How Our Broken Food System Drives Chronic Disease - March Newsletter

This newsletter provides interesting insights about our broken food system and directs you to our favorite resources, farmers, doctors, thinkers, and organizations. We hope you enjoy the content.

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Chronic diseases such as obesity, diabetes, and hypertension plague our country, with 60% of Americans afflicted by one chronic disease and 40% by two. The pandemic has highlighted our chronic disease epidemic, as obesity in particular carries a significantly heightened risk of COVID-associated hospitalization and death. As Dr. Mark Hyman has emphasized, only 12% of Americans are metabolically healthy, 75% are overweight, 42+% are obese, and 50% have pre-diabetes or type 2 diabetes. 20% of children and adolescents are obese, and The American Obesity Association expects 60% of Americans to be obese by 2030.

Our food system churns out ultra-processed food stripped of nutrients and packed with high fructose corn syrup. For decades, our federal government has incentivized the production of corn, soy, hay, and wheat, and massive food companies have profited through monocultures, agrochemicals, and tillage. These industrial practices have degraded our soil, polluted our water, destroyed biodiversity, and hooked Americans to refined carbohydrates that make us sick.

How we farm directly impacts soil health, plant health, animal health, and ultimately human health. Here are a few resources that have helped me better understand our food system, our chronic disease epidemic, and the myriad benefits of regenerative agriculture.

True Cost of Food - Measuring What Matters to Transform the U.S. Food System

In this report, the Rockefeller Foundation measures the true cost of our food system by accounting for health, environmental, and societal costs. The report concludes that the actual cost of the U.S. food system is at least three times higher than the expenditure on food. In 2019, Americans spent ~$1.1 trillion on food. The health care costs associated with diet-related diseases amount to $1.1 trillion per year. Our production system’s environmental costs, measured by GHG emissions, water use, soil erosion, and biodiversity impact, equate to $900 billion per year. Lastly, the unaccounted for livelihood costs (e.g., child labor, unlivable wages, and lack of standard employment benefits) are approximately $100 billion per year. Accounting for health, environmental, and societal costs, the report finds that the true cost of the U.S. food system is at least $3.2 trillion per year. Moreover, the true cost of food disproportionately burdens people of color, who are more likely to suffer from diet-related diseases, have less access to water and sanitation, and often work in food production jobs for less than a living wage. For a deeper dive on the methodology the Rockefeller Foundation applied, see this technical appendix. For a related discussion about true cost accounting for food, listen to Pietro Galgani’s interview on the Investing in Regenerative Agriculture and Food podcast.

The Obesity Code (by Dr. Jason Fung)

In this quick read, Dr. Jason Fung maintains that obesity and diabetes are hormonal imbalances caused by poor eating and consistently elevated insulin levels. According to Dr. Fung, the standard prescription of cutting calories and exercising more has utterly failed to result in lasting weight loss, and has unnecessarily led to shame and despair. Dr. Fung stresses that sustained weight loss is only possible when key hormones like insulin are reset and balanced.

By urging a low fat diet for so many decades, our federal government, doctors, and nutritionists have pushed Americans to eat more sugar in the form of refined carbohydrates. Proteins such as meat and dairy are relatively expensive, and less expensive vegetable proteins are not typical of the American diet. That leaves us with highly refined carbohydrates, which are incredibly cheap due to hefty agricultural subsidies for corn and wheat. High fructose corn syrup and nutritionally deficient flour inundate our heavily processed foods. Dr. Fung persuasively argues that the federal government is subsidizing, with our own tax dollars, the very foods that are making us obese and diabetic. Affordability leads to greater consumption, which leads to more obesity, and ultimately more tax dollars go to anti-obesity programs and more money goes to medical treatment.

Dr. Fung explains that increased carbohydrate intake releases more insulin, which plays a critical role in uptaking glucose into our cells for energy. Highly processed foods and persistent snacking elevate insulin levels and ultimately induce insulin resistance, the “Lex Luthor of modern medicine’s archenemies, including obesity, diabetes, fatty liver, heart disease, and high blood pressure.” Though type 2 diabetes stems from excessive insulin resistance, many doctors have improperly prescribed insulin–the exact opposite of what they should be doing. Because the common root cause of diabetes and obesity is high and persistent insulin levels, both diseases are increasingly observed as a syndrome termed diabesity. Dr. Fung further underscores the phenomenon of time dependence, whereby it becomes more difficult to sustain weight loss the longer one has been obese.

For a much more detailed analysis of insulin, insulin resistance, fat storage, fatty liver, body set weight, child obesity, macronutrients, intermittent fasting, and what and when to eat, I highly recommend reading The Obesity Code. On the diabetes front, a close friend with health care expertise has praised Virta Health, an innovative startup focused on reversing diabetes through effective and sustainable carbohydrate restriction and safe medication removal. According to Virta Health, “its continuous remote care model has shown great success reaching underserved patients, including rural Americans, those living in food deserts, veterans, Native Americans, and older adults.”

The Big Fat Surprise: Why Butter, Meat, and Cheese Belong in a Healthy Diet (by Nina Teicholz)

This investigative work painstakingly debunks many dietary myths that continue to misguide Americans today. Nina Teicholz traces the origins of the low-fat high-carbohydrate diet to Ancel Keys, a principal architect of the diet-heart hypothesis. In the 1950s, Keys blamed saturated fats from animal foods for the rising rate of heart disease due to its purported effect on cholesterol. Backed by the American Heart Association, the National Institutes of Health, and Time magazine, the diet-heart hypothesis quickly became dogma, with any dissenting viewpoints vehemently stamped out. Over the next several decades, the average American heard only one thing from key institutions, doctors, and nutritionists: eating eggs, butter, red meat, and full fat dairy products is bad for you.

As the low-fat diet took hold, Americans began consuming more sugar, white flour, heavily processed grains, and other highly refined carbohydrates. One of the awful unintended consequences of the low-fat diet was the rise of polyunsaturated vegetable oils (such as corn or soybean oil), which replaced animal fats in an attempt to lower cholesterol. Though completely unknown before 1910, by 1999, 7-8% of all calories consumed by Americans came from vegetable oils. Oil hydrogenation was a key invention that “changed the landscape of food processing” because it converted oil into a solid form that opened up countless food possibilities. Depending on the level of hydrogenation, vegetable oils could be tailored for cookies, cupcakes, pastries, crackers, and virtually any snack. For McDonald’s and other fast food chains, vegetable oils were great for frying foods.

Crisco, crystallized cottonseed oil, was the key product that introduced trans-fatty acids into America’s food supply. Research ultimately demonstrated that a diet high in trans-fats raised LDL-cholesterol (the “bad” cholesterol) and lowered HDL-cholesterol (the “good” cholesterol). When trans-fats were ultimately banned, vegetable oils like sunflower oil replaced them through new processes (such as interesterification). Companies like Kraft Nabisco had to reformulate their marquee products (e.g., the Oreo cookie) to ensure the same consistency, texture, and flavor. Teicholz notes that the new fat replacers’ effects on health have barely been studied. Fast-food chains like McDonald’s, Burger King, and Wendy’s swapped out hydrogenated oils for regular vegetable oils, which create toxic oxidative breakdown products when heated.

Growing research over the past few decades has confirmed the importance of dietary fat and demonstrated that the low-fat diet has been terrible for health, as evidenced by our exploding rates of obesity and diabetes. Teicholz stresses that animal fats (e.g., lard, tallow, and butter) are “stable, do not oxidize, and have been consumed since the beginning of recorded human history.” Saturated fats like red meat, cheese, eggs, and whole milk are nutrient-dense and do not lead to weight gain. There is no scientific basis for replacing them with trans-fats and oxidizing vegetable oils deleterious to our health.

Unfortunately, our habits are deeply ingrained, and many Americans still think it’s healthier to purchase low-fat yogurt packed with artificial ingredients than full-fat yogurt. My baby girl loves Kerrygold Salted Butter, and I never feel bad about giving it to her (even plain). The same goes for the full fat Good Culture cottage cheese she devours and the delicious BoboLinks 100% grass-fed beef snack sticks my kids and I love. Whenever someone has tried to give her a non-fat or low-fat product, she refuses to eat it. Far too many of us choose products that are less healthy and much less flavorful because we mistakenly think it is better for us or will lead to weight loss. On the flipside, people often select self-declared healthy snacks that are full of sugar, vegetable oils, and artificial ingredients. For a deeper examination of the harmful seed oils we regularly consume, check out Dr. Cate’s The Hateful Eight: The Enemy Fats that Destroy Your Health.

Farmacology (by Dr. Daphne Miller)

Dr. Miller’s thoughtful book explores how “the art and science of agriculture–from choice of seed to soil management–can positively impact your personal health.” Albert Howard’s The Soil and Health inspired Dr. Miller to spend time on farms to better understand the connections between farming and health. In reflecting upon her experience as a doctor, Dr. Miller notes that medical training hardly focuses upon nutrition and how to keep people healthy. Rather than encouraging preventative care, medical care is generally reductionist, following a “diagnose and conquer” strategy that narrowly examines one factor. However, our health needs are often complex and prescribing vitamins, supplements, and other drugs frequently does not improve patients’ health.

Dr. Miller toured many farms across the country to learn more about the soil microbiome, the importance of cows and other animals to thriving ecosystems, adaptive multi-paddock grazing, the health and taste benefits of raw milk, integrated pest management on vineyards, biodynamic farming, urban farming, and more. She weaves analyses of her patients throughout this enjoyable book and explains how optimal treatment often involves simple dietary changes.

How the Intelligence of Plants and Animals Can Help Us Reclaim Our Health - Fred Provenza on The Doctor’s Farmacy Podcast

In this fantastic interview with Dr. Mark Hyman, Fred Provenza shares his well-researched view that food is medicine. Provenza highlights the vital role that key plant compounds known as phytochemicals play in plant, animal, and human health. Animals select plants based on nutritional needs, and use plants therapeutically and prophylactically. Modern agricultural practices focused on high yield have dramatically stripped fruits, vegetables, grains, and animals of their phytochemical richness and key minerals.

Compounding the depletion of phytochemicals in our food, our diets’ biodiversity has plummeted as we predominantly consume corn, wheat, and soy products. Monocropping soy, corn, hay, and wheat, dousing our land with chemicals such as glyphosate, and tilling our land have severely degraded our soil. And as Provenza stresses, the soil microbiome is directly tied to the microbiome of plants, animals, and humans. According to Provenza, robust plant diversity creates “grocery stores and pharmacies for the creatures below ground.” There is a symbiotic relationship whereby plants feed the soil microbiome, and soil microbiota help plants get their nutrients. By destroying diversity and ultra-processing our food, we have limited access to phytochemicals key to nutrition and flavor. Provenza cautions that many plant-based products are ultra-processed. He further notes that phytochemicals in meat have been recently discovered, and that meat contains many essential nutrients that cannot be obtained from plants. He stresses that regeneratively raised animals promote thriving ecosystems and produce nutrient-dense meat, and that we must be careful not to treat all meat as CAFO meat.

Provenza laments that 60% of our diet comes from three plants, and the rest from twelve. He marvels at plants’ dynamic ability to produce different compounds at different times of the day and during different seasons, and has observed that animals are in tune with such variation. He explains that plants have as many as twenty senses, and can effectively communicate with other plants, often through an underground web of mycorrhizal fungi.

If you find this overview interesting, you should definitely check out Provenza’s book Nourishment, which I loved. I was blown away by the breadth of this book, which extends far beyond agriculture and biology to metaphysics and political science.

Dr. Mark Hyman’s The Doctor’s Farmacy Podcast

I’m a massive fan of Dr. Hyman and The Doctor’s Farmacy Podcast regularly has fascinating interviews about our food system, personal health, chronic diseases, and regenerative agriculture. Dr. Hyman stresses that food is medicine and serves as our most important biological modifier. He has successfully treated many patients’ chronic diseases by changing their diets and guiding them towards whole unprocessed foods with as few ingredients as possible. Whether you want to learn more about the root causes of chronic diseases, regenerative meat, superfoods, sugar, flour, and refined vegetable oils, Dr. Hyman is a fantastic resource. For an excellent overview of regenerative agriculture, the key principles of soil health, and the disastrous impact of CAFOs and conventional farming on human and planetary health, check out Dr. Hyman’s interview with Allen Williams, one of the leading pioneers of regenerative agriculture. I also suggest reading functional nutrition dietician Brigid Titgemeier’s A Solution to Our Broken Food, Farming & Healthcare Systems: Regenerative Healthcare, which beautifully covers many of the themes addressed here. As Brigid quotes Wendell Berry in the first line of her article, “People are fed by the food industry, which pays no attention to health, and are treated by the health industry, which pays no attention to food.”