I am constantly discovering the various ways our systems fail to promote true well-being and health, functioning mainly to produce profits at the expense of all other considerations. Nutrition is absolutely vital to our health, yet doctors do not receive adequate nutrition education and many graduating medical students do not feel they have sufficient knowledge to competently give nutritional advice to their patients. Nutrition research is also shamefully underfunded in relation to the prevalence of inflammatory diseases that are closely related to diet.
Diabetes has been on the rise for decades and, in true American fashion, we are obsessed with telling individuals that they need to make better food and exercise choices. We do this rather than examining the choices that are realistically available, government policies that have created the systems which constrain those choices, or the important contribution of non-dietary factors to conditions we typically think of as purely physical, like obesity and heart disease.
The price of food has increased three times more than median wages since 2008. Inadequate compensation and protections for workers, alongside the abysmal state of public transportation infrastructure, leave many without enough money or time to cook healthy foods on a budget, though cooking at home is a key factor to improving diet. Within the food industry there is rampant exploitation of migrant farmworkers and workers in the meatpacking industry that enabled industry giants to make $75 billion in profits in 2016.
Additionally, the quality of available foods is eroding, as is our ability to make informed choices. This is due to the inordinate amount of power that large companies have been allowed to exercise in the food industry with the tacit approval of federal antitrust regulators. The four largest companies in many food and agriculture sectors control more than 60% of the market, whereas the average for most sectors is 40-45%. These large manufacturers buy up smaller competitors, but keep the brand name of the smaller company and purposely conceal their connection in order to maintain the illusion of independence and choice.
Why does everything come back to this capitalist idea that bigger, faster, and more efficient is better? It is a complete myth. Many of the systems that have been labeled “highly efficient” are not; it is simply that we are looking at a very narrow set of variables or outcomes.
The availability of farm subsidies has distorted the share of calorie-rich, but nutrient-poor crops like corn and soybeans in the market. In the U.S., about 90 million acres each of corn and soybeans are planted each year while only 10 million acres--3% of cropland--were used for fruits, nuts, and vegetables. This balance does not comport with what we are told we should be consuming, but farmers are forced through subsidy regulations and their inability to compete with agricultural industry giants to continue their role in the overproduction of corn.
Corn’s energy density, low cost, and availability has made it the feed of choice for animal and fish farming. It fattens the animals up much more quickly than their natural diet and therefore cuts costs. However, in cattle farming for example, cows develop health problems like liver abscesses from eating corn feed rather than grass, which they evolved to eat. This results in meat that is less healthy to eat and contributes to the overuse of antibiotics. Both of these have direct impacts on public health.
Studies indicate that humans evolved on diets with about a one to one ratio of omega-6 to omega-3 fatty acids, but the ratio of today’s typical Western diet is about 15 to one. Grass-fed beef contains less fat overall than grain-fed beef and up to five times as much omega-3 as well as other health benefits like a greater prevalence of antioxidants. Farmed salmon, also fattened on corn, have a significantly decreased amount of omega-3 in relation to omega-6 compared to wild salmon. Omega-6’s have been associated with pro-inflammation while omega-3’s have proven anti-inflammatory benefits. Omega-3’s have shown to be effective in the treatment of depression and have shown potential for the treatment of schizophrenia and dementia.
There is widespread recognition of the rise of antibiotic resistance and its connection to the overuse of antibiotics in animal agriculture. But such extensive use of antibiotics would not be necessary if animals were fed a proper diet. We consume the antibiotics given to animals both in their meat and in fruits and vegetables fertilized with manure from antibiotic-treated animals. This may also be linked to the dramatic increase in asthma and allergic diseases in children as the use of antibiotics in early childhood has been associated with a greater risk of those diseases.
As a society, we have also not adequately acknowledged the importance of non-dietary factors to various aspects of physical health. Chronic stress decreases our body’s ability to regulate inflammation, which underlies coronary heart disease and is associated with depression as well as many other conditions. Inflammation contributes to obesity by making it simultaneously harder to lose weight and easier to gain weight. Adverse childhood experiences affect physical health through a dysregulated stress response system and have been linked to childhood obesity. We can actually see the physical effects of chronic stress in shortened telomeres. Telomeres are a special sequence at the end of our chromosomes that serve a protective function for DNA. Telomeres shorten naturally in the aging process, but their length can be affected by other factors as well, like chronic stress. When they are short enough, cells can no longer replicate and may also become dysfunctional, causing inflammation and malfunctions in replication that lead to diabetes, cardiovascular disease, and some types of cancer. Shortened telomeres have also been shown to cause more severe cases of COVID-19. What is amazing is that we do have the power to counter the effects of these non-dietary factors with a dietary approach.
Rather than individualizing health problems or seeing each label as an isolated issue, we need to zoom out to appreciate how the complex interaction of these various forces influence the state of our health. It takes a systems-level view of societal structures as well as a more holistic approach to our physical and mental health to create a truly sustainable world.