Blog | Tuesday, January 24, 2017

Feeding people, and democracy, to death

As a physician, and a specialist in disease prevention and health promotion, I have long been nothing less than sickened by the unending flow of misinformation about food. My job is protecting the health of people, and misinformation about diet and health is toxic to them. It makes me figuratively sick because it makes so many actually sick.

Diet is profoundly important to every aspect of health. When bad, diet is a major contributor to chronic disease, disability, and premature death, to say nothing of comparably ghastly impacts on every aspect of planetary health. When optimal, diet is a major contributor to both vitality and longevity, and fortuitously, to sustainable food systems, climate stabilization, preservation of aquifers, and the protection of biodiversity, too.

The prospect of such benefits, however, is perennially threatened by the unending deluge of diverting alternatives to fundamental truths about healthful, sustainable dietary patterns. The truth competes endlessly with everything from marketing hype to outright lies, false promises to propaganda.

I spend a lot of time wrestling with the forces that converge where information and misinformation about diet and health come together. Over the past 20 years or so, I have authored three editions of a nutrition textbook for medical education and practice, the principal purpose of which is to differentiate what we know and should apply to patient care from all the rest. A few years ago, I was asked to write a review article on much the same topic. Similar efforts populate these very columns.

And, of course, this very matter has been germane to the care of my patients all these years, to the health promotion programming my lab has developed, and to the basic care and feeding of my own family. Since just about everybody eats just about every day, differentiating between dietary sense and nonsense is the furthest thing from a theoretical exercise. It is practical, up close, hands on, and personal. In my family's case, thanks to my wife, we've made our own conclusions about the matter accessible to everyone else, too.

Feeding people well, in other words, depends a lot on reliable information. It depends on truth.

Lately, we've all had a reminder that exactly the same pertains to feeding democracy well. Democracy, too, thrives on truth, and sickens on propaganda.

We are all bearing witness to this now, as each day brings new revelations about fake news, social media distortions, echo chambers, and most ominously, the intercession of a foreign power in the sanctity of our election process, and thus our very sovereignty.

For reasons best expressed by Bertrand Russell, it may often be easier to sell lies than truth. However much we may value popularity, it correlates very inconsistently with credibility.

This is pretty dire, no matter our party or native preferences. We've all been told that propaganda is toxic to democracy by no lesser source than the Founding Fathers.

The Second Amendment, whatever its merits, is, inarguably, second. Something else comes before it, because something else is presumably even more important, and that something else is truth. The First Amendment protects the freedoms of speech and the press, and it's not likely to be an accident that the Founders gave it primacy.

Of course, there's a bit of a conundrum here. The unfettered flow of information allows for the unfettered flow of misinformation, too. The best defense against that is not the law, but sense the Founders may have hoped would be more common than it proves to be.

The Founders, and our Constitution, tell us just how toxic propaganda can be: it is the number one threat to the viability of our democracy. In this modern age, I believe it is the number one threat to our personal vitality as well. I am far from alone. Even the National Institutes of Health, in developing a strategic plan to guide all of its nutrition research, includes the distinction between what we know reliably from all the rest among its priorities.

The fundamentals of diet for the promotion of human health really are very clear to just about everyone not actively involved in marketing alternatives. Yes, of course calories do count. Yes, of course, an absurd excess of sugar is bad for us. No, of course added sugar isn't the ‘one thing’ wrong with our diets, any more than saturated fat ever was. No, we will never get good answers to silly questions about diet. Yes, we can beneficially customize diets for health, and weight loss, but only in the context of fundamental truths that pertain to us as a species, all but universally.

I have previously lamented that whatever the respective toxicities of bad carbs and bad fats, the ingestion of nonsense about diet by gullible masses is far worse than either. Propaganda is the real poison. As it turns out, it is now a fixture in both our diets and our politics. That leaves me worried as doctor and citizen alike. We are seemingly inclined to look on passively as both we the people, and our democracy, are fed to death on much the same diet.