In general, I agree with a lot of what you're saying here about eating more vegetables and way less sugar being the way to go health-wise, but I do want to respond to some specific things you've said.
> You can find really good junk food everywhere, or pay a really high price to eat in high-level Italian restaurants for example, but it is very difficult to eat standard meat-with-vegetable-without-sugar-added, except in Asian restaurants
Restaurants are typically not where I go to eat healthy food anywhere in the world, although I do think you have a pointed that American restaurants are often relatively junk food oriented.
> ban every processed food, sauce, appetizer....
There is nothing inherently wrong with "processed" food; it is entirely possible to use industrial processes to make a perfectly healthy and wholesome food product. Take for example, (this is by no means an endorsement) Larabar [1]. They make snack bars that typically contain 2-3 ingredients that are all just dried fruit. Should they be banned as "processed" food because of how they are made?
> If you would not eat a spoon of every single ingredient of some food, don't eat it
This is a ridiculous statement and is one of the main reasons why I'm commenting. I wouldn't eat a spoonful of yeast, should I not eat bread? I wouldn't eat a spoonful of salt, should I not eat... anything?
> It looks like this is hard to do in the USA: you don't easily find, for example, yogurt without sugar added.
I've never lived in an area in the United States where I've ever had any problem finding anything like this.
1. The number of ingredients in something does not directly indicate how (un)healthy it is. The fact that Larabar contains 2-3 ingredients says nothing about its nutritional value.
2. In fact, many people would not consider Larabar to be a "processed" food to begin with because it literally is just 2-3 fruits and nuts mashed together. You could make something very similar in your own kitchen. The way you're speaking makes it sound like "processed" food is anything that is cooked or combined in some way. That is not how people use the word IME.
3. Have you looked at the sugar content of Larabar? It's not low, nor would I consider it healthy or wholesome. They likely chose dates specifically because of their extremely high sugar content so that they could pretend they are healthy while actually including unhealthy amounts of sugar in their product under the guise of dates.
Likewise, HFCS has about the same blend of sugars as honey, yet it is considered unhealthy and honey is considered healthy somehow. I'd like someone to explain how that works.
Honey is only considered "healthy" by people who know nothing about nutrition but who think "natural" is automatically good [0]. Honey is no better for you than HFCS, but no worse either (except in infants because honey often contains botulism spores that infants cannot fight [1].)
FWIW, I don't think honey is considered healthy. In any nutrition recommendation I'm familiar with, it is considered a part of added/free sugars, aka something to limit.
Maybe, if HFCS were consumed in equal amounts as honey, it would also be considered healthy. Hormesis is a strange thing - too much of a good thing will turn it into a bad thing.
> There is nothing inherently wrong with "processed" food
There's a distinction between processed and ultra-processed (or highly processed). For example, canned fish is processed (added salt and oil), while a frozen TV dinner is ultra-processed (many ingredients added, some of which you probably don't have in your kitchen).
Processed food is fine assuming you're aware of what's in it, how it's processed, and make sure you're not overeating any of it.
> There's a distinction between processed and ultra-processed (or highly processed). For example, canned fish is processed (added salt and oil), while a frozen TV dinner is ultra-processed (many ingredients added, some of which you probably don't have in your kitchen).
Sure, but OP said ban all processed food. That's what I'm responding to, not "ban all ultra-processed food." That said, I do find your categorization to be troubling. Just because something is a frozen dinner doesn't necessarily mean that it's bad for you. Whether or not something is good or bad for you is based entirely on its chemical composition; it has absolutely nothing to do with how it has been put together or what form factor its being distributed in.
It may sound like I'm being pedantic, but I think these kinds of short cuts are actually genuinely harmful. I've known many people who have thought "cheeseburgers from McDonald's are unhealthy not because cheeseburgers are unhealthy but because they are processed" and then gone right ahead and made themselves cheeseburgers that have three to four times the calories, fat, and salt of the McDonald's counterpart.
Does that make McDonald's a healthy option? Absolutely not. But why is McDonald's unhealthy? It's because the food they serve is unhealthy. It's not that the food that is served at McDonald's is unhealthy because McDonald's is unhealthy.
> Processed food is fine assuming you're aware of what's in it, how it's processed, and make sure you're not overeating any of it.
s/Processed//
If people want to eat healthier, they need to pay attention to the ingredients in the things they're eating. If we're going to regulate something, we need to regulate the ingredients that go into things people eat. Using buzz words like "processed" and "ultra-processed" with definitions that are, at best, not well understood by the general population just leads to people working around personal/social rules/regulations.
Just because your t-bone steak is local organic grass-fed whatever does not make it good for you. That food is just not healthy, even if it is the only ingredient. We did not evolve eating food like that with any kind of regularity. If you want to be healthy, you need to just not eat it.
A lot of non-technical people get hung up on the marketing terms than actually thinking through the fundamentals.
For e.g. "Handspun ice-cream! OMG!". Uhh..what difference does it make if it is hand-spun or machine-spun? It is not tool of spinning ice-cream, but what the process is. To majority of non-techy people, processed or machined or anything to do with automating a method is highly repulsive - thanks to the hipster marketing.
The general take away is - "Automated machines will never replace the touch of the hand"... oh really? then how come we can make insanely precise things called semiconductors in almost a completely automated fashion. Some fabs don't even have operators inside, just technicians or engineers. This is an extreme example just to make a point.
But then there are things that do make a difference. Take for instance homogenized vs non-homogenized milk. This processing destroys lactoferrin which is a molecule that strongly binds iron and reduces its absorption. Before someone argues this is actually bad, understand first why milk has lactoferrin and how this apparently only cosmetic process of homogenization has nutritional and health consequences.
Definitely, if you want imperfections, artisan value and appreciate craftsmanship, there is nothing wrong with handmade goods.
Just don't tell me that your Japanese knife when hand sharpened cannot be as good as something done by a robotic arm. Otherwise, I have some news - Japanese knife's edge sharpness(not durability) is no match for a surgical scalpel which is made by millions in quantities in fully automated fashion for less than $20. Or even a razor blade that costs $0.10. If scalpels were made from bluesteel (RH 62+), which is a horrible idea for a scalpel but just to make a point, then they would totally match a Japanese knife's durability too.
I could find countless examples where machines can have proper process control (SPC with control charts), high repeatability and can work well given all PMs are done and they're well maintained - totally out perform humans in many handcrafted jobs. Even things that we traditionally associate with artisan such as Guitars can be manufactured better and for cheaper by machines. "Only a master luthier can tell if the wood is good by knocking on it and feeling the resonance" - absolutely not. We can have ultra precision transducers and a whole bunch of DSP to figure that out and actually quantify that bullshit claim of artisanal value.
"But they have no human-like imperfections" - sure, just add random variation in the runtime code and imperfections can be automated.
What bothers me about this artisanal movement is not about craftsmanship, but about the marketing of it - just say it's handmade. Not because it is better but we want to preserve old ways of doing things. Don't say machines are not capable because I will show at your door and automate your job away.
I feel like you're blowing past some pretty significant psychological factors. People find it interesting and valuable to own a one-of-a-kind item that nobody else can ever have. An artist might paint pretty much the same thing a hundred times, but those small differences make each one slightly more valuable than a mere print. And the fewer instances there are in the world, the more valuable it is, at least in theory. Also, people like it when, for example, a favorite table was made over tens of hours of work by an expert carpenter, and they imagine that it was a labor of love by someone happy to have their work be a part of someone's life. It's personal somehow. There's also a lot of signaling involved in these "artisanal" or "handmade" marketing labels, because they are legitimately associated with higher-quality goods. Manufacturers mechanize processes to cut costs, and if they're so concerned with cutting manufacturing costs maybe they cut corners on quality too - this is how "Made in China" got a bad reputation even though of course China is perfectly capable of making high-quality goods. Finally, if an object is individually made by hand then there's a kind of automatic quality control that doesn't necessarily exist in an automated process.
And I seriously doubt that anyone will claim that a knife sharpened by a robot arm reproducing the exact movements of a human will produce an inferior product. The problem is that most automated sharpeners are some variant of a rotary grinding wheel run linearly along the blade and, unless you're sharpening a machete, there are all sorts of aspects of the blade geometry that are ignored by this process but can be accounted for by a skilled worker at a whetstone.
> Japanese knife's edge sharpness(not durability) is no match for a surgical scalpel which is made by millions in quantities in fully automated fashion for less than $20
If you started hamming your scapal against a chopping board everyday, it would get blunt very quickly. Comparing two knives with completly different use cases makes no sense.
> "But they have no human-like imperfections"
Easier said than done. You would need some sorts of adversarial model that would quantify which random variations were pleasing and which were not. People. Often prefer inperfections, but that does not mean all or most inperfections are desired.
Actually I do take issue with your example of grass-fed steak. Not sure why you would think it is not healthy, not even going to debate that. But do not dismiss it thinking the actual grass-feed has no impact. It increases the saturated of the meat of ruminants. If you want to go on a learning trip, look into the research made in the 40s about fattening cattle with saturated vs unsaturated fats.
I think it is a bit meaningless to talk about the merits or demerits of particular ingredients (other than the obviously bad such as rancid fats, pollution by heavy metals, or high in toxins) Humans evolved to eat a varied diet and the more variety of nutrient dense food you have the better off you will be. The main issue with nutrition is how can we teach people to eat better while keeping the production costs down.
I recognize I'm bloody lucky to be able to afford the food I get to eat every week, but just thinking of the resources required to have everyone eat this way is very hard. How sustainable would it be for everyone to eat fresh seafood every weekend or constantly import oranges to northern latitudes? Part of the problem is that people choosing processed food leads to an increasing divide in costs between the processed and the freshly prepared, only due to economies of scale. And it will only keep getting worse. My parents' generation all had fresh milk delivered daily at their homes (relatively affordable even for the middle class), today how many people could afford something like that? It took only a little time when cheaper options appeared for it to become uneconomical and nowadays even if you wanted to pay a premium, how big would it be?
A big mistake is to only focus on macronutrients when micronutrients are as important. Even then, it is a relatively unexplored field, how many chemical species you think an apple has? We have explored relatively few classes and particular examples of vitamins and it would be misleading to just go by the RDA of a few classes of chemicals which were explored because of simplicity, technical development at the time? How many vitamin E analogues are in a kernel of wheat? When did we stop doing this basic research into food and nutrition? There are millions of different molecules in natural food, how much is destroyed by processing? Like the homogenization of milk, which is practically very vigorous stirring and yet it destroys lactoferrin.
I generally agree with your points, especially with the flagrant discrimination between processed and unprocessed food, but I think you're being unproductively predantic, especially if it comes to what might be useful for the "general population". My impression is that it's easiest to be consistent if you adopt a fairly simple (unnuonced) set of principles that guide your doet and lifestyle, then adapt it as you gain more control. Exercise good, processed bad, is probably a great place to start for most people —including the author if they hadn't already done the research. As a Canadian, even though we get a lot of stuff from the states AND even though the states has some kind of "added sugar" labelling, I was pretty disgusted to see some things in supermarkets. Yes Walmart has a pretty decent grocery section now, but it sits next to McDonald's where you can get 30 chicken nuggets for $10, the boxed foods aisles that have an exhaustingly low supply of no sugar options, and the fried chicken section where $3 goes seemingly a lot farther if you don't think about it.
> My impression is that it's easiest to be consistent if you adopt a fairly simple (unnuonced) set of principles that guide your doet and lifestyle, then adapt it as you gain more control. Exercise good, processed bad, is probably a great place to start for most people —including the author if they hadn't already done the research.
Exactly. Approximations are good, because they allow you to start doing things now, rather than procrastinating because you need to do proper research first.
You don't need to research the best exercise in the world before you start exercising. Just start exercising, and don't hurt yourself.
You don't need to do the nutrition research. Eat lots of vegetables, cut down on sugar and salt.
...and of course, you can still do the research later, if you want to. But if the proper research will take you say 10 years, it is better to spend those 10 years already exercising and eating vegetables and avoiding sugar.
> Does that make McDonald's a healthy option? Absolutely not. But why is McDonald's unhealthy? It's because the food they serve is unhealthy. It's not that the food that is served at McDonald's is unhealthy because McDonald's is unhealthy.
It sounds to me like this is the crux of your argument.
I think I'd agree and hopefully add some clarifying points.
1. Processing
Processing doesn't necessarily make things less healthy. It depends on the type of processing and what is being processed.
If you blend a steak, it isn't less good for you (although it is more susceptible to food poisoning). Adding heat to things like meat can actually make them more bio-available since they're easier to digest. Adding heat to vegetables can break down certain vitamins and make the result less healthy.
Additionally, heating food in certain ways can make it less healthy because of the cooking process. Anything that chars the food or introduces partially combusted hydrocarbons (burned cooking oil, grilling/smoking, etc.) adds carcinogens to the food.
2. Macro-nutrient profile
Food satiety is relatively well understood: protein, water and fiber are all appetite suppressants. People need a certain amount of fat and probably desire at least a small amount of carbs (although the last part can be overcome in some people).
For a sedentary person, a diet high in carbs and fat is probably not good, as it will result in weight gain.
For someone with higher energy needs - say someone building a trail through the woods with a mattock - they may need to eat 6000 Calories per day just to maintain their body weight.
For a sedentary person, a diet high in protein will be distasteful and probably wasteful.
For professional athletes competing in strength sports, they may eat over 2g / kg of body mass of protein as part of a diet tailored to their goals.
Broadly speaking, in order to promote the health of a person, the macro-nutrient profile of their food should match their body and their activity levels.
3. Micro-nutrients
Eating vegetables are good for you. The more raw the vegetables are, the better they are for you (probably). There is often a trade-off that needs to be struck between palatability and optimum health benefit.
There is also a wide array of micro-nutrients that can come from eating meat of various sorts.
There are many conflicting opinions here, without a broad consensus, so I'll leave it at that.
4. Weird stuff
Often times people will bring up ingredients in processed food that they don't know what it is, or even how to pronounce it.
I don't think people are bad to want to avoid stuff like that.
But for the most part, I have real doubts that this is the cause an health problems in even a small fraction of consumers.
So, this mean that McDonalds is as healthy as the burgers I make at home? I was under the impression that their food is loaded with sugar and strange additives.
> So, this mean that McDonalds is as healthy as the burgers I make at home?
Sure, as long as you use similar ingredients.
> I was under the impression that their food is loaded with sugar and strange additives.
It's not. The beef patty really is just beef. The bun is white bread, just like you can buy at the grocery store. And the condiments are self-evident. It's just that that they've nailed the production process so precisely that what you get tastes almost exactly the same, every time.
A lot of people have this warped, black and white view of "healthy" and "unhealthy", but the reality is that it's a spectrum, and you can get reasonably healthy food at McDonalds but eat like crap at home.
Their hamburger doesn't look any different than what I would make at home. I don't have any grocery store bought buns in front of me, but I assume it would have similar ingredients. The pickles are not the most natural, but once again, it's not much different than what I would buy in a grocery store.
The biggest difference for me personally is that I would usually make a salad or another vegetable along with homemade burgers and fries, but it wouldn't even cross my mind to order that at McDonald's. I suppose I bring that on myself.
Regular Bun: Enriched Flour (Wheat Flour, Malted Barley Flour, Niacin, Iron, Thiamine Mononitrate, Riboflavin, Folic Acid), Water, Sugar, Yeast, Soybean Oil, Contains 2% or Less: Salt, Wheat Gluten, Potato Flour, May Contain One or More Dough Conditioners (DATEM, Ascorbic Acid, Mono and Diglycerides, Enzymes), Vinegar.
100% Beef Patty: 100% Pure Usda Inspected Beef; No Fillers, No Extenders.
Prepared With Grill Seasoning (salt, Black Pepper).
Ketchup: Tomato Concentrate from Red Ripe Tomatoes, Distilled Vinegar, High Fructose Corn Syrup, Corn Syrup, Water, Salt, Natural Flavors.
And here we get at the root of the problem with the North American diet... The fact that people think an ingredient list like this is acceptable or 'not that bad' is a problem.
The 'white bread' ingredient list looks nothing like real bread. Sugar? Oil? These are ingredients in muffins and cakes, not bread. The wheat they use has been processed to the point that a few key vitamins have to be added back just to make it legal again.
The ketchup and pickles are basically jam and sliced candy, there's so much sugar in them.
Not to mention the salt levels in everything.
If you eat low quality white bread and cheap condiments with every meal, you might as well have a candy bar and a bag of chips instead. But we've normalized it, we think we're eating home cooked food each time we reach for a plastic bottle or bag.
I also want to point out that "100% Pure USDA inspected beef with no fillers or extenders" doesn't mean what it sounds like. What this doesn't list are all the things that are allowed to be in your cheap, factory farmed beef and still be called 100% pure beef, like ammonia-treated lean highly textured beef (LFTB or 'pink slime': https://en.wikipedia.org/wiki/Pink_slime), HGH, antibiotics, etc.
By all means go out and enjoy some junk once in a while, but we've gotta stop normalizing ultra-processed foods in our homes.
No one's claiming that McDonald's hamburgers are super healthy and that we should be eating them every day, just that they're no worse the typical home-made burger. But they're also not bad. The problem with the average American diet isn't really the ingredients, but the size.
So not much better than the McDonald’s buns, and maybe a little worse. I’m guessing that the above ingredients are all required for a hamburger bun that is both shelf stable and cheap.
I’m not sure what the takeaway of that is. Maybe I should get the more expensive and presumably more natural buns? Either way, the McDonald’s buns aren’t any worse than what most people are eating at home.
They're not the cheapest of course, but hardly some absurd luxury at 33.8p each, they're a lot nicer than squidgy cheap rolls that are unlike anything you could reproduce at home or see a baker produce, and have pretty much the same ingredients list you'd use at home, if you used commercial yeast and bothered with three different flours.
And there's no selection bias or anything - I haven't looked at the ingredients list before, that's not why I buy them. I buy them because they're nice enough and so far I haven't bothered to bake rolls, mainly because my demand for them is more erratic than slice[able] bread.
As a doctor, your primary job is to make sick people healthy, not to make healthy people more healthy.
This is why you want to have a high compliance, meaning that the sick person does what the doctor recommends. This is mostly caused due technical or behavioral complexity.
You can increase compliance by reducing complexity. At the same time, the accuracy decreases.
Example:
High Accuracy / High Complexity: "Do not eat frugugle, fergerio, flululu and fnyvoo." Why low compliance? Because the behavioral complexity is very high, especially for sick people:
1. Find the food ingredients list.
2. Loop over the ingredients list and compare the current item with the "do not eat"-list.
3. Make a decision for every ingredient, if this is in the list ("frugugle" is on the list, but one ingredient is "fruguglelase", what's my decision?)
Lower Accuracy / Lower Complexity: "Do not eat products with more than 3 ingredients." Why higher compliance? Because the behavioral complexity is lower:
1. Find the food ingredients list.
2. Count the amount of ingredients.
3. Make a decision after reading max. 3 ingredients.
IMHO it's easier to start with the second approach, because you make progress faster, and keep the momentum going.
This whole argument strikes me as very silly. If I want to eat healthy foods badly enough to change my diet and check the ingredients every time I buy something, I'm not going to want to oversimplify it to the point of near meaninglessness by adopting a rule like "3 ingredients or fewer." I'm perfectly capable of learning what ingredients to avoid.
And if I'm sick, and there are clinical details that are important to my treatment, then I'm absolutely not going to be satisfied with a low-accuracy simplification.
> There is nothing inherently wrong with "processed" food
I don't know if I'd go as far as to say "wrong" but certainly the less processing a food has, the better, primarily because you get to retain more of the fiber content (and so the food is more filling).
>There is nothing inherently wrong with "processed" food; it is entirely possible to use industrial processes to make a perfectly healthy and wholesome food product.
Given how profit in the food industry and addiction is so closely tied together, I don't see how this is possible.
I can eat a spoon of salt, or yeast. It is not particularly good but I know what it is, and I know the toxic dose. I won't eat a spoon of sodium benzoate or E324 or I don't know which food additive, I can't buy it in a food store, it is not "food" by itself. So I don't eat it :-)
I'm not sure a big spoon of salt will make you any less sick than a big spoon of sodium benzoate, but that's fair. I definitely agree that people should avoid eating things they do not understand; I think most of my disagreement with your original post is semantic, but I do still appreciate it. :-)
> You can find really good junk food everywhere, or pay a really high price to eat in high-level Italian restaurants for example, but it is very difficult to eat standard meat-with-vegetable-without-sugar-added, except in Asian restaurants
Restaurants are typically not where I go to eat healthy food anywhere in the world, although I do think you have a pointed that American restaurants are often relatively junk food oriented.
> ban every processed food, sauce, appetizer....
There is nothing inherently wrong with "processed" food; it is entirely possible to use industrial processes to make a perfectly healthy and wholesome food product. Take for example, (this is by no means an endorsement) Larabar [1]. They make snack bars that typically contain 2-3 ingredients that are all just dried fruit. Should they be banned as "processed" food because of how they are made?
> If you would not eat a spoon of every single ingredient of some food, don't eat it
This is a ridiculous statement and is one of the main reasons why I'm commenting. I wouldn't eat a spoonful of yeast, should I not eat bread? I wouldn't eat a spoonful of salt, should I not eat... anything?
> It looks like this is hard to do in the USA: you don't easily find, for example, yogurt without sugar added.
I've never lived in an area in the United States where I've ever had any problem finding anything like this.
[1] https://www.larabar.com/