Pinoy Kasi
Nutritionism
By Michael Tan
Philippine Daily Inquirer
First Posted 00:53:00 07/30/2008
Filed Under: Food, Health
July is Nutrition Month, so I thought I should cap the month with an article on an emerging problem called nutritionism, which on the surface seems to be scientific but ends up producing more nutritional problems.
I’ll start with the confusing news we get all the time about various foods. Remember when we were warned not to eat eggs daily? Then the doctors said, well, maybe one a day is fine. Others said, sure, one a day but not the egg yolk. We’ll find similar confusing, even contradictory, advice around foods like meats, fish, wine, coffee, and, lately, particular vitamins, minerals and, in recent years, phytochemicals (which means, quite simply, plant chemicals).
‘Tiki-tiki’
A new book, “In Defense of Food,” by Michael Pollan, helps us through the nutritional maze of our times. Pollan reviews academic articles and interviews scientists to trace the history of nutrition as a science. We learn about how William Prout, an English doctor and chemist, first identified the three principal constituents of food: protein, fat and carbohydrates. The German Justus von Liebig followed by identifying three vital minerals: nitrogen, phosphorus and potassium, which, not surprisingly, are well known to gardeners and farmers by their chemical symbols: N, P, K, found in fertilizers. Finally, the Polish biochemist Casimir Funk discovered vitamins in the 1920s.
In the 20th century, medical scientists worked with nutritionists to identify diseases caused by deficiencies of particular substances. Some of the discoveries were quite dramatic, like scurvy caused by vitamin C deficiency and, in the Philippines, beriberi, caused by vitamin B deficiency. I’m suddenly remembering a radio jingle from my childhood, “Tiki-Tiki ... for baby,” Tiki-tiki being a local formulation of B vitamins that was first developed to combat beriberi.
Through time, people have come to think of nutrition mainly in terms of, well, nutrients, each of which is seen almost like medicines, to be taken for specific ailments. Ironically, as modern societies began to process foods, we began to see more nutritional problems. Beriberi, for example, came from polishing rice, which resulted in removing B vitamins. Other processed foods became problematic because they had too much of particular substances, sodium being the most notorious, found in high levels in nearly every imaginable processed food, from canned soups to potato chips.
Pollan has few kind words for sugar, incorporated into all kinds of foods and beverages. Pollan warns about “metabolic syndrome,” currently a catch-all term used to refer to a breakdown of different body systems as our metabolic processes go awry partly from the overloading of sugar in the body.
Pollan describes how the food industry thrives on nutritionism, selling their products with all kinds of claims about the ingredients. The irony is that food processing often means a removal of important nutrients, which are then put back into the product, together with a label and ads proclaiming the benefits of this “fortification.” Just this morning, I saw a brand of drinking water being advertised as being packed with vitamins!
The result, Pollan writes, is that we are no longer eating food, but “food-like substances.” I thought of our own instant noodles as an example of “food-like substances,” ironically given the blessings of the Department of Health if the products are “fortified” by iron or other nutrients, never mind that the country is being turned into a Noodles Republic of malnourished children (and adults).
Orthorexics
Pollan sees the importance of nutritional research, and believes there are uses for nutritional supplementation, including the use of vitamins. The problem with nutritionism is that we fool ourselves into thinking that we are using science to solve our problems. Nutritionism is bad science and taken to an extreme, it leads to “orthorexics,” which Pollan defines as “people with an unhealthy obsession with healthy eating.”
Unfortunately, orthorexia is fanned by a combination of commercialism (including very deceptive advertising) and science itself. At the beginning of today’s article I referred to the confusing news items about the benefits and dangers of certain foods, which are often based on studies published in scientific journals.
Since I teach research at the University of the Philippines, I particularly appreciated Pollan’s discussion of the flaws in the famous Women’s Health Initiative, also known as the Nurses’ Study, which has been following almost 50,000 American nurses for several years now to establish correlations between their health and their lifestyles.
Diet is a major part of the research, with all kinds of findings claiming health benefits from certain foods, but Pollan raises important questions about how reliable the research is. He gives examples from the food frequency questionnaire used in the study to show how difficult it is to get responses. For example, there is this question: “Did you eat chicken or turkey during the last three months?” If the answer is yes, the respondent then has to answer other questions: “When you ate chicken or turkey, how often did you eat the skin?” and “Did you usually choose light meat, dark meat, both?”
Pollan interviewed Gladys Block, a well known epidemiologist who developed the food frequency questionnaire, with Block herself commenting that nutrition science “has led us astray,” with its “over-interpretation of the data” from these questionnaires. Block said the questionnaires were meant only to rank people with their relative consumption (i.e., in relation to other people) rather than coming up with exact consumption figures.
As a medical anthropologist, I’ve repeatedly warned my students about this danger of over-reliance on surveys like the Women’s Study. Public opinion (e.g., Do you approve of the performance of President Gloria Gloria Macapagal-Arroyo?) is fairly easy to measure; diet, nutrition and health are far more complicated.
It’s not surprising that nutritionists talk about phenomena like the “French paradox,” referring to the French (and Italians, and Mediterranean cultures) diet whose foods seem unhealthy if you look at them purely as chemicals and substances but who are relatively healthy. Again, nutritionists have tried to identify the “secret” substances, from olive oil to red wine and even foie gras (goose liver) while other scientists wonder if it’s not just what you eat but how you eat it: The French and the Italians enjoy their food, eating slowly, in good company and good spirits.
Pollan quotes Marlon Nestlé, a nutritionist: “The problem with nutrient-by-nutrient nutrition science is that it takes the nutrient out of the context of the food, the food out of the context of the diet, and the diet out of the context of lifestyle.”
It’s time our Food and Nutrition Research Institute, or the Philippine Council for Health Research and Development, looked for new directions in nutritional research, going beyond nutrients and looking at how food impact culture and people.
|
