Statement Commentaries Eating 1) I eat a nutritious and well-balanced diet. The third energy input type in the Wellness Energy System is food. Eating (including digestion and assimilation) is the process whereby nutrients are extracted from food, combusted with the oxygen supplied by breathing, and transformed into electrochemical and heat energy. The newly acquired organic molecules are also used in the production of raw materials needed for building and repairing body parts. Recent U.S. history has reflected a growing concern with nutrition and its relationship to health. In February 1977, a select committee of the U.S. Senate under the direction of Senator George McGovern published the first Dietary Goals for the United States. Its purpose, McGovern stated, was “to point out that eating patterns of this century represent as critical a public health concern as any now before us.” Despite pressure from many special interest groups and lobbies, especially in the meat and dairy industry, the Committee’s recommendations took a radical departure from the nutritional dogma that most Americans at that time had been raised on. We were urged to increase consumption of fruits, vegetables, and whole grains and decrease our consumption of red meat, saturated fats, sugar, salt, and foods high in cholesterol. In 1992, the U.S. Department of Agriculture (USDA) went further, issuing its Food Guide Pyramid as the beginning of a nationwide project to reeducate Americans about the need for a healthy diet. Dairy products and other protein foods like meat and beans were relegated to a much less important status than carbohydrates, fruits, and vegetables, which formed the foundation of the pyramid. At the narrowest part of the pyramid—indicative of the minor role they should play in the diet—were placed “fats, oils, and sweets” with the disparaging recommendation, “Use Sparingly.” At about the same time as the Pyramid’s introduction, studies from around the world began to pour in that correlated the consumption of fresh fruits and vegetables with a significantly lowered incidence of heart attack and many types of cancer. The U.S. National Cancer Institute instituted its “5 a Day” program throughout the U.S. in 1991, recommending five to nine daily servings of fresh fruits and vegetables. Research indicated that this change alone could reduce risk of both heart attack and cancer by as much as 55 percent. These dietary guidelines were again updated in 2000 as Nutrition and Your Health: Dietary Guidelines for Americans, Fifth Edition (2000), a joint publication of the US Department of Health and Human Services and the Department of Agriculture (and will continue to be updated 1 © 2002, 2021 John W. Travis, MD, MPH and Wellness Inventory every five years). The guidelines were expanded to include a number of vital distinctions—like the need for healthy fats (fatty acids) versus the danger of unhealthy fats (saturated fats)—a recommendation for safety measures in storing and preparing foods, and a strong encouragement to exercise as a necessary part of a healthy lifestyle. Some researchers, like Meir Stampfer, M.D., Dr.P.H., of the Harvard University School of Public Health (who served on the committee for the 2000 <I>Guidelines</I> update), and Walter Willett, M.D., Dr.P.H., chair of the Department of Nutrition at Harvard, think that additional changes should have been cited. In fact, Willett’s book <I>Eat, Drink, and Be Healthy</I> offers another pyramid model that makes more distinctions. Among the differences from the USDA model, the Harvard “Healthy Eating Pyramid” puts nuts and legumes in their own category instead of lumping them together with fish, poultry, and eggs. It also de-emphasizes dairy products, placing them in a category with calcium supplements. It further recommends a daily multivitamin supplement and allows for moderate alcohol consumption, as appropriate. Dietary Guidelines for Americans 2015-2020 (Department of Health and Human Services and the USDA), the most recent edition of the guidelines, which are issued every five years, brings an updated approach. Previous editions of the Dietary Guidelines focused primarily on individual dietary components such as food groups and nutrients. However, people do not eat food groups and nutrients in isolation but rather in combination, and the totality of the diet forms an overall eating pattern. The components of the eating pattern can have interactive and potentially cumulative effects on health. These patterns can be tailored to an individual’s personal preferences, enabling Americans to choose the diet that is right for them. A growing body of research has examined the relationship between overall eating patterns, health, and risk of chronic disease, and findings on these relationships are sufficiently well established to support dietary guidance. As a result, eating patterns and their food and nutrient characteristics are a focus of the recommendations in the Dietary Guidelines for Americans 2015-2020. The Dietary Guidelines for Americans provides five overarching Guidelines that encourage healthy eating patterns, recognize that individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern, and acknowledge that all segments of our society have a role to play in supporting healthy choices. These Guidelines also embody the idea that a healthy eating pattern is not a rigid prescription, but rather, an adaptable framework in which individuals can enjoy foods that meet their personal, cultural, and traditional preferences and fit within their budget. Several examples of healthy eating patterns that translate and integrate the recommendations in overall healthy ways to eat are provided. The Planetary Health Diet An international team of scientists has developed a diet it says can improve health while ensuring sustainable food production to reduce further damage to the planet. The "planetary health diet" is based on cutting red meat and sugar consumption in half and upping intake of fruits, vegetables and nuts, according to the report published in the January 2019 of the medical journal The Lancet. Dr. Walter Willett, lead author of the paper and a professor of epidemiology and nutrition at the Harvard T.H. Chan school of public health, explained that the report suggests five strategies to ensure people can change their diets and not harm the planet in doing so: incentivizing people to eat healthier, shifting global production toward varied crops, intensifying agriculture sustainably, stricter rules around the governing of oceans and lands, and reducing food waste. And the report say that 2 © 2002, 2021 John W. Travis, MD, MPH and Wellness Inventory the Planetary Health Diet can prevent up to 11.6 million premature deaths without harming the planet. This reminds us that while diet is an individual choice the ramifications of our own pattern of eating takes place is a larger ecological and global context.’ ____________________________________________________________________________ 2) I minimize my intake of highly refined or processed foods. The problems with what we eat are many. As a population, we eat a lot of “junk,” or empty calories. We eat highly processed foods, chemical additives, irradiated and genetically altered foods, “bad” fats . and more. Snacking and eating out, particularly at fast-food restaurants, have become great American pastimes, indicative not only of our love for burgers, tacos and pizza, but also of a lifestyle shift in the population at large. Just take a trip to your local shopping mall and watch how many people walk along with food or drinks in hand. Many malls also have “food courts” in which one can purchase a slice of pizza, a deep-fried egg roll, a corn-dog, and a sugar-filled yogurt cone and consider that a “meal.” In addition, modern food processing methods, such as milling, lead to nutritionally empty foods. While we may be eating more grain-based foods today than we did in 1975—which sounds positive at first hearing—many of these “grains” are actually white-flour breads, pastas, and pizza crusts, or tortillas and corn chips. When these highly-processed foods are covered with melted cheese, moreover, they fill us up but don’t necessarily do us a lot of good. As to fat consumption, we have cut our consumption of red meat significantly since the 1970s, but we have turned to another high-fat source as our substitute. During the 1970s, the average American consumed ten pounds of cheese per year. In 2017, according the the FDA, the average American consumed over 39 pounds of cheese per year. Thirty more pounds and a 300 percent increase! In general, even though vast segments of the population are always “on a diet,” we are eating slightly more food today—around 460 additional calories per day—than we did in 1970, according to a Pew Research Center Report, "What’s on your table? How America’s diet has changed over the decades" (2016). While that may not sound like a big increase, it is compounded by the fact that we are exercising less. Today, about half of all American adults - 117 million people - have one or more preventable, chronic diseases, many of which are related to poor quality eating patterns and physical inactivity, according to Dietary Guidelines for Americans 2015-2020. Rates of these chronic, diet-related diseases continue to rise, and they come not only with increased health risks, but also at high cost. In 2008, the medical costs linked to obesity were estimated to be $147 billion. In 2012, the total estimated cost of diagnosed diabetes was $245 billion, including $176 billion in direct medical costs and $69 billion in decreased productivity. 3 © 2002, 2021 John W. Travis, MD, MPH and Wellness Inventory According to the Center for Medicare & Medicaid Services, health care spending in the US rose to $3.5 trillion in 2017, accounting for 17.9% of the Gross National Product.