We are very sick. Way sicker than you could imagine.
It is costing us money, health, happiness, productivity and much more.
1/5 under the age of 20 in Sweden, and almost half of Swedes suffer from at least one chronic disease.
Chronic diseases comprise around 80% of Sweden’s total healthcare cost.
In Europe, the problem is as big.
The cost of lifestyle-related chronic disease is around 1000 billion Euros every year which is 8 times the national budget of Sweden.
Yet, America is leading the way.
In 1930 7.5% had at least one chronic disease, today that number is closer to 60%.
To make it more concrete, that is close to 200 million individuals in the US alone suffer from a disease that is lifestyle-related.
We are slowly realizing that almost all chronic diseases are metabolic in origin.
This means that something in the process of making energy goes wrong. Over time, this leads to what we call chronic diseases.
In the US it is estimated that 88% of the population has something vital to energy production that is not functioning properly.
This is a scary proposition for the future of health in that country. But, the US just acts as the canary in the coal mine for disease.
The US is leading the way. They also have robust data on their population.
Because of this, I have chosen to make the exploration of the link between diet and disease by looking at Americans.
The US acts as a country that is ahead of us which we can look at to not make the same mistakes they did.
Great innovators and visionary thinkers usually have one thing in common.
They reason from first principles to discover unconventional ways of solving problems.
The great physicist Richard Feynman used to solve problems entirely on his own, not relying on previous expert knowledge.
He broke the problem down into the smallest fundamental parts that he could prove. From there he built his theories and solutions.
Elon Musk used the same method while getting into the space travel industry.
He asked the basic question of what was necessary to build a rocket.
In only a couple of years, SpaceX cut the price of space travel 10x. Making the enormously costly endeavour of sending rockets into space profitable.
By boiling a problem down to its most fundamental truths we can generate truly unique solutions.
When it comes to health you may not be able to do this (in the sense of fundamental truths).
But, what we can do is try to define some fundamental assumptions and then reason from there.
So, before we start we need to ask ourselves what assumptions we stand on.
I am going to make three assumptions that I think we can all agree on.
1) Chronic disease is not normal & is a modern phenomenon
Chronic diseases are lifestyle-related diseases.
Lifestyle-related disease is not evolutionarily adaptive. It lowers the chance of procreation and increases the chance of dying.
The theory of evolution gives us some truths.
Evolution forces organisms to optimize for procreation and survival.
Health is important for both of these.
Surviving is hard (more than 99% of species are extinct)
The species that have survived this long have developed robust mechanisms to protect against disease.
Animals in the wild do not suffer from any chronic disease.
Humans that live in the wild do not suffer from any modern diseases either. That is why they are called modern.
These modern, chronic, diseases were extremely rare up until the early 1900s.
With only a couple of generations, chronic disease has skyrocketed.
Because of this, it cannot be explained by genes.
It must instead be explained by some shift in the environment.
Something in our environment has drastically changed.
This change has led to almost 60% of Americans suffering from at least one chronic disease today.
2) Good recommendations lead to good outcomes
Let’s assume that the health recommendations that the governments give are good.
If we follow them, then disease in our society should lower over time.
Now, let’s assume the population are following the recommendations.
At the same time, disease is still exponentially rising.
If this is the case then the recommendations must be very wrong, missing something huge or outright bad.
3) Diet drives disease
Let’s assume diet is a large part of being healthy (which most of us believe).
We have dietary aspects or food groups.
Over time the consumption of these has three alternative routes:
We eat the same amount of it.
We eat more of it.
We eat less of it.
If chronic disease rises while we eat the same amount or less of something it is likely not driving disease.
If chronic disease rises while we eat more of something it may be driving the rise.
Let’s look at what we can find.
There is some sort of cultural consensus about what is driving disease.
This consensus runs all the way up to governments around the world.
We all have some general idea of what we need to do to remain healthy, or at least symptom-free.
We need to move more, eat less, and have good relationships.
If we get more specific, we would say that we shouldn’t smoke and that we should avoid sugar.
The CDC (Center for Disease Control) talks about four driving factors of disease:
Lack of exercise
Bad dietary patterns
Three of them have nothing to do with diet.
Before we get into diet we need to shortly go over them to see if any of them are a likely candidate for the increase in disease.
With the third assumption in mind, if they have decreased while diseases have increased they are not likely driving the rise.
In 1954, just less than half of all American adults smoked.
With a big push from governments, scientists, and doctors this number is now around 14% today.
Smoking is likely not driving the increase in disease.
The calories coming from alcohol increased slowly during the 1900s.
In 1960 it was 109kcal per day, and in 1980 it reached its peak at 185kcal per day. Today it has stabilized at around 160kcal per day.
The largest rise in disease occurred after the 1980s.
Thus, alcohol consumption is also not likely to be driving the increase in disease.
Lack of Exercise
The CDC recommends adults get 150 minutes of moderate exercise per week.
In 1998, around 40% of Americans reached these numbers.
Today this is closer to 55%.
Again, not a likely driving factor behind the rise in disease.
Here we can make a simple counter-argument.
Even though more people may be exercising more, our entire culture has become more and more sedentary.
Despite this, I do not think lack of exercise is where we should look when trying to solve the chronic disease epidemic.
Three out of the four driving factors the CDC lays out do not seem to have increased alongside chronic disease.
This is not to say they do not have a negative impact on health.
If all drivers of disease were decreasing then disease should also decrease.
Despite the decrease in these drivers chronic disease is increasing faster than ever. This tells us it must be something we are missing.
This leaves us with Bad Dietary Patterns.
Disease & Diet
There are two chronic diseases that are somewhat certain to have a dietary link. Diabetes (type-2) and obesity.
The increase in type-2 diabetes follows a similar increase.
In 1960, 0.9% of Americans were diabetic and in 2020 that number had risen to 8.3%.
Chronic disease has risen throughout the 1900s.
When we look at the graphs there is something that seems to have happened around 1980-1990.
If you recall from my previous newsletter, the large push to replace dietary saturated fat from animals with unsaturated fat from seed oils started in the 1960s.
But, the first dietary guidelines for Americans were introduced in 1980.
This marks the true change in dietary patterns for Americans and soon the rest of the West.
Soon after the rates of obesity skyrocketed.
Again, correlation does not infer causation.
Yet, the dietary guidelines often use correlation to make their recommendations.
Today we’ll see that the recommendations they make are illogical if we use the assumptions we agreed on.
Side note – the dietary guidelines are basically the same as in 1980…
The question to answer becomes:
What dietary aspect is a, or the, driving factor behind the rise in chronic disease (especially seen in the past 50 years or so)?
What foods are driving disease?
What have we increased our consumption of?
There are only four food categories in which our consumption has significantly increased in the past 50 years.
Sugar – 88kcal more today
Grains – 125kcal more today
Meat – 185 kcal more today
Seed oils – 423kcal more today
Looking at the graph you can see that our consumption of sugar and grains was relatively high back in 1960, and that both have decreased since the 1990s.
The consumption of meat and seed oils has steadily increased but the line is much steeper for seed oils.
Let’s put the food categories in relative terms instead so we can get a better grasp of the increase.
Sugar – 17.1% more today
Grains – 29.5% more today
Meat – 37.3% more today
Seed oils – 153.2% more today
I’m sure you have heard that red meat is bad for you.
If you follow my writing you will soon understand why I believe that red meat is not only healthy but should be a staple in a healthy diet for humans.
Now you might think – meat has increased by 37.3%, but surely it may at least be a driver of chronic disease.
Well, let’s look closer at the meat category.
The consumption of meat has increased since 1960, but only from poultry (chickens and turkey).
Both pork and beef consumption has decreased. They are thus not likely candidates for the increase in disease.
Here is something for the nerds out there.
Monogastric animals (one stomach) do not have the ability to convert polyunsaturated fatty acids into either monounsaturated or saturated.
Well, the main reason seed oils are bad for us is the content of polyunsaturated fatty acids.
Chickens are, much like us, not eating a species-appropriate diet, and are instead fed seeds.
These seeds are high in polyunsaturated fatty acids which accumulate in their fat tissue, which we then eat.
The fat from poultry (and pork) is also driving the increased consumption of polyunsaturated fatty acids.
Seed oils, oh, seed oils.
Seed oils, as you now know, are a very modern phenomenon.
Edible seed oils were introduced in 1910 with Crisco.
Since then the consumption of them has steadily risen and in the past 50 years, this rise has been almost exponential.
Americans eat less sugar, grains and red meat than in the 1990s. At the same time, we have seen the fastest increase in chronic diseases known to man.
The only dietary aspect that could explain this is seed oils.
The estimated per capita consumption of soybean oil increased >1000-fold from 1909 to 1999.
Balsbalg et al 2011
From 1909 to 1999 the consumption of soybean oil in America rose 123 810% while at the same time, sugar consumption increased by 59%.
This is from a study looking at the change in the ratio of omega-6 and omega-3 fatty acids in humans.
Evolutionarily this ratio seems to have been between 1:1 and 4:1, omega-6 to omega-3.
Today, mainly due to seed oils, it is closer to 20:1.
This is the largest change in fat composition seen in humans ever.
Again, large mismatches will have large negative consequences.
Americans follow the recommendations.
Despite this, they are sicker than ever.
Could it be because of seed oils?
Something that has largely flown under the radar.
The only dietary aspect that has risen at the same time and pace as chronic disease.
Unlike the people in charge of making recommendations, we know that correlation does not mean causation.
To say that seed oils alone are responsible for the rise in chronic disease would be an oversimplification of a complicated problem.
Complex problems need complex solutions.
All the solutions governments the world over have tried failed miserably.
Let’s be good scientists.
Epidemiology can only show correlation.
From this, we can derive testable hypotheses.
With what we have gone over today the only logical hypothesis to make is that seed oils are a driving factor of chronic disease.
To test this we need to look at experimental studies, chemistry and evolution.
This way we can come to a complex answer to a complex question.
Before we jump into the experimental studies we need to gain a grasp on the chemistry of fats.
We do this so that we have some basis for why seed oils may be harmful to us.
In the next post we will answer:
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