Junk mail, junk science, junk food, junk DNA: The list of terms we can plunk “junk” in front of seems endless. Usually the point is to negate the meaning of the second word but all too often it refers to things we don’t understand (DNA), are trying to avoid (food) or have no other way of describing (science). But since the word’s out there I think we need a new term, one that describes all the outrageously stupid, yet ostensibly expert, advice out there with respect to food – let’s call it junk nutrition. Which, in the best tradition of junk anything, masquerades as solid scientific advice, uses pseudo scientific terminology and does its level best to terrify us into giving up all the real foods, like butter, that make life worth living.

Worse, in its attempt to confuse us with bafflegab, junk nutrition is far too easy to get wrong, which explains why – as I am desultorily skimming an article in The New Yorker about some person, Stephen A. Smith who apparently “shapes the discourse of the sports world” (be still my beating heart)  I read the following:

“I used to think almond milk was best, but then somebody told me – a trainer told me – there’s too much estrogen up in there. In the almond milk. That’s right. [And] you don’t want to walk around with man boobs if you don’t have to.” (beat, chuckle, rat-a-tat)

P-pardon? Almond “milk” will do what?

Now I absolve Mr. Smith as he appears to be quoting his trainer, but honestly, somebody, somewhere, needs to get their nether regions out of whatever black hole they have become stuck in – as they have clearly confused soy and almond “milk”. (In quotes, incidentally, to remind you that no matter what marketers have told you neither soybeans nor almonds actually contain milk, which comes from female mammals). Soy. er. juice does indeed contain small amounts of phytoestrogens that do mimic estrogen and could, if ingested in sufficiently high quantities, cause said man boobs. Though you’d have to drink an awful lot of it. But how many people will read this and believe Mr. Smith’s trainer? More important, why didn’t the editor catch this?

Who knows, maybe it was one of those product placement things, paid for by the soy drink people.

Junk nutrition, in a nutshell. Eat/drink X so you’ll be healthy, avoid Y (salt, meat, sugar) so you’ll live longer. Trouble is, the stuff they tell you to replace the real food with, like butter, is often a pale imitation (margarine) cooked up by a chemist for a specific purpose. In the case of margarine, a French chemist who was trying to find a fat that could travel with the French army without going rancid. And therein lies the rub. The fake stuff is  (1) manufactured, (2) additive-full  and often contains genetically-modified whatsits (which they do not have to declare because it is not a genetically modified organism or GMO that’s grown/farmed) and   (3) untested so could easily cause some kind of weird side effect down the road. But there it is, large as life, dumb advice pretending it’s health news. This is how you convince otherwise reasonable people that a dark pink fake substance calling itself a hamburger is somehow … superior.

If you want a hamburger with a vegetarian spin, eat a felafel. At least you’ll know human hands were involved there somewhere, not a robotic arm in some factory. Plus it won’t contain  synthetic additives most of which  I cannot pronounce and wouldn’t even try. I can see why the EU has rules about what can call itself sausage or cheese – the terms mean something. But of course nobody would eat the stuff if you called it what it is: fake mushed up chemicals mixed with a bit of beans and plant based something-or-t’others with flavorists (yes, that’s a thing) adding some of that (flavour) at the end of the process. That latter bit, incidentally, is based on a molecular breakdown of what real food, like an orange or a carrot, tastes like.

Human beings cannot make certain necessary nutrients, vitamins, which we get from food. So if you don’t eat meat, milk, eggs, fish, cheese and so on be careful to get enough B12 and niacin and various other trace vitamins that aren’t present in plants. Iron too, as it difficult to absorb iron from plant-based sources. (Pair your plant based protein with something containing vitamin C, like tomatoes or red peppers. It will aid iron absorption.)

In the late 18^th century when they also believed they had the nutrition thing down pat an Estonian scientist, Nikolai Lunin, noticed something puzzling. When he fed mice all the known nutrients (fat, carbohydrates, protein, broken down chemically), the mice sickened and died. Then he gave them milk and they were just fine thank you very much. Lunin didn’t know why, it was many decades later before anyone realized vitamins were essential to life. (Think pallegra and scurvy and other vitamin deficiency diseases.)

Salt of the Earth

The junk nutrition advice, of course, doesn’t stop there.  Take salt. (No, really, have some salt. It will make your food taste a lot better Just ask any chef.)

One of the few things Ronald Reagan said that I actually remember had to do with salt. When someone asked the Gipper about salt for some obscure reason he replied that yes, he did try not to oversalt things but honestly, eating something like a hard boiled egg without salt, well, only a raccoon could do it.

I don’t know where this notion that salt is evil came from since I can’t find any real research to back it up. But one day I realized that when I reached for the salt cellar some random stranger was glaring at me. And so it began.

It is true that if you have  congestive heart failure (i.e., if your heart muscle is not especially effective, usually when you’re quite old or have had heart attacks), there can be a buildup of fluid in your system (edema) and eating too much salt can exacerbate that.  Often, people with this disorder are prescribed diuretics, which makes cutting back on salt a good plan. And a small number of people with high blood pressure are sensitive to salt.

But normal healthy people sprinkling a bit of salt on their food, or cooking with salt? Not a problem.

Bodies awfully good at maintaining balance. Homeostatis as  Walter Cannon called it some 150 years ago. So, if you go a little crazy with the salt, as I have been known to do with popcorn, what happens genius? You get .. thirsty. And you drink more water. Whereupon said salt is flushed out of your system.

Alas, the salt-is-bad-for-you talk has taken on a life of its own and like most truisms no longer needs to prove itself; it’s simply become true by dint of repetition.  It is so because everybody says it is so, even though nobody knows why.

A rather elegant Scandinavian study, in fact, demonstrated much of what I’ve said here. Currently my desk has eaten my hard copy and I can’t seem to find it on my hard drive, but the gist was this: In a large study (tens of thousands of people) researchers found that increasing salt intake resulted in people drinking more fluid and passing out the salt in their urine. (The study measured the amount of salt excreted.) Voila. Balance, courtesy of physiology.

In hospital, where I recently spent a fair bit of time with a family member, the food tray arrives with tasteless food accompanied by a teensy packet of pepper. No salt anywhere. And let me tell you, that food needs something to make it palatable. I took to ducking into every McDonald’s I passed, just to take a few salt packets to toss in my purse.

What I found especially galling with the hospital food and its nanny-ish refusal to provide even a teeny packet of salt was that almost everyone there was old, frail and needed to gain weight and strength. Needed food in other words. But everybody was picking at their dinner, probably because it didn’t have a lot of taste. Ah, news flash people. Making food tasteless means the patient is far less likely to eat it, thereby exacerbating said frailty. Recuperating after a long hospital stay without food, now that’s what is dangerous. Not that teeny packet of salt. Seems to me the not-starving-to-death thing trumps the possible (minor) risk to your heart down the road, since, let’s face it, most people who are pushing 90, which a lot of people on this ward were, it’s not 20 years down the road you should be worrying about but next week.

[One a completely different note, I wonder if we’re going to start seeing the incidence of goiter increase as ever younger people decide no salt is the right amount of salt. And iodized salt, with iodine, as you’ll recall, is what made an enlarged thyroid, aka goiter, a thing of the past.]

Aside from anything else, salt is vital to keeping your electrolytes/fluid in balance. In hot weather when you reach for a Gatorade, all you’re doing is replacing the sugar and salt you’ve lost. And, for some of us, whose heart valves do not function as well as the norm, extra salt is necessary to keep enough blood coursing through our system.

Salt was so precious it was used as currency at a certain point in time. But gosh, we know better now. We have Google.

As with much junk nutrition, the voices are loud and crabby and rude. But, to paraphrase a maxim attributed to Louis XIV, “Do not assess the justice of a claim by the vigour with which it is pressed.”

How Sweet It is

Then there’s sugar. Public enemy #1 (or #2, depending on your stance on salt). Meanwhile, inclusion criteria for Type 2 diabetes have been lowered (which means more of us are being subsumed into the “diseased” category) so more of us are being told we should check our glucose regularly (thereby making Bayer, the largest maker of those glucometers rich and helping it take over the world), obsess over our diets and of course start taking the drugs. I have of course rambled on about this before but, oddly, my post does not appear to have changed the world.

Yes, too high glucose is bad. It means that there is sugar circulating in our system that can’t be used as fuel – and our cells need that to function. When this happens, our bodies will store fat – because frankly you’re just as heavy as you need to be in order to survive. If your cells can’t get the glucose they need from the food you’re metabolizing into glucose (which pretty much most food is), they will turn to stored fat for that glucose. At some point that tilts into pathology (diabetes). But our cells, all our cells especially our brain cells, need glucose to function. Lower the levels too much and your brain won’t work. This is especially true for older people.

Metabolism is highly complex: a deft and sophisticated dance between intake and output. Unfortunately, the numbers we revere and try to adhere to (using our personal beepy machines) do not reflect that complexity at all; on the contrary they turn this nuanced, balanced system on its metaphorical ear.

For the elderly this lowering of blood sugar – with the so called ideal being somewhere around 6, which is too damn low – can have dire consequences in terms of cognitive ability. I wonder sometimes how much of this increase in dementia we’re told we’re seeing has to do with the ostensible increase in the diagnosis of type 2 diabetes and lowering of glucose levels lower than anyone over 60 or thereabouts can take.

A 25-year old can fast, detox or do any one of a number of crazy things but usually be OK. (Of course in a very small number of cases this could uncover an underlying heart problem.)  At that age bodies by and large function at peak efficiency. So if there’s no food available glucose will be pulled from elsewhere – fat, muscle. With an  older person, not so much. As we age our ability to keep that balance becomes less efficient, so if we don’t take in nutrients the first thing to go is the brain. We have large brains and they need fuel. Glucose. If they don’t get it, they falter. And I would remind you that once you hit your forties immunologically, physiologically, you are on the downhill slope. In fact, to quote an article in the journal Progress in Cardiovascular Diseases (61 [2018] 10-19) entitled “In Defense of Sugar: A Critique of Diet-Centrism”, the author, a Dr. Edward Archer bluntly states that “without sugar we die”. And no, he is not in the pocket of Big Sugar.

Dr. Archer adds that sugars are so “foundational” to biological life and so central to human health that the simple sugar glucose is “one of the World Health Organization’s Essential Medicines”. Furthermore, given that sugar has been part and parcel of our diet for a long long time, it makes no sense to suddenly blame sugar for everything from obesity to metabolic diseases. No one substance can be responsible for all of society’s ills, such as poverty and packaged foods and fast food and sedentary lifestyles, not to mention time-strapped parents unable to make (more expensive) food from scratch after working two jobs just to pay the rent. Never mind drug companies keen to sell their drugs. This “diet-centrism”, writes Dr. Archer, is neither evidence based nor scientific. And he has the three long pages of references to prove it.

What concerned me most while I was in and out of the hospital “advocating” as they call it (such a bizarre notion, that patients need someone there to prevent harm when, presumably, everyone’s goal is to treat the patient and get them home in one piece) was watching the glee with which the glucose numbers were tested. No matter that in an elderly person a blood sugar level of 5.5 (ideal from the hospital’s perspective) is way too low. In fact, better too high than too low since too low can kill you before next Tuesday; versus long term high glucose which will kill you eventually, years down the road. Don’t know about you, but I’d rather give up some mythical tomorrow for a today when my brain actually works.

Keeping up with the Numbers (game)

But numbers – like the ones the glucometer spits out – are easy. They give us an easy benchmark against which to compare ourselves to some “ideal” and today the high-tech, beepy machines that can measure everything from body temperature and glucose to blood pressure and heart rate, are everywhere especially in acute care settings. These, alas, by reducing the complexities of physiology to a check list make us think we’re safe and on top of things.

Trouble is, we rarely if ever genuinely understand what those numbers mean, much less how they alter with time.

The other day I semi watched as a woman, accompanied by a man who had clearly googled “taking your blood pressure at the pharmacy” before heading out of the house, explain to his female companion why lower was always better. I hovered for an instant then moved on. Nothing to see here folks.

It seemed wiser to keep going and not engage; not stop to explain to this gentleman that the blood pressure measure (even if the pharmacy apparatus was dead on which it probably was not) reflects a dynamic element of life. Blood pressure rises and falls with exertion, with stress, after eating. One measurement means nothing – the only way to have a bit of a sense of the trend is to take your bp several times a day, several times a week, then average it out over time. (Personally, having a man loom over me telling me lower was always better as I took my blood pressure at a pharmacy would make my blood pressure skyrocket. )

And there definitely is such a thing as too-low blood pressure. Take postural hypotension as it’s called: blood pressure plummeting when you suddenly get up. It can cause dizziness, queasiness, even a fall. At worst, a fracture. Pushing those numbers too low may look pretty but they sure as god made little green apples don’t translate into good health. True, persistently high blood pressure is indeed a risk for heart attack and stroke. But simply pushing bp down because lower is always better is idiotic. That heart, after all, resides within an actual person; a person who might want to feel well enough to actually have a life,  which too low blood pressure would not allow.

The trick, as with anything else, is balance. And understanding that individuals differ; what is right for one person may be totally wrong for another. Understanding that age needs to be factored in, not to mention our state of health. But in averaging out numbers and deciding how we compare to some mythical norm it’s all too easy to lose  sight of the actual physiology of what’s going on.

I can understand the impulse to stay on top of things, control what happens. Trouble is we can’t. No amount of obsessing over diet and all these numbers will guarantee future health. Much as we’d like to believe in the crystal ball of the numbers game.

All we can do is take each day as it comes, do our best to eat well, get enough rest/sleep, reduce stress to the best of our ability and carry on. Life is complicated enough without our adding junk nutrition to the mix.

In the immortal words of Garfield the cat, what is diet, after all, but die with a “t”?