Health

Americans are among the most unhealthy people in the world. According to the Centers for Disease Control and Prevention, almost two-thirds of Americans—approximately 97.1 million adults and 6.7 million children and teens—are overweight. The number of overweight Americans has more than tripled in the last twenty years. In addition to high rates of obesity, Americans suffer higher rates of heart disease and cancer than people living in any other country in the world. Cardiovascular disease is the number one cause of death in America, and at least 58 million Americans experience some form of heart disease. Cancer is the second highest cause of death in the United States, resulting in more than five hundred thousand deaths per year.

Despite the fact that rates of obesity, cardiovascular disease, and cancer are rising, the sorry state of American health is not new. Health experts have admonished people to eat healthy foods and to exercise since the 1950s, but the incidence of “lifestyle diseases”—noncommunicable diseases related to unhealthy lifestyles and unbalanced diets—continues to increase. Since many health problems are related to a poor diet, government health departments have issued numerous guidelines over the last fifty years to help the public navigate the bewildering abundance of food choices. However as new research about the causes of lifestyle diseases surfaces, the guidelines quickly become outdated. Thus, many people remain confused about which foods, and in what quantity, constitute a healthy diet.

In 1956 the U.S. Department of Agriculture (USDA) published a leaflet called Food for Fitness—a Daily Food Guide, in which it outlined the Four Basic Food Groups: 1) Meats, poultry, fish, beans and peas, eggs, and nuts; 2) dairy foods, including milk, cheese, and butter; 3) grains; 4) fruits and vegetables. These guidelines recommended that Americans prepare their meals from the Four Food Groups, relying heavily on the meat and dairy groups. The primary goal of the Four Food Groups was to ensure that Americans consumed sufficient vitamins, minerals, and other nutrients. Food producers enthusiastically endorsed the Four Food Groups because every one of their products had a place in the guidelines. Thus, they felt justified in promoting all foods as healthy, including foods that were high in fat and calories.

Unfortunately, many people began to complain that the Four Food Groups was primarily a campaign to promote the meat and dairy industries. As stated by nutritionist Neal D. Barnard, “Dairy products got their own group, and it was prominently featured. If you look at the fine print on the posters that are in schools, it indicates that the Dairy Council has put these out. They print the posters, and they still promote the old Four Food Groups because it increases sales of their products. It’s the same with the meat producers.” Despite questions about its reliability, the Four Food Groups guide remained the principal source for nutritional information until the 1970s.

By the 1970s a growing body of research began to associate overconsumption of certain food components—saturated fat, cholesterol, and sodium—with the risk of chronic diseases, such as heart disease and stroke. According to Harvey Levenstein, author of Paradox of Plenty: The Social History of Eating in Modern America, the government was slow to acknowledge the association between foods high in saturated fat and cholesterol—meat and dairy—and health problems because their research efforts were largely responsive to beef and dairy interests. However, nongovernmental health organizations, such as the American Heart Association and the American Cancer Society, pioneered aggressive research into the relationship between diet and health. As stated by Levenstein, “Not only did they subsidize research into the deleterious effects of various foods on their particular ailments, they also took the lead in disseminating any adverse results. They began spending millions to warn the public of the supposedly terrible consequences of eating foods containing too much sodium, sugar, and animal fats, as well as the perils of being overweight.”

Thus began a new era in health education known as the Negative Nutrition or Selective Nutrition period. Instead of placing emphasis on eating enough nutrients, Negative Nutrition warned against eating certain kinds of foods. Dairy was a major target, because the cholesterol in milkfat and butterfat was believed to contribute to heart disease and other deadly illnesses. Sugar was also targeted as an addictive drug that was responsible for cancer, heart disease, diabetes, skin ailments, hyperactivity, and schizophrenia, among other mental and physical ailments. A few years later, meat products came under suspicion because they contained saturated fat, another contributor to heart disease. In 1977 the Senate published the Dietary Goals for the United States, which included new nutrition objectives, and within four years, Negative Nutrition became the core of national nutrition policy. In 1980, based on the Senate’s Dietary Goals, the USDA published the Dietary Guidelines for Americans, a comprehensive nutritional reference guide that is updated every five years.

Food producers responded to the USDA’s Dietary Guidelines by introducing hundreds of “low-fat,” “low-calorie,” “fat-free,” “cholesterol-free,” and “sodium-free” versions of their foods. To further confuse matters the Ronald Reagan administration lifted previous restrictions on advertising health claims, and advertisements for “heart-healthy” and “healthwise” products became the public’s primary source for nutritional information. Unfortunately many food producers pandered to the demand for low-fat and low-cholesterol foods using false advertising. In response to the onslaught of unsubstantiated health claims on food labels, the government passed the Nutrition Labeling and Education Act (NLEA) in 1990. The act ensured that consumers had access to accurate nutritional information, including a list of the product’s ingredients as well as the calorie, fat, sodium, cholesterol, and sugar content.

Soon after passing the NLEA, the USDA published an updated version of the Four Basic Food Groups guide, known as the Food Guide Pyramid, in 1992. The Food Guide Pyramid, which follows the Dietary Guidelines for Americans, pictures fruits, vegetables, and grains at its broad base, recommending six to eleven servings of grains and three to five servings of fruits and vegetables per day. The guide locates meat and dairy products on the next (smaller) section of the pyramid, recommending daily consumption of two to three servings from the meat and dairy groups. Last, the guidelines place oils, sweets, and fats at the narrowest tip of the pyramid, indicating that these foods should be used sparingly. As stated in the Food Guide Pyramid Booklet, “By following the Dietary Guidelines, you can enjoy better health and reduce your chances of getting certain diseases.”

Many people disagree with the Food Guide Pyramid and argue that the guidelines still recommend excessive amounts of meat and dairy products. In 1992 the Physicians Committee for Responsible Medicine (PCRM), a health and nutrition advocacy group, unveiled its recommended New Four Food Groups guide. The New Four Food Groups recommends a diet based primarily on grains, vegetables, fruits, and legumes (or anything in a pod, such as beans, lentils, or peas). Many vegetarian organizations advocate the New Four Food Groups and contend that the foods suggested by these guidelines provide all the necessary nutrients for good health, contain no cholesterol, and are very low in fat. Supporters also argue that the low-fat content of these foods makes them especially valuable to ensure long-term weight management. As reported by PCRM, “The major killers of Americans—heart disease, cancer, and stroke—have a dramatically lower incidence among people consuming primarily plant-based diets. Weight problems—a contributor to a host of health problems—can also be brought under control by following the New Four Food Group recommendations.”

The twentieth century saw remarkable discoveries in the field of health and nutrition, but the array of information available to guide consumers is bewildering. The conflicting information offered in the Food Guide Pyramid and the New Four Food Groups can be frustrating and discouraging for people trying to follow healthy lifestyles and avoid disease. Rather than struggling to adhere to a rigid set of regulations, many dietitians now maintain that a healthy diet incorporates the basic principles of variety, balance, and moderation. Thus, no food is taboo, so long as it is only eaten once in a while. As stated by the American Dietetic Association, “Rather than being taught to avoid certain foods, [people] should be taught ways to incorporate all foods into a healthy diet that is based on the principles of variety, balance, and moderation.”

In Health: Opposing Viewpoints, authors examine the importance of a healthy diet and other issues related to health in the following chapters: What Factors Pose the Greatest Health Risks and Benefits? Are Exercise and Weight Loss Treatments Beneficial? Are Alternative TherapiesBeneficial? How Can Government Policies Promote Good Health? Throughout these chapters, authors debate the issues that affect the health of all Americans.