The nutrition counterculture

When we look back over our American nutritional history over the last 50 years, it's hard not to come to the conclusion that much of the innovation in nutrition did not come from official agencies like the Food and Nutrition Board of the Institute of Medicine, the National Academy of Sciences, the FDA, the USDA, or the AMA.

Instead, it came from the popular culture. It came from bold, extravagant claims made by maverick figures like Ancel Keys, Nathan Pritikin, Dean Ornish, and Robert Atkins. Of course, some ideas have now fallen by the wayside, dismissed in a broad American "experiment" as ineffective, impractical, or kooky. But it permitted experimentation on an extraordinary scale with millions of people following a particular strategy at a time.

The advice of the official agencies tended to be reactionary. When nutritional deficiencies (remember those?) of the early 1900s were prevalent, they issued advice on food choices to help alleviate deficiencies. When deficiency transformed into excess after World War II, "smart" food choices from food groups and "sensible eating" became the theme.

Unfortunately, the advice was always adulterated by the enormous influence of various special interests, anxious to protect their national franchise. Powerful groups like the meat industry, wheat producers, and the dairy industry all made sure they had a big hand in crafting and influencing what was told to the American people.

The result: the advice offered by official groups has always represented the compromise of what some agency wished to convey to the people and the very powerful input of industry. What if the government decided to advise us what automobile to buy? Imagine the uproar in the auto industry when Washington tells us to buy Toyota for fuel economy and reliability. How long would that advice last?

That's why almost no knowledgeable adult follows the advice of the USDA, the National Academy of Sciences, or the Food Pyramid. I believe that we all intuitively recognize that the advice is watered-down, sometimes silly, sometimes downright unhealthy.

Nonetheless, the national experiment in diet that has taken place since 1950 has led to a collective wisdom of what is good and what is bad. The most productive conversations on nutrition therefore take place outside of the USDA and Washington. It occurs, instead, in places like bookstores, websites, and the media. Of course, there's lots of misinformation and profiteering in these sectors, as well. But like the enormous force unleashed by the collective wisdom of those contributing to the Wikipedia phemonenon, we've zig-zagged to something closer to the truth than ever uttered by an official agency.

Comments (2) -

  • JT

    6/25/2007 2:18:00 AM |

    Nice post.  The New York Times writer Thomas Friedman said it well I thought when he titled his last book, The World is Flat.  With easier access to information - in particular due to the internet - knowledge is no longer held by just a few.  New ideas to solving problems can be distributed like never before - and I am thankful for that as it has allowed me to discover your book and ideas.      

    While this post isn't so much about nutrition maverick figures, thought to mention one figure that was left out, Dr. Barry Sears and his many best selling books titled The Zone.    
    Dr Davis, since you are an author too, thought you might enjoy this somewhat fortunate and humorous story on how Dr. Sears became an author.  

    My family and I knew Dr. Sears several years before he became a best seller author.  Originally Barry and his brother Doug were small businessmen selling health food products.  In particular Barry was known for helping begin the borage and primrose oil business.  Later I remember the two Sears brothers sold nutrition bars that were low in sugar and high in chromium for weight loss.  He would send my parents big boxes of the bars and they just loved them.    

    Barry though never was much of a businessman.  His heart seemed to be into science and research and not running a company.  

    One day the poor business practices caught up with the Sears.  They were not paying their bills and so companies stopped selling them product.  With out options left Barry wrote the book he always wanted to write, The Zone.  He did not believe his book would sell though - and if it did only a few thousand would be sold locally.  When he found a group to promote the book he asked that his 1-800 # be added to the book so that if a reader had questions he/she could call him personally.      

    Well, the rest is history.  The Zone went on to become a New York Times best seller.  And as Doug Sears told us  - when the book came out they were flat broke, were not able to pay the phone bill  - and the 1-800 phone line would not stop ringing from customers who had read the book. It took awhile before royalties came in.  For awhile the two thought they would have to declare bankruptcy even though they had the best selling book in America and were on the brink of becoming international nutrition celebrities.

  • Dr. Davis

    6/25/2007 12:35:00 PM |

    Wow! Great personal insights.

    I agree. Barry Sears has made a significant contribution to the national conversation on healthy eating. Even though a few years old now, many of the things he said still hold true and remain relevant.

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How can I get my lipoproteins tested?

How can I get my lipoproteins tested?

This question came up on our recent online chat session and comes up frequently in phone calls and e-mails.

If lipoprotein testing is the best way to uncover hidden causes of coronary heart disease, but your doctor is unable, unknowledgeable, or unwilling to help you, then what can you do?

There are several options:

1) Get the names of physicians who will obtain and interpret the test for you. Go to the websites for the three labs that actually perform the lipoprotein tests: www.liposcience.com (NMR); www.berkeleyheartlab.com (electropheresis or GGE); www.atherotech.com (VAP or centrifugation). None of them will provide you with the names of actual physicians. They will provide you with the name of a local representative who will know who the doctors in your area who are well-acquainted with their technology. I prefer this route to just having a representative identify a laboratory in your area where the blood sample can be drawn, because you will still need a physician to interpret the results¾this is crucial. The test is of no use to you unless someone interprets it intelligently and understands the range of treatment possibilities available. Don’t be persuaded by your doctor if he/she agrees to have the blood drawn but has never seen the test before. This will be a waste of your time. That’s like hoping the kid next door can fix your car just because he says he fixed his Mom’s car once. Interpretation of lipoproteins takes time, education, and experience.
2) Seek out a lipidologist. Lipidologists are the new breed of physician who has sought out additional training and certification in lipid and lipoprotein disorders. Sometimes they’re listed in the yellow pages, or you can search online in your area.
3) Contact us. I frankly don’t like doing this because I feel that I can only provide limited information through this method. I provide a written discussion of the implications and choices for treatment with the caveat to discuss them with your doctor, since I can’t provide medical advice without a formal medical relationship. We also charge $75 for the interpretation. But it’s a lot better than nothing.
4) Make do with basic testing. Basic lipids along with a lipoprotein(a), C-reactive protein, fibrinogen, and homocysteine would provide a reasonable facsimile of lipoprotein testing. You’ll still lack small LDL and postprandial (after-eating) information, but you can still do reasonably well if you try to achieve the Track Your Plaque targets of 60-60-60.

In 20 years, this will be a lot easier. But for now, you can still obtain reasonably good results choosing one of the above alternatives.
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Marathoners, triathletes, and heart disease

Marathoners, triathletes, and heart disease

Curious thing: People with lipoprotein(a) gravitate towards elite levels of exercise.

I tell my lipoprotein(a) patients that, if they want to see a lot of other people with lipoprotein(a), go to a marathon or triathlon.

This effect applies more to males than to females, just as the fascination with numbers seems to be confined to men, too. That's why I've posted in past about the "prototypical" lipoprotein(a) male.

I believe this is a big part, perhaps the only, reason why there seems to be a modest increased risk for cardiovascular events despite high exercise levels in marathoners. It has nothing to do with the exercise itself; it has to do with the kind of people who choose to exercise at this level.
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