You Are What You Eat

The typical American diet is not only the number one killer of Americans but, beyond that—partly because of the obesity epidemic—the leading cause of disability in the USA. So what we eat determines more than anything else how long we live, and also whether we eventually become disabled or not.

If food is the main cause of death and disability, and if most deaths are preventable and related to diet, then of course nutrition is the most important subject in medical school, right? It’s the very first thing the doctor discusses with you at every visit, right?

How can it be that, in medicine, science and practice are so completely separated from each other?

Unfortunately, doctors suffer from a severe deficiency—of training. Most medical students never learn anything about the impact of a healthy diet on the course of a disease and graduate without this powerful arsenal of knowledge. In addition, there are institutional obstacles—lack of time and lack of reimbursement. Doctors are not usually paid to give their patients advice on better self-care. And of course, drug manufacturers also influence medical education and practice. The director of the Institute for the Medical Humanities concluded a medical ethics article about the influence of Big Pharma on medical education with the following words: "The question is what represents the greater betrayal of our professionalism—our willingness to be bought, or our willingness to argue away and deny things, to create the appearance that we are not willing to be bought?" Ask your doctor when the last time was that he was lavishly wined and dined by a big broccoli conglomerate.

With smoking, it was similar in the 1950s. Even then, there had been decades of research results showing the connection between cigarettes and cancer, but it was largely ignored, in part because smoking was normal. The average per-capita cigarette consumption was 4000 a year—on average, half a pack a day. Back then, the American Medical Association assured people that "moderate smoking" posed no problem. After all, most medical professionals smoked themselves. Back then there was the same separation between science and practice: incontrovertible facts confronted the inertia of personal habits.

Only 25 years, 7000 studies, and countless dead smokers later—namely, in the 1960s—did the first report by the US health authority against smoking appear. You would think that after the first 6000 studies the time would have come for a few discreet hints—but no such luck. Big Tobacco had power, and today’s alcohol, meat, sugar, dairy, salt, egg, and processed-food manufacturers use the same strategies as the tobacco industry to twist the scientific evidence and confuse the public.

Big Food is a trillion-dollar industry with thousands of trade associations that invest hundreds of millions of dollars to lobby where our laws are made. The biggest lobby groups are PepsiCo for industrial foods, followed by sugar, meat, and dairy.(The dairy industry is the only food retailer with a budget of over one hundred million ollars.) That tells us a lot about the American diet. Cui bono? Who profits from it?

Nowadays only one to two percent of doctors smoke, but most continue to consume foods that contribute to our epidemic of diet-related diseases. Until the system changes, we will have to take responsibility for our health and that of our family ourselves. We can’t wait for society to catch up with the science, because this is a matter of life and death.

Taking fate into your own hands

Longevity researchers consider diet to be the "most important intervention for promoting health and preventing most age-related chronic diseases." Women who start eating healthier at 20 could extend their life expectancy by about eleven years, men by 13 years. Eating more legumes, whole grains, and nuts, eating less meat, and drinking fewer sugary beverages like soda extends lifespan the most. And it’s never too late. If you start eating healthier at 60, you may gain eight or nine years of life. Even a change at 80 can still add a few years. The fate of your own health begins with the next meal.

Beverages

You may have heard that the human body consists of 70 percent water. That’s true for newborns, but Aristotle already knew: "Old age is cold and dry." Older people are about 50 percent water. Because of lower fluid reserves, a diminished sense of thirst, and declining kidney capacity, older people are particularly susceptible to dehydration, especially if they take laxatives or diuretics. What is the best way to ensure adequate hydration?

Different committees, consistent recommendations

There are countless guidelines for what we should eat. But what should we drink? A committee to develop corresponding guidelines brought together leading health experts, including Dr. Walter Willett, then chair at the Harvard Department of Nutrition. The committee was to assess the harms and benefits of different beverage categories, and also determine the relative effect of these beverages on health, measured on a six-level scale from best to worst.

That soda drinks came in last place will surprise no one. Beer and whole milk ended up in the same group and were classified as to be avoided. The scientists found milk concerning because it is linked with prostate cancer and aggressive ovarian cancer, which follows from its clearly demonstrated effect on levels of insulin-like growth factor 1, as I show in the chapter IGF-1. The second-healthiest beverages were tea and coffee, preferably without sweetener or coffee creamer. And the top beverage? Water.

Hell or high water?

In the chapter on beverages in How Not to Die, I return to the origins and debunk the myth of the recommendation to drink at least eight glasses of water every day. I also address the question of cause and effect in the variety of studies that link low water intake with a broad spectrum of diseases. An overview of all these studies on water consumption and mortality can be found at see.nf/h2olongevity. Three studies showed a positive effect on mortality, four did not; accordingly, the connection remains unclear.