Are food companies responsible for the epidemic in diabetes, cancer, dementia and chronic disease and do their products need to be regulated like tobacco? Is it time for a class action suit?

Adapted from: Peper, E. & Harvey, R. (2024). Are Food Companies Responsible for the Epidemic in Diabetes, Cancer, Dementia and Chronic Disease and Do Their Products Need to Be Regulated Like Tobacco? Is It Time for a Class Action Suit? Thownsend Letter-the examiner of alternative medicine.  https://www.townsendletter.com/e-letter-26-ultra-processed-foods-and-health-issues/

Erik Peper, PhD and Richard Harvey, PhD

Why are one third of young Americans becoming obese and at risk for diabetes?

Why are heart disease, cancer, and dementias occurring earlier and earlier?  Is it genetics, environment, foods, or lifestyle?

Is it individual responsibility or the result of the quest for profits by agribusiness and the food industry?

Like the tobacco industry that sells products regulated because of their public health dangers, is it time for a class action suit against the processed food industry? The argument relates not only to the regulation of toxic or hazardous food ingredients (e.g., carcinogenic or obesogenic chemicals) but also to the regulation of consumer vulnerabilities. Addressing vulnerabilities to tobacco products include regulations such as how cigarette companies may not advertise their products for sale within a certain distance from school grounds.

Is it time to regulate nationally the installation of vending machines on school grounds selling sugar-sweetened beverages? Students have sensitivity to the enticing nature of advertised, and/or conveniently available consumable products such as ‘fast foods’ that are highly processed (e.g., packaged, preserved and practically imperishable). Whereas ‘processed foods’ have some nutritive value, and may technically pass as ‘nutritious’ food, the quality of processed ‘nutrients’ can be called into question. For the purpose of this blog other important questions to raise relate to ingredients which, alone or in combination, may contribute to the onset of or, the acceleration of a variety of chronic health outcomes related to various kinds of cancers, cardiovascular diseases, and diabetes.

It may be an over statement to suggest that processed food companies are directly responsible for the epidemic in diabetes, cancer, dementia and chronic disease and need to be regulated like tobacco. On the other hand, processed food companies should become much more regulated than they are now.

More than 80 years ago, smoking was identified as a significant factor contributing to lung cancer, heart disease and many other disorders. In 1964 the Surgeon Generals’ report officially linked smoking to deaths of cancer and heart disease (United States Public Health Service, 1964).  Another 34 years pased before California prohibited smoking in restaurants in 1998 and, eventually inside all public buildings. The harms of smoking tobacco products were well known, yet many years passed with countless deaths and suffering which could have been prevented before regulation of tobacco products took place.  Reviewing historical data there is about a 20 year delay (e.g., a whole generation) before death rates decrease in relation to when regulations became effective and smoking rates decreased, as shown in figure 1.   

Figure 1. The relationship between smoking and lung cancer. Reproduced by permission from Roser, M. (2021). Smoking: How large of a global problem is it? And how can we make progress against it? Our world in data.

During those interim years before government actions limited smoking more effectively, tobacco companies hid data regarding the harmful effects of smoking. Arguably, the ‘Big Tobacco’ industry paid researchers to publish data which could confuse readers about tobacco product harm. There is evidence of some published articles suggesting that the harm of cigarette smoking was a hoax– all for the sake of boosting corporate profits (Bero, 2005).

Now we are experiencing a similar problem with the processed food industry. It has been suggested that alongside smoking and vaping, opioid use, a sedentary ‘couch potato’ lifestyle, and lack of exercise, ultra-processed food (UPF) that we eat severely affects our health.

Ultra-processed foods, which for many constitutes a majority of calories ranging from 55% to over 80% of the food they eat, contain chemical additives that trick the tastebuds, mouth and eventually our brain to desire those processed foods and eat more of them (Srour et al., 2022).

What are ultra-processed foods? Any foods that your great grandmother would not recognize as food. This includes all soft drinks, highly processed chips, additives, food coloring, stabilizers, processed proteins, etc. Even oils such as palm oil, canola oil, or soybean are ultra processed since they heated, highly processed with phosphoric acid to remove gums and waxes, neutralized with chemicals, bleached, and deodorized with high pressure steam (van Tulleken, 2023).

The data is clear! Since the 1970s obesity and inflammatory disease have exploded after ultra-processed foods became the constituents of the modern diet as shown in figure 2.

Figure 2. A timeline from 1850 to 2000 reflects the increase in use of refined sugar and high fructose corn syrup (HFCS) to the U.S. diet, together with the increase in U.S. obesity rate. The data for sugar, dairy and HFCS consumption per capita are from USDA Economic Research Service (Johnson et al., 2009) and reflects  historical estimates before 1967  (Guyenet et al., 2017). The obesity data (% of U.S. adult population) are from the Robert Wood Johnson Foundation’s Trust for America’s Health. (stateofobesity.org). Total U.S. television advertising data are from the World Advertising Research Center (www.warc.com). The vertical measure (y–axis) for kilograms per year (kg/yr) on the left covers all data except advertising expenditures, which uses the vertical measure for advertising on the right. Reproduced by permission from Bentley et al, 2018.

This graph clearly shows a close association between the years that high fructose corn syrups (HFCS) were introduced into the American diet and an increase in TV advertising with corresponding increase in obesity. HFCS is an ultra-processed food and is a surrogate marker for all other ultra-processed foods.  The best interpretation is that ultra-processed foods, which often contain HFCS, are a causal factor of the increase in obesity, and diabetes and in turn are risk factors for heart disease, cancers and dementias. 

Ultra-processed foods are novel from an evolutionary perspective.

The human digestive system has only recently encountered sources of calories which are filled with so many unnatural chemicals, textures and flavors.  Ultra-processed foods have been engineered, developed and product tested to increase the likelihood they are wanted by consumers and thereby increase sales and profits for the producers.   These foods contain the ‘right amount’ processed materials to evoke the taste, flavor and feel of desired foods that ‘trick’ the consumer it eat them because they activate evolutionary preference for survival.  Thus, these ultra-processed foods have become an ‘evolutionary trap’ where it is almost impossible not to eat them.  We eat the food because it capitalized on our evolutionary preferences even though doing so is ultimately harmful for our health (for a detailed discussion on evolutionary traps, see Peper, Harvey & Faass, 2020).

An example is a young child wanting the candy while waiting with her parents at the supermarket checkout line. The advertised images of sweet foods trigger the cue to eat. Remember, breast milk is sweet and most foods in nature that are sweet in taste, provide calories for growth and survival and are not harmful. Calories are essential of growth. Thus, we have no intrinsic limit on eating sweets unlike foods that taste bitter.

As parents, we wish that our children (and even adults) have self-control and no desire to eat the candy or snacks that is displayed at eye level (eye candy) especially while waiting at the cashier. When reflecting about food advertising and the promotion of foods that are formulated to take advantage of ‘evolutionary traps’, who is responsible?  Is it the child, who does not yet have the wisdom and self-control or, is it the food industry that ultra-processes the foods and adds ingredients into foods which can be harmful and then displays them to trigger an evolutionary preference for food that have been highly processed?

Every country that has adapted the USA diet of ultra-processed foods has experienced similar trends in increasing obesity, diabetes, cardiovascular disease, etc. The USA diet is replacing traditional diets as illustrated by the availability of Coca-Cola. It is sold in over 200 countries and territories (Coca-Cola, 2023).

An increase in ultra-processed foods by 10 percent was associated with a 25 percent increase in the risk of dementia and a 14 per cent increase in the risk of Alzheimers’s (Li et al., 2022). More importantly, people who eat the highest proportion of their diet in ultra-processed foods had a 22%-62% increased risk of death compared to the people who ate the lowest proportion of processed foods (van Tulleken, 2023). In the USA, counties with the highest food swamp scores (the availability of fast food outlets in a county) had a 77% increased odds of high obesity-related cancer mortality (Bevel et al., 2023). The increase risk has also been observed for cardiovascular disease, coronary heart disease, cerebrovascular disease and all cause mortality as is shown in figure 3 (Srour et al., 2019; Rico-Campà et al., 2019).  

Figure 3. Association between consumption of ultra-processed foods and all cause mortality. Reproduced from Rico-Campà et al, 2019.

The harmful effects of UPF holds up even when correcting for the amount of sugars, carbohydrates or fats in the diet and controlling for socio economic variables.

The logic that underlies this perspective is based upon the writing by Nassim Taleb (2012) in his book, Antifragile: Things That Gain from Disorder (Incerto). He provides an evolutionary perspective and offers broad and simple rules of health as well as recommendations for reducing UPF risk factors:

  • Assume that anything that was not part of our evolutionary past is probably harmful.
  • Remove the unnatural/unfamiliar (e.g. smoking/ e-cigarettes, added sugars, textured proteins, gums, stabilizers (guar gum, sodium alginate), emulsifiers (mono-and di-glycerides), modified starches, dextrose, palm  stearin, and fats, colors and artificial flavoring or other ultra-processed food additives).

What can we do?

The solutions are simple and stated by Michael Pollan in his 2007 New York Times article, “Eat food. Not too much. Mostly Plants.” Eat foods that your great grandmother would recognize as foods (Pollan, 2009).  Do not eat any of the processed foods that fill a majority of a supermarket’s space.

  • Buy only whole organic natural foods and prepare them yourself.
  • Request that food companies only buy and sell non-processed foods.
  • Demand government action to tax ultra-processed food and limit access to these foods.  In reality, it is almost impossible to expect people to choose healthy, organic foods when they are more expensive and not easily available in the American ‘food swamps and deserts’ (the presence of many fast food outlets  or the absence of stores that have fresh produce and non-processed foods). We do have a choice.  We can spend more money now for organic, health promoting foods or, pay much more later to treat illness related to UPF.
  • It is time to take our cues from the tobacco wars that led to regulating tobacco products.  We may even need to start class action suits against producers and merchants of UPF for causing increased illness and premature morbidity.

For more background information and the science behind this blog, read, the book, Ultra-processed people, by Chris van Tulleken

Look at the following blogs for more background information.

References

Bentley, R.A., Ormerod, P. & Ruck, D.J. (2018). Recent origin and evolution of obesity-income correlation across the United States. Palgrave Commun 4, 146. https://doi.org/10.1057/s41599-018-0201-x

Bero, L. A. (2005). Tobacco Industry Manipulation of Research. Public Health Reports (1974-)120(2), 200–208.  http://www.jstor.org/stable/20056773

Bevel, M.S., Tsai, M., Parham, A., Andrzejak, S.E., Jones, S., & Moore, J.X. (2023). Association of Food Deserts and Food Swamps With Obesity-Related Cancer Mortality in the US. JAMA Oncol. 9(7), 909–916. https://doi.org/10.1001/jamaoncol.2023.0634

Coca-Cola. (2023). More on Coca-Cola. Accessed July 14, 2023. https://www.coca-cola.co.uk/our-business/faqs/how-many-countries-sell-coca-cola-is-there-anywhere-in-the-world-that-doesnt

Johnson, R.K., Appel, L.J., Brands, M., Howard, B.V., Lefevre, M., Lustig, R.H., Sacks, F., Steffen, L.M., & Wylie–Rosett, J. (2009). Dietary sugars intake and cardiovascular health: a scientific statement from the American Heart Association. Circulation, 120(10), 1011–1020. https://doi.org/10.1161/CIRCULATIONAHA.109.192627

Li, H., Li, S., Yang, H., et al, 2022. Association of ultraprocessed food consumption with the risk of dementia: a prospective cohort study. Neurology, 99, e1056-1066. https://doi.org/10.1212/WNL.0000000000200871

Peper, E., Harvey, R. & Faass, N. (2020). TechStress: How Technology is Hijacking Our Lives, Strategies for Coping, and Pragmatic Ergonomics. Berkeley: North Atlantic Books, pp 18-22, 151. https://www.amazon.com/Beyond-Ergonomics-Prevent-Fatigue-Burnout/dp/158394768X/ref=sr_1_1?crid=1U9Y82YO4DKKP&keywords=erik+peper&qid=1689372466&sprefix=erik+peper%2Caps%2C187&sr=8-1

Pollan, M. (2007). Unhappy meals. The New York Times Magazine. https://www.nytimes.com/2007/01/28/magazine/28nutritionism.t.html

Pollan, M. (2009). Food Rules: An Eater’s Manual. New York: Penguin Books. https://www.amazon.com/Food-Rules-Eaters-Michael-Pollan/dp/014311638X/ref=tmm_pap_swatch_0?_encoding=UTF8&qid=1689373484&sr=8-2

Rico-Campà, A., Martínez-González, M. A.,  Alvarez-Alvarez, I., de Deus Mendonça, R., Carmen de la Fuente-Arrillaga, C.,  Gómez-Donoso, C., & Bes-Rastrollo, M.  (2019). Association between consumption of ultra-processed foods and all cause mortality: SUN prospective cohort study. BMJ; 365: l1949  https://doi.org/10.1136/bmj.l1949 

Roser, M. (2021).Smoking: How large of a global problem is it? And how can we make progress against it? Our world in data. Assessed July 13, 2023. https://ourworldindata.org/smoking-big-problem-in-brief

Srour, B., Fezeu, L.K., Kesse-Guyot, E.,Alles, B., Mejean, C…(2019). Ultra-processed food intake and risk of cardiovascular disease: prospective cohort study (NutriNet-Santé) BMJ,365:l1451. https://doi.org/10.1136/bmj.l1451 

Srour, B., Kordahi, M. C., Bonazzi, E., Deschasaux-Tanguy, M., Touvier, M., & Chassaing, B. (2022). Ultra-processed foods and human health: from epidemiological evidence to mechanistic insights. The Lancet Gastroenterology & Hepatologyhttps://doi.org/10.1016/S2468-1253(22)00169-8

Taleb, N. N. (2012). Antifragile: Things That Gain from Disorder (Incerto). New York: Random House Publishing Group. (Kindle Locations 5906-5908).  https://www.amazon.com/Antifragile-Things-Disorder-ANTIFRAGILE-Hardcover/dp/B00QOJ6MLC/ref=sr_1_4?crid=3BISYYG0RPGW5&keywords=Antifragile%3A+Things+That+Gain+from+Disorder+%28Incerto%29&qid=1689288744&s=books&sprefix=antifragile+things+that+gain+from+disorder+incerto+%2Cstripbooks%2C158&sr=1-4

Van Tulleken, C. (2023). Ultra-processed people. The science behind food that isn’t food. New Yoerk: W.W. Norton & Company. https://www.amazon.com/gp/product/1324036729/ref=ox_sc_act_title_1?smid=ATVPDKIKX0DER&psc=1

United States Public Health Service. (1964). The 1964 Report on Smoking and Health. United States. Public Health Service. Office of the Surgeon General. https://profiles.nlm.nih.gov/spotlight/nn/catalog?f%5Bexhibit_tags%5D%5B%5D=smoking


Can you trust the recommended dietary guidelines? Do they decrease diabetes?

Corporate profits tend to be more important than health of the American public.  I was shocked that the U.S. delegation  attempted to block  a resolution of the World Health Organization to encourage breast feeding.  Independent research has overwhelming demonstrated that breast feeding is much more health promoting that formula feeding (fewer infections, less diarrhea, lower asthma rates and obesity, etc) (Jacobs, 2018).. As  the editorial in 2016 The Lancet reported that universal breast-feeding would prevent 800,000 child deaths a year across the globe and yield $300 billion in savings from reduced health care costs and improved economic outcomes for those reared on breast milk.

The action of the U.S. delegation is appalling and is also tends to reflect numerous government agencies such as United States Department of Agriculture (USDA) and the Food and Drug Administration (FDA) which are directly or indirectly influenced by pharmaceutical industry or agricultural business (Hamblin, 2015Ornstein, 2017).

USDA nutritional guidelines have been manipulated through corporate influence to the extend that these guidelines can no longer be trusted. The U.S. has lobbying–legally acceptable corruption– to increase corporate profits at the expense of most of its population.

The major public health issue is the obesity epidemic which started after the new USDA dietary guidelines were published in 1980. Even the current guidelines to prevent obesity, metabolic disease and diabetes are harmful for most people. The  factors that contribute to illness, health and longevity are complex and affected by individual differences and environment. For example, longevity and health are linked to social support and meaningful connections and genetics (Holt-Lunstad et al, 2010Pinker, 2017).

Watch the superb Youtube presentations by Gary Taubes and Tim Noakes that describe factors that contributed to the diabetic epidemic and how to prevent and possibly reverse type 2 diabetes; however, there are many other components that contribute to health and illness.

Gary Taubes is an investigative science and health journalist and co-founder of the Nutrition Science Initiative (NuSI). He presents the 7th Annual C. Everett Koop Distinguished Lecture.

Dr. Tim Noakes is a South African scientist, and an emeritus professor in the Division of Exercise Science and Sports Medicine at the University of Cape Town. He eloquently argues how grains and carbohydrates are the major cause of diabetes.

References

Hamblin, J. (2015). How agriculture controls nutrition guidelines. Meat producers showed dominance over scientists this week, preventing discussion of sustainability. The Atlantic. https://www.theatlantic.com/health/archive/2015/10/ag-v-nutrition/409390/

Holt-Lunstad J, Smith TB, Layton JB (2010) Social Relationships and Mortality Risk: A Meta-analytic Review. PLOS Medicine 7(7): e1000316. https://doi.org/10.1371/journal.pmed.1000316   http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1000316

Jacobs, A. (July 8, 2018). Opposition to breast-feeding resolution by U.S. stuns World Health Officials. The New York Times. https://www.nytimes.com/2018/07/08/health/world-health-breastfeeding-ecuador-trump.html

Lancet editorial. (January 30, 2016). Breastfeeding: achieving the new normal. The Lancet.  https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00210-5/fulltext

Ornstein, C. (January 17, 2017). From Twitter to treatment guidelines, industry influence permeates medicine. NPR. https://www.npr.org/sections/health-shots/2017/01/17/510226214/from-twitter-to-treatment-guidelines-industry-influence-permeates-medicine

Pinker, S. (2017). The secret to living longer may be your social life. TED2017.

Read The case against sugar

An ounce of prevention is worth a pound of cure.

Albert Schweitzer began working in equatorial lowlands of West Africa in 1913. He was astonished to encounter no cases of cancer among the thousands of native patients he saw each year. However, as the natives [took to] living more and more after the manner of the whites, cancer in his patient population became ever more frequent (Taubes, 2016, pp 257).

Wise elders, grand parents or statesmen have been  traditional roles for aging adults. Wisdom transforming into Alzheimer’s disease does not compute (Peper, 2014).

In 1960’s Surgeon Captain T. L. Cleave proposed that common western diseases (diabetes, colon cancer, ischemic heart disease, gallstones, obesity, diverticulosis, and dental carries), to which I would add Alzheimer’s disease, autoimmune diseases and allergies, could not be due primarily to genetic factors but to new factors in the environment to which man had not yet had time to adapt (Cleaves et al, 1969). As he states, “One such factor was the processing of food which resulted in the consumption of large quantities of pure sugar and starch.  This led to disease because man was evolutionary adjusted to eating smaller amounts of carbohydrates intimately mixed with fiber and protein.”

Clinicians and epidemiologist have consistently reported that none western cultures, whether the Masai in Africa, the Inuit in Northern Canada, the Japanese in Japan, or the Native American, had very low incidences of these western diseases. Yet, when these people adapted a western diet of highly refined carbohydrates and sugar the prevalence of these diseases increased and approached the incidence in western cultures (Burkitt & Trowell, 1975; Taubes, 2016).

Historically these illness were initially observed in the ruling class.  The affluent class was privileged and tended to eat more refined carbohydrates and sugars (white bread, cakes, pastries and sugar in coffee and tea). It is only recently that this class effect is reversed. Lower economic classes tend have a higher prevalence of these western diseases.  Affluent people can afford and often eat low processed organic foods while economically disadvantaged people cannot afford low processed foods and instead eat predominantly highly processed carbohydrate and refined foods.

Highly refined processed foods and sugar–not fats–are  significant risk factors for the development diabetes and cardiovascular disease and mortality (Imamura et al, 2015; Taubes, 2016; Yang et al, 2014) . What is not as well known is that some cancers and Alzheimer’s disease also correlates with the increase intake of refined carbohydrates and sugar (Das, 2015; Kandimalla et al, 2016; Peper, 2014).

It is highly likely that the increase in beta-amyloid protein plagues in the brain is not the cause of the Alzheimer’s but the brain’s defense mechanism to protect it from the fluctuating high insulin and glucose levels. A high sugar and simple carbohydrate diet are risk factors for inflammatory diseases such as diabetes, heart disease and metabolic syndrome.  These inflammatory diseases are recognized as a precursor for Alzheimer’s. Alzheimer’s is sometimes described as Type 3 diabetes (Kandimalla et al, 2016; Steen et al, 2005).

Taking the perspective that foods are significant risk factors for the development of these western diseases, the focus should be on prevention and less on treatment.  The research to develop drugs to treat Alzheimer’s have up till now been unsuccessful despite that the billions spent on attempting to develop new drugs. For example, the pharmaceutical company Eli Lilly has spent 3.7 billion dollars over the last decade while the National Institutes of Health spends more than half a billion dollars a year on pursuit of treatment (Coghlan, 2017).

The treatments cost of these western diseases, which at best ameliorate the disorders, is overwhelming.  In the USA, we spent $147 billion to treat obesity and $116 billion to treat diabetes. While the medical costs to treat diabetes for a single patient is about $6000/year or $400,000/lifetime (Pollan, 2009).

As a refined carbohydrates and high sugar diet is a risk factor for western diseases, the focus should be on prevention. Thus, reduce sugar and refined carbohydrates intake and increase high fiber vegetable.  To implement such a simple preventative measure means:

  1. Educate the public about the harm of sugars and refined carbohydrate foods.
  2. Ban advertising of foods that are high in sugar and refined carbohydrates.
  3. Reward companies to produce foods low in sugar and refined carbohydrates.
  4. Tax food products high in sugar and refined carbohydrates just as tobacco has been taxed.

I am positive that in the future when we  look back at the 20th and early 21st century, we will be appalled that the government allowed people to poison themselves with sugar and highly refined carbohydrates. Just as we now warn against the harm of tobacco, limit the sales to minors,  and have ongoing public health stop smoking  campaigns.

For much more information, read science writer Gary Taubes superb well researched and engaging book,  The case against sugar. 

cover-case-against-sugar

References:

Burkitt, D.P. & Trowell, H.C. (1975).  Refined carbohydrate foods and disease: Some implications of dietary fibre.  York: Academic Press.

Cleave, T.L., Campbell, G.D., & Painter, N.S. (1969). Diabetes, coronary thrombosis and the saccharine disease, 2nd ed. Bristol, UK: John Wright.

Coghlan, A. 2017). The Alzheimer’s problem. New Scientist, 233(3110), 22-23.

Das, U. N. (2015). Sucrose, fructose, glucose, and their link to metabolic syndrome and cancer. Nutrition31(1), 249-257.

Imamura, F., O’Connor, L., Ye, Z., Mursu, J., Hayashino, Y., Bhupathiraju, S. N., & Forouhi, N. G. (2015). Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fractionBmj351, h3576.

Kandimalla, R., Thirumala, V., & Reddy, P. H. (2016). Is Alzheimer’s disease a Type 3 Diabetes? A critical appraisal. Biochimica et Biophysica Acta (BBA)-Molecular Basis of Disease.

Peper, E. (2014). Affluenza: Transforming Wisdom into Alzheimer’s Disease with Affluent Malnutrition and Immobility. Neuroconnections, 9(2), 32-35.

Pollan, M. (2009). Big food vs. big insurance. New York Times, September 10, A29.

Steen, E., Terry, B.M.  Rivera, E.J., Cannon, J.L., Neely, T.R., Tavares, R., Xu, X. J., Wands, J.R., & de al Monte, S. M.  (2005). Impaired insulin and insulin-like growth factor expression and signaling mechanisms in Alzheimer’s disease-is this type 3 diabetes? Journal of Alzheimer’s Disease, 7(1), 53-80.

Taubes, G. (2016). The case against sugar. New York: Alfred A. Knopf.

Yang, Q., Zhang, Z., Gregg, E. W., Flanders, W. D., Merritt, R., & Hu, F. B. (2014). Added sugar intake and cardiovascular diseases mortality among US adultsJAMA internal medicine174(4), 516-524.


Healthy movement is the new aging

Born on 26 November 1911, Mr Robert Marchand and 105 years old, managed cycling 22.55 km (14 miles) at the national velodrome and set a new record for the furthest distance cycled in one hour for riders over 105. (Reynolds, 2017).

Meet 105-year-old Robert Marchand, the centenarian cyclist chasing a new record: https://www.youtube.com/watch?v=Ey48j6dDNEo

As people age there is an increase in Western Diseases such as hypertension, diabetes, gout, cancer, dementia and  decreases in physical fitness (Milanović et al, 2013Tauber, 2016).   To assume that the cause of these illnesses is the natural process of aging may be too simplistic. Although aging does affect physiology, there are other factors that contribute to the increase in “Western Diseases” such as diet, lifestyle and genetics.

A significant contributing factor of Western Diseases is diet especially  the increase in sugar and simple carbohydrates. Whether you are Pima, Tohono O’odham, and Navajo American Indian Tribes in Arizona, Intuits in Northern Canada, Japanese Americans, or indigenous populations of Kenya, when these people stopped eating their traditional diet and adapted the western high glucose/fructose/simple carbohydrate diet, the degenerative Western Diseases exploded (Bjerregaard et al, 2004; Burkitt & Trowell, 1975; Knowler et al, 1990; Tauber, 2016). Diabetes, hypertension, and cancer which were previously rare skyrocketed within one generation after adapting the Western life style diet. In some of these populations, 30% or more of the adults have diabetes and a significant increase in breast cancer.

The reduction of episodic high intensity physical activity and being sedentary are additional risk factors for the onset of diabetes and cardiovascular disease (Dulloo et al, 2017). As Mensing & Mekel (2015) state, “Sitting is the new smoking.”  Sitting encourages more sitting which leads to nonuse of muscles and causes neural and muscle atrophy.  Our physiology is efficient and will prune/eliminate what is redundant.  This is reflected in the popular phrase, “Use it or lose it.”  As we sit for hours in front of digital devices, use escalators, elevators, or drive cars, we are not using the muscles involved in dynamic movement.  We are usually unaware of this degenerative process. Instead,  we may experience difficulty walking up the stairs  which encourages us to take the escalator or elevator. When we do not use the muscles or are limited in movement by discomfort and pain, we move less. As we move less, we become  weaker which is often labeled as aging instead of non use.

Just, because most people loose fitness, it may not represent what is possible or optimum.  Instead, we may want to emulate the diet and fitness program of Mr. Robert Marchand who at age 103 set a new world record and improved the distance bicycled in one hour from 24.25 km at the age of 101 to 26.92 km at the age of 103. A 11% improvement! As New York Times science writer Gretchen Reynolds reports, “Lifestyle may also matter. Mr. Marchand is “very optimistic and sociable,” The researcher who did the study, Dr. Billat says, “with many friends,” and numerous studies suggest that strong social ties are linked to a longer life. His diet is also simple, focusing on yogurt, soup, cheese, chicken and a glass of red wine at dinner (Reynolds, 2017).

The improvement in bicycling performance and physiological indicators such as ⩒O2max increased (31 to 35 ml.kg-1min-1; +13%), appeared to be due to a change in his training regimen (Billat et al 2016).  At age 101 he changed his bicycling training program from riding at a steady speed for one hour to riding 80% at an easy pace and 20% at high intensity.  This is a  type of interval training and includes enough recovery allows the body the recover and strengthen. This analogous to our evolutionary movement pattern of walking interspersed with short distance high intensity running.

As a hunter and gather we often moved steadily and then had to run very fast to escape a predator or catch an animal.  After extreme exertion, we would rest and regenerate (if we did not escape we would be lunch for the predator). Thus episodic high intensity activity with significant rest/regenerative periods is the movement pattern that allowed our species to survive and thrive. Research studies have confirmed that high intensity interval training offers more physiological benefits–increases cardiorespiratory fitness which is a strong determinant of morbidity and mortality– than moderate intensity continuous training (Weston et al, 2014).

Thus when Mr. Marchard changed his exercise pattern from moderate intensity continuous training to high intensity interval training with enough recovery time he set a new world record at age 103. Two years later he set a new world record at age 105.

Exercise improves brain function and interval training appears to improve brain function most.  When rats had prolonged exercise, the brain’s stores of energy is significantly lowered in the frontal cortex and hippocampus all areas which area involved in thinking and memory. If on the other hand, the animals had a single intense bout of exercise and were allowed to rest and feed than the brain levels of glycogen was 60% high in the frontal and hippocampus areas.  This suggest that the brain can then function better (Matsui et al, 2012).

This perspective is supported by the evolutionary hypothesis discussed by Neuroscientist Daniel Wolpert who points out that brains evolved, not to think or feel, but to direct movement. When movement is no longer needed the brain shrinks and gets reabsorbed which is illustrated by the sea squirt. This animal swims as a juvenile and then anchors on a rock and is passively moved by the currents. Once anchored, it no longer needed to coordinate movement and reabsorb its own nervous system. See Daniel Wolpert’s remarkable TED talk, The real reasons for brains.

The remarkable feat of Mr. Marchand offers suggestions for our own health. Enjoy healthy movement and exercise and incorporate our evolutionary movement patterns:  episodic high intensity followed by regeneration. At the same time include a healthy diet by reducing sugars and simple carbohydrates.  Finally, it helps to have the right genes.

References:

Billat, V. L., Dhonneur, G., Mille-Hamard, L., Le Moyec, L., Momken, I., Launay, T., & Besse, S. (2016). Case Studies in Physiology: Maximal Oxygen Consumption and Performance in a Centenarian CyclistJournal of Applied Physiology, jap-00569. http://jap.physiology.org/content/jap/early/2016/12/29/japplphysiol.00569.2016.full.pdf

Bjerregaard, P., Kue Young, T., Dewailly, E., & Ebbesson, S. O. (2004). Review Article: Indigenous health in the Arctic: an overview of the circumpolar Inuit population. Scandinavian Journal of Social Medicine32(5), 390-395. https://www.researchgate.net/publication/51366099_Indigenous_Health_in_the_Arctic_An_Overview_of_the_Circumpolar_Inuit_Population

Burkitt, D.P. & Trowell, H.C. eds. (1975). Refined carbohydrate foods and disease: Some implications of dietary fibre. New York: Academic Press.

Dulloo, A. G., Miles‐Chan, J. L., & Montani, J. P. (2017). Nutrition, movement and sleep behaviours: their interactions in pathways to obesity and cardiometabolic diseases. Obesity Reviews18(S1), 3-6.

Knowler, W. C., Pettitt, D. J., Saad, M. F., & Bennett, P. H. (1990). Diabetes mellitus in the Pima Indians: incidence, risk factors and pathogenesis. Diabetes/metabolism reviews6(1), 1-27.

Matsui, T., Ishikawa, T., Ito, H., Okamoto, M., Inoue, K., Lee, M. C., … & Soya, H. (2012). Brain glycogen supercompensation following exhaustive exerciseThe Journal of physiology590(3), 607-616.

Mensing, M., & Mekel, O. C. L. (2015). Sitting is the new smoking-Modelling physical activity interventions in North Rhine-Westphalia. The European Journal of Public Health25(suppl 3), ckv171-037.

Milanović, Z., Pantelić, S., Trajković, N., Sporiš, G., Kostić, R., & James, N. (2013). Age-related decrease in physical activity and functional fitness among elderly men and women. Clinical interventions in aging, 8, 549-556.

Reynolds, G. (2017, February 8). Lessons on Aging Well, From a 105-Year-Old Cyclist. Retrieved from: https://www.nytimes.com/2017/02/08/well/move/lessons-on-aging-well-from-a-105-year-old-cyclist.html?rref=collection%2Fsectioncollection%2Fhealth&action=click&contentCollection=health&region=rank&module=package&version=highlights&contentPlacement=5&pgtype=sectionfront

Taubes, G. (2016). The Case Against Sugar. New York: Alfred A. Knopf.

Weston, K. S., Wisløff, U., & Coombes, J. S. (2014). High-intensity interval training in patients with lifestyle-induced cardiometabolic disease: a systematic review and meta-analysisBritish journal of sports medicine48(16), 1227-1234. http://www.rcsi.ie/files/facultyofsportsexercise/20141201122758_High-intensity%20interval%20traini.pdf

Wolpert, D. (2011) The Real Reason for Brains.  http://www..com/tatedlks/daniel_wolpert_the_real_reason_for_brains.html

Youtube video: Meet 105-year-old Robert Marchand, the centenarian cyclist chasing a new record: https://www.youtube.com/watch?v=Ey48j6dDNEo

 

 

 


What the food companies forgot to tell you: For the sake of profits we promote metabolic syndrome, obesity and diabetes

Should  a five year old be responsible for being obese?

Drinking diet sodas increases the urge to eat more!

Sugar is more addicting than cocaine!

Calories from sugar are NOT the same as calories from other types of foods.

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As you are reaching for another diet soda, low fat yogurt, or low calorie dessert, you are compromising your health by increasing the risk for metabolic syndrome, diabetes and obesity. The artificial sugar substitutes increase feeling of hunger and encourage you to eat more while the low fat foods are made more appetizing by adding sugar (Lustig, 2012; Lustig et al, 2012).  As sugar is more addicting than cocaine (Ahmed et al, 2013; Lenoir et al, 2013), how can you assign personal responsibility to young child who is obese with the statement, “You are responsible for being fat and for eating too much sugar laced foods!”  Watch the superb documentary, Fed Up,  based upon impeccable science. It explores America’s obesity epidemic and the food industry’s role in aggravating it. It systematically shows that everything we’ve been told about food and exercise especially by the food industry and federal government for the past 30 years is dead wrong. The documentary can easily be viewed from streaming video services such as Google Play, Netflix, or Amazon Prime Instant Video.

For the impact of sugar on health and the myth of self-responsibility, watch the 2013 TEDxBermuda talk, Sugar–the elephant in the kitchen, by Robert Lustig, MD, Professor of Clinical Pediatrics, University of California, San Francisco.

The movie, Fed UP, and Professor Lustig’s 2013Ted talk serve as a call to action to take control of the foods we serve and eat. Support policies to promote food health:

  • Increase local taxes on every soft drink sold and use the income to support public health.
  • Demand that schools and public institutions serve children real food and not sugar laced fast foods.
  • Support policies that prohibit sales of soft drinks to minors just as alcohol is prohibited to minors.
  • Eliminate all soft drinks from public institutions and work sites just as smoking is prohibited.

References

Ahmed, S. H., Guillem, K., & Vandaele, Y. (2013). Sugar addiction: pushing the drug-sugar analogy to the limit. Current Opinion in Clinical Nutrition & Metabolic Care, 16(4), 434-439.http://journals.lww.com/co-clinicalnutrition/Abstract/2013/07000/Sugar_addiction___pushing_the_drug_sugar_analogy.11.aspx

Fed Up.(2014). American documentary film directed, written and produced by Stephanie Soechtig.http://fedupmovie.com/#/page/home

Fowler, S. P., Williams, K., Resendez, R. G., Hunt, K. J., Hazuda, H. P., & Stern, M. P. (2008). Fueling the Obesity Epidemic?Artificially Sweetened Beverage Use and Long‐term Weight Gain. Obesity, 16(8), 1894-1900.http://onlinelibrary.wiley.com/doi/10.1038/oby.2008.284/full

Lenoir, M., Serre, F., Cantin, L., & Ahmed, S. H. (2007). Intense sweetness surpasses cocaine reward. PloS one, 2(8), e698.http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0000698

Lustig, R. H. (2012). Fat chance: beating the odds against sugar, processed food, obesity, and disease. Penguin.

Lustig, R. H., Schmidt, L. A., & Brindis, C. D. (2012). Public health: The toxic truth about sugar. Nature, 482(7383), 27-29.http://www.nature.com/nature/journal/v482/n7383/full/482027a.html


Be aware of evolutionary/ecological traps

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Dead bird on Midway Island in the North Pacific, 2000 miles from any other islands. The bird mistook attractive coloring of plastics that float in the ocean as food. From: https://www.youtube.com/watch?v=dtJFiIXp5Bo

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Being captured by a digital device. From: http://images.gameskinny.com/gameskinny/c9689c75994e58a03dbc5e489d346e55.jpg

How come birds on Midway Island are dying?

How come your son keeps playing computer games even after he said he would stop?

How come you ate all the French fries and the dessert even though you promised yourself to reduce your calorie intake?

How come you procrastinated and did not get up from the couch to exercise?

How come you watched pornography?

The usual answer is absence of will, self-control or self-discipline. The person is automatically blamed for making poor life choices. If you had more self-worth than you would not let yourself get obese, addicted to computer games, or watch pornography. Blaming the victim is easy, however, there are other factors that underlie the person’s covert/unconscious choices. Many of these illness producing behaviors (e.g., overeating, playing the computer games, sitting and sitting) are responses to external cues that in prehistoric times promoted survival, reproduction and health. To respond rapidly and appropriately  to those cues offered a reproductive advantages while not reacting would reduce your survival. In many cases there are no upper limits to turn off our responses to these cues because the more the person responded to those cues the more was there a reproductive advantage. Now, however, our adaptive preferences have become maladaptive because the cues that trigger the same behaviors lead to lower fitness and illness (Schlaepfer et al, 2002; Robertson et al, 2013). The cues have become evolutionary/ecological traps!

Some of the recent evolutionary/ecological traps include:

Vigilance for survival. While playing a computer games, the person rapidly responds and continuously experiences immediate rewards (e.g., successful shooting the target, points, next game level). This process activates the same  survival mechanisms that hunter used for thousands of generations. A visual or auditory stimuli represents  sources of food or danger (a game animal to hunt for food, an attack by a predator or an enemy). The visual/auditory cue captures the person’s attention and if the person reacts to that cue he would probably survive. On the other hand, if he did not react, he may not survive and reproduce. In our modern world, similar stimuli now hijack the neurological pathways that in earlier times supported survival. Over activation of these pathways is a cofactor in the development of ADHD and other disorders (Peper, 2014). For a superb discussion of  how cellphones, computers, gaming and social medial are changing our brains, read Dr. Mari Swingle’s new book, i-Minds (Swingle, 2015)

Energy for survival: Eating carbohydrate/sugary and fat foods are necessary for survival as humans constantly searched for energy sources to support life. Breast milk and almost any fruit that is sweet contain calories and supports growth. If the food was bitter it was usually harmful. For most of our evolutionary past, we would eat as much as possible because food was scarce. There was no evolutionary advantage to limit food intake as the stored calories would supply enough calories to survive during periods of famine. In our modern world, our survival mechanisms have been hijacked by advertising and the oversupply of foods which  contribute to the epidemic of obesity and diabetes.

Being a couch potato and not moving again is again survival mechanism. In a prehistoric world with limited food supply, the less movement (the fewer calories you burned), the longer you could survive. You would move when you needed to build shelter or search for food. Again in a world where shelter and food are often abundant, there is no intrinsic mechanism to initiate movement.

Sexual arousal for reproduction: Men are often captured by pornography. They can watch for hours and feel aroused. The whole porn industry is based upon hijacking our sexual drive for reproduction.

Our brain does not discriminate between actual visual and auditory stimuli, imagined or film/video images. Until the late 19th century everything we saw and heard was real. Only in the 20th century could we produce images and sounds that appeared real. These film, TV , and the ever present digital displays activate the same neurophysiological pathways as when the stimuli were actually real.  A scene on a digital screen triggers the same biological pathways and responses that for thousands of generations supported survival. If we did not respond we would not have survived.  If you have any doubt, watch a scary horror movie and check how you feel afterwards. You may feel more scared, your sleep may be disturbed, your heart rate increased, and you probably interpreted any noise around you as possible danger. Thus, cues in the environment may become evolutionary/ecological traps in the same way that birds on Midway Island in the North Pacific, 2000 miles from any other islands, mistook the attractive coloring of plastics as food. See: https://www.youtube.com/watch?v=dtJFiIXp5Bo. Should the birds be blamed because they have no self-control?

What can you do!

Recognize that modern industries for the sake of profits have hijacked our cues that had evolved to aid survival (Kemp, 2014).

Recognize that not reacting to product cues means inhibiting the intrinsic biological triggered survival responses. Yes, it is possible not react to the stimuli and demonstrate self-control; however, it is not only a problem of will. It is a problem that our cues have been hijacked and tricked for commercial profit.

Society may need to protect its own populations from commercial exploitation of evolutionary/ecological traps. A young child is automatically drawn to the visual stimuli on a smartphone and tablet which parents use to quiet the child during dinner. In this process they are activating the pre-wired biological pathways that captured attention for survival. By over activating these pathways, the brain is changing in response to this activation which increases the risk of developing ADHD, autism, and mood deregulation including anxiety, depression, and anger management, and other forms of addictive behavior (Swingle, 2015). In addition, school performance and memory retention are reduced when students take notes using their keyboard or read text from digital screens (OCallaghan, 2014). It will take the family and society to limit the availability of these cues until self-control has been developed. Similarly, the availability of cheap calories in large food portions, sugars in soft drinks and sugar and fats in snacks, need to be limited if the epidemic of obesity and diabetes is to be reversed.

It may be unreasonable to think that people can easily interrupt their biological responses to cues that have been created to increase profits. We need to take collective responsibility and limit the availability of commercially augmented evolutionary traps and cues in the same way we need to limit the plastic in the ocean so that the birds at Midway Island may be able survive. Without respecting our evolutionary past, our future may not be different from those Midway Island birds.

References

Kemp, C. (2014). Trapped!. New Scientist, 221(2960), 43-45

OCallaghan, T. (2014). Goodbye, paper: What we miss when we read on screen. New Scientist.224 (2993). 41-43.

Peper, E. (2014). Support Healthy Brain Development: Implications for Attention Deficit/Hyperactivity Disorder. Psychophysiology Today, 9(1), 4‐15.

Robertson, B. A., Rehage, J. S., & Sih, A. (2013). Ecological novelty and the emergence of evolutionary traps. Trends in ecology & evolution, 28(9), 552-560.

Swingle, M.K. (2015). i-Minds. Portland, OR: Inkwaterpress.com ISBN-13 978-1-62901-213-1

Schlaepfer, M. A., Runge, M. C., & Sherman, P. W. (2002). Ecological and evolutionary traps. Trends in Ecology & Evolution, 17(10), 474-480.


Concered about food and health?

If you are concerned about food and health, watch Michael Pollan’s presentation, How Cooking Can Change Your Life. It is pragmatic and full of wisdom.


Cut out the sugar-it is toxic!

Putting it simply: Too much sugar in our diet is harmful and when we return to our paleolithic diet, health tends to improve.

Sugar intake in all different forms is the single most important ingredient that contributes to diabetes. In the last one hundred years our sugar intake has radically increased as is shown in figure 1.

sugars a

Figure 1. Sugar intake per capita in the United Kingdom from 1700 to 1978 and in the United states from 1975-2000. The line on the right with black dots is the obesity rates in the United States in non-Hispanic white men aged 60-69 y. Values for 1880-1910 are based on studies conducted in male Civil War veterans aged 50-59y. From: Johnson RJ et al, AJCN 2007; 86:899-906;  Initial source: http://www.indiana.edu/~oso/Fructose/Fructose.html

Even though research and clinical findings over the last one hundred years have shown that increased sugar and processed simple carbohydrate  intake are contributing factors to many illnesses ranging from diabetes, obesity, cancer and even epilepsy, the data is now undisputable.  As Mark Bittman wrote in the New York Times on February 27th, “Sugar is indeed toxic. It may not be the only problem with the Standard American Diet, but it’s fast becoming clear that it’s the major one.” 

When  researchers accounted for poverty, aging, exercise, total food intake, and other factors, increased sugar intake increased diabetes and decreased sugar decreased diabetes.  As the authors state, “for every 150 kcal/person/day increase in sugar availability (about one can of soda/day) there was associated with increased diabetes prevalence by 1.1% (p <0.001).”  (Basu S, Yoffe P, Hills N, Lustig RH (2013) The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data. PLoS ONE 8(2): e57873. doi:10.1371/journal.pone.0057873)

Presently, the level of proof linking sugar to diabetes is equal to if not better than the level of proof that linked cigarette smoking to lung cancer and other illnesses. Despite the overwhelming scientific data, it will be an uphill battle to change our diet and diet recommendations from the highly processed high glycemic index diet that promotes inflammation and diabetes to a low glycemic index Paleolithic diet that supports health. The major agricultural and food processing businesses have significant influence with the USA Government (for Senate and House members lobbying pays for the election), the  FDA and USDA priorities are also highly affected through direct and indirect lobbying efforts or by the financial reward to be offered a job in the agribusiness after working for the FDA or USDA.  In the USA lobbying and being rewarded with a highly paid job in industry is the expression of the democratic process–for the rest of the world it is called bribery.  Thus, it is likely that agricultural and food processing industries will continue to delay and obstruct any recommendations to reduce sugars and highly processed carbohydrates in our food supply. A preview of this battle has already occurred when Major Michael Bloomberg of New York City intended to restrict sales of sugary soft drinks to no more than 16 ounces a cup in city restaurants, movie theaters, stadiums and arenas. A barrage of negative comments filled the media spaces. For example,  Bloomberg News,  reported  the comments by Kirsten Witt Webb, a Coca-Cola (KO) spokeswoman, who said  in an e-mail. “They can make their own choices about the beverages they purchase. We hope New Yorkers loudly voice their disapproval about this arbitrary mandate.”   

Soft drinks and soft drinks contain often eight or more table spoons of sugar per drink as shown in Figure 2.

coca cola and sugarFigure 2. Amount of sugar cubes in soft drinks. Source: http://www.sugarstacks.com/beverages.htm

The sugar/highly processed foods battle will be similar to the battle the smoking lobby fought for the last 30 years. Just like tobacco subsidies, farmers receive subsidies to grow corn to make more low cost high fructose corn syrup. As recent as 2005 tobacco farmers were still receiving  a billion and a half dollars in subsidy while farmers growing corn received more than seven billion dollars in subsidies as shown in Figure 3.

corn subsidy

Figure 3. Farm subsidies in 2005. source: http://en.wikipedia.org/wiki/Agricultural_subsidy

At the same time pharmaceutical companies continue to reap a financial bonanza from the sugar diet induced illnesses. They will create more and more drugs to attempt to reduce the illnesses and symptoms.

We cannot expect the US government to promote our health as the lobbying power by agribusiness is overwhelming. We cannot expect published information, whether on the web or in print, to be accurate as advertising dollars significantly affect editorial decisions.

We can start eating differently ourselves and with our families and friends. Begin now. Do an experiment by eating a predominantly Paleolithic diet. For the next two weeks, eat only foods that are real foods which your great grandparents recognized as food. Thus nothing out of box or can. Nothing that has been processed or prepared!  Buy only foods in their natural form. Shop at  farmers’ markets or only at the periphery of the supermarket: vegetables and fruits, the meat and fish counters. After eating this diet  for two weeks, check how you feel.  Many people report having more energy, feeling less tired and irritability,  and  some experience a reduction in arthritic pains, inflammation, headaches and even anxiety.  For dietary suggestions see the common sense recommendations in Michael Pollan’s book, In Defense of Food: An Eater’s Manifesto.


What is the best single thing we can do for our health

There are so many factors that contribute to our health: diet, social support, preventative medical screening, etc.   Yet, what is one single most important procedure that gives largest return of investment for your health? Listen to  Dr. Mike Evans describe the  procedure that if is used as treatment- one hour a day three times a week- reduces pain by 47% for patients with arthritic knees;  if the treatment is done most days, patients with diabetes reduce the progression of their disease by 58%; post menopausal women who have the treatment four times a week reduce hip fractures  by 41%; the treatment also reduces anxiety by 48% and patients with depression who receive a low dose of this treatment experience  relief of depression by 30%  while those on a high dose experience a  47% relief; in addition, it is the number one treatment of fatigue.

The treatment is 30 minutes of exercise–mostly walking–as described in the superb YouTube video, 23 and 1/2 hours: What is the single best thing we can do for our health?