In grocery stores and supermarkets, food sections may be roughly divided into two categories: (A) fresh produce, and (B) processed, prepared, preserved, and packaged food. The foods in category A, the vegetables and fruits of the produce section, promote heart and general health. Unfortunately, the foods in category B, processed foods, are today preponderant in the American diet. Is it a coincidence that obesity is widespread?
By a vote on June 18, 2013, the delegates at the annual meeting of the American Medical Association classified obesity as an official disease. In 2004, the US Department of Health and Human Services designated obesity as a disease. In 1998, the National Institutes of Health declared obesity a disease, and the US Surgeon General, David Satcher, MD, pronounced obesity a “national epidemic” as well. At least on one occasion in the 1990s, the US Secretary of Agriculture proclaimed obesity a national epidemic.
In my opinion, all Americans should read the #1 New York Times best seller Salt Sugar Fat: How the Food Giants Hooked Us, by Michael Moss, a Pulitzer Prize–winning investigative journalist for The New York Times. Today, the US is “the most obese country in the world” (p. 22). (This quotation and others, and much of the subsequent information in this article, is gleaned from the book.) A total of 35% of adult Americans are obese, and two-thirds are overweight (p. 22). A “body mass index [BMI], a simple ratio of height to weight” (p. xvi) of 30 or greater indicates obesity. A BMI of 25 or greater indicates overweight.
Obesity is correlated with coronary artery disease, type 2 diabetes mellitus, and hypertension (high blood pressure), a risk factor for myocardial infarction (heart attack) and heart failure (with an increased workload for the heart) (pp. xvi, 267). Heart disease is the number one cause of mortality in America. Definitely overweight, my father, the Honorable L. Welch Pogue, Esq., had a major heart attack at the age of 57, read about heart disease, right away lost 30 pounds on purpose, adopted an essentially low-fat, plant-based diet, and in time walked 1 hour every day until his death at over 103½ years of age—with his mind as sharp as a tack to the end.
The 300 processed food manufacturers (pp. 213, 220) “dominate the American diet” (p. xxx), with 60,000 products in the supermarkets (pp. 27, 98), relying on salt, sugar, and fat, which “override our dietary self-control” with foods “so perfectly engineered to compel overconsumption” (pp. xix, 253, 333, 346). Salt, sugar, and fat are “the three pillars of processed food” (pp. xiii, 22, 39, 70, 264, 281, 289, 293, 337). With sugar and fat intake, brain pleasure centers light up bright yellow in functional magnetic resonance imaging studies (pp. 148–149, 276), just as with cocaine (p. xxvii). Increasing the amount of sugar intake leads to a “bliss point” (a range) of maximum taste satisfaction, disposing the consumer to crave sugar (pp. xxv, 10, 11, 30, 34, 38, 42–43, 316) in a virtual addiction. This caused the National Institutes of Health's Nora D. Volkow, MD, to urge some people to “just stay away” from processed sugar (p. 342). On average, Americans consume 22 teaspoons of added sugar per day (pp. 4, 23, 362n4), over two-thirds from processed food (p. 17). A 20-ounce soda has 15 teaspoons of sugar (p. 99). (One teaspoon contains 4.2 g of sugar [p. 370n59].) The American Heart Association suggests a limit (beyond needs) of five teaspoons per day for women and nine for men (p. 23). Nearly all processed food has added sugar, including high-fructose corn syrup (p. 21). Excess sugar intake is stored as fat (pp. 31, 116). Newborn babies love sugar (pp. 11, 18). Babies dislike salt, but adjust to liking it, upon coaxing, on or after the age of 6 months; the food industry has created a craving for salt (pp. 10–11, 278–280).
Increased saturated fat intake correlates with obesity and type 2 diabetes and with “cholesterol, clogged arteries, heart attacks, and strokes” (pp. 187, 214–215). Michael Moss stresses that “fat is an energy colossus. It packs 9 calories into each gram, more than twice the caloric load of either sugar or protein” (pp. 153, 263–264). For fat, instead of a “bliss point,” there is a quite potent “mouthfeel” (dryness, gumminess, and moisture release); in terms of its allure, fat can be added to food without limit (pp. 42, 154, 157–158, 171, 174, 218, 264, 329). Cheese is the biggest single source of saturated fat, which is converted by the liver into cholesterol (p. 163). Besides cheese, sources of saturated fat include pizza, red meat, chocolate cake, cookies, frozen dinners, candy, potato chips, corn chips, butter, and mayonnaise (pp. 178, 213, 215–216). The US Department of Agriculture's recommended daily limit for saturated fat is 15.6 g (pp. 155, 215).
Caldwell B. Esselstyn Jr., MD, a former Cleveland Clinic surgeon and the present director of the Cardiovascular Prevention and Reversal Program at the Cleveland Clinic Wellness Institute, emphasized that since 1993 the Food and Drug Administration permits food manufacturers to label (on packages and bottles) a product “fat free” or with “zero fat” if it contains less than 0.5 g of [artery-clogging] fat per serving. If salt, sugar, or fat is reduced, often one or both of the other two components of this triad are increased (pp. xxvi, 70). Fierce competition exists to outsell competitors and to enhance market volume, market share, shelf space share, and stomach share (pp. xii, xiii, xxix, 26, 27–28, 48, 83, 89, 95–96, 108–109, 110, 239, 257, 262, 310, 320, 338, 340, 377n110); Wall Street analysts and shareholders press and push for profits (pp. 262, 301, 322, 338–339).
Increased salt intake over time correlates with hypertension, stroke, myocardial infarction, and kidney damage (pp. 267–268, 271, 291, 295, 302, 304, 310). In Finland, government-promoted per capita salt consumption reduction by one-third correlated with “an 80 percent decline in the number of deaths from strokes and heart disease” (pp. 302–303, 310).
In the US, the salt intake of boys in their teens and men <40 is more than 10,000 mg per day (p. 268). Table salt contains 40% sodium; 10,000 mg of salt contains 4000 mg of sodium (p. 403n268). The federal government's suggested limit is 2300 mg of sodium a day (1500 mg for those particularly vulnerable) (pp. 271, 282, 290, 404n271). (One teaspoon of salt has about 6000 mg of salt, i.e., 2300 mg of sodium [p. 403n268].) The American Heart Association advises all adults to consume <1500 mg of sodium a day (p. 404n271).
Three-fourths of salt intake is from processed foods (p. 270), with only 6% of sodium intake from table salt (p. 269). Almost all processed food has added salt (p. 270). Salt has “addictive qualities” (pp. 276–277, 283, 305).
A weighty, grave indictment of processed foods, those foods that have great amounts of salt, sugar, and fat added, arises from the fact that many leading executives in the processed food industry with vigilance and diligence avoid eating the products of their own companies (pp. xvi–xvii, 39, 123, 208–209, 250–251, 314, 336, 341).
Long ago, American women generally were homemakers, preparing meals from scratch using fresh foods (pp. 61–66). Today, about 80% of women aged 25 to 54 are in the workforce (p. 246), and many have never been taught how to “cook from scratch” (pp. 64–65, 220). Americans largely depend upon processed foods (with much added salt, sugar, and fat—preservatives, maskers of poor taste, and crave-creators) sold in grocery and “convenience” stores and in supermarkets (pp. xiii, xxix, 38, 57, 210, 220, 270, 283, 288, 300). A land of fresh food has become a land of factory food and fast food—and a land of fatness, of overweight and obese people, including children. The corporate food factories are consistently in control of culinary cooking culture (and of consumer cravings). Combined with limitations on salt, sugar, and fat, cooking from scratch switches control to the consumer. Long live this empowerment!