David Freedman's recent article in the Atlantic, "How Junk Food Can End Obesity," has attracted a lot of eyeballs, including many belonging to my colleagues and correspondents. Quite a few of these have encouraged me to react, so reacting I am.
First, I like David Freedman. Professionally, he is a very smart guy; a thoughtful, careful, but open-minded journalist; and an excellent writer. I have enjoyed many of his pieces over the years. And, from my limited personal interaction with him, he seems like a genuinely good guy into the bargain. So while I disagree with Mr. Freedman in this instance, I am not inclined toward any kind of ad hominem attack.
The column in question runs to well over 10,000 words. But just as Michael Pollan's 13,000 word manifesto in the New York Times Magazine on "nutritionism" is handily distilled down to "eat food, not too much, mostly plants" -- so, too, can Mr. Freedman's thesis be repackaged to fit in a nut shell: "Processed food is here to stay, so we are better off making it a part of the solution than maligning it." Perhaps Mr. Freedman could summarize it better himself -- but he's not here, so let's run with what we've got.
I actually see the good, as well as the bad, in this position, and will address each in turn. Then, rather than end with the ugliness of discord, I will presume to suggest what Mr. Freedman "meant" to say. There is, I think, a beautiful opportunity hiding here. If Mr. Freedman disagrees with my aspirational tinkering, he will be at liberty to post his rebuttal. My impression, though, is that once past the provocative headline, Mr. Freedman's view is reasonably moderate, and moderately reasonable -- just like my own!
First, here is what's good about the Freedman Junk Food Thesis (FJFT):
There is such a thing as a better chip. And, frankly, sometimes nothing but a chip will do. It's all well and good that spinach is very good for us, but it's not of much use when it's time to dip into the salsa, hummus, or guacamole. I admit it: From time to time, I eat chips -- and I like it!
But I eat only very good chips -- and that, I think, is part of what the FJFT implies: We can improve diet and health using the very foods we already know and love. I agree with this quite emphatically, and not based solely on opinion, personal practice, or even 20 years of clinical experience. My support for this concept is evidence-based. We have abundant real-world stories of dramatic effects -- including the loss of over 100 pounds -- attributable wholly, or at least mostly, to the nutritional profiling system I helped develop, which enables people to identify and choose more nutritious options in any given food category, including chips, at a glance.
We have, as well, the results of a Harvard study of the same system in over 100,000 people showing that when food choices are better in general, they add up to a better diet, which in turn adds up to lower rates of chronic disease, obesity, and premature death.
Another part of Mr. Freedman's platform that is, in my opinion, good, is the anti-elitist plank. We can tell people to eat real food and call it a day, but most foods most Americans eat come in bags, boxes, bottles, jars and cans. Like it or not, that's the reality -- and public health practice that ignores the reality it is attempting to ameliorate is off to the races with a self-inflicted bullet hole in each foot. We have been advising people to eat more fruits and vegetables for decades and have precious little to show for it.
And while money figures in this, it is not the only barrier. There are many reasons why people don't eat more fruits and vegetables -- and we will need to overcome them all to make meaningful progress. As for price and food choices in general, it is in large part urban legend that more nutritious foods cost more. Sometimes they do, often they don't. The real problem is that most people lack the skill-power to identify the more nutritious foods in the first place. That's a problem we can fix.
What's bad, in my view, with the FJFT, is that junk food is, by its very definition, not good for us. If it tasted good, and were good for us, what basis would there be to call it junk? So Mr. Freedman's position -- or at least his headline (which, by the way, may have been crafted by an editor rather than the author -- that is often the case) is coy, or cagey, or willfully disingenuous. Junk food CANNOT help solve health problems, because as soon as it does so, it's no longer junk food.
Junk should never have been a food group in the first place! How we ever let it become one is a mystery that redounds to our collective shame. We would not build cars or computers or phones out of junk but seem to sanction using just such construction material for the growing bodies of our sons and daughters, grandsons and granddaughters. Truly, that is a travesty of modern culture, and a blight on the body politic.
Anything done to "improve" junk food that does not remove it entirely from the category of junk food is the dietary equivalent of putting lipstick on that proverbial pig. Throwing nutrients into a vat of glow-in-the-dark gloop does not exonerate the gloop. That is the ominous threat insinuated by the FJFT, and the reason I must oppose it: It puts a foot on the slippery slope that leads to the exoneration of nutrient-fortified gloop.
When, and only when, the vat of gloop is redirected to filling potholes or some other useful purpose -- and replaced outright with a mix of wholesome ingredients -- can a food qualify as healthful. But then, as noted, it's no longer junk.
This can be done with almost any kind of food. We can, indeed, have better chips. We can have better cookies, crackers, cereals, and pasta sauces. If they are only a tiny bit better, it won't matter much. But if they are meaningfully better, the net effect across the expanse of food choices we make can add up to something very meaningful indeed -- including, as noted, a much reduced risk for obesity, chronic disease, or premature death. This, I think, is what Mr. Freedman meant to say.
This is where I see a beautiful opportunity in the place of potentially ugly and unproductive discord. We will always eat. Unlike tobacco companies, which can disappear entirely, food companies of one kind or another are here to stay. And so they will either be part of the solution, or part of the problem.
Mr. Freedman is saying -- and I agree -- that they can be part of the solution by providing us better choices. But for that to matter, they will need to be truly better choices -- not another bait-and-fake. We've had more than enough of products that boast of some nutritional virtue on the front, while revealing the far homelier whole truth only in fine print. Fat-reduced peanut butter makes noise about being fat-reduced; it stays as quiet as possible about the copious additions of sugar and salt.
We will need to be able to judge overall nutritional quality and not succumb to the perils of "one-nutrient-at-a-time" assessments. And, if they build it, we need to come buy it. We will need to share a taste for salutary change. Building a better chip won't chip away at the junk food problem if we don't choose the better chip. In my view, it will take some creative public-private cooperation to orchestrate a contemporaneous change in the food demand to receive, and reward, a favorable change in the supply. It does no one any good when more nutritious products go down in flames, as most infamously the McLean Deluxe did.
Mr. Freedman and I agree that there is potential to engage the companies that produce our packaged food in efforts to improve diet and health. We agree that we can benefit meaningful by trading up our choices in every aisle of the supermarket. And we agree that big food companies are here to stay.
But while I agree that we can benefit from choosing a better chip, I think it's flaky at best to suggest that junk food will ever be beneficial. It is, in fact, oxymoronic -- give or take the oxy. If a food is good for us, it isn't junk.
Should we be eating more produce? Of course. While waiting for that happy consummation, can we eat better food in packages, and improve our diets and health? Certainly. But "junk food," per se, really needs to go away. Our culture needs to renounce its dependence on junk as a prominent construction material for the up and coming cohort of Homo sapiens -- because it's dragging them down. As long as food remains characterizable as junk, the notion that it can do our health any favors is, in a word, bunk.
-fin
Dr. David L. Katz: http://www.davidkatzmd.com/
http://www.facebook.com/pages/Dr-David-L-Katz/114690721876253
http://twitter.com/DrDavidKatz
http://www.linkedin.com/pub/david-l-katz-md-mph/7/866/479/
For more by David Katz, M.D., click here.
For more health news, click here.