What Ever Happened to the Joy of Eating?

With every meal, many Americans consume a hefty portion of guilt along with whatever else happens to be on their plates.

We struggle to choose foods that not only satisfy hunger, but that don’t cost too much and can be prepared and eaten quickly (since eating on the run is now a national pastime). And, oh yeah, most of us also try to make sure that a few morsels meet part of the growing list of government recommendations for health--from the National Cancer Institute’s “5 a Day” campaign aimed at increasing our intake of fruits and vegetables or from the wholesome base of the USDA’s food pyramid.

What happened, one might ask, to the simple joy of eating? And why, with so much information about nutrition available to us, do we persist in eating so badly?

Those are questions that befuddle the nutrition community, from the 11-member panel of scientists that recently drafted the latest U.S. dietary guidelines to researchers investigating the actions of leptin, the hormone that appears to play a key role in obesity. And with good reason. For all the mind-boggling molecular accuracy with which scientists can now identify and analyze nutrients and their caloric content, more Americans than ever before--more than half the population--are overweight.

Sure, there are many of us who weigh too much simply because we eat too much. But there are many others who want to do the right thing but view the copious and often contradictorynutritional information we hear with frustration and confusion. When it comes to teaching people how to eat well, it seems the harder we try, the more we fail.

This is not a problem we can afford to ignore. The health hazards of obesity are now second only to tobacco as the leading cause of chronic diseases (from high blood pressure to kidney disease), disability and premature death, claiming nearly 300,000 lives annually in the United States.

It’s not just adults whose poor eating habits cause health problems. The American Diabetes Assn. and the American Academy of Pediatrics recently reported that non-insulin-dependent diabetes--the type once limited mostly to overweight adults--now accounts for as much as 45% of newly diagnosed diabetes cases in children.

So what now? The reaction of public health officials and researchers is to move diet and exercise to the top of national health priority lists. That will produce . . . more committees, more reports, more information and more recommendations.

Last month, the USDA brought bestselling diet doctors together for a “great nutritional debate.” Congress now has its Congressional Prevention Coalition--a 42-member group founded by Reps. Jim Leach (R-Iowa) and Jim Moran (D-Va.) and Sens. Mike DeWine (R-Ohio) and Bob Graham (D-Fla.). In May, the U.S. Department of Health and Human Services is scheduled to hold a “nutritional summit” in Washington to address the problem of national obesity, among other topics. Even the military is going on the attack; in the fall, the Pentagon asked the National Academy of Sciences to address “weight management” among military personnel.

We all yearn for easy answers--I’m no exception. As someone who intends to live a long and healthy life--and is the author of a diet book for children--I’m an avid believer in the benefits of nutritional research. The problem is, we’ve begun to approach our food as if science can provide us with a simple solution. And it can’t.

During almost 20 years of reporting about health, medicine and nutrition, I’ve sat at conferences, meetings and debates and listened to experts offer their various and often conflicting ideas about our diets: too much fat, too little protein, too much sugar, too many foods that hike the glycemic index, not enough whole grains, not enough exercise and not enough knowledge about nutrition.

Despite what you’ll hear from the bestselling diet doctors, there is no one answer. Seeking a single scientific cure is nearly as bad as ignoring the problem altogether. That’s because, as William Dietz, director of the Centers for Disease Control and Prevention’s Division of Nutrition and Physical Activity, notes, “knowledge is not the same as behavior change.”

It seems clear to me that this overreliance on science has fostered several consistent themes in the way we think about food.

Traditional Foods Can Fall Into Disfavor

First, as a nation, we have succumbed to a sort of food fanaticism. It’s a troubling cycle that seems to carry all the fervor of political purges: A food that’s been a staple of American life is suddenly deemed unacceptable.

Just think of the poor egg. In the 1950s, no self-respecting mother--including mine!--would have dreamed of sending her children to school without an egg for breakfast. But this low-cost, readily available source of protein lost favor in the 1970s because of the 212 milligrams of dietary cholesterol that it packs per yolk. (The average daily intake of dietary cholesterol recommended by the National Heart Lung and Blood Institute is 220 to 260 milligrams for women and 360 milligrams for men.)

Egg consumption went into a slow tailspin, going from its heyday of 402 eggs consumed per person each year in 1945 to an all-time low of 233 eggs per person in 1991, according to the American Egg Board.

Then guess what? Studies began to expose the good ingredients lurking inside the shell. The egg white is rich in protein, low in calories. Even the yolk didn’t look quite so bad when scientists figured out that dietary fat was probably a bigger player in raising blood cholesterol levels than the cholesterol in the egg.

Along the way, the American Heart Assn. eased its recommendations to limit our egg intake. Then, adding to the information, along came the marketers: The American Egg Board launched the “Incredible, Edible Egg” campaign to alert consumers to the newfound benefits of its product (and to downplay the disadvantages); at the same time, some farmers even began feeding their chickens fish meal to boost their eggs’ omega-3 fatty acids, a substance that appears to reduce the risk of heart disease. Suddenly, eggs were no longer nutritional outcasts; consumers, as usual, could be forgiven for feeling nutritionally out of it.

Almost as important as our demonization of certain foods is the tendency to glorify others, usually on the basis of oversimplified interpretations of scientific evidence. The best example: fat-free foods that were elevated to nutritional sainthood when researchers in the 1980s began linking fat to increased cholesterol levels and the risk of heart disease and cancer. The 1995 Dietary Guidelines for Americans reinforced that message by advising us to eat a low-fat diet.

Spurred by our demand, the food industry provided a multitude of low-fat and fat-free products, from cakes and cookies to whipped topping, frozen yogurt and “Guiltless Gourmet” snacks.

Trouble was that too many Americans saw the “fat free” label as a license to overeat. Rather than savoring one high-fat cookie, why not scarf down a whole box of fat-free morsels? But, of course, fat-free food is not calorie-free, and the results were disastrous: When we switched to low-fat foods in the 1980s and ‘90s, the percentage of fat in the average American diet declined slightly, according to the USDA. But because we were actually eating more calories per day, the amount of absolute fat consumed rose. And guess what? So did obesity rates.

Other misguided efforts led to the nearly monastic suggestion of using no oil or other kind of fat on salads and vegetables. Vinegar or a touch of lemon was preferred. Not only did this practice rob us of taste, but it made absorption of fat-soluble vitamins--the powerful antioxidants such as vitamins A and E--much more difficult. (While the final chapter of the antioxidant story has yet to be written, I’ve read enough to be sure to add a little oil to my salads.)

Based on these and other scientific findings, the latest draft of the dietary guidelines urges Americans to be less fat-phobic and more fat-savvy. What that means is that it’s OK to drizzle a little olive, walnut, canola or any of the other so-called “good” oils on your salad. Just don’t go overboard. Better to eat only minimal amounts of fried chicken, french fries and high-calorie baked goods that pack a lot of saturated fat and trans fatty acids--now recognized as the most dangerous kinds of fat.

Putting What We Eat in Medical Terms

Perhaps where we have gone wrong the most is in medicalizing eating. Diet books offer foods and recipes as a weapon against disease. The grocery store shelves feature bold new designer foods that are nearly potent enough to come with their own prescription labels. That’s not just fresh-squeezed juice; it’s calcium-fortified orange juice for strong bones. Don’t spread butter on your toast; try the cholesterol-lowering margarine instead. Those chicken breasts? They’re sauteed in polyunsaturated oil and served with folic-acid-fortified pasta. And those aren’t just tomatoes on our salad--they’re lycopene-containing vehicles topped more and more often by a vitamin E-fortified salad dressing.

Cookbook authors have jumped on the medicalization bandwagon, producing recipes that pander to many medical conditions. Among the recent volumes that have crossed my desk are “The Menopause Cookbook,” “Cook Your Way to the Life You Want,” “The New Eating Right for a Bad Gut” and “God’s Diet,” a book for a spiritually based weight-loss program that focuses only on food God made.

Put this tendency to believe that science provides us with the answers alongside our decreased physical activity, and of course you have a recipe for poor health and increased obesity. But there’s a further irony and confusing message here. Although we’ve medicalized our approach to eating, we don’t encourage people to get the medical support they need for the problems that result from poor eating habits.

One of the few types of medical treatment for which you cannot get tax deductions is the treatment of obesity. (Treatment for smoking, drug addiction and alcoholism are all, by contrast, tax deductible.) To Judith S. Stern, professor of nutrition and internal medicine at UC Davis, the obesity epidemic is just that--a medical epidemic “that should be treated as seriously as any infectious disease epidemic,” she says, “because it is increasing and I don’t see the end in sight.”

These problems stem, it seems to me, from a distinctly modern American trait that goes way beyond our eating habits: We’ve come to rely on science to cure us of all that ails us; we are always ready to jump aboard the bandwagon of the next best scientific idea.

At the risk of sounding like Pollyanna, there’s a lot to be said for rediscovering the true joy in eating and reestablishing some good, old-fashioned habits such as family meals and moderation.

Don’t dismiss the scientists--they’re doing a lot of useful work. Don’t stop learning about nutrition--there’s much to be gained by understanding what we eat. But the clearest message that comes from the years I’ve spent listening to the nutritional debates is this: Take each piece of advice with a grain of salt, and add a big dash of common sense.