#023 Food: A Manifesto (The Finale, Zooming In)
“We are fat and ill because we live in a world full of food that makes us fat and ill.” If we live in a world like this, what on earth do we eat?
As I wrote in Part 2 of this series, a lot of the food we have access to depends on where we live and what we can afford (our economic circumstances).
In this final post in the series, we will take a deep dive into what sort of food we should eat to boost our wellbeing, not only now, but years into the future.
But first, a quick recap.
Why does what we eat matter?
Poor diet is a larger contributor to our burden of disease risk.
Dietary risk factors were the 3rd leading risk factor contributing to ill health and premature deaths after tobacco use, and overweight and obesity in Australia, in 2018.
Dietary risks factors are twofold. First, where adequate amounts in the diet are required to prevent disease (i.e. eating lots of fruits and vegetables). Second, diets with excessive consumption contribute to disease development (i.e. eating too much red and processed meat).
According to the Australian Institute of Health and Welfare, the 12 individual dietary risk factors are:
a diet low in: fruit and vegetables, milk, nuts and seeds, whole grains and high fibre cereals, legumes, polyunsaturated fat, and fish and seafood
a diet high in: sodium, sugar-sweetened beverages, and red and processed meats.
Dietary risk factors combined were the 4th leading risk factor contributing to deaths – 15,802 deaths (9.9 per cent of total deaths) in 2018.
Dietary risk factors were linked to 16 diseases and contributed to:
50% of coronary heart disease total burden.
26% of bowel cancer burden.
26% of type 2 diabetes burden.
26% of stroke burden.
So first, let’s talk about the easy wins and the must dos.
EVERYONE would benefit from eating more vegetables.
There is no upper limit to the number of vegetables you could consume. If you are a long time reader of Well, Well you might remember the first post on increasing plant consumption (to more than 30 different types of plants a week) to improve gut microbiome health.
Most adults do not meet the recommendations for fruit and vegetable consumption. Based on the latest available data from the 2020–21 National Health Survey, for adults aged 18 and over, it is estimated that:
55% do not meet the recommendations for daily fruit consumption.
91% do not meet the recommendations for daily vegetable consumption.
94% do not meet the recommendations for daily fruit and vegetable consumption.
There were also 12% who did not eat any fruits and 1.6% did not eat any vegetables.
The figures are similarly terrible for children. Based on the latest available from the 2020–21 NHS, for children aged 2−17, it is estimated that:
37% do not meet the recommendations for daily fruit consumption.
90% do not meet the recommendations for daily vegetable consumption.
91% do not meet the recommendations for daily fruit and vegetable consumption.
5.3% do not eat any fruits and 4.1% do not eat any vegetables.
Reflecting on your own, or your family’s consumption – how do you stack up?
As part of kindergarten health screening, I had to fill out a form recently asking how many serves of fruits and vegetables my 5 year old eats per day. Cue horror (and a bit of embarrassment)! Despite knowing lots about diet and wellbeing, I struggle to consistently get my 5 year old to eat his 5 serves every day.
Simon Hill, in his excellent book The proof is in the plants: How science shows a plant-based diet could save your life argues that big food companies spend a lot of money to develop ultra-processed foods to be cheap, durable, and addictive.
And this is one of the key reasons why 94 per cent of Australians are failing to eat enough fruits and vegetables. According to research, the average Australian purchases 208kg of ultra-processed foods per year. This is the equivalent of 11,000 Tim-Tams per person, or more than 30 per day!
Hill argues “what these food scientists look to create is hedonic hunger, an insatiable craving for certain foods without the presence of physical hunger.”
Think about it. The last time you ate an ultra-processed snack – a snickers bar, some twisties or chips - you enjoyed the taste, the texture, the smell – even the sound that these foods make when we eat them. You probably weren’t super hungry when you ate it – maybe you were bored, maybe you had a strong craving for something salty and crunchy. No wonder the average Australian consumes 826 calories from ultra-processed foods per day.
What exactly is an ultra-processed food? Common culprits (that you might not even realise are ultra-processed!!) are breakfast cereal, protein and muesli bars, plant-based milks, packaged breads, flavoured yoghurt, and processed meat like ham, bacon and salami. You can see how it is pretty easy to get to 826 calories or more from ultra-processed foods per day.
While eating these foods every now and then isn’t the end of the world, you definitely don’t want a substantial amount of your (or your kids) daily calories from ultra-processed food.
A 2018 French study found that for every 10 per cent increase in the consumption of ultra-processed foods, there was a 12 per cent overall increase in cancer risk, and an 11 per cent increase in breast cancer risk.
So we have established that we need to eat more fruits and vegetables and less ultra-processed food for our wellbeing.
What else should we eat?
Through eating more plants, we will naturally eat more fibre. But we need to get more obsessed with fibre.
All too often people are obsessed with protein (the number of times I have heard people say “you don’t eat meat, where do you get your protein from?”) – but there is pretty much no one in the developed world suffering from a protein deficiency, regardless of if you are keto, vegan, paleo etc etc.
Most Australians don’t eat enough fibre. One study found that 42.3 per cent of children and 28.2 per cent of adults met the Adequate Intake (AI), and less than 20 per cent of adults met the Suggested Dietary Target (SDT) to reduce the risk of chronic disease.
Consuming enough fibre is protective against developing colorectal cancer – the third most common form of cancer in the world. For every 90g of whole grains (i.e. barley, brown rice, farro, quinoa, oats, whole wheat pasta/bread) consumed, the risk of colorectal cancer is lowered by 17 per cent. For every 10g of additional fibre per day, the risk of colorectal cancer is lowered by 9 per cent.
A good reason to up your fibre intake!
To reduce your risk of chronic disease, the suggested daily fibre intake is 28g for women and 38g for men.
What are some high fibre foods? Black beans (7.5g per ½ cup), guava (9g per cup), chia seeds (7g per 2 tbsp), prunes (10 prunes = 6.5g), lentils (1/2 cup = 6g), medjool dates (3 dates = 5g) and blackberries (1 cup = 7.5g) will help you boost your fibre intake.
The third thing you might wish to focus on is cutting back meat, particularly red and processed meat. Meat consumption is an emotive topic – and I am not here to say don’t eat meat at all – just to think about how much and what type you are consuming.
Most of us know of the environmental impact of meat consumption so I am not going to go into that here, but if you are interested in the topic, this article has a good summary.
According to the World Health Organization, though diets today still vary by geographical context, average global consumption of all types of meat per capita has increased substantially in the past half-century, and global meat production is anticipated to further increase by 50 per cent by 2050.
In 2019, Australian’s ate 29kg of pork, 26kg of beef, and 11kg of sheep. That’s 66kg of red meat per year, for the average Australian (and this doesn’t include chicken or processed meat – which we are equally high consumers of!).
The EAT-Lancet Commission on Healthy Diets from Sustainable Food Systems is one of few global expert groups that have suggested quantitative targets for red and processed meat consumption. The group stated that red meat consumption, globally, should be reduced by more than 50 per cent by 2050, in order to have a healthier diet. For red meat, they advise no more than 98 g per person per week (which is around 1.5 serves). They advise “low intake, if any” of processed meat. In 2015, the WHO’s International Agency for Research on Cancer (IARC) announced that consumption of processed meat is “carcinogenic to humans (Group 1),” and that consumption of red meat is “probably carcinogenic to humans (Group 2A)”.
Group 1 carcinogens also include tobacco and asbestos. Group 2A also includes diesel engine exhaust, Formaldehyde and Polychlorinated biphenyls (PCBs). What illustrious company for red and processed meats!!!
A 2019 study that followed 70,696 Japanese subjects over 16 years found that swapping just 3 per cent of calories from red meat protein for equivalent plant protein resulted in a 42 per cent reduction in risk of dying from cardiovascular disease! It is easy (and cheaper!!) to swap meat out once you start – you could swap beef mince for lentils in your favourite lasagne.
Some great plant protein additions to your diet might include tempeh (150g = 22.5g protein), tofu (150g=19.9g), legume pasta (1 cup = 11.4g), cooked edamame beans (1/2 cup = 11.1g), nutritional yeast (a great cheesy tasting sprinkle – I put it on everything from popcorn to pasta! – 2tbsp = 7g).
This might seem super overwhelming – thinking about what we eat is an emotional topic!
But the key aim of this series is to highlight that while we as individuals how the power to make better food choices, there is still a collective responsibility we have to ensure everyone has access to affordable healthy food.
Thinking about the strong vested interests at play that want you to make unhealthy food choices, and rethinking what you choose to put on your plate is the first step – it might seem tiny, but if everyone does it by just starting with one healthier swap or one healthier meal, it will have a big impact on your own health, and on the food system.
Some further resources on food you might want to check out:
Books
Dr Tim Spector – Food for Life: The new science of eating well
Dr Tim Spector – Spoon-fed: Why almost everything we’ve been told about food is wrong
Simon Hill – The Proof is in the Plants
Henry Dimbleby – Ravenous: How to get ourselves and our planet into shape
Social Media – great food and nutrition accounts
What to eat ideas, Nutrition and Recipes
@minialistbaker
@deliciouslyella
@thestaplestore
@luisegreenkitchenstories
@mynewroots
@zoe
@drmarkhyman
Bargain wholefoods shopping
@wholesavers – good tips on healthy food items on sale at Coles, Woolies and Aldi
Also google your local Community Supported Agriculture program. A CSA program connects communities with local farmers. You pay a subscription fee and get a box full of seasonal goodies every week. I joined the local CSA in Canberra (Southern Harvest Association) and pay $54 a week for an extended box – this week I got mint, watermelon, raspberries, eggplant, capsicum, garlic, potatoes, corn, and cucumbers – all grown locally, non-certified organic/spray free. The flavour and freshness are miles apart from supermarket fruit and veg which has often been refrigerated for months before you eat it.
Podcasts
The Proof
Rich Roll Podcast
The Drive with Peter Attia
Huberman Lab
Hopefully this Food Manifesto has given you some (healthy) food for thought. Let me know what was most surprising or what you are hoping to change (if anything!) in the comments.
Be well,
Alicia