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The Way To Eat Now

On Monday morning, I woke to the news that the US government agencies USDA and HHS had released their latest dietary guidelines. The emphasis this time seemed to be about reducing our salt intake. On average, Americans consume 3,500 mg of sodium every day. The new guidelines recommend reducing this to at least 2,300 mg per day for the not-at-risk population (at risk of diabetes, high blood pressure, children etc.) and 1,500 mg per day for the at-risk population.

So, how bad are we Americans in our eating ? I liked this graphic from the report.

The USDA and HHS put out these guidelines every five years. This year’s report has been praised for their bluntness compared to the complicated and less accessible reports of the past (not that most of us even read these reports, including the current USDA Secretary, Tom Vilsack, who said that he has never read the report till he got this job). For example, on page 66, they explicitly advocate reducing the amount of pizza and warn that many foods that are labelled “Whole Grain” or “100% Wheat” may not be whole grain at all. One applauded that they explicitly said “fill half your plate with fruits and vegetables” instead of the more vague “eat more vegetables”.

The Unhealthy Ecosystem

Another graphic that I liked from the report is this:

While we may quibble over the size of the individual factor compared to the rest of the factors, the ecosystem we live in is a major contributor to the unhealthy lifestyle that we’re a part of.

By now, many of us know that they cannot just put out scientifically sound advice without facing the wrath of the food industry. I first found out about this via Michael Pollan, a lucid writer and a leading journalist probing behind the malaise of our contemporary eating culture and the unhealthy practices of the American food industry and their effects. In an illuminating and insightful article titled “Unhappy Meals” back in 2007, he wrote the following about a defining moment in the advent of our current eating fad:

No single event marked the shift from eating food to eating nutrients, though in retrospect a little-noticed political dust-up in Washington in 1977 seems to have helped propel American food culture down this dimly lighted path. Responding to an alarming increase in chronic diseases linked to diet — including heart disease, cancer and diabetes — a Senate Select Committee on Nutrition, headed by George McGovern, held hearings on the problem and prepared what by all rights should have been an uncontroversial document called “Dietary Goals for the United States.” The committee learned that while rates of coronary heart disease had soared in America since World War II, other cultures that consumed traditional diets based largely on plants had strikingly low rates of chronic disease. Epidemiologists also had observed that in America during the war years, when meat and dairy products were strictly rationed, the rate of heart disease temporarily plummeted.

Naïvely putting two and two together, the committee drafted a straightforward set of dietary guidelines calling on Americans to cut down on red meat and dairy products. Within weeks a firestorm, emanating from the red-meat and dairy industries, engulfed the committee, and Senator McGovern (who had a great many cattle ranchers among his South Dakota constituents) was forced to beat a retreat. The committee’s recommendations were hastily rewritten. Plain talk about food — the committee had advised Americans to actually “reduce consumption of meat” — was replaced by artful compromise: “Choose meats, poultry and fish that will reduce saturated-fat intake.”

A subtle change in emphasis, you might say, but a world of difference just the same. First, the stark message to “eat less” of a particular food has been deep-sixed; don’t look for it ever again in any official U.S. dietary pronouncement. Second, notice how distinctions between entities as different as fish and beef and chicken have collapsed; those three venerable foods, each representing an entirely different taxonomic class, are now lumped together as delivery systems for a single nutrient. Notice too how the new language exonerates the foods themselves; now the culprit is an obscure, invisible, tasteless — and politically unconnected — substance that may or may not lurk in them called “saturated fat.”

The linguistic capitulation did nothing to rescue McGovern from his blunder; the very next election, in 1980, the beef lobby helped rusticate the three-term senator, sending an unmistakable warning to anyone who would challenge the American diet, and in particular the big chunk of animal protein sitting in the middle of its plate. Henceforth, government dietary guidelines would shun plain talk about whole foods, each of which has its trade association on Capitol Hill, and would instead arrive clothed in scientific euphemism and speaking of nutrients, entities that few Americans really understood but that lack powerful lobbies in Washington. This was precisely the tack taken by the National Academy of Sciences when it issued its landmark report on diet and cancer in 1982. Organized nutrient by nutrient in a way guaranteed to offend no food group, it codified the official new dietary language. Industry and media followed suit, and terms like polyunsaturated, cholesterol, monounsaturated, carbohydrate, fiber, polyphenols, amino acids and carotenes soon colonized much of the cultural space previously occupied by the tangible substance formerly known as food. The Age of Nutritionism had arrived.

And this emphasis on nutrients hasn’t vanished. As Marion Nestle, a professor of Nutrition, Food Studies, and Public Health at NYU notes in her blog:
They still talk about foods (fruits, vegetables, seafood, beans, nuts) when they say “eat more.”  But they switch to nutrient euphemisms  (sodium, solid fats and added sugars) when they mean “eat less.” They say, for example: “limit the consumption of foods that contain refined grains, especially refined grain foods that contain solid fats, added sugars, and sodium.” This requires translation: eat less meat, cake, cookies, sodas, juice drinks, and salty snacks.

In a column on NYT, Mark Bittman provides some other suggestions to change the ecosystem, suggestions such as reducing government subsidies on processed food (what!, I didn’t know we subsidised the manufacture of processed food), subsidising sustainable meat production and farming, taxing unhealthy foods and their advertisements, and enforcing truthful labelling of food products. One of the interesting ideas he lists is the breakup of the USDA and a greater empowerment of FDA. He writes:
Currently, the U.S.D.A. counts among its missions both expanding markets for agricultural products (like corn and soy!) and providing nutrition education.  These goals are at odds with each other; you can’t sell garbage while telling people not to eat it, and we need an agency devoted to encouraging sane  eating.

And The Reactions From The Food Industry

The reactions from the food industry has been predictable. The US Beverage Association has lashed out against the report:
To suggest that Americans ‘drink water instead of sugary drinks’ fails to be grounded in the totality of the science,” Dr. Maureen Storey, senior VP for science policy for the ABA, told just-drinks. “If consumers are seeking ways to reduce caloric intake, our industry provides myriad no-and low-calorie and smaller-portion beverage options, in addition to bottled water. While many consumers may enjoy tap or bottled water, beverages with no- and low-calorie sweeteners are more appealing to others and may in fact help people lose weight or maintain a healthy weight,” Storey added. “This is a position supported by health organisations including the American Dietetic Association.

And the American Salt Institute calls the report “Drastic, Simplistic and Unrealistic”.

But they don’t need to worry. With the emphasis on sodium, I see a future filled with “reduced sodium” versions of products, much like the “carb free” or “sugar free” versions that now hound us. One more choice. And by the way, does “reduced sodium” automatically include reduced sugar or will we have all sorts of combinations of products to choose from. And if you think this is just a spoof, here is what the report in NYT had to say:
David S. Smith, a vice president at Campbell Soup who oversees research and development, said his company was offering reduced-sodium versions of hundreds of its products, in some cases replacing regular salt with smaller amounts of sea salt.”

Other References:

  • Washington Post has an interesting slideshow on the history of the guidelines, specifically the main graphics used to illustrate the recommendations.
  • Marion Nestle’s blog post on the nutrition euphemisms in the report that require translations into actual food for practice.

Ten Miles

On Thursday last, I decided to run ten miles, my longest in a long time. The last time I ran ten miles was over a year and a half ago. I found it appealing to aim for a distance that has two digits. The last time I had run anything close to that distance was back in January, when I ran eight miles, once.

My running has been heading downhill for a long time. The stress of parenting is the most recent excuse. Before that, it was Kitty’s death. But the sudden loss of interest, a runners’ equivalent of a writer’s block, began before Kitty’s death. Its origins remain murky.

Some people find Jesus as they approach middle age. I found running. Unable to conceive a child, we followed a doctor’s advice that I stop biking, not that I biked much. Worried more about gaining weight more than losing shape, I took to the unused treadmill that lay in a room frequented only by Kitty to relieve himself. A couple of months later or so, I ran the first 10K of my life. A few days later, Shanthala told me of a friend of hers who was looking for company in her pain as she trained for a marathon. Shanthala asked me if I wanted to volunteer. I said yes. I don’t know why I said yes. Maybe it was the euphoria of having run a distance that had double digits. Or maybe it was because I was dropped on my head when I was a baby.

To me, running a marathon is akin to climbing a peak. I knew somewhere deep down that I’d never attempt a mountain, at least not one with ice axe, ropes and crampons. I don’t have a death wish. But I did have some deep desire to push myself physically. Marathon provided an out for that desire.

Less than a year later, I had run two marathons, one of them (Big Sur Marathon) considered one of the toughest marathons in the US. I had finished in the top 10% of my age group and in the top 12% overall. A year more and my running resume read as follows: best mile time – 5:40, best 5K – 20 mins, best 10K – 40 mins, 10 miles under 70 minutes and half marathon in 92 minutes. For over two years, I ran a half marathon every weekend. Once, for two weeks, I ran a half marathon every other day. But when it came to running the 10 miles on Thursday, my mind was filled with dread.

Thursday dawned cool and a little cloudy. The nanny was coming and so I was free to run alone. I took my time getting ready to run. I returned phone calls that could have waited. I checked email more times than usual. I did everything possible to delay the inevitable. The strategy had worked well in the past. I would look up at the clock in mock horror, decide that it was too late to run long, run four miles on the treadmill and postpone knowing that I couldn’t really run ten miles, at least not in eighty minutes. But, I had asked the nanny to come early and so even after one more phone call, the clock still showed 10:30. The sun continued to hide. Out of reasons and time, I booted up and headed out the door.

A free application on the iPhone, RunKeeper, showed me the distance, instantaneous speed, average speed and calories burned as I ran. It also tracked my run using Google Maps and produced a final map of my run. I had only the estimated distance of the path I covered during my runs. Now, I would finally know the distances accurately and know what my actual pace had been over so many of the long runs that I had done over this path.

My heart lurched when I hit what I thought was the 1.5 mile mark. The iPhone said that I had only covered about 1.25 miles. And when I hit what I thought was the 2 mile mark, the iPhone said 1.7 miles. So, all this time when I had thought that I had run some really fast paces on this track, they were wrong (my best times at various distances didn’t change as they were run on a different track). Since the trail has mile markers every half mile, I decided to check if the iPhone was accurate. At the real 2 mile mark, the elapsed time was 16 minutes. I winced inwardly. That meant a pace of 8 minutes to a mile. I felt like I was running a decent pace and I had internally hoped that the pace would be just a little faster than the 8 minute pace. I worried that I couldn’t complete ten miles at this pace. As I crossed the next half mile marker, I checked the iPhone. It was measuring the distance correctly. I couldn’t doubt its clock. I was face to face with the primary reason I had avoided running this distance.

Three years back, I added biking to my workout and started biking extensively. But my prowess at running didn’t transfer to my biking. While hardly anybody overtakes me while I’m running, just about everybody overtakes me when I bike. Biking in addition to running tired my legs and one day, I woke up to find that running even a mile exhausted me. I had overtrained. I cut back on my biking and running.

I was running alone all this time. Occasionally, someone would join me for a short run, but that was rare. At home, I ran the same trail because I didn’t want to use the car to get anywhere to run. With no specific goals to aim for and my running having levelled off, crunching down the same path thrice a week, alone, probably began to demotivate me. Then, Kitty died. Nine months later, Maya was born. And my running never recovered. I had internally set myself a pace of 8 minute mile as an indicator of my fitness level. If I ran slower than that, mentally I considered myself finished. I began to fear running distances that showed me that I was finished.

As I continued my run on Thursday, the day continued to remain cool. There are a few highway overpasses and underpasses on the trail, but the trail is flat otherwise (RunKeeper says that the total elevation gain for the distance is 217 feet). As I approached the three mile marker, I saw the clock register 23 minutes and felt a little better. What I had thought of as the 3.5 mile mark was only the 3.2 mile mark. So, all this time when I thought that I was running 7 miles, I was actually running only 6.4. I typically do an out and back run and so deciding the midpoint was important. I began to have doubts if I’d complete 10 miles. I didn’t want to run 5 miles one way only to find that I had to walk (or worse limp) at the end.

At my peak, I’d run three, sometimes four, times a week. One run was what was called threshold training, one was interval training and one was a long run. When I threw biking into the mix, I couldn’t sustain the three runs and bike. So, I began to cut back my running. I figured that I’d let biking pick up a bit before I went back to my running regimen. But, not only had I overtrained, I had also upset my training rhythm.

I had been a couch potato till I married and even after then, my exercise was limited to hiking on weekends. When I started running regularly, I had to force myself out the door for a long time. I had to fight hard to overcome my old habits. Running a marathon was a simple and straight goal and so pursuing it was easy. But, running for the sake of running, especially given the monotony of the track was hard to sustain, especially since I had spent thirty five years of my life not bothering to do anything physically more strenuous than turning the page of a book or type on a keyboard. Furthermore, I had no company or support.

How long does it take to form a habit that becomes natural, that doesn’t require a ridiculous amount of willpower to sustain ? A popular answer is 21 days. Back in 1960, a cosmetic surgeon called Maxwell Maltz published a book called Psycho-Cybernetics (considered the trendsetter in the current self-help movement) in which he declared that it took 21 days to form a new habit. His answer was based on his discovery that it took 21 days for amputees to lose the sensation called phantom limb.

Last year, a paper in the European Journal of Social Psychology revised the answer to 66 days. According to PsyBlog, which is where I learned of this study: “What this study reveals is that when we want to develop a relatively simple habit like eating a piece of fruit each day or taking a 10 minute walk, it could take us over two months of daily repetitions before the behaviour becomes a habit. And, while this research suggests that skipping single days isn’t detrimental in the long-term, it’s those early repetitions that give us the greatest boost in automaticity.” The study also found that some people seemed more habit-resistant and that not all habits are equal: some take much longer to form.

To make matters worse, old habits die hard. In 2005, MIT published a study that found that the neural pathways triggered by the old habits don’t disappear, but just go  dormant. Once the old contexts are reasserted, the old habits come roaring back. According to Ann Graybiel, the principal researcher of the study: “”It is as though, somehow, the brain retains a memory of the habit context, and this pattern can be triggered if the right habit cues come back”.

While I had formed the habit of running regularly, once the rhythm was upset, the old habit of not exercising reasserted itself and I was back to fighting to lace up each time I decided to run. And as time elapsed, this became more stronger than the relatively newer habit of running regularly. Like an unused muscle, the neural pathway associated with running atrophied.

As I neared the four mile mark, I told myself that I’d turn back and add two additional miles by running the half mile loop around the park near our house. But, I passed the four mile mark and kept going. Another half mile to make the distance nine miles, I told myself. As I neared the 4.5 mile mark, I told myself that the place I had originally thought of as the 5 mile mark was looming close and so I’d run upto there before turning back. As I got closer to that mark, I berated myself for being so attached to times and paces and not just enjoying the damn run. Suddenly, it was like a curtain being pulled back. I felt light and relaxed and told myself that I’d turn back once the iPhone said that I had run 5 miles. If that meant, I’d have to walk the last mile or so, so be it. When I turned back at the 5 mile mark, the clock registered 38 minutes. I was under my eight minute mile barrier!

Slow down or you’ll regret it, I told myself. But I couldn’t. Just another mile at this pace, I said. I skipped stopping at the water outlets along the way. The clouds had mostly cleared, but the heat hadn’t picked up yet. The old joy of running had come back. I felt at peace as I kept running. My legs felt good and my breathing was normal. I measured my strides and found that I was sticking to the 90 steps per foot that is considered a secret to running with minimal impact and thereby avoiding injury. I was going to finish ten miles and to hell with the pace.

All the knowledge about how important it is to be fit didn’t help me return to running as smoothly as I had hoped. My mother’s mother suffered from severe arthritis as does my mother. Many studies have shown that runners have a lower chance of contracting arthritis compared to couch potatoes. My father, like many of his generation, suffers from diabetes. Physical fitness helps fight diabetes (diet is critical too). A friend of mine joked about my running, “Everyone falls ill and dies and all this running means squat”. And then I ran across the theory of compressed morbidity. Proposed by a Stanford University Professor, James Fries, and validated by many studies, this theory states that if you’re physically fit and have a healthy lifestyle, your death will involve a lot less suffering and you’ll die quicker than those who’re not physically fit or have had healthy lifestyles. I ran across various articles that sang paeans to running and its benefits, especially if done well. I read how we evolved to run and how running is in our genes. But, my running regimen continued to deteriorate. I put up a picture of a runner with the sign: “The only way to be a good runner is to run”. I still didn’t return to my old regimen.

When I passed the 7 mile mark, I saw that only 52:30 minutes had elapsed. I was at a 7:30 minutes per mile pace. If I could even do 8 miles with this pace, I’d be thrilled, I told myself. I could walk the rest of the distance, for all I cared. As I neared the 8 mile mark, I willed myself to run just a little faster to reach it just under the hour mark. I sailed past the 8 mile mark when the elapsed time was 59:30. I was ecstatic. I slowed down because my legs felt a little tired. I slowed down a lot. I ran the ninth mile at a comparatively slow pace of 8:40. My legs felt good again and I picked up the pace. I wanted to finish a little better than 80 minutes, my self-imposed fitness limit.

When I crossed the ten mile mark, the clock said 1:15. I had averaged 7:30 minute miles for 10 miles. This was beyond my wildest dreams. I was so thrilled, I couldn’t walk straight (though the cramping and soreness that began shortly after had probably something more to do with this). I felt like my running life had been resurrected. I have started dreaming that one day, I’ll run an ultra-marathon, a distance greater than the marathon. Maybe, just maybe, I’ll celebrate my 50th birthday by running 50 miles.