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EDITORIAL

THE US EMPIRE IS ABOUT TO COLLAPSE: POPULATION HEALTH MAY BE THE CAUSE--David Bissonnette RD, PhD

Dr. Bissonnette is an Associate Professor of Nutrition at Minnesota State University, Mankato where he does obesity research. He advances that obesity is a mere symptom of a much greater social malaise, which medical science has failed to address.

He is the author of two textbooks: NUTRITION REVOLUTION: Influencing the Social and Medical Determinants of Health; and Nutrition for Healthcare Professionals: Introduction to Disease Prevention. He produced the documentaries: OBESITY IN AMERICA: A National Crisis,  A DIABETIC NATION: An American Tragedy, and DEPRESSION: The Whole Truth. He manages the website: The Nutrition Report.

 

THE AMERICAN EMPIRE IS ABOUT TO COLLAPSE. Although our political system and heads of government are certainly complicit – by way of their blindness and inability to form a long-term vision – what is really driving this pending collapse is the health of our nation. Close to 70% of adults and 35% of youth are either overweight or obese, and afflicted by chronic disease; the consequence is a yearly healthcare expenditure exceeding $2.6 trillion, which is driving the US healthcare system to the brink of insolvency. The disturbing growth in the prevalence of obesity, was initially detected by epidemiologist Dr. Katherine Flegall in the late 1980s, although some growth had already begun in the 1970s. She believed she was observing a momentary statistical anomaly, that would eventually self-correct. This wasn’t the case. The growth was real and soon after the US obesity prevalence maps, published throughout the 1990s and early 2000s by NIH, would shock the nation. A surprising few acknowledge that the way we ate and lived were the true vectors driving this epidemiological disaster—not diet alone. What makes the obesity epidemic simply untenable is that close to 50% of pregnant women are now either overweight or obese. These women are at high risk of giving birth to a progeny weighed down with poor health; the social consequences are simply untenable. To do nothing more about obesity than what our doctors are attempting—namely weight loss diets and appetite suppressants—would most certainly be the formula for societal collapse.   

 

So why did the field of medicine become so myopic in its treatment? The problem is that, rather than uncovering the causes of obesity, medical researchers and practitioners were content to only treat the symptoms. The belief was that we were either eating too much, not exercising enough, or both. A diet revolution soon ensued in the 1970s which introduced popular diet gurus like Robert Atkins and Dr. Tarnower who proposed altering macronutrients to remedy the national weight gain problem. In response, millions of Americans embraced weight loss diets, and in the four decades which have proceeded the trend—according to Dr. Traci Mann, a researcher at the university of Minnesota—the weight problem of the American public has gotten worse.

 

Consequently, over the last five years, the treatment strategy changed; lifestyle coaches began promoting the benefit of both healthy eating and exercise, while doctors, who no longer promoted weight loss diets, embraced appetite-suppressants as part of a permanent therapeutic modality for continued weight loss and maintenance.  This was a strategic error in the treatment of the disease.

 

The direct treatment of food and energy intake should never have been a medical focus; Dr. Flegall’s findings should have acted as the impetus for a much deeper search for its true cause. Indeed, obesity was merely the symptom of a much deeper pathology. Instead, for the last 50 years, the diet industry has highjacked obesity and made it into a multibillion dollar weight loss enterprise with each new diet as ineffective as the last. Nonetheless we persist in embracing each new and ‘groundbreaking’ weight loss strategy with unrelenting vigor. And, so we side-stepped the true cause and kept treating the symptoms. 

 

The truth is that we’ve been conditioned to overeat. Overeating has plagued Americans since the early to mid-19th century. The US Health Reform Movement that took root in the early 19th century was a social response to the dinner tables of the rich and elite of the American Industrial Revolution, that were lavished with meats, sauces, wines and beers. There was consternation, back then, at the portions and richness of the foods that adorned the tables of the new American aristocracy. They refused to listen to the health reformers who preached temperance.

 

The origins, however, of our unrestrained appetites stem from Europe. Excessive lavished eating had been nurtured amongst the aristocracy in England, France, Sweden, Denmark, and Italy for close to 200 years, leading up to the 18th century (Flandrin, 1999). In fact, it originated in the 1600s, at a time when the pleasure of food, was immoderately celebrated by the nobility. Indeed, in the 17th century, French cuisine spread to the kitchens of the European aristocracies, with literary works like Le Cuisinier Francais, describing and defending the pleasure of food and drink. These early cookbooks propelled into the popular realm culinary experimentation aimed at cultivating and exciting the palates (Flandrin, 1999). And, so they did, but not without leading many to overindulge.

The cultural celebration of gluttony reached its apex among aristocracies around Europe with the publication of Grimod de La Reynière’s Alamach des gourmands in 1804.  It was the crowning literary work for the lovers of food and drink. Jean-Louis Flandrin (1999), Professor Emeritus at the University of Paris depicts the impact of the Alamach:

“…it became possible to admit without shame to what once had been considered the deadly sin of gluttony.”

Flandrin points out that the term gourmand (gluttonous, in English) was changed to gourmet, a word which had no pejorative sting, and which even conveyed a touch of sophistication. And so, to be gluttonous became acceptable, a new social norm that flew in the face of the Catholic church’s moral teachings that it had upheld for centuries (Kishlansky et al. 1991).

British philosopher John Locke (1632-1704) was one of the early thinkers who set fire to the precepts that supported a belief in God. In his 1690 essay titled: An Essay Concerning Human Understanding, he advanced the relativistic argument that morality was debatable in that it was based on experience, and that it was not an absolute theological reality. David Hume continued to advocate for this type of skepticism in 1748 with An Inquiry Concerning Human Understanding. His thesis launched him onto the British landscape as a deist and skeptic, who directed a frontal attack on organized religion that was grounded on the belief of the age “that nothing was known and nothing was knowable. Hume had no tussle applying the idea of uncertainty to the revealed truth of Christianity. This opened the door to the abandonment of morals, for if God did not exist, and nobody could be certain of the Church’s teaching on morals, then everyone was indeed left to interpret life and its meaning in their own individualistic way.

So then in that sense, the dietary revolution of the 18th century, which gained popularity amidst the gluttonous diet of the aristocrats, was in stark contrast with the simple catalogue of bread, porridge, herbs, roots and ale, interspersed with infrequent and small amounts of shellfish, fish and pork, that were consumed by the peasants of the early Middle Ages.

The peasants followed a good and simple diet and a lifestyle that had many mandatory fasts scheduled by the Catholic Church, and that matched the liturgical themes of the Church calendar (Bokenkotter, 2004). There was an order and a rhythm that changed with seasons and Church feasts. Monasteries, during the early middle Ages, exemplified the impact of these rhythms on health, physical fitness and intellectual development. The monks followed a life of balance between physical work, spiritual readings and prayer that was central to the life of the community. And it is this order that provided the opportunity to cultivate a life of purpose rooted in deep joy and meaning, which invariably translated into good health and longevity

John Horvat (2013), author of Return to Order wrote that this order is important for societal growth, and must be based “…on the four cardinal virtues—prudence, justice, fortitude, and temperance—since they are the moral virtues upon which all other virtues are hinged and which specifically regulate man’s use of material things.”

It is this rhythm, which is solidly anchored on the high moral ground of virtue, and Christian perfection, that is missing in today’s frenetic lifestyle (Horvat, 2013). We long, instead, for the sensations achieved through gluttony, and no longer follow the ebb and flow that is so innately attached to our nature, which is naturally ordered to seek God. Once this order is missing in a person’s life, and in a society at large, incalculable consequences begin to occur. It begins with stress and anxiety—leading invariably to disease—and ultimately to an obesity crisis that is crippling our nation and possibly fueling its demise.

 

Bibliography:

 

  1. Bokenkotter, J. A (2004). Concise History of the Catholic Church. New York: Doubleday, 580 pp

  2. Flandrin, J-L (1999). Seasoning, Cooking and Dietetics in the Late Middle Ages. In: Food: Culinary History from Antiquity to The Present (Jean Louis Flandrin and Massino Montanari eds). New York: Columbia University Press, p: 312-327

  3. Horvat-II, J. (2013) Return to Order: From a Frenzied Society to an Organic Christian Society, York (PA): York Press, 382 pp.

  4. Kishlansky, M., Geary, P. and O’Brien, P. (1991). Civilization in the West. New York: Harper Collins Publishers, 1021 pp.

 

There is some level of controversy surrounding the impact of non-nutritive sweeteners on appetite control. Connie Dieckman RD, LD, MEd, writes:"The first nonnutritive sweetener, saccharin, was discovered in 1879. Since then, four other nonnutritive sweeteners, along with the herb extract stevia and the fruit extract luo han guo, have joined the category. The seven nonnutritive sweeteners currently approved for use in the United States are acesulfame-K, aspartame, luo han guo (monk fruit) extract, neotame, saccharin, stevia, and sucralose. The use of nonnutritive sweeteners in weight management is a point of much discussion and research. The 2010 Dietary Guidelines recommend that “replacing added sugars with non-caloric sweeteners may reduce calorie intake in the short-term, yet questions remain about their effectiveness as a weight management strategy. Read more here: Today's Dietitian

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INSATIABLE identifies the obesity epidemic more as a symptom of a much more profound social malaise than organic disease. This unique analysis of what has been until now primarily a medical condition attributes this social malady—now defining American society— as a deep insatiable hunger that drives chronic diseases, medical epidemics, and social unrest. Using many interpretive lenses, Dr. Bissonnette draws the reader into an in-depth exploration of many other epidemics such as depression, anxiety, substance abuse, adverse childhood experiences, hopelessness, and loneliness, now peppering the American landscape.

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