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401 pages, Kindle Edition
First published May 7, 2019
Some diet gurus tell us to beware all grains; others tell us that we should fear supposedly 'acid-producing' foods ranging from dairy to meat and coffee. These new diets are perhaps best seen as a dysfunctional response to a still more dysfunctional food supply: a false promise of purity in a toxic world.. But actually our food may not be that unhealthy, heart disease and stroke have gone down enormously since the beginning of the 20th C and since 1963, the peak year for coronary disease mortality in the US, has declined tto the extent that "621,000 fewer deaths occurred from coronary heart disease than would have been expected had the rate remained at its 1963 peak".
Age-adjusted death rates for stroke have declined steadily since the beginning of the century. Since 1950, stroke rates have declined 70%, from 88.8 in 1950 to 26.5 in 1996. Total age-adjusted CVD death rates have declined 60% since 1950 and accounted for approximately 73% of the decline in all causes of deaths during the same period. CDCThe consumption of saturated fat and cholesterol has declined (since a height of 1909), cigarette smoking has declined from 42% to 16% and mean blood pressure in the population has declined. The number of people who have hypertension being treated successfully has increased and there have been many effective advances in diagnosing and treating heart disease and stroke and the underlying conditions. This isn't to say there aren't health challenges from dietary causes, but it is saying that overall our diet has improved and we are healthier and living longer!
“The story of modern cooking is not a simple tale of decline but a more complex and hopeful one. When we say that ‘no one cooks any more’ we often have in mind a particular version of home cooking that depended on women being confined to a life of unpaid labour. By contrast, the new cooking of our times is done by a wider range of people in a wider range of ways.”(284)
“We speak of having better food choices, but for the most part, we eat the foods that food companies want to sell us.”
“As things stand, our culture is far too critical of the individuals who eat junk foods and not critical enough about the corporations that profit from selling them. We spend a lot of time discussing unhealthy foods in terms of individual guilt and willpower and not enough looking at the morality of big food companies that have targeted some of the poorest consumers in the world with products that will make them sick, or the governments that allowed them to do so.”
I picked this up after reading an Atlantic article discussing it and a few related titles. I was disappointed, mostly because Wilson's comments about how we should eat are uninformed. This book is really just an extended opinion piece rather than an evidence-based assessment of what is wrong with our food system and our diets. To be fair, Wilson isn't a nutritionist and doesn't pretend to be, and her goal is to make sweeping statements about the global food system. And she does helpfully point out the perniciousness of the spread of processed foods and oils.
But she makes a lot of wrongheaded statements. Though some are couched as opinions, they still come across as if they are based on evidence (though they are not). For instance, she says (p. 214):
To me, eating more vegetarian meals—but not exclusively so—feels like a pragmatic path through the jungle of modern food options. . . . 'Only buy the best meat you can afford, grass-fed for preference,' say a host of experts on ethical eating. [No source cited!] . . . For me, the best compromise has been to make meat a smaller element than it used to be in my family's eating without eliminating it altogether.
First, a lot of experts on "ethical eating" would say eating animals is unethical. And setting ethics aside, meat is unhealthy, period. Read How Not to Die by Michael Greger or Dean Ornish's work or the work of Neal Barnard and the Physician's Committee for Responsible Medicine and you will realize that the best science shows that meat, dairy, and eggs promote a host of illnesses and have no dietary upside. So reducing meat is better than not doing so—but eliminating it is even better. Wilson, however, implies that eating some meat is somehow preferable to being vegan, and that is simply not true.
To take another example, in the epilogue where she does actually give diet advice, she says (pp. 300-01):
For most of us, a less meat or less sugar diet is easier to achieve than one without any meat or sugar at all. . . . What does a healthy pattern of eating look like? Many nutritionists advocate the Mediterranean diet, consisting of olive oil, fish, nuts, vegetables, legumes, and fruits. Others prefer the newer concept of a Nordic diet, a sustainable way of eating rich in berries and dark grains such as rye, barley, and oats; rapeseed oil; and oily fish such as herring and salmon. But those of us who live neither in the Mediterranean nor [in] Scandinavia may have to invent our own patterns of eating. Fumiaki Imamura told me that since moving to the United States and Britain from Japan, he had asked many people what a healthy local diet looked like 'and no one has been able to answer me.' The fact that no one can yet identify a healthy American diet is worrying, but you could also see it as an opportunity. The future of our diets is a blank slate on which we are free to write our own rules.
This is really a pernicious and wrongheaded message. First, so what if it's "easier" to reduce meat and sugar than to eliminate it? No kidding! It's also easier to eat fast food than to cook a meal. I don't need a journalist to tell me it's easier to do the unhealthy thing than the healthy thing.
More important, Wilson should not be perpetuating the myth that nutrition is some confusing, trackless wilderness that we must get through based on our intuition. It is simply not true that "no one can yet identify a healthy American diet." And of course, diets are a "blank slate" only if you don't care what science tells us about what we should be eating. Science tells us to eat a whole-food plant-based diet, with minimal (or no) refined oils and sugar. Science does not tell us that we should be eating oil or fish. Again, the work of Neal Barnard and the Physician's Committee on Responsible Medicine is helpful here, and he has a great short video explaining that a vegan diet is healthier than the Mediterranean diet.
In short, though some aspects of this book are useful, much of the information in it is just intuition, sentiment, and guesswork, and some of it is flat wrong. I think the wrong information outweighs what is useful, and I do not recommend it.