Wednesday, March 3, 2021

Preventive Medicine: What one thing makes a diet ‘good’?

by Dr. David L. Katz
nhregister.com

First, let’s be careful about “good.”

Dietary guidance should not adorn the wag of an admonishing finger. The “good” in question is of the “good is as good does” variety, not of the “good versus evil” variety. That distinction gets all too murky all too often in the opposing assertions that dominate the pop culture of this social media moment. Diet good is as diet good does. What good is that?

Diet tends to be good as a noun (as in “dietary pattern”), and far less good as a verb. When diet implies “dieting” — there is little lasting good in the offing. I won’t belabor this, but a lot of truly “bad” ideas can work well for short-term weight loss, all but inevitably followed by weight regain with interest. There is so much wrong with “dieting” that the case could be made, indeed, I’ve made it, that “dieting” should die. We “di-et” alone, we live-it together. Together is better. Together would be good.

But what of the one thing? My choice is: balance. No, not carbs; not saturated fat; not sugar; not sodium. To be clear, this is not “balance” of the all things in moderation variety; that is a slippery slope toward all manner of dietary debacle. This is “balance” of the good causes require good effects variety, conjoined to a balanced view of what effects truly matter.

A dietary pattern is good if it represents the balanced array of nutrients from an assembly of wholesome foods, mostly plants, that serves our native adaptations. The critical balance is between dietary composition, and metabolic needs. Those vary, of course, by species; a balanced diet for wildebeest involves a lot of grass, while a balanced diet for lions may involve a lot of wildebeest. At its origins, food is about sustenance and survival, and those needs are bounded by the adaptations of a given kind of animal. Protest though we may, we humans are a kind of animal, with a particular suite of adaptations governing the fundamentals of our nutrition requirements.

There is a balance, as well, between health and pleasure. The pleasure factor of “good” food is an essential part of the requisite balance that reconciles concepts of how we “should” eat with how we really will. There are bridges that can be built between loving food, and food that loves us back — and on the other side, a balance worth pursuing. Good food gives pleasure; so does good health. Other things being equal, healthy people have more fun. Take a moment, chew on that.

There is, too, a balance in perspective integral to any valid concept of “good” food. Can food be “good” if sourcing it is predicated on overt abuse and torment of our fellow creatures? Few if any decent people want gratuitous cruelty on their menu. Modern dietary patterns conceal a great deal of just that — to creatures that think and feel in all the ways the dogs and cats we call members of our families think and feel. That is an extreme expression of imbalance, a case of cognitive dissonance. The only way to account for behaviors that condone cruelty by people with consciences that renounce it — is a failure to acknowledge what should be common knowledge. Mass producing animals on factory farms is an unbalanced assault on the sanctity of life.

We must, of course, be in balance with the rest of nature if we are to fill our plates and bellies but not empty the world of its great treasures: fish in the seas, birds in the air, the stunning breadth of biodiversity, pristine aquifers, open grasslands, teeming rainforests. Eating in balance with the competing requirements of a vital planet is not negotiable, for by any other means, we are eating not only our food, but our children’s food, too. When dinner as usual ruins the destiny of our own kind and all others, diet has gone “bad” by any valid connotation.

There is, in addition, the obvious: a “good” diet confers good health. This is intrinsically all about balance.

We are fortunate that where so much hangs in the balance: human health and pleasure, planetary health, the treatment of our fellow creatures, the sustainability of food production – “good” populates a confluence. That’s a sweet spot, if ever there was one.

Dr. David L. Katz is a board-certified specialist in preventive medicine/public health.