May 30, 2011

Caveman Diary, 3: You Can Call Him Mr. Taubes

You have to know your Sidney Poitier movies to grok that title, of course, but the Mr. Taubes I'm referring to is Gary Taubes, who wrote the history of metabolic science called Good Calories, Bad Calories, which I finally finished reading. But first this digression from another movie:

Dr. Melik: This morning for breakfast he requested something called "wheat germ, organic honey and tiger's milk."
Dr. Aragon: [chuckling] Oh, yes. Those are the charmed substances that some years ago were thought to contain life-preserving properties.
Dr. Melik: You mean there was no deep fat? No steak or cream pies or... hot fudge?
Dr. Aragon: Those were thought to be unhealthy... precisely the opposite of what we now know to be true.
Dr. Melik: Incredible.

Did Woody Allen, in "Sleeper," simply intend to be ironic, or was his general distrust of social trendiness at last vindicated? As far as steak and deep fat are concerned, my current motto is "bring it on." Not too much in the way of cream pie or hot fudge, but maybe he's right about that too.

Although I must confess something here. While the term "paleolithic diet" has become a new buzzword, I notice that as I drive south to San Francisco, I do not really see any mastodons grazing on the green hills of southern Marin County. Nor do I have any idea what roots, berries, bark and insects human beings were gathering 12,000 years ago. Calling a diet that is mostly animal products (meat, poultry, fish, eggs and cheese) and leafy green vegetables, with the occasional banana or cantaloupe (oranges and pineapples score high as allergens for me), "paleolithic" is another instance of substituting the American penchant for "branding" in place of what we used to do called "thinking."

What makes sense to me is that Gary Taubes is probably right that the "Dietary Guidelines for Americans" promulgated in 1977 by the McGovern subcommittee on health, in which the citizens of this country were advised to derive about 65% of their caloric intake from carbohydrates, stood metabolic science, as it was understood at that point, completely on its head. Carbs drive insulin drive fat, is the simple (and accurate) formulation, and we can see the results all around us. One hundred years ago, Americans ate about 10 pounds of sugar per year. Now the typical diet includes 140-150 pounds of sugar, including high fructose corn syrup; 200 pounds of flour and grain; 130 pounds of potatoes, including french fries and potato chips; and 27 pounds of corn (in a form other than HFCS, such as the corn starch filler used in many processed foods). And the results? About 65% of the American populace is overweight (BMI greater than 25) and about 33% of the populace is obese (BMI greater than 30). 11% of the entire population is diabetic, and 27% of all Americans over the age of 65 have Type II diabetes. The estimated additional health care cost, per annum, caused by diabetes and its complications is $218 billion per year, and since many of the obese younger than 65 can be considered "pre-diabetic," it stands to reason that this number will increase as the Baby Boom enters its (rotund) retirement years.

It is also true that obesity in the United States has been increasing on a steady upward slope ever since the Civil War, which suggests that the Industrial Revolution, and the patterns of sedentary behavior which it promotes, may have played a role along with changes toward a refined-carb diet (or simply toward the ubiquity of weird foods, such as HFCS, which Fred Flintstone surely never drank in his Dino-Shakes). Or the departure from farm life, where about 80% of Americans used to live and work. Who had time to get fat?

It's also true, as Taubes notes in his peroration, that no systematic trial of a controlled, longitudinal nature has ever been conducted in the United States to test the "carbohydrate hypothesis." Most of the official positions on obesity might be called "characterological:" people lack the will power to inhibit their ingestion of calories, or they're too lazy, or they're just "American" (of which, of course, your faithful diarist has himself been guilty). Scientifically speaking, of course, these "explanations" don't really make a lot of sense. Maybe there is something to the idea that the status quo is simply profitable, and the Powers That Be don't want a systematic refutation of the "Dietary Guidelines." The Corn Refiners Association, the lobbying group for HFCS, certainly thinks so. ("Sugar is sugar," they say. That's a defense?) There's a ton of money to be made in selling statins, even if cholesterol isn't really the problem. New drugs are developed all the time to deal with the many complications of diabetes. The political parties talk mainly about economics and politics when "dealing with" Medicare's exploding costs. Should we raise taxes? Should we have "death panels?"

How about: maybe the populace shouldn't be so freaking sick (and here again the irony of Michael Moore shouldering the task of satirizing our health care system becomes apparent.) Maybe we should try to figure this obesity thing out, and do something about it.

Although, one must admit again, sickness is a bonanza for some big companies. They can keep raking it in until the system collapses, more or less like the pancreas of one more victim of Type II, succumbing in the parking lot (without necessarily knowing he's crossed the goal line), on a fall Sunday morning before a football game, as he drains that last of ten 16-oz. Buds, and the hypothalamus, Islets of Langerhans and the liver finally toss in the towel and declare: "No más."

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