Tag Archives: metabolic syndrome

Don’t Blame the Dentist for Your Cavities

Among the more absurd ideas being peddled by certain diet cults these days is the idea that mainstream guidelines for healthy eating are directly responsible for the ongoing American epidemic of metabolic syndrome. If you know a hardcore Paleo dieter or a high-fat/low-carb eater, then you probably know someone who believes this astoundingly ridiculous notion, having learned it from Denise Minger’s book Death by Food Pyramid or from Paleo guru Robb Wolf’s blog ravings or from some other mouthpiece of Paleo or HFLC dietary doctrine.

The logic of the argument is well summarized in the promotional copy for Minger’s opus. Here’s a sample: “Shoddy science, sketchy politics and shady special interests have shaped American dietary recommendations—and destroyed our nation’s health—over recent decades. The phrase Death by Food Pyramid isn’t shock-value sensationalism [no, of course not], but the tragic consequence of simply doing what we have been told to do by our own government—and giant food profiteers—in pursuit of health.”

If your IQ is higher than 85, you don’t need me to tell you that this line of reasoning depends on one very big and very false assumption: namely, that most Americans actually obey mainstream dietary recommendations. In fact, the diet of the average American is very nearly the opposite of what is recommended in official resources such as the U.S. government’s Dietary Guidelines for Americans.

Among these guidelines is the familiar recommendation to consume at least five servings of fruits and vegetables daily. Only 11 percent of Americans meet this requirement. The American Heart Association recommends that adults consume no more than six teaspoons of added sugar each day. The average American consumes 22 teaspoons of added sugar each day. The USDA’s MyPlate program advises people to get at least half of their grains in the form of whole grains. Forty percent of Americans never eat whole grains. The American Heart Association recommends that fish be eaten at least twice a week. Only one-third of Americans eat fish even once a week. And so on.

Not only do most Americans fail to follow mainstream dietary recommendations, but they also don’t even know what these recommendations are—or that they exist at all. According to a large scientific survey conducted a few years ago, fewer than half of American adults have ever heard of the Dietary Guidelines for Americans and less than 40 percent are aware that these guidelines include the recommendation to eat five or more servings of fruits and vegetables daily.

Blaming mainstream dietary recommendations for the high rates of obesity, heart disease, and type 2 diabetes in America is logically equivalent to blaming dentists for the high rate of tooth decay among our citizens. The American Dental Association recommends that people brush their teeth at least twice a day and floss at least once a day. Only 53 percent of Americans follow the first of these recommendations and even fewer of us follow the second. Ninety-two percent of American adults have decayed teeth, despite almost universal exposure to the ADA’s recommendations for dental hygiene. So do we blame the dentists? That wouldn’t make much sense, because the incidence of tooth decay is much lower among those who actually do follow ADA guidelines. Similarly, only a fraction of Americans follow mainstream dietary recommendations, but those who do are much healthier than those who don’t.

Proof that following mainstream nutritional guidelines results in much better health than does eating like the average American is piling up rapidly. Some of the best recent evidence comes from a study associated with the ambitious Dietary Patterns Methods Project. This project is investigating the health effects of various eating patterns that are consistent with mainstream dietary guidelines. The first study to issue from the project measured the degree to which the diets of 424,000 older men and women conformed to each of four indexes of healthy eating—the Healthy Eating Index 2010, the alternative Healthy Eating Index 2010, the alternative Mediterranean Diet, and the DASH diet—and correlated this data with death risk over a 15-year period.

The mortality rate for those whose eating patterns conformed most closely to each of these indexes was significantly lower than it was for those whose eating patterns conformed least closely. Since the subjects were American, it is safe to assume that the men and women who had the lowest scores on these indexes tended to eat the typical American diet. According to this study, the people whose eating habits fell furthest outside official recommendations were up to 28 percent more likely to die of cancer or heart disease between the ages of 62 and 77 than were those who ate according to mainstream dietary guidelines.

Despite such evidence, Paleo and HFLC diet advocates continue to conflate mainstream dietary recommendations with the typical American diet. They do this most insidiously with their use of the term “standard American diet” (or SAD—get it?) to refer to both the way the average American eats and the way mainstream nutrition scientists advise people to eat.

Consider these sentences from “Paleo Runner” Aaron Olsen’s review of my book, Diet Cults: “Considering the fact 2/3 of Americans are either overweight or obese, I fail to see how mainstream recommendations such as the SAD should be used as a template for an optimal eating strategy. The reason diet fads are so popular in the first place is because the SAD has failed us so miserably.”

Here we have an egregious misrepresentation of the “agnostic healthy eating” guidelines I present in the book, which are based on mainstream nutrition science, not on what the average American eats. But is this misrepresentation deliberate or merely a consequence of the reviewer’s own prior brainwashing? I won’t hazard a guess, but it is evident that some high priests of the Paleo and high-fat/low-carb diets choose to conflate mainstream dietary guidelines with the standard American diet despite knowing full well that the two are worlds apart. In so doing they betray not only a startling lack of intellectual integrity but also a troubling assumption about the intelligence of the eating public.

Here, in essence, is what these folks expect you to believe: that if a typical American eater, who spends $1,200 annually on fast food, were to hire a registered dietitian to help him get healthier, the R.D. would make no changes to her client’s diet.

For the record, I don’t think you’re that stupid.