcare systems worldwide will bankrupt them.

Most recently we’ve seen a direct correlation between poor Covid-19 outcomes and the diseases of obesity ⁸ ⁹. Despite this, obesity as a public health issue is not getting any media or political attention, and there doesn’t seem to be any initiative to address it.

Doesn’t that seem odd to you? With the clear correlation between obesity and poor COVID-19 outcomes, no government worldwide has initiated a discussion around weight loss or indeed, improving the health of its citizens.

It really begs the question why. And while we’re on the whys, why are we gaining so much weight? We’ve never had more access to health and dietary information and monitoring devices - through web and app-based services. We’ve certainly never been more inundated with services from health coaches of all backgrounds. And we've never had more access to home gym equipment and on-demand exercise guidance.

So why the skyrocketing rates of obesity?

Is it because we’re overwhelmed with conflicting nutrition information? A great many nutritionists, health coaches, and functional medicine doctors are disseminating quality nutritional advice continually. Since I started blogging and educating about a grain-free, whole foods, low carb, omnivore, nose-to-tail, probiotic diet in 2010 there have been hundreds of high profile voices join in. Just to name a few, we have Mark Sisson, Mark Hyman, Chris Kresser, Jason Fung, Dr. Berg, Dr. Mercola, Robb Wolf, Dr. Bret Scher, Nina Teicholz, Dr. Perlmutter, Dave Asprey, Dr. Ken Berry, and Dr. Robert Lustig.

Is there an abundance of conflicting information in nutrition circles still? To be sure. But that conflict typically comes down to meat or no meat, carb restriction or no. Both sides of this controversy are committed to high quality, whole, unprocessed foods and neither side is fuelling the obesity epidemic.

And, let’s be honest. There’s conflicting information about almost any subject online. It doesn’t stop people from getting their cars fixed, their teeth fixed, their homes fixed. So why such trouble fixing our growing waistlines?

With all the websites with ‘one click to download your free beginner’s guide,’ I don’t think we can’t say it’s because we don’t know where to start.

And with all the websites devoted to weight loss and the popularity of instagram’s before and after threads, I don’t think we can say it’s because we’re happy being sick and fat.

So we’ve got copious information, copious resources, and abundant, easy access to the tools to turn this around. And still we are unable to get our weight in check. Should we infer that we’re just unmotivated and lazy?

Or could it be something about the food supply itself?

I mean, the sheer ubiquity of over-sweetened, over-salted, over-processed, hyper-palatable, seemingly addictive, nutritionally adulterated foodstuffs available today is absolutely dizzying.

Let’s explore that further.

Who protects our food supply and makes our dietary recommendations? In Canada it’s Health Canada. There are similar regulatory agencies set up globally. But almost all have followed the direction and science endorsed by the Dietary Guidelines for Americans. So has this organization and their dietary recommendations been independently and duly scrutinized for conflicts of interest and quality control, in light of the obesity epidemic? It seems that process has begun. From Dr. Lustig’s site:

Current Dietary Guidelines for Americans – 2015 to 2020

For the past 35 years, the federal government has published the Dietary Guidelines for Americans (DGAs) —the principal policy guiding diet in the United States—with the goals of promoting good health, helping Americans reach a healthy weight, and preventing chronic disease.

Since the introduction of the DGAs, however, there has been a sharp increase in nutrition-related diseases, particularly obesity and diabetes, which the DGAs have been unable to stem. A number of experts have expressed concern about both the science underlying the DGAs as well as the process used to draft them. Some of these issues are outlined here. The science behind the guidelines is not settled and Congress is concerned.

The process for developing the Dietary Guidelines for Americans is the subject of a major new report by the National Academies of Sciences, Engineering and Medicine:

Redesigning the Process for Establishing the Dietary Guidelines for Americans ¹⁰

And, from the American Journal of Clinical Nutrition, reviewing Nina Teicholz’s Big Fat Surprise (book review):

In 1977, Philip Handler, the then-President of the National Academy of Sciences, stated, in his testimony to the US Senate Select Committee on Nutrition and Human Needs, “What right has the federal government to propose that the American people conduct a vast nutritional experiment, with themselves as subjects, on the strength of so very little evidence that it will do them any good?” Handler underestimated the scope of the experiment that eventually affected most of the world’s population. How this nutritional experiment came about, its unproven ability to prevent heart disease, and the potential negative consequences of the long-term dietary changes are reviewed in meticulous detail in Nina Teicholz’s book The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet. With the >50 y of research and debate on the diet-heart issue, Teicholz compiled a historical treatise on how scientific belief (vs. evidence), nongovernment organizations, food manufacturers, government agencies, and moneyed interests promised more than they could deliver and, in the process, quite possibly contributed to the current world-wide obesity epidemic. ¹¹

Indeed, reading Teicholz’s book it’s clear we have nutritional guidelines that are questionable and dangerous. It’s also clear they have been informed by industry lobbyists and conventional dogma instead of open discourse and scrutiny of the best contemporary scientific data. To this end, Teicholz is now the ED of The Nutrition Coalition, which is a non-profit organization devoted to overhauling U.S. nutrition policy so that it’s actually based on quality scientific evidence. The coalition began their work in 2015.

Despite this, the current updated American Dietary Guidelines (2020-2025 - they’re updated every 5 years) are still rife with problems. The 2020 Dietary Guidelines Advisory Committee Report points out that they don’t meet adequate intake goals of key nutrients like iron, vitamin D, vitamin E, choline, and folate. Even when citizens are following the guidelines perfectly, they will be deficient in important nutrients.

Well, we still have incredible access to whole, unadulterated food in the Western world, right? We can still choose those foods if we want to.

Enter food deserts.

Yes, this is a thing. Between 2000 and 2006 the U.S. government reviewed data and mapped more than 6,500 food desert tracts. These are essentially areas where people have limited access to affordable healthy food choices. The areas are typically low-income with low vehicle availability and/or poor access to transit, often with high unemployment and large minority populations. These are usually densely populated urban areas. At the same time as these food deserts create a void of healthy food choices, they fill that void with an overabundance of fast food and hyper-processed junk food options.

For more information on American food deserts please see the USDA Characteristics and Influential Factors of Food Deserts. To understand the incidence in urban Canadian centres, see Food Deserts in Canadian Cities.

Clearly there is a lack of food accessibility for specific populations in North American cities. This has to factor in to the obesity epidemic. In his 2019 University of Washington Tacoma BA thesis, honours student, Christian Bell, examines the issue, and explores the various innovative solutions that communities have undertaken.

Even in well serviced areas in North America today the sheer volume of nutritinally-deficient, hyper-palatable, ultra-processed foods is overwhelming. I remember the shocking difference between our grocery stores and those in Amsterdam on a trip there in 2012. The stores in Amsterdam were filled with produce, dairy, and fresh deli and fish products, packaged for convenience but much more affordable than fresh food is here. By contrast, up to 80% of our normal grocery stores in Canada/ the U.S. are now comprised of processed food products.

Why is this? Are we to believe the players in the food industry don’t know what causes overeating and what switches on and off the ability to self regulate appetite within the human body? Are we to believe they aren’t hiring scientists to maximize addictive food behaviour and systematically angling to push those foods to their target audience with ever more slick advertising and packaging and placement?

It’s called ‘The Bliss Point’.

In The Secrets of Sugar, an award winning Fifth Estate documentary, industry insiders talk about ‘the bliss point’ where food becomes so palatable it’s hard to stop eating it. They also expose how the food industry hires people to figure this out for their products while intentionally confusing and subverting nutritional data and product labelling. If you haven’t seen it, it’s a rather riveting expose that I highly recommend.

So our dietary regulatory agencies and food manufacturing corporations are failing at directing us toward better dietary practices. Our municipalities are failing at ensuring we have access to healthy foods. Surely we have our doctors to rely on?

“Unfortunately, most doctors are nutritionally illiterate. And worse, they don’t know how to use the most powerful medicine available to them: food.” Dr. Micheal Greger MD

From Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey ¹²:

The teaching of nutrition in U.S. medical schools still appears to be in a precarious position, lacking a firm, secure place in the medical curriculum of most medical schools. Concerns remain that many future physicians will lack adequate preparation in this essential component of modern medical practice. Despite these challenges, a minority of medical schools still manage to provide substantial nutrition training for their students. Medical school faculty should encourage administrators to retain the nutrition education currently offered and expand it to provide, at a minimum, the 25 nutrition education hours needed to properly train physicians.

25 hours is the recommended, upgraded standard to ‘properly’ teach physicians about nutrition. In contrast, most private nutrition schools require 1-2 years of intensive study in nutrition. Dietetic schools require more hours, however their curriculum is based on the same government endorsed dietary guidelines that have been making so many of us obese. Nutrition school curriculum exists outside of this sphere of influence so those within the field can critically assess dietary information for themselves. This is why you pay out of pocket to see a nutritionist. In reality, what’s the difference?

Dieticians will help you figure out the foods to take with the medication you’re given for your type II diabetes. They will tell you to eat more whole grains and reduce the fat.

Nutritionists will help you follow a diet very low in carbs and higher in protein and healthy fats, to reduce your need for diabetic medication - or reverse the condition such that medication isn’t needed.

So where do we go from here?

We are locked in a raging health crisis of a virus that impacts those with obesity-related health problems much worse than those with a healthy BMI, yet as a global community we are exclusively consulting doctors and ‘health’ agencies for medications and injectables and respiratory devices and PPE to bring us out of this. And nobody is talking about obesity.

Moreover, nobody is talking about health.

Shouldn’t we be?

Do you have a health question? Maybe it’s time to Ask the Nutritionist.

1. CDC. “Adult Obesity Facts.” Centers for Disease Control and Prevention, 11 Feb. 2021, www.cdc.gov/obesity/data/adult.html.

2. Canada, Health. “Obesity - Canada.ca.” Canada.ca, 2019, www.canada.ca/en/health-canada/services/healthy-living/your-health/lifestyles/obesity.html.

3. Leitner, Deborah R., et al. “Obesity and Type 2 Diabetes: Two Diseases with a Need for Combined Treatment Strategies - EASO Can Lead the Way.” Obesity Facts, vol. 10, no. 5, 2017, pp. 483–492, www.ncbi.nlm.nih.gov/pmc/articles/PMC5741209/pdf/ofa-0010-0483.pdf, 10.1159/000480525.

4. Powell-Wiley, Tiffany M., et al. “Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association.” Circulation, vol. 143, no. 21, 22 Apr. 2021, 10.1161/cir.0000000000000973.

5. “Obesity and Cancer | CDC.” Www.cdc.gov, 10 Mar. 2021, www.cdc.gov/cancer/obesity/index.htm.

6. O’Neill, S., and L. O’Driscoll. “Metabolic Syndrome: A Closer Look at the Growing Epidemic and Its Associated Pathologies.” Obesity Reviews, vol. 16, no. 1, 18 Nov. 2014, pp. 1–12, onlinelibrary.wiley.com/doi/pdf/10.1111/obr.12229, 10.1111/obr.12229.

7. World Health Organization. “Obesity and Overweight.” Who.int, World Health Organization: WHO, 9 June 2021, www.who.int/en/news-room/fact-sheets/detail/obesity-and-overweight.

8. Al‐Sabah, Salman, et al. “COVID‐19: Impact of Obesity and Diabetes on Disease Severity.” Clinical Obesity, vol. 10, no. 6, 20 Oct. 2020, 10.1111/cob.12414. Accessed 4 May 2021.‌‌

9. Gao, Min, et al. “Associations between Body-Mass Index and COVID-19 Severity in 6·9 Million People in England: A Prospective, Community-Based, Cohort Study.” The Lancet Diabetes & Endocrinology, Apr. 2021, 10.1016/s2213-8587(21)00089-9.‌

10. National Academies of Sciences, Engineering, and Medicine. 2017. Redesigning the Process for Establishing the Dietary Guidelines for Americans. Washington, DC: The National Academies Press.https://doi.org/10.17226/24883.

11. McNamara, Donald J. “The Big Fat Surprise: Why Butter, Meat and Cheese Belong in a Healthy Diet, by Nina Teicholz. Reviewed by DJ McNamara.” The American Journal of Clinical Nutrition, vol. 102, no. 1, 1 July 2015, pp. 232–232, 10.3945/ajcn.115.107284. Accessed 27 Nov. 2019.

12. Adams, Kelly M, et al. “Nutrition Education in U.S. Medical Schools: Latest Update of a National Survey.” Academic Medicine : Journal of the Association of American Medical Colleges, vol. 85, no. 9, 2010, pp. 1537–42, www.ncbi.nlm.nih.gov/pubmed/20736683, 10.1097/ACM.0b013e3181eab71b. Accessed 6 Dec. 2019.

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