Diet and Health: Implications for reducing chronic disease risk

Although my focus on this site is fasting, it is just as important to understand what is optimal for health when you are not fasting. I look at it this way: Fasting is the cleansing period when you give the body a chance to eliminate or consume those materials it needs the least resulting in a slightly healthier cell and system state. It's like giving your body a chance to rid itself of unwanted or detrimental substances so that it can operate a little more efficiently and in a state that is more aligned with normal function. So on the days that I am eating, I want to be putting food in my system that continues to support that healthy state. 

After a period of fasting, I always find, especially if I have a particularly difficult fasting day, that I don't want to go through that kind of experience again so think a little more carefully of what I am putting in my system. Do I want to eat that cheese cake knowing that it is not the best fuel for my system or should I focus on the veg and fruit more knowing that the result should be more beneficial.

Now this is the tricky part and the part that I have spend much of my life experimenting with to figure out what is the right food selection. So this article is our introduction to food. I thought I would start with what the national researchers have determined is the right way to eat and then over time overlay other research that may provide new insights into what makes better sense for the body. This is a very tricky proposition though. As humans we generally do not have immediate response to foods unless: 1) we have an allergy, 2) they are very chemically reactive such as coffee, 3) we over consume a particular food resulting in an overdose type of reaction. In other words, almost any food taken in small amounts will not have an immediate detrimental or beneficial affect on the body.


This is what makes food selection so difficult as you really only see the results of your food choices after some time of consumption and then the results are often difficult to attribute to either a single food selection or unhealthy combinations. As an example, we generally can agree that eating donuts would not be the best choice for say two out of three meals a day. But how different is that from toast, butter and jam in the morning and a peanut butter and jam sandwich for lunch?

Then we have the other end of the spectrum being those foods that 1) promote healthy cell development and growth, 2) reduce the unwanted accumulations of body fat, 3) prevent of reverse physiological damage to organs and systems. 
  
So as a baseline of what is considered healthy eating, I am starting with a publication called Diet and Health: Implications for Reducing Chronic Disease Risk which is a book prepared by the US Committee on Diet and Health, National Research Council. This is an almost 800 page research compilation and can be found for free at http://www.nap.edu/catalog/1222.html. The book was published in 1989 and although over 25 years old, still represents much of what the medical and sciences establishment supports. The committee is comprised of Committee on Diet and Health, Food and Nutrition Board, Commission on Life Sciences, and the National Research Council all together totaling 74 listed contributors and supporters in the research.

The three major objectives of this study were: 

1. To develop criteria for systematically evaluating the scientific evidence relating dietary components, foods, food groups, and dietary patterns to the maintenance of health and to the reduction of risk of chronic disease;
2. To use these criteria to assess the scientific evidence relating these same factors to health and to the reduction of chronic disease risk
3. To propose dietary guidelines for maintaining health and reducing chronic disease risk, to suggest directions for future research, and to provide the basis for periodic updates of the literature and guidelines as new information on diet and health is acquired.  

The report also outlines the main reason for undertaking this study which was to systematically examine dietary components over the entire spectrum of major chronic diseases. It notes that several reports to date and as used for the basis of this report where not comprehensive in crossing the boundary from simple dietary risk assessment and risk factors to the complex task of determining how these risk factors influence the entire spectrum of chronic disease. The report is therefore focusing on risk reduction rather than the management of clinically manifest diseases. The committee focused on chronic diseases that diet is believed to influence being:

• atherosclerotic cardiovascular diseases
• hypertension
• certain cancers (esophagus, stomach, large bowel, breast, lung, and prostate)
• diabetes
• obesity
• dental caries
• chronic liver disease

So as part of my contribution to this body of knowledge, I plan to focus on the above list of diseases and how diet can influence them. My first starting point is to take the dietary recommendations from this study as a baseline. You will find these recommendations very familiar as they are for the most part derived on previous bodies of knowledge primarily from the 80's. These recommendations are as follows:

1. Reduce total fat intake to 30% or less of calories. Reduce saturated fatty acid intake to less than 10% of calories, and the intake of cholesterol to less than 300 mg daily. The intake of fat and cholesterol can be reduced by substituting fish, poultry without skin, lean meats, and low or nonfat dairy products for fatty meats and whole-milk dairy products; by choosing more vegetables, fruits, cereals, and legumes; and by limiting oils, fats, egg yolks, and fried and other fatty foods. 
2. Every day eat five or more servings of a combination of vegetables and fruits, especially green and yellow vegetables and citrus fruits. Also, increase intake of starches and other complex carbohydrates by eating six or more daily servings of a combination of breads, cereals, and legumes (A serving is equal to a half cup for most fresh or cooked vegetables, fruits, dry or cooked cereals and legumes, one medium piece of fresh fruit, one slice of bread, or one roll or muffin).
3. Maintain protein intake at moderate levels. The committee recommends maintaining total protein intake at levels lower than twice the RDA for all age groups (e.g., less than 1.6 g/kg body weight for adults). 
4. Balance food intake and physical activity to maintain appropriate body weight.
5. The committee does not recommend alcohol consumption. For those who drink alcoholic beverages, the committee recommends limiting consumption to the equivalent of less than 1 ounce of pure alcohol in a single day. This is the equivalent of two cans of beer, two small glasses of wine, or two average cocktails. Pregnant women should avoid alcoholic beverages.
6. Limit total daily intake of salt (sodium chloride) to 6 g or less. Limit the use of salt in cooking and avoid adding it to food at the table. Salty, highly processed salty, salt-preserved, and salt-pickled foods should be consumed sparingly.
7. Maintain adequate calcium intake. 
8. Avoid taking dietary supplements in excess of the RDA in any one day. 
9. Maintain an optimal intake of fluoride, particularly during the years of primary and secondary tooth formation and growth.

I suggest you visit the site where this report is published if you want more detail on the research that resulted in these recommendations. However, I do not intend to provide any further detail here. My goal is to use these well studied and supported premises as a baseline for what is considered sound dietary management to minimize the risk of the above listed chronic diseases. 

Where my efforts will focus on is what other studies and research is available that may provide different perspectives on these well healed ideals. As a starting point, I identified the following three statements within the report that open an entire line of questioning for me:

1. No studies in humans have yet examined the benefits of changing to low-fat diets; however, such evidence exists from experiments in animals.
1. So how has low fat become such an important aspect linked to good health?
2. If the work has not been done, why is no one doing it?
3. How is a leap from animal experiences result in wholesale acceptance of the percieved benefits of low fat diets?
2. Sugar consumption (by those with an adequate diet) has not been established as a risk factor for any chronic disease other than dental caries in humans.
1. yet there is not mention of the potential risks of concentrated carbohydrates to the body.
2. what is an adequate diet and what amount of sugar does it contain?
3. The known effects of sugar consumption, blood sugar impacts and diabeties dont seem to factor into this statement.
3. Experience in long-term management of obesity indicates that neither frequent fluctuations in body weight nor extreme restrictions of food intake are desirable.
1. Is this based on the conventional diet and caloric restriction methods?
2. Is it referring to extremes that most people could never achieve in the first place?
3. Yet most diets for morbidly obese people are based on extreme caloric restriction and weight fluctuations occur regularly as diets are abandoned and weight is regained.
4. what is the role of fasting in diet and health? Is that considered extreme and should be avoided based on this statement? 

So as a launch point for fasting and health, I want to start to explore alternate information and build a bridge from this foundation of society accepted dietary norms, to fringe ideas and successes  that my be helpful in completing the picture.

One last comment I want to make is the idea of group think. In this report there were a large number of experts reviews works completed by other experts who have all referred to other expert work as foundational starting points. This results, in my mind, to a state of accepted group think. The conclusions of this report do not shake the foundations of societies ideals on food and nutrition, but rather provide slight pressure on the edges of these ideas. To me this is a safe way to make subtle influences on a set of beliefs that need radical reframing. We will be looking at the state of chronic disease in future articles, but when I read this report, it was hard not to see the acceptance of these diseases as simply the background state. That this is how it always was and now these scientists are coming up with recommendations on how to reduce these states. Rather than look at what has changed in the last 100 years and then investigate those changes and the impacts on health. It is this type of thesis the society accepts as science and research and that creates hugh resistance to change due to the existing body of misaligned knowledge. 

What I am looking for is research that is occuring in smaller circles, groups that are asking better questions to find new perspectives, and openness to ideas that are promising but different than the norm. It is this knowledge that I intend to bring forward as a comparison and I hope to be part of that living experiment.