I needn't belabor the news that Paula Deen, a celebrity chef on TV (that was news to me; nobody tells me anything...) "came out" with her Type 2 diabetes. Paula Deen's cooking has apparently long been a study in Southern-style indulgence, with an emphasis on the deep fryer and plenty of butter. From what I have gleaned, Ms. Deen has never met a nutrition fact she didn't like to ignore.
But I'm not inclined to wag a finger at Ms. Deen. Nor do I want to wade into the debate about her advocacy for a particular diabetes drug to treat a condition she need not have developed in the first place.
I want simply to talk about the opportunity to love food that loves us back, and the fundamental importance of making that the prevailing norm.
First, food matters. We have incontrovertible evidence, reaffirmed many times over the past several decades, that the major determinants of premature mortality and chronic morbidity in modern society are tobacco use, dietary pattern and physical activity. Or, as I like to put it -- feet, forks and fingers.
We have clear evidence that even moderate improvements of diet and activity can prevent Type 2 diabetes in nearly 60 percent of high-risk adults, and evidence that more fundamental improvements to lifestyle could prevent almost all of it -- and certainly more than 90 percent. We know that children now get Type 2 diabetes, while a generation ago it was called "adult onset" diabetes, because the condition in children was essentially unheard of.
We know that diet can be and often is the difference between good health, and ill health. This is not controversial.
The trouble is, we have propagated the view that we have to choose between food we love, and health we love. And since food provides immediate gratification, while good health is a long-term return on a long-term investment, the immediate gratification of food tends to prevail. We eat, drink and make merry -- and defer worrying about the cost. But the cost eventually comes due -- all too often in the form of a serious chronic disease that need not have occurred.
As chronic diseases develop at ever younger age, while we live to ever older -- the percentage of our lives encumbered by that "cost" is rising. And, consequently, so is the cost itself. We pay dearly.
In essence, then, we are mortgaging our health to pay for the pleasure of our palate. This may be hard to justify under any circumstances. But there would, at least, be a case to be made if the only way to enjoy food were to give up health. If the only food that tasted good were bad for us, we would have a tough decision to make. And some might say -- to hell with health! They might come to regret it, but we could all understand the choice.
But there is no such choice to be made. There are variations on the theme of optimal eating available to us all. Among them is the Mediterranean diet, which is itself a dietary theme and parent to a number of variations. Important about them all is this: Many of us would go to Mediterranean countries and gladly spend our good money on the excellent food! Not because the food is good for us -- but because it's just plain good!
But it is also good for us. It offers us the opportunity to love food that loves us back. To get pleasure in the pursuit of health, and health in the pursuit of pleasure. The Mediterranean diet offers this -- and so do many other cuisines around the globe. Whatever your palate, there is room for you where culinary pleasure and health converge.
Given this possibility, why practice the brand of denial that seems to prevail? Those of us who advocate for healthful eating need not be culinary cretins. My wife, raised in southern France, is a fabulous cook. Catherine and I, and our kids -- love good food. We just love food that loves us back.
And chefs need not fry butter to show they care about cuisine. In an age of epidemic obesity and diabetes, chefs can shoulder the responsibility of making food that is both good, and good for us.
An analogy springs to mind. Cars can have incredible horsepower. They can also have great fuel efficiency. There was a time when great horsepower at the expense of lousy fuel efficiency was fine. But we now know the costs of that profligacy -- monetary costs, and more importantly, environmental costs. We are now inclined to demand both fuel economy and performance, or strike a balance between the two. But the world no longer condones a "to hell with fuel efficiency" attitude, because the stakes are too high.
I suppose you might watch a car race for fun (I don't get that, actually, but different strokes...), but in doing so, you generally aren't planning on getting that kind of car, or driving that way. Car racing is not intended as an audience-participation experience. If cooking shows were a similar diversion, it might not matter much what the chefs are cooking. But if, as seems probable, the intent is "go ahead and try this at home!" -- then what's cookin' truly does matter.
The stakes are every bit as high in our kitchens, as in our garages. Our health, the health of those we love -- is on the line. So maybe it's time for us all to draw a line in the sand and not cross. Chefs who can't make food both good and good for us don't really have enough expertise to warrant our attention. They don't have the full culinary skill set modern living requires. We should tune them out.
Pretending that food doesn't matter to health is at best denial, at worst a serious delusion. We should not mortgage health to pay for culinary delight, any more than we should give up culinary pleasure to purchase health. We can love food that loves us back.
Bring on the chefs talented enough and responsible enough to help us bake that particular cake, and eat it, too!
For more by David Katz, M.D., click here.
For more on diet and nutrition, click here.
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