Is the Standard American Diet really making us sick?
/In my clinical practice and life experiences, I’ve found one thing to be true: the Standard American Diet (SAD) is a destructive industry of excess, convenience and apathy. It’s at the root of chronic diseases, and our medical professionals work hard to diagnose and prescribe medications for diseases that are preventable with a different diet – a more natural diet. If you’re thinking we need a different lifestyle, too, you’re right. Consuming foods we were designed to eat will, inevitably, change a person’s lifestyle.
What is the Standard American Diet (SAD), anyway? Simply look around at food options that are “standard” across our country, advertising our culture of distractions, accessibility, affordability and prioritizing business over wellbeing. Every small town boasts a Subway, McDonald’s, Domino’s, Chick Fil’A, Starbuck’s and other fast-food, chain restaurants. People are actually excited for In-N-Out to open in Idaho. Yet foods on these menus are high in refined carbohydrates (white flours and sugars), preservatives, additives, dyes, salts, calories and saturated fats including, until recently, trans fats from partially hydrogenated oils1 (now banned from our food system2).
Americans spend less money at the grocery stores versus eating out3. What are we buying? More than 30% of our purchases at grocery stores are “dry goods”, though that doesn’t tell us much. About 70% of the average 31,795 items in grocery stores are processed or ultra-processed foods3,4 – shelf-stable packages of cereals, crackers, cookies, chips, candy, snacks and sodas full of (guess what?) refined carbohydrates, preservatives, additives, dyes and excessive salts, sugars and calories. The “dry” goods. However, we’re also buying processed meats (Lunchables, cured deli meats, chicken strips), dairy-like foods (sprinkled “yogurt” marketed to kids, creamers and non-dairy beverages), “baked” goods (donuts, croissants, cookies), frozen meals (fish sticks, prepared foods), plus energy drinks, seasonal treats, and alcohol.
For decades, we were told to blame America’s poor health on salt, fat and sugar. Yes, an excess of these foods is problematic, but are they the main contributor to poor health? Turns out, the culprit in SAD is ultra-processed foods, which our bodies no longer recognize and which scientific researchers are finally determining make us sick.
In January, I read an article called, “Why is the American diet so deadly” in which researcher Kevin Hall identified a key problem in American’s “uniquely poor health”: industrial techniques and chemical modifications5. This clarification echoes what I’ve learned, know and teach: focusing on individual parts of a food, like sugar, fat or salt doesn’t describe an underlying health problem because, well, sugars, fats and salts are normal components of real food. (Think apples, avocados, seaweed.) Rather, the processing of foods is another factor, entirely.
So, what are ultra-processed foods, exactly? In 2009, Carlos Montiero, a Brazilian doctor, defined a food as ultra-processed when it’s “refined, bleached, hydrogenated, fractionated, or extruded—in other words, when whole foods are broken into components or otherwise chemically modified. If you can’t make it with equipment and ingredients in your home kitchen, it’s probably ultra-processed5.”
Yet it’s more complicated than that, because many processed foods, like olive oil, yogurt and ravioli, are made in a processing plant and most people don’t have the equipment (let alone skills, time, ingredients or interest) in making these foods at home. Certain ways of processing limit unnecessary ingredients, thereby rendering these convenience foods, um, healthier? The verdict is still out because it’s complicated. As such, Marion Nestle, an acclaimed molecular biologist and nutritionist, adds that an ultra-processed food also “has…the purpose of replacing real food . . . and, usually, (has) to be loaded with additives5.”
Nevertheless, ultra-processed foods have been studied in scientific settings for less than a couple of decades, and the findings about whether they contribute to chronic diseases that plague Americans are mixed. These studies are difficult to conduct, with many variables, yet it seems that people eating a diet high in ultra-processed foods that both tasted good and are calorie-dense tend to eat about 1000 more calories per day than on a minimally processed diet5. Similarly, people who ate ultra-processed foods that were neither calorie-dense nor tasted good ate about the same as when on a minimally processed diet – and lost weight5. Hm. Notably, that study was small (18 people) and short (4 weeks)5. Yet a survey of 200,000+ people using dietary recall concluded that sugary soda and processed meats increased risk of cardiovascular disease, while breads and cereals, certain dairy products and savory snacks decreased risk of cardiovascular disease (notably, of just one of the many diseases plaguing Americans)5. Another conundrum.
Additional studies are linking high intakes of fats and refined sugars, common to the Standard American Diet, to obesity, elevated blood sugar and lower levels of brain-derived neurotrophic factor (BDNF)4. Reduced levels of BDNF are linked to neurological declines like depression7, poor learning and memory; metabolic imbalances like energy regulation and appetite control6; and neurodegenerative diseases like epilepsy, Parkinson’s, Alzheimer’s, multiple sclerosis and stroke7. Herein lies a few links between the SAD, altered metabolism and various chronic diseases from imbalanced caloric density, food excess5 and malnutrition from consuming ultra-processed foods6.
Our government itself may contribute our nation’s obesity, diabetes, heart disease and chronic disease epidemics, having subsidized commodity foods, modified farming for mass production, and turned American crops into ultra-processed, shelf-stable, nutrient-poor and calorically dense food-like substances that have become unrecognizable by the human body. For decades, the Dietary Guidelines for America have promoted foods for people on a time and financial budget, thereby promoting the SAD. Is there a connection worth studying? Probably.
Professor and author, Alan Levinovitz, says “the answer is staring us in the face” – our food habits (eating ubiquitous, cheap, delicious, calorie-dense foods) is directly related to health outcomes (weight gain, a major factor in many chronic disease). In other words, the proof is in the pudding.
References
1. https://www.ncbi.nlm.nih.gov/books/NBK209844/
2. https://www.fda.gov/food/food-additives-petitions/trans-fat
3. https://www.fmi.org/our-research/food-industry-facts
6. https://pmc.ncbi.nlm.nih.gov/articles/PMC6170050/
7. https://pmc.ncbi.nlm.nih.gov/articles/PMC8820686/
Links:
· Read, “Why is the American diet so deadly?” in the New Yorker
· For guidance in understanding your personalized nutrition needs, contact Jamie HERE.
Jamie Truppi, MS, CNS, is a functional nutritionist, author, food writer, edible educator and mama to two beautiful children. You can purchase her book "Clean Food, Messy Life" locally at Iconoclast Books in Hailey or HERE. Follow her on Facebook and Instagram. Visit jamietruppinutrition.com for more information.