Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The entire approach to food based on nutrients is wrong

Shantanu Nundy, MD
Conditions
August 20, 2011
Share
Tweet
Share

The science of nutrition is changing and not in the way you might expect. After years of “reductionist” thinking — where food has been viewed as the sum of its parts – a call to treat food as food has been sounded. No more poring over nutrition labels to calculate grams of fat or chasing down the latest go-to chemical – be it vitamin E, fish oil or omega-3. Instead we are being asked to call a potato a potato and a piece of steak, well, a piece of steak.

If you haven’t heard about this sea change yet, you are not alone. The food science industry that markets “food products” for our consumption has done a good job giving their laboratory creations a semblance of health with phrases like “low fat” and “high in vitamin C.” For our part, the medical community is also to blame. Despite evidence to the contrary, we have been slow to renounce the “fat is bad” mantra or break away from the nutrient-based approach to eating that first swept the country over 30 years ago.

Until very recently, the dissenting opinion was expressed mainly by food journalists and self-proclaimed naturalists. In the book Good Calories, Bad Calories, Gary Taubes argues persuasively that the science behind vilifying fats is fatally flawed and proposes that carbohydrates, and in particular sugar and high fructose corn syrup, are the real bad guys. Michael Pollan, perhaps the best quoted food journalist-cum-activist, goes further to suggest the whole notion of understanding food by its constituent parts – fat, protein and carbohydrates or even saturated fats, unsaturated fats, and trans fats – is plain wrong. He opens In Defense of Food with three dictums for healthful eating: “Eat food. Not too much. Mostly plants.”

Now the scientific and medical literature is coming around. A review in the Archives of Internal Medicine of over 500 trials found “insufficient evidence” that the intake of dietary fat (except for trans fat) is associated with coronary heart disease. More recently, an editorial published in the Journal of the American Medical Association (JAMA) August 2010 entitled “Dietary Guidelines in the 21st Century – a Time for Food” writes “little of the information found on food labels’ ‘nutrition facts’ panels provides useful guidance for selecting healthier foods to prevent chronic disease.”

Don’t let the plain academic language lull you – what these scientists have published in arguably the world’s most prestigious medical journal is that the entire approach to food based on nutrients is wrong.

It’s not that eating the right nutrients is hard (how are you supposed to know if less than 30% of your calories comes from saturated fats?) and that the science of nutrient-based eating is bad (this is too academic to get worked up about), it’s that our focus on nutrients has actually made our food more unhealthy. In an effort to engineer “better” foods, we created trans fats, which we now know are deleterious to health, and food products that are low in fat but high in dough conditioners (whatever that is). Indeed, as saturated fat consumption has decreased, our collective burden of chronic disease and obesity has only increased.

So if fat is not bad, and we shouldn’t be thinking about food in terms of individual nutrients, what are we left with? Surprisingly, we are pretty much where we were in our grandparents’ generation, a time before we thought we could improve health by manipulating individual nutrients, and when food was just food. As the JAMA article concludes “… although this approach may seem radical, it actually represents a return to more tradition, time-tested ways of eating.”

In fact, the most convincing studies of dietary patterns that prevent or retard chronic disease are food-based. Fruits, vegetables, whole grains, and nuts have been consistently associated with lower risk of disease while fish consumption has lowered the risk of death from heart disease. And these effects are above and beyond what you see from diets with equal levels of protein, fat, and carbohydrates.

A food-based approach to eating is not only healthier but also easier. Instead of worrying about things you can’t see, smell or taste; it asks you to pay attention to what you are putting in your mouth. It supports an eating plan of fruits and vegetables, whole grains, and unfettered meats over processed foods, packaged meats, and sugar-laden beverages; and favors home-cooked food over store-brought or restaurant meals.

So the next time the hunger pangs strike, check your energy bar at the door and drive on by the local diner. Instead go to your local grocery store, buy yourself some fresh food, and prepare yourself a hearty, wholesome and healthy meal.

Shantanu Nundy is an internal medicine physician and author of Stay Healthy At Every Age: What Your Doctor Wants You to Know.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Practices have failed to analyze the clinical content of their EHR

August 20, 2011 Kevin 2
…
Next

KevinMD posts of the week, August 21, 2011

August 21, 2011 Kevin 0
…

ADVERTISEMENT

Tagged as: Primary Care

Post navigation

< Previous Post
Practices have failed to analyze the clinical content of their EHR
Next Post >
KevinMD posts of the week, August 21, 2011

ADVERTISEMENT

More by Shantanu Nundy, MD

  • a desk with keyboard and ipad with the kevinmd logo

    Making tailored health education standard of care

    Shantanu Nundy, MD
  • a desk with keyboard and ipad with the kevinmd logo

    In medicine, the greatest save is not having to make a save at all

    Shantanu Nundy, MD
  • a desk with keyboard and ipad with the kevinmd logo

    Cancer patients get better care than patients in primary care

    Shantanu Nundy, MD

More in Conditions

  • Clinical ghosts and why they haunt our exam rooms

    Kara Wada, MD
  • High blood pressure’s hidden impact on kidney health in older adults

    Edmond Kubi Appiah, MPH
  • How declining MMR vaccination rates put future generations at risk

    Ambika Sharma, Onyi Oligbo, and Katrina Green, MD
  • How one unforgettable ER patient taught a nurse about resilience

    Kristen Cline, BSN, RN
  • Why regular exercise is the best prescription for lifelong health

    George F. Smith, MD
  • When the weight won’t budge: the hidden physiology of grief, stress, and set point

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 9 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why specialist pain clinics and addiction treatment services require strong primary care

      Olumuyiwa Bamgbade, MD | Conditions
    • Harassment and overreach are driving physicians to quit

      Olumuyiwa Bamgbade, MD | Physician
    • Why peer support can save lives in high-pressure medical careers

      Maire Daugharty, MD | Conditions
    • When a medical office sublease turns into a legal nightmare

      Ralph Messo, DO | Physician
    • Addressing menstrual health inequities in adolescents

      Callia Georgoulis | Conditions
  • Past 6 Months

    • Forced voicemail and diagnosis codes are endangering patient access to medications

      Arthur Lazarus, MD, MBA | Meds
    • How President Biden’s cognitive health shapes political and legal trust

      Muhamad Aly Rifai, MD | Conditions
    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • The One Big Beautiful Bill and the fragile heart of rural health care

      Holland Haynie, MD | Policy
    • Who gets to be well in America: Immigrant health is on the line

      Joshua Vasquez, MD | Policy
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
  • Recent Posts

    • The shocking risk every smart student faces when applying to medical school

      Curtis G. Graham, MD | Physician
    • Clinical ghosts and why they haunt our exam rooms

      Kara Wada, MD | Conditions
    • High blood pressure’s hidden impact on kidney health in older adults

      Edmond Kubi Appiah, MPH | Conditions
    • Deep transcranial magnetic stimulation for depression [PODCAST]

      The Podcast by KevinMD | Podcast
    • How declining MMR vaccination rates put future generations at risk

      Ambika Sharma, Onyi Oligbo, and Katrina Green, MD | Conditions
    • The physician who turned burnout into a mission for change

      Jessie Mahoney, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The entire approach to food based on nutrients is wrong
9 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...