Choose food over nutrients

The CDC recently release their Second National Report on Biochemical Indicators of Diet and Nutrition.  Distilled from 495 pages of detailed data and explanations, the current message being broadcasted in the media is that the "U.S. population has good levels of vitamins A and D and folate."

My first reaction?  Of course Americans have good levels of vitamins A and D and folate!  We drink gallons of milk (which is fortified with vitamins A and D), and eat copious quantities of refined grain products (which are fortified with folic acid).

Fact: The FDA mandated that, starting in January 1998, all enriched flour be fortified with folic acid.  This mandatory fortification, which includes foods like enriched bread, flour, cornmeal, rice, pasta, cookies, cakes, crackers and snack foods, was implemented to reduce the number of brain and neural tube defects (like anencephaly and spina bifida) in newborn babies.  These defects are more likely to occur when mothers consume less than 400 micrograms of folic acid a day.

And fortification has worked: the rate of birth defects due to folate deficiency has declined since 1998.  Hooray for governments that treat the entire population instead of just targeting the group at risk!  Right?

Um.  Maybe not.

While I am glad that our government health organizations (CDC, FDA, USDA) have helped decreased the rate of certain deficiency diseases, it seems that this approach has not been ideal for the prevention of chronic diseases, not to mention the promotion of optimum health.

For example, the recommended dietary allowance (RDA) of vitamin C -- 90 mg/day for adult men and 75 mg/day for adult women -- is based on the prevention of survey, a disease that occurred most frequently in the early part of the second millennium (1400's to 1700's) among sailors on seafaring ships who did not have access to fresh fruits or vegetables for months at a time.  Symptoms of scurvy include general weakness, anemia, gum disease, and skin hemorrhages.

Human beings are one of the few animals who cannot synthesize vitamin C from glucose and, therefore, must eat foods to obtain it.  Good sources of vitamin C include a medium orange (51 mg), a small grapefruit (39 mg), a raw sweet red pepper (94 mg), and a small papaya (95 mg).

Today, survey is most frequently seen in elderly people and alcoholics.  In other words, people who exist on a diet devoid of fresh fruits and vegetables.  Hardly a diet to promote optimum health.

I wonder, when the CDC measures the levels of our biochemical indicators, are they basing the results on the RDAs?  Are the reports really proclaiming "Hooray, most people have enough serum vitamin C to avoid scurvy!?"

I hope not.

I worry that, in an age of nutritionism (thank you to Gyorgis Scrinis, via Michael Pollan, for the new term!) we are so focused on getting enough of each particular nutrient, that we forget to eat real food.  A processed food that has been enriched with the latest "wonder nutrient" is much more attractive to the average American consumer than an apple sitting quietly in the produce section with no Nutrition Facts label to boast how much fiber it contains and no packaging to brag about the various phytonutrients inside.  When, in fact, most processed food has been stripped of its original wholesomeness and filled and coated with FDA-approved adulterants: sugar, salt, fats and chemical additives.

What am I getting at?  Maybe if Americans started eating real food again, the government would not have to mandate the fortification of processed food and then congratulate themselves when they find a measureable increase in serum levels.  Yes, levels of vitamins A and D and folate are up, but so is the incidence of diabetes and obesity.  This is a big disconnect for me.  I wonder, how can we be so happy that serum levels of specific nutrients relevant are good when the health of the overall body is so lacking?

I predict that if Americans made therapeutic lifestyle changes (i.e. exercised more) and started eating a whole foods diet, the rates of chronic diseases would plummet (as Dean Ornish and Mark Hyman have both shown)...and the need for fortification would be nil.