The All-American Food Fight
Unnoticed so far by the British media there is what is being described as the "All-American Food Fight" currently in progress in the United States. No, this has nothing to do with genetically modified crops – an issue which keeps the British in constant fear of turning into monsters. No, it is to do with what is normally the rather mundane subject of official dietary advice. With more than 1 in 6 of the American population now officially deemed to be obese, the interest in such things is high.
Every five years the US Department of Agriculture (USDA) updates its advice to Americans on what constitutes a balanced diet. At the heart of their guidelines lies the famous 'food pyramid' – a widely accepted, uncontroversial way of illustrating a varied and healthy approach to eating, with fats, oils and sweets occupying the smallest volume at the apex of the pyramid, and bread, cereal, rice and pasta in the largest section at the bottom. All very sensible stuff.
The guidelines were last revised in 1995 and the drafts of the 2000 revisions have already been published. This time, however, USDA decided to host what it billed 'The Great Nutrition Debate', to be conducted by 'leading nutrition experts' prior to issuing the final version of Dietary Guidelines for Americans.
This staged debate was curious for two reasons. First, why hold the debate now when the drafts have already been prepared? Second, why fill the debating room not with 'nutritional experts' at all but with authors of best-selling diet books, a number of which have been roundly condemned by 'real' nutritional experts. Presentations were made by, among others, Dr Morrison Bethea, author of Sugar Busters! Cut Sugar to Trim Fat, Dr Dean Ornish, who wrote Eat More, Weigh Less, and Dr Robert Atkins of New Diet Revolution fame. Only Dr Keith Ayoob seemed to have any real credentials as a nutritionist, and it was he, unsurprisingly, who appeared to be the only one who said anything of any real sense in the debate.
To say that contributors such as these came to the debate with open minds and without vested interests would, of course, be quite absurd. Riding on the back of the anti-obesity drive in the USA each had his or her own pet, and some would say cranky, diet dogma to propound. It is not surprising, therefore, that they failed to agree on anything much at all. Some said cut carbohydrates and eat protein-rich meats. Others argued the reverse. Eggs and dairy products were definitely in according some 'experts' while others recommended diets which totally excluded them. You might have expected that they would all agree on the saintly broccoli, but apparently not. No, the only common ground seemed to be that exercise was good and sugar was bad. And that was the 'Great Nutrition Debate'.
The American media, unlike their British counterparts, tend to give government departments and their public announcements an easy ride. This was certainly the case with this seemingly quite daft debate. And none of them asked what the real point of it was, other than it gave prime time TV coverage to the authors of the current wave of food-fad paperbacks. It is not until one starts to delve into USDA's draft guidelines themselves that the purpose of this farce starts to become apparent. 'Delving' in this context is rather more difficult than it sounds for even in draft form the guidelines run to over 130 pages. In a country of obese people, the sheer volume of this dietary advice reflects the average weight of its citizens.
At first it seems that there is little change from the 1995 guidelines. Except, and you may have guessed it by now, when it comes to sugar. Before USDA even gets round to suggesting that perhaps Americans might entertain the idea of eating a little less and taking more exercise, it is on the case of sugar, along with the already universally pilloried saturated fats. No mention yet in the guidelines of smaller servings or abstaining from binge feeding. Both the US Government and the maverick, but extremely popular, diet 'specialists' somehow come to the same, limited conclusion: Keep away from sweet things and the flab will roll off every American and the billion dollar diet-book market will evaporate overnight.
This kind of nutritional advice, consisting of simple proscriptions, some at least having little in the way of a genuinely scientific foundation, is doomed to failure. Many Americans are now recasting being fat as being beautiful – perhaps a last opportunity for genuine defiance in an increasingly conformist and Puritanical society. Americans are fat not because they drink too many soda pops but because they have lost the concept of what eating is all about, to the extent that some 'specialists' are now suggesting that food should be regarded as a 'dangerous drug'.
Europeans who visit the United States for the first time are instantly struck by the sheer volume of food that is put before them in even the most humble restaurant or fast-food outlet. The American sandwich, for example, most usually consists of two thin slices of bread whose only function is to convey up to half a pound of beef, turkey, pastrami or whatever to the consumer's mouth. Everywhere are signs saying 'Bigger', 'Giant', 'Whopper' and a 'regular' Coke is the smallest Coke you can buy. 'More' equals 'better'. Not surprising then that such troughing behaviour, combined with increasingly sedentary lifestyles, now kills more Americans than tobacco.
What is needed if this trend is to be reversed is a radical re-shaping of the relationship that people have with what they eat, and the relationship between food consumption and physical activity – not simple diet tips which are lost in the constant scream of contradictory nutritional advice to which Americans are exposed every day. If USDA and its contributors to the 'great debate' think they can achieve anything by trying to heap the blame onto just a few easy culprits like sugar or salt, then they have a poor grasp of human psychology: "Hey Marlene, I didn't have a candy bar today, gimme some more of those fries."
It's very easy for us in Britain, of course, to be critical of Americans in this way. We can still get a sandwich, if we shop around, where the bread actually seems to be a significant ingredient. And while we may be getting a little fatter than we used to be, at least most of don't wobble quite as much as our counterparts across the Atlantic. But this smugness should be tempered by the fact that the same paths which have led Americans to lose the plot when it comes to food and nutrition are the ones down which we ourselves are now progressing. We are surrounded by the same cranky diet books, and the same proscriptive 'advice' on a 'healthy' diet which more often just reflects the ideology of the day rather than evidence and hard data.
We also have an additional problem here which is less evident in the USA – grotesque class inequalities in diet and health. In Britain the middle classes tend to eat quite well, but worry a great deal about it. Working class families, on the other hand, eat much less well in terms of both balance and quality, but also care much less about the consequences. The people who, perhaps, might benefit most from good nutritional advice are often those who don't get it – either because they are not targeted or the messages are communicated in such a moralising and pious tone as to guarantee their lack of attention.
USDA's 'Great Nutrition Debate' has set a dangerous precedent which, hopefully, the British government will resist. Yes we have problems in this country, just as in the USA, and our own special ones as well. But we will not solve them by emulating the American model of trying to deal with them. When government policy chimes with the minimal consensus that can be extracted from a room full of competing paperback writers, then we might start to suspect that the lunatics really have taken over the asylum.