100 Million Years of Food, page 20
True to billing, the topaz waters around the islands are a delight to snorkel, though I stupidly skimp on sunscreen, hoping that the melanin in my skin will shield me from sunburn. Dream on! The skin on my back, after months of enduring blizzards and frost in Ottawa and Sapporo, blisters like pork fat on a grill. As for the remarkable age-defying Okinawan cuisine … I find instead sausages, Spam, eggs, and burgers, everything deep-fried, stomach-clingingly greasy. What happened?
In a plot twist the Marquis de Sade could not have devised with more cruel irony, the prefecture went from being Japan’s healthiest to one of its sickliest in just a few decades. The “26 Shock,” as locals call it, saw male life expectancy nosedive from fourth place among Japanese prefectures in 1995 to twenty-sixth place five years later.56
To sketch out the dietary debacle of Okinawa, we need to go back to April 1, 1945, the day when 50,000 troops drawn from the XXIV U.S. Army Corps and the III Marine Amphibious Corps landed. After the Battle of Okinawa, or the “Typhoon of Steel,” as locals refer to it, weary Okinawan survivors spent the first few months in internment camps, completely dependent upon American rations: Spam, biscuits, dried ice cream, powdered milk, Lucky Strikes, even military jackets for those who had no clothing left. The humaneness with which they were treated by the American occupiers was sometimes overshadowed by the brutal incompetence of the postwar administration of Okinawa. The islands became known as a dumping ground for unwanted bureaucrats (some twenty-two bureaucrats cycled through the top post during twenty-seven years of occupation) and unsavory soldiers. During one half-year crime spree in 1949, American soldiers perpetrated twenty-nine murders, eighteen rapes, sixteen robberies, and thirty-three assaults on the Okinawan populace.57
Okinawa became a Cold War pawn. The Japanese government and imperial household, eager to be rid of their American conquerors but also valuing the Americans as a counterbalance against the Russians, made secret overtures to hand the Okinawan islands over to the United States as a convenient location for American military bases. Okinawa fell under the trusteeship of the U.S. military (officially the U.S. Civil Administration of the Ryukyu Islands, or USCAR) and became a critical staging point for military conflicts in Asia. USCAR played up the cultural “Ryukyu” distinctiveness of the Okinawans (who have a different cultural history and language than Japanese mainlanders), hoping to drive a wedge between the locals and the Japanese, and built lavish cultural friendship centers around the islands. Okinawans quickly became hooked on beef, coffee, fast food, cars, and other staples of the occupiers, tossing aside the elders’ mainstays of sweet potatoes and seaweed as famine food. As much as the Americans were an oppressive and much-hated presence on the island, native Okinawans couldn’t help but adopt the American diet and lifestyle.
One night in Naha, after searching in vain for wholesome traditional Okinawan food, I end up in an open-air bar just off the main drag, where a barmaid shakes cocktails under a strip of electric blue lighting and brays at customers’ jokes. I chat with a middle-aged Ryukyu man with puffy bags sagging under his eyes. “We don’t like Japanese. We don’t like Americans,” he mutters drunkenly.
Trapped in the crossfire of empires, politics, and war, Okinawans have much to be resentful about. This time around, however, the enemy is not a soldier in a uniform wielding a rifle or bayonet but the burger, fries, and soft drink wielded by a pimply teen in a different uniform, as well as the car used to get to the fast-food joint. The evil rotting the prefecture’s health comes in the form of cheap and addictive processed foods, the availability of motorized vehicles, the convenience of one-stop shopping at a supermarket or mall instead of visiting scattered stores, the television that obliterates social life, and the steady smoking habits of its citizens. As a result, Okinawans have experienced a surge in lung cancer rates, type 2 diabetes, waistline size, and suicides, and the aforementioned drop in life expectancy. As one doctor in Okinawa has put it, this is the second Battle of Okinawa, fought behind cultural lines, with perhaps just as many lives at stake.58
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This chapter has so far dealt with calorie intake and consumption. However, we should not neglect the topic of what happens to food as it exits our body (or refuses to exit, in the case of constipation sufferers, who comprise some 15 percent of people in North America59). Throughout our evolutionary history, squatting was the normal way of having a bowel movement. Sitting toilets, which became common in Western nations from the nineteenth century onward, create an unnatural 90-degree bend for the passage of fecal material, and thus straining is required to expel feces. When we squat, this angle is straightened out completely, and therefore much less time (around one minute to complete a bowel movement from a squat versus two minutes on a sitting toilet, according to one study) and effort are required to expel feces. This might explain why constipation, hemorrhoids, and diverticulosis (a condition causing pouches to form in the colon) are much more common in Western populations than in Asia and Africa, where squat toilets are the norm.60
Online stores sell kits to convert sitting toilets to squat toilets, or you can build your own convertible squat/sitting toilet using online examples as guides. Be forewarned: If you didn’t grow up using squat toilets, it takes practice to learn how to poop from a squat. At least one study has found that there may be increased risk of a stroke from shifting to a squat-style toilet, due to the effort involved in squatting and standing, so the elderly and people with high blood pressure should consult with a physician before switching to squat toilets.61
THE FUTURE OF FOOD
When the hype is greater than the science it burns all of us.
—K. LANCE GOULD, quoted in Shari Roan, “A Slow Change of Heart”
Most people today agree that something is wrong with our lifestyle habits, but there is sharp disagreement among both experts and the public on what needs to be done to restore our health. Are today’s food and health activists on the right track or misguided? I met with three of the leading proponents of nutritional advice—Dr. Dean Ornish, a cardiologist and proponent of low-fat diets; Sally Fallon Morell, a booster of traditional American farm diets; and Mark Sisson, an ex-Ironman athlete and a blogger and writer on the Primal (Paleo) lifestyle—to see why smart people reached opposing perspectives on the optimal diet. I also visited food idealists in Australia, Canada, and the United States who, with courage and determination, are trying to change the way we live and eat or raise food, particularly foods that are more ecologically sustainable; happily, it turns out that eco-friendly foods are also more suitable for our nutritional needs. As we shall see in this chapter, however, these activists are being confronted with major hurdles due to the nature of capitalism and our fear of novel foods.
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Dean Ornish is a busy man. Besides teaching medicine at the prestigious medical school at the University of California, San Francisco, Dr. Ornish was appointed by President Barack Obama to the White House Advisory Group on Prevention, Health Promotion, and Integrative and Public Health. He had previously been appointed to the White House Commission on Complementary and Alternative Medicine Policy by President Bill Clinton, and has served as “a physician consultant” to President Clinton since 1993 and to several members of Congress. Through his numerous books and articles, Dr. Ornish advises the public to eat less fat (preferably around 10 percent of their total daily calories), stay away from saturated fat and cholesterol, eat little meat, limit alcohol consumption, and eat a lot of whole grains. (In his other suggestions, such as eating vegetables and fruits, staying away from processed foods and sugar, spending time with loved ones, and exercising, Dr. Ornish is in agreement with most other food and health writers.) In several studies that he led, there is evidence that his low-fat/low-meat diets, in combination with moderate exercise, stress management, cessation of smoking, and group psychological therapy, lower the risk of heart disease without the use of lipid-reducing drugs.
This brings up three important questions. First, is it the low-fat and low-meat diet that does the trick in reducing heart disease, or are the lifestyle interventions of exercise, stress reduction, smoking cessation, and group therapy the real key? In conversation with Dr. Ornish, I point out the “Spanish paradox”: Spanish people consumed 30 percent more fat in 1980 than they had in 1966, particularly saturated fat (a 48 percent increase), yet heart disease decreased over the same period; in Japan, there was a similar postwar increase in fat and cholesterol consumption while heart disease also dropped. Dr. Ornish responds, “One has to be very careful about drawing conclusions from just looking at one factor in a population when there are so many other things that have been changing during that time as well.” Fair enough—the authors of the “Spanish paradox” study themselves were skeptical that increased consumption of fat in Spain led to decreased heart disease, suggesting instead that increased antioxidants in the Spanish diet from eating more fruits could have been the real reason behind lowered rates of heart disease (wine and sugar consumption dropped slightly). Conversely, perhaps the belief that saturated fat is artery-clogging was so deeply ingrained in the minds of the study’s authors that the possibility of saturated fat lowering heart disease was literally unthinkable and heretical to them. Increased fat in the diet may replace foods more dangerous for heart health; for example, carbohydrate-rich diets (the Spanish diet in the 1960s was based heavily on bread, potatoes, pulses, and rice) raise serum triglyceride and VLDL (very-low-density lipoprotein) cholesterol levels, both major factors for heart disease.1
The second important question to ask: Does a low-fat, low-meat diet reduce overall mortality? After all, it’s not very encouraging if we avoid the risk of heart disease but increase our risk of dying from something else. When I showed a video of Dr. Ornish to one of my friends in Los Angeles, she said, “Oh, he looks healthy. He’s the same age as you?” She scrutinized the screen. “He has a lot of hair.” I’m forty-one. Dean Ornish is twenty years older than me. So perhaps he has figured out the secret to long, healthy life. In some respects, Dr. Ornish’s suggested diet looks similar to the diets of the peoples with the greatest longevity (Okinawans, Nicoyans in Costa Rica, Sardinians, Ikarians) and indeed of most people in the world prior to industrialization. It’s low in meat—our preagricultural ancestors did a pretty good job of hunting out the big mammals, and climate change mopped up the rest—and high in plant foods. Also, as discussed earlier, the link between low protein intake and longer life has been studied and demonstrated in various animals, and it’s likely that the human life span may benefit from low protein (especially low animal protein) intake as well.
This link between protein restriction and longevity is also consistent with evolutionary biology: Nature favors longer life spans in animals that don’t have adequate nutrition to compete and reproduce at an earlier stage in life. To put it another way, eating meat and fat may help you be fertile, attractive, and strong at a younger age, but it will also help you into the grave a bit faster.
When I suggested the evolutionary biology scenario to Dr. Ornish, he was not fond of this interpretation—“I’m not sure that natural selection explains everything,” he says. He believes that his diet promotes health at all stages of life, young and old, but I doubt any sumo wrestler or weight lifter would win a title on Dr. Ornish’s low-fat, low-animal-protein diet. Girls who eat a lot of meat and dairy tend to reach menarche (their first menstrual bleeding) at an earlier age, and girls who have early menarche tend to die younger; women who lack body fat are more likely to be infertile.2
Additionally, a diet that promotes a long life span in youth may not necessarily be an effective diet for an elderly or sick person. The major health risks for a younger person stem from chronic diseases like cancers and heart disease, which develop over the course of decades. For an elderly person, by contrast, the important task is to weather any illness that strikes, in which case eating more animal protein may promote longevity. Also, people who are moderately overweight tend to live longer, as previously discussed, and one possible reason is that metabolic reserves may enable sick people to overcome disease.
The third question to ask with regard to a low-meat, low-fat diet: Is it easy to follow? A typical set of meals for Ornish and his family might include whole-grain cereal with soy milk and fresh fruit, whole-wheat toast, and pomegranate or orange juice, along with a cup of tea or coffee; alternatively, he might fix an egg-white omelet with spinach and mushrooms, or low-fat cheese or turmeric (reputed to have anti-inflammatory benefits). As a treat, Ornish and his family indulge in whole-grain pancakes or waffles with a little maple syrup. The family takes daily multivitamin and fish oil supplements. For dinner, they serve vegetables like corn, broccoli, and cauliflower (cooked in a steamer to preserve most of the flavor and nutrients), along with a few prawns or some fish. He argues that foods can taste delicious without adding a lot of fat, salt, and sugar, which he believes mask the true flavors of food.3 Some health professionals bemoan the difficulty in getting patients to comply with Dr. Ornish’s relatively bland, low-fat, low-salt, low-sugar fare. Still, it seems reassuringly familiar, the kind of food that most doctors and nutritionists today would recommend.
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At the opposite end of the dietary spectrum are the nutritional activists who advocate a high-fat, high-meat diet. On a shimmering blue morning, a woman with a tidy press of white curls greets me at her farm. Sally Fallon Morell is the co-owner of and the force behind P. A. Bowen Farmstead, a sixty-acre farm an hour’s drive from Washington, D.C. Sally proposes that we tour the cheese-making operation housed inside. We don white coats and hairnets, dip our plastic shoes into antiseptic pools, and stroll through sparklingly clean rooms holding racks of cheddar and blue cheese in various stages of processing. Leaving the building, we walk along dusty roads to the pasture area, where chickens roam in grass recently vacated by cattle and feed on maggots that have emerged from the cattle dung. We pass a fish pond stocked with bass, sunfish, catfish, koi, and minnows, along with a handsome flock of sturdy Silver Appleyard ducks, then trudge over to a patch of forest where a herd of hogs, a heritage breed of Berkshire, Tamworth, and Spotted Pig, grunt excitedly in response to Sally’s shrill call. Besides one day providing meat, their job is to clear undergrowth, eventually rendering the forests suitable for the cattle to range through. When we amble over to a herd of grazing cattle, Sally pauses to enjoy the sight.
I’ve been walking around in a button-up shirt and stiff black dress trousers under a hot sun, so I’m relieved when we return to the main farm building. Today is the weekly chicken slaughter day. Under the shade of a roof, a team of men and women, young and old, work on a mini assembly line, slitting, bleeding out, scalding, and gutting a pile of chickens as country music pipes in the background.
When Sally decided to throw her full effort into this farm, some people raised eyebrows—after all, she grew up in an affluent Los Angeles suburb and is in her midsixties; her husband, a farmer from New Zealand, is eighty-eight, though vigorous. The farm is still in its early stages and has yet to turn a profit—but how can it? She feeds the chickens grass peas from Pennsylvania instead of cheaper genetically modified soy; she doesn’t use antibiotics on her cows; she doesn’t pasteurize her milk; her animals are all free-range. It’s a noble effort, but she admits to “sleepless nights.” As she says, “I’m the one who wakes up in the middle of the night. I have tremendous sympathy for farmers.” Her husband helps with tractor work, but Sally is the one who pours her money and soul into the farm.
Sally Fallon Morell is a fighter in another way; she’s perhaps the most controversial nutritional activist in the United States today. The bestselling book that made her famous is provocatively titled Nourishing Traditions: The Cookbook That Challenges Politically Correct Nutrition and the Diet Dictocrats (written with Mary Enig, a nutritionist and biochemist, and first published in 1995). The introduction ranks among the most rousing and incendiary calls to arms ever penned in a cookbook. Sally and Mary take aim at the nefarious “Diet Dictocrats,” whose sundry ranks include “doctors, researchers, and spokesmen for various government and quasi-government agencies,” such as the Food and Drug Administration, the American Medical Association, the National Institutes of Health, medical schools and nutrition departments, and the American Cancer Society and the American Heart Association, which are “ostensibly dedicated to combating our most serious diseases.”4
Sally and Mary’s book made waves by insisting that a healthy diet includes a lot of fat (including saturated fats), cholesterol, salt, calcium, raw milk, and fermented foods, and few to no soy products; basically, it’s a traditional American farm diet. In the book, Sally approves of the “five B’s”: bacon, butter, beef, sourdough bread, and blue cheese.5 (When I meet Sally on her farm, she points out that beans are also praiseworthy.) Further fanning the flames of controversy, Sally and her colleagues offer legal assistance to farmers who sell raw milk—illegal in parts of the United States and all of Canada and Australia, but legal in most of Europe—and argue for the merits of a raw-milk formula over breastfeeding for women who are deemed unsuitable for breastfeeding.6
