Seriously!

For the last month I've been hoping to finish a pictorial review of Peter Jackson's 2nd Hobbit installment. It got started over Christmas break, but instead of finishing it, I've chosen to do other things with my time…

I serve on our state's board of directors for family physicians, and one of the things on my mind a lot in this role has been food and nutrition. (See "Leonardo and GMO", 9/29/13). Since last fall I've started reading "Food and Western Disease", by Staffan Lindeberg, and am interested in reading "Nutrition and Physical Degeneration" by Weston Price. Both recommend a return to a more natural and whole-foods diet, rich in vegetables but also, depending on location, incorporating a moderate amount of meat such as wild fish and game. By moderate amount I really just mean more than the zero amount argued for by T. Colin Campbell in "The China Study", which I read a few years ago. All three of these books are, as best I can tell, well-researched. All three, regardless of amount of animal protein they recommend, conclude that our modern diet of highly processed grains and feedlot-raised meat is unhealthy.

There are two major points I am struggling with right now, in considering this conclusion. (It is a conclusion with which I agree, and which more popular recent books such as "Grain Brain", "Wheat Belly", and Campbell's new work "Whole" also come to.)

The first is that none of this work is being taught to either new medical students or current physicians. In medical school I had one-half of one day on nutrition. On my drive over to Seattle from Omak for this quarter’s board meeting, I listened to five straight hours of CME (continuing medical education) covering a wide range of topics—not one of them nutrition. Nutrition is relegated to “alternative” medicine, while drugs and surgeries, which really should be the last “alternative” when lifestyle changes fail to achieve health, are the definitive focus.

My second struggle is with the disparity between the nutritional recommendations that I am or should be giving my patients, and what they can afford. Calorie for calorie, nutrition-dense food comes in at 10 times the cost of junk food: $36.32 per 2000 calories of healthy foods vs $3.52 per 2000 calories of junk food according to a 2007 University of Washington study.

When one considers that the U.S. has the highest income gap among the 30 most-developed nations, these data on foods costs help explain why we have the worst health statistics to match—and why, in addition to having overall worse health (e.g., the richest cohort in an unequal-income country like the U.S. is less healthy than the richest cohort in a more-equal country like Sweden or Japan), countries with a greater income gap also suffer from a greater health gap between rich and poor. If you’re rich, you can buy walnuts and kale and pomegranates and wild Alaskan salmon. And if you choose not to and only eat Big Macs, you can still buy yourself the statins and insulin injections and coronary artery stents.

In moments of such consideration, I have to step back and remind myself to not take myself too seriously. Yes, I will do what I can in the quest to right such wrongs, and do my best. But I am only one little hobbit, and the orcs are many and fierce. Look for a more light-hearted post next month. ☺