Dear Rosie From LA

by Michael Applebaum, MD, JD, FCLM

Dear Rosie From LA,

Thank you for your call.

Although I practice safe driving by using a hands-free microphone and earpiece, road conditions do capture my thinking and divert me from both depth of thought and precision of language.  Forgive me.

You asked me why I wrote to the Feds about the Food Pyramid.  All the reasons I gave were true: 

As a doc, I believe that preventive medicine is the best

The Food Pyramid has obviously failed (i.e., too many illnesses are overweight and obesity related) and needs replacement (i.e., it has had long enough to prove it is a failure)

The Food Pyramid is not the proper device if weight loss is the intentionality of it


But let me elaborate a little now that I am absent oncoming traffic.

What is the purpose of the Food Pyramid, or the Dietary Guidelines for Americans 2005, for that matter?  If it is to help Americans eat “healthily” (whatever that is) or achieve/maintain a desired weight (we know what that is), then they are a bust.

Current focus is on the problems of overweight and obesity.  Neither is an issue of food quality so much as food quantity.  Suppose there are two women equally active, the same height, the same percentage of body fat and each weighing 200 pounds.  One woman eating 5000 calories per day, all carbs, is arguably not substantially better off weight-wise than the other woman eating 5000 calories per day, all protein.  Suppose there are two men, equally active, the same height, the same percentage of body fat and each weighing 165 pounds.  One man eating 1500 calories per day, all simple carbs and fat, will certainly weigh less after one month, than the other who eats 5000 calories per day distributed in exactly the same proportions as suggested in the Food Pyramid.

Granted, the Pyramid does not suggest eating 5000 calories per day.  The point is that the solution to overweight and obesity is found in energy balance, not energy source.  Similarly, prevention of overweight and obesity is found in energy balance, not energy source.  The focal point of the Pyramid is more on energy source than energy balance.  Understanding its energy inferences requires more effort and deciphering than most people appear to be willing to undertake and follow.

It is the wrong tool for the job, if addressing overweight and obesity, both prevention and cure, are its intents.

As we discussed, the Pyramid has been criticized for being too confusing.  “Do you eat more from the little top or bigger bottom?”  “If I eat more from the little top will I get a bigger bottom?”  “If something is so good, why isn’t it at the top?  Or is it?”  “How big is a serving?”  And so forth.

USDA has to be confusing.  It serves too many masters.  On the one hand is the US economy, world trade, agri-business and the many dependent on the immanent industries for employment; all certain that they want to prosper.  On the other is the consumer, uncertain as to whether he or she is interested in knowing how to “eat better” let alone doing it.  This creates two problems.  The first is that certainty will almost always prevail over uncertainty.  The consumer loses.  Second, USDA has one hand too many.  It is conflicted.  Business builds bigger bank balances by selling more to consume.  Consumers keep weight down by buying less to consume.  If USDA were endowed as the man who murdered Richard Kimball’s wife, no problem.  All would know where it stood.  It would either serve the consumer or someone else.

Confusion creates a vacuum.  A clarity vacuum.  This vacuum gets filled by the priests of, in my opinion, crap-speak.  Anointed by the media, they become the sources for undisputed pseudo-information, presented virtually without criticism or evaluation.  Very clear.  They occupy the ever-widening bandwidth of infotainment presented by one-time “journalists” whose company lends false bona fides to the claims  “To be healthy wealthy and wise, you must eat macronutrients in the very specific ratio of 1:1:1.3.”  “Lean is all about timing.”  “Ketogenic dieting is a way of life, good for all, young and old, alike.”  The “info” part is lacking.  It is really noisertainment.

As it is the cause for at least some of the confusion, the Pyramid is not the solution.

Regarding only the issues of overweight and obesity, it is my humble opinion that the best message for the government and the other avowedly concerned authorities to disseminate is the message of how people can affect what they already do to achieve a more desirable weight.  Modifying what is familiar is easier than implementing a daunting new system.  Easy works, daunting doesn’t.  And herein lies other problems: the lies of how difficult it is, how the massive and dreaded “lifestyle change” is needed, how even the basic changes are not easy.  These officially perpetrated and propagated means of confusing and misleading serve to disempower people.  They breed hopelessness.  Why start if you cannot succeed?  The message is so depressing, it makes me want to eat for comfort.  It should not go unnoticed that our tax dollars have gone to creating excuses for failure, not solutions to success.

There is further analysis and a need to discuss the nature of “healthy eating,” but you are probably getting a bit tired so I will move on to the last topic.

You asked me about some “legal” solutions to the problems of overweight and obesity.  If we are declaring war on these killers, we have a choice.  That choice is either to fight the war aggressively, as if we can and want to win, or to fight it half-heartedly.

If we want to fight a war aggressively, then we need to visit our friend, intentionality, again.  I am not a conventional soldier.  I do not know how Norman Schwarzkopf, Colin Powell, Tommy Franks, Douglas MacArthur or Dwight Eisenhower thought.  Yet, I would be surprised if they mobilized their forces without clear plans of attack intended to result in victory plus several contingency plans for foreseeable problems.  To win, I suspect they had to coordinate fighting forces, monitoring personnel, logistical support, etc.

If we are to win Weight War I (WWI), we need to identify the enemy.  Once identified (which we have though we may not have acknowledged it yet), we must mobilize and coordinate assets to vanquish it.  The government, in all three of its branches, commands our assets which include information creation and controls over the information distribution channels (psyops of a sort) and the legal system (courts metric, if you will).

As examples, the FCC could clamp down on traitorous transmissions whose propaganda serves to mislead the citizenry, the FDA could evaluate product claims and bring suits and the government could authorize publication of comprehensible, specific guidelines for actions that each citizen can take to win WWI.

As you will recall, my suggestions for legal action were designed to protect children from nutritional abuse, whose consequences are life-long, debilitating and deadly.  Certainly I realize that even in a country where people appear to put all sorts of garbage into their mouths, some of my proposals may be unpalatable to a few.  Still I feel that they are conversation-worthy.  As extensions of familiar legal concepts, they represent starting points for discussion.  The ultimate form of principles applied may be unrecognizable from the original.  This is not bad.  This is a possible result of improvement.  The idea is to have a point from which to begin dialogue.

The pyramids are the creations of a dead and ancient civilization.  They are the Past.  It is the 21st century.  It is time to live into the future and leave the past behind.