Obesity and overweight are a growing pandemic that has become more pronounced over the last 50 years, but which is far from being the exclusive concern of modern times. Currently, the WHO estimates that more than 600 million adults in the world suffer from obesity, and almost 400 million adolescents and children. The latest European report points to a global prevalence of overweight, BMI > 25, above 50%, and obesity of around 25%. Despite the limitations we recognize in BMI, from an epidemiological perspective it is still a good indicator of the state of the population. In Portugal, the same report points to prevalence rates close to the European average. The world is "fat", and the trend is not improving.
The association between obesity and disease is recognized, although dangerously denied by some. Pure ideological blindness. It has been established that obesity increases the risk of coronary heart disease, hypertension, heart failure, type II diabetes, some types of cancer and others, and is associated with a 4-year reduction in life expectancy. In fact, the American Medical Association and the World Obesity Federation define obesity as a disease, a "chronic pathological process". The WHO, on the other hand, is more conservative and does not subscribe to the classification, defining obesity as "a deleterious process of fat accumulation that poses a high health risk". But in essence there is consensus. The risk is real, with an increased likelihood of developing serious co-morbidities and early mortality.
Health concerns are far from being the only, or even the main, motivation for someone wanting to lose weight. Nor is it only those who suffer from excess who do so. Society has created aesthetic and personality standards that have changed over time, putting great pressure on those who don't fit the "ideal". A kind of informal hierarchy from which we are excluded if we deviate, generating negative feelings of guilt, shame and powerlessness, exploited by an entire industry eager for profit and individuals looking for notoriety. We are given the idea that we can be thinner, more attractive, youthful and loved if we do what they say, if we buy what they sell. And this emotional manipulation hasn't changed at all in the last two centuries.
Don't think that this is going to be an anti-diet article. Not at all. But exploiting this weakness is at the root of many of the deceptions and myths associated with diets. People choose to believe in what offers them a quick and practical solution to the problem, following rituals that they may not understand, but with which they identify. And social networks have made this phenomenon even more obvious, bombarding us with the information we want to hear, not the information we need to hear. We choose the groups we belong to and the people we follow according to our own prejudices. Truth becomes relative. Not a reflection of reality, but a reinforcement of our own beliefs. It's not about lying. Nobody lies without knowing the truth, and producing "bullshit" or inventing "fad diets" does not require such conviction. It only serves to impress and offer a solution to a common problem, which highlights who owns it. For money, or simply to be "flattered".
When it all began
We don't know if favored body patterns existed at the dawn of civilization, but sculptures preserved from millennia ago to the present day suggest an association between body fat and fertility in women. In an era marked by cycles of plenty and famine, body fat was like survival insurance. A woman's life expectancy was too short for the chronic problems associated with obesity to even manifest themselves, and reproductive success would have been a much stronger selective pressure. Nor would they have the aesthetic concerns and social pressures that arose later, when civilization found itself with more free time to think about such things. They no longer had to worry about hunting and gathering food, or running away from a bear to avoid being eaten.
If this was a favored profile in the early days of civilization, everything changed in classical Greek antiquity. Or at least the first historical evidence emerges. Obesity was seen not only as a decay of the body, but also of the mind. The concept of "diaitis", the word that gives rise to "diet", is extended to lifestyle and is not restricted to food. The wealthy spent hours exercising, and for the poor, obesity was not a concern. Hippocrates was the first to associate excess weight with illness, recommending a restricted diet, exercise and inducing vomiting as treatment. The father of medicine was also the father of bulimia, and of a practice that remained common among the nobility for centuries. Another Greek physician, Soranus of Ephesus, recommended teas and laxatives for weight loss. But in ancient Greece, the ideal standard was not the thinness that marked the 19th and 20th centuries, but a muscular body in men and shapely in women. Manifested in the sculptures of the Greek gods who represented the model of perfection. In a way, this remained true for men, but became more extreme for women. In fact, the ideal of beauty was centered on men's bodies and women's shapes were even considered inharmonious. Ugly. At some point in history, this view changed.
Until the Renaissance, body standards and eating behavior were very much conditioned by religion and the Church. It was a dark time in which little civilization evolved. Gluttony was considered a mortal sin, and the body a polluted vehicle that polluted the spirit. Fasting was seen as a penance that brought man closer to God. Moments of revelation reported by saints of the Church, which could be nothing more than hallucinations provoked by "anorexia mirabilis", a mental state altered by prolonged deprivation of food. For women, seen almost as the embodiment of sin and temptation, fasting was a form of purification and proof of self-control towards carnal pleasures. Penitent suffering has always been associated with purification, and it's not surprising that it's such an easily accepted behavior among people. There is a certain romanticism and mystique to fasting, which has come back as we know in recent years. As you'll see, food fads are cyclical and almost everything there is to invent has been invented.
The first published book on diets probably appeared in 1558, "The Art of Longevity", by Luigi Cornaro, an obese Italian who in his 40s decided to lose weight on a diet of 350 g of food a day and 400 ml of wine. Strangely enough, he actually lived to be almost 100. In 1614, another Italian, Giacomo Castelvetro, published "The Fruits, Herbs and Vegetables of Italy", in which he criticized the English diet, full of meat and sugar, in favour of the traditional Italian diet. It could be said that this was the origin of what came to be called the "Mediterranean Diet", later glorified by Ancel Keys in the 20th century. In 1730, Gorge Cheyene wrote "The Natural Method of Curing Diseases of the Body". Also obese, he followed an exclusive diet of milk and vegetables, but regained all his weight when he returned to his regular diet. He became a vegetarian, considering that all the nervous diseases that affect us derive from eating confined and anxious animals. That there is no difference between eating an animal and a human being.
The Victorian era and the 19th century
But the modern concept of diet and many of the myths surrounding it originated in the 19th century, during the Victorian era and the height of the British Empire (1820-1914). A time marked by economic prosperity, the Industrial Revolution and important scientific advances. A society stratified into classes, and in a way the body and appetite reflected social position and personal ambition. Being fat was a privilege of the rich, expressing power and authority. But at the same time, there was evidence of the harmful effects that obesity could have on health, from the autopsies that were carried out more and more frequently at the time and which drove the advance of medicine. Corpulence, the word used for obesity at the time, was the cause of increasingly common diseases.
The Victorian era was greatly influenced by the thinking of Thomas Malthus and his catastrophic theory of population growth. In 1798, he published "An Essay on the Principles of Population", in which he predicted a crisis caused by the inability to produce enough food for an exponentially growing population. The shadow of scarcity and economic disaster hung over the 19th century, placing society in a dilemma. The immorality of eating excessively and contributing to the depletion of resources, and the fear of being too fragile to survive the Malthusian catastrophe. A dichotomy that polarized opinion at the time and pushed eating behaviour to the extreme.
It was also around this time that the "professional fasters" appeared, real attractions of the time who wanted to demonstrate the possibility of living almost without food, or with just a few teas or infusions as sustenance. They were willing to reveal "the secret" in exchange for money. An attitude with which we find great parallels today. Some of these "con artists"They were even unmasked at the time, not eating in public but making up at night like alarms what they had deprived themselves of during the day. They were looking for fame and money, in direct antagonism to the Empire, which wanted strong men capable of war and surviving extreme conditions. Eating behavior was also a social and political positioning.
The British Vegeterian Society was created in 1846 by a group of doctors led by John Mayor, in opposition to the dominant Victorian regime based on meat and lots of sugar from the colonies. They believed that vegetarianism was a healthier, more sustainable and moral dietary option. Arguments that continue today. It was around this time that experiments on animals proved that they also felt pain, just like us. Because of its greater sustainability, vegetarianism could be the answer to Malthus' catastrophe. It also had a strong spiritual component due to its parallels with the plant-based diet of Eden. It's no coincidence that eating meat is a sin in certain religious celebrations. Ultimately, morality comes from food. From the yielding to temptation of Eve who ate from the forbidden tree, and from the loyalty of Adam who put his wife before God by eating too. The penalty for humanity was a moral conscience and the shame of its naked body.
And it was also in the Victorian era that celebrities became society's role models in their most unreasonable eating habits. Just like today. And the most popular was the romantic poet Lord Byron, a "sex symbol" from the 19th century that everyone wanted to emulate. And a complete idiot when it came to eating. To lose weight, he would spend long hours and even days fasting and then eat compulsively at dinner. He would cover himself with several layers of clothing to sweat and lose weight. And he also created the vinegar diet, which was drunk before meals to reduce appetite and "dissolve fat". Did you think this was a recent invention with a scientific basis? Not at all. Byron was already doing it before your great-great-grandfather was born. At the time there was at least one fatal case reported, probably because it led to ridiculous exaggeration. Only gastroesophageal lesions and erosion of tooth enamel are typical of this practice, which shows no evidence of effectiveness for weight loss. Only one favorable Japanese study, sponsored by a vinegar producer.
Women have always been a target of diet culture and social pressure to fit into a pattern. Unlike men, "corpulence" was never seen as a sign of power, ambition and status. Eating little and fasting were well-accepted practices as a sign of restraint, self-control, purity, and fragility in a patriarchal society. At the end of the 19th century, the model woman was personified in the Empress of Austria, Elisabeth von Wittelsbach, also known as Sisi, and her 40 cm waist, which she struggled to maintain with exercise, laxatives and emetics. Sisi was anorectic, but nevertheless the model of the perfect woman. Body trends took a turn for the worse in the 19th century, moving from an "hourglass" shape, with wider hips and bust and a narrow, corseted waist, to total thinness.
If you think there is fatphobia today, you can't imagine how obese people were treated back then. With thinness synonymous with beauty, morality and purity, some authors suggested that obese people should be imprisoned. The more spiritual destined them to burn in hell. They were openly mocked and ridiculed without condescension. They were only recognized in circus shows where they were the main attraction. For example, Leonard Williams, an American doctor, accused women of fattening up their husbands to make them docile. Amelia Summerville wrote in her book "Why Be Fat?" that she would rather die than be fat. It was the scientists themselves who bullysbecause, it was said, fat people "were funny and had an intrinsic lack of dignity".
It was in the second half of the 19th century that the first popular diet books for weight loss began to appear. In 1860, an English mortician, William Banting, published an account of the method he had invented to lose 30 kg - "Letter on Corpulence". The publication gained such fame that the expression "I'm banting" became synonymous with "I'm on a diet". It was the first diet "low-carb", based on meat, some vegetables and wine. In fact, Banting's diet was quite sensible compared to others that emerged in the 19th century. The tapeworm diet is one of them, in which the person ate tapeworm eggs so that the parasite could develop in the intestine. There was also the sand diet, in which people ate sterilized sand to aid digestion and detoxify the body. If birds eat stones, and if babies try to put them in their mouths all the time, we rational beings should do the same. Another famous diet that lasted for decades was the "20 min Standing", in which after meals we had to stand for 20 minutes to speed up intestinal transit and facilitate digestion. The end of the 19th century also saw the emergence of "Fletcherism", a movement that Horace Fletcher himself called a "cult" and which included prominent figures such as Mark Twain, Kafka and Kellogg. Basically, you could eat anything as long as you chewed each bite at least 100 times. Fletcher was an entrepreneur and art dealer who needed to lose weight, at a time when insurance companies were already calculating premiums by penalizing body weight. And so the century turned.
Having mentioned Kellogg, it's also worth mentioning his contribution to defining the American dietary pattern, and that of the modern world. It all began in the last decades of the 19th century, at a time when breakfast for American families was different from today's, with eggs, bacon, sausages and other indulgences far from what was considered healthy, even at the time. Among those who shared this opinion was a young doctor, John Harvey Kellogg, who linked the diet of that era to the dramatic increase in the prevalence of gastric disorders. Kellogg argued that diet was the foundation of robust health, and pioneered the association between our dietary habits and disease. He opened a sanatorium in Battle Creek, a kind of spa which he called "The Battle Creek Sanitarium March". Here he promoted a differentiated diet in which cereals were introduced and salt and sugar were completely abolished. In 1894, John Kellogg met an entrepreneur in Denver who had invented a crunchy wheat-based cereal, the inspiration for a breakfast version at his sanatorium. Toasted wheat cereal flakes, with no added sugar, which he called "granola".
John was a doctor and dedicated himself to the health of his patients, with little time to run a growing cereal business that expanded far beyond the small sanatorium. His brother Will took charge of the business and the production of granola, faithful to the principles that John Kellogg defended - as natural as possible, and without sugar. At Will's suggestion, a very successful corn-based version was created, later registered as "Sanitas Tosted Corn Flakes". One of Kellogg's sanatorium customers was Carl Post, who tried the granola and was fascinated by the concept and taste. Post was a businessman and knew that sugar would improve the product. He started his own production, creating a company with his name, Post, which would become Kellogg's main rival in the following years. Will saw the competition gaining ground and didn't give up. During his brother's trip to Europe for a scientific conference, Will Kellogg bought kilos of sugar and added it to his cereal. The sanatorium's customers liked it a lot.
John didn't like it when he returned and saw his concept perverted by his own brother. They split up, and Will opens his own cereal processing company, our familiar Kellogg's. At least two court disputes took place, with Will always coming out on top in the litigation. From there it was a gallop to the position it occupies today as one of the largest producers of processed cereals in the world, dominating a significant slice of the market. In the 1970s Kellogg's accounted for 45% of total US sales, losing share as other cheaper brands and retailers' white lines emerged. Kellogg's, and also C Post, changed the paradigm of the American breakfast, which spread around the world. Cereals with milk and loads of sugar. A subject that came up for public discussion later, in the 1980s.
The 20th century
The 20th century got off to a good start, but lost its way in the meantime. In 1918, physician Lulu Hunt Peters published his book "Diet and Health: The Calorie Key", which sold millions of copies and was the first bestseller of the genre. Peters advocated calorie counting, a method he himself used to lose weight, and that being fat was a sin. He blew it. Self-control was the key to being thin. Even though there was no way of accurately calculating energy expenditure at the time, the 1200 kcal diet he advocated couldn't fail as long as you stuck to it. It was the first diet book for the general public with any scientific rigor. The same can't be said for William Hay, an American doctor who in the 1930s advocated classifying foods into alkaline, acidic and neutral, claiming that they shouldn't be combined in the same meal. Basically, proteins were acidic, starches, vegetables and fruit alkaline. The rest were neutral. Where have we heard this before? That was the birth of the alkaline diet.
The most dramatic changes in diet culture came after the First World War, now with the USA in the lead. But the female ideal of thinness remains and is even accentuated, now almost masculine, without curves. The tobacco industry saw a whole new market here and started advertising tobacco for women to lose and maintain weight. Lucky Strike had the slogan "smoke a Lucky instead of eating a sweet". At the time, even doctors argued that it was a healthy habit, even though the harms of smoking were not yet known. And if smoking made you lose weight, there was nothing better than depression. The Great Depression of 1929, which changed eating behavior in American society. Once again, overeating and being fat became immoral when many were starving. Paradoxically, the need for slimming aids and diet miracles became even more evident. One of the few markets that grew during this period. Priorities. In addition to Hay Dietother idiotic regimes emerged in the 30s. A Beverly Hills DietThe grapefruit diet, the lemonade diet, the banana and milk diet. The 20s and 30s of the 20th century were probably the most extreme, with the perfect woman's body idealized in severe thinness, slender and unfeminine without hips or bust. Eating disorders skyrocketed and anorexia became a topic in the medical community.
In 1933, a French doctor pejoratively defined cellulite in a sensationalist magazine as "a combination of water, waste, toxins and fat that form a bad mixture". He said it was exclusively a female problem, different from fat and almost impossible to lose. It was the first time that the term cellulite was associated with aesthetics, at a time when female body standards of extreme thinness were being affirmed. Decades earlier, cellulite was considered normal. It had always existed on women. Around this time, the first dietary treatments, massages and specific exercises for cellulite began to appear in France. They arrived in the USA later, after Vogue published an article in 1968 entitled "Cellulite: the fat you couldn't lose in the old days". Chaos ensued.
World War II came and the world changed. Millions of young Americans went to Europe and Asia to fight, and women went to the factories to help with the war effort. With the men gone, women gained importance in society and the shapeless, masculine body went out of fashion. Curves were back. In 1942, the American government rationed foods such as meat, cheese, canned goods, sugar, coffee and milk. It was unpatriotic to eat more than your allotted portion, and wrong not to eat everything on your plate. Ancel Keys saw the opportunity to study the effect of food deprivation on his own life. Minessotta Starvation Experiment (1944-1945), where he subjected young men and normal-weight "volunteers" to severe energy restriction (55%) for several weeks. "Volunteers" because they were conscientious objectors who refused to go to war, and sentenced to community service. The choice was between study or prison. It was such a painful experience that one of the participants cut off a finger just to get out of the study. Keys concluded that energy restriction did in fact lead to weight loss, Sherlock! about 25% from the initial weight loss, but at a gentle pace that allowed survival for a long time even when fat reserves were low. At the cost of great anxiety, constant and obsessive thinking about food, and a lot of suffering.
The war ended and the late 1940s and early 1950s were a revolutionary time for the world of diets and body image. Women gained social status and the most feminine shapes were back. Narrow waists and wide hips, espoused by icons such as Marilyn Monroe and Liz Taylor. It also became more common to find stores with "plus size", for adults and now also for children. But even then the malice towards the obese didn't end. "Nobody loves a fat girl" was an advertisement for cookies at the time. God did not approve of obesity, and books like "Pray Your Weight Away" or "I Prayed Myself Slim" were launched to the public. If gluttony was a sin, faith would help you lose weight.
Ancel Keys gained notoriety at the time and greatly influenced nutritional guidelines in the USA. He argued that a diet high in saturated fat caused cardiovascular disease, and the market responded with versions "light" of conventional products. Despite being accused of fraud in his "7-Countries Study", which found an association between saturated fat consumption and coronary heart disease in seven hand-picked countries, the work marked a whole era of nutritional guidelines for reducing fat consumption and adopting a more Mediterranean dietary pattern. But despite this, between the 1950s and 1960s obesity rose by 15% in the USA. This was a period when the most fashionable method for losing weight was calorie counting, again under the influence of Keys and his "Minessotta Starvation Experiment". You eat less than you spend, you lose weight. Ancel Keys was a scientist, despite his well-known arrogance and self-centeredness.
In the mid-1960s, the body standard dictated by fashion changed again towards thinness and straight, more masculine lines. Against the prevailing nutritional guidelines, Herman Taller published "Calories Don't Count" in 1961, a book that advocated carbohydrate restriction and the ketogenic diet as a solution to weight loss. He began selling supplements that were nothing more than oils in capsules, and was convicted of fraud in 1967. Around the same time, two other diets became popular. A "The Drinking Man's Diet", which also tends to low-carb but with a martini with every meal. And the "Sleeping Beauty Diet", popularized by Elvis Presley, where you took sleeping pills for days. You don't eat when you're asleep. Genius. The decade was also marked by the official recognition that smoking caused cancer. A slap in the face after so many years of advertising it to lose weight.
Despite so many diets, obesity continued to rise. In the late 60s and early 70s, pre-made meal plans and more creative miracle diets began to appear. In 1963 Weight Watchers appeared, one of the first and most recognized self-help groups, with weekly meetings based on four basic pillars: healthy eating, exercise, behavioral change and social support. These pillars are still the foundations of the programs with the most scientific support. Mark Hughes founded Herbalife in 1980, also with the group dynamic we know. He commits suicide 20 years later, but the company prevails with a new manager brought in from Disney. In reality, Herbalife has had little influence on trend-setting. It hasn't added anything new, although it is currently one of the largest companies in the food supplement sector and deserves to be mentioned. It is also one of the most controversial due to its business model, overpriced products in a closed multi-level market, the legal version of a "pyramid scheme", and highly emotional sales strategies that promise worlds and funds. Another side to the cult of diets.
But the publication in 1972 of "Dr. Atkins' Diet Revolution" was a landmark in the 1970s, not the first ketogenic diet as we've seen, practically free of carbohydrate sources, but the one that had the most influence. Unlike previous diets, which were temporary until you lost the desired weight, Robert Atkins said that it was possible to maintain this diet for the rest of your life. The diet became so popular that 1 in 10 Americans followed it in the 1970s, despite controversy among the medical community, which was generally against high-fat diets. Ancel Keys' doctrine was the dominant one in academic and scientific circles. The Atkins Diet became an internationally recognized brand. All this despite the fact that there was already enough evidence at the time that all the weight and volume lost at the beginning was water and not fat. That carbohydrates were not the problem, but rather excessive calorie intake.
In 2002, Robert Atkins published a remake of his book, even more successfully than the first. It is estimated that 1 in 6 Americans by that time had followed his diet at some point, and many millions around the world. Once again, Atkins created the diet to solve a problem that was his own. He was obese, and managed to lose weight with the diet he "invented". Inspired by previous versions of diets low-carband especially in a 1963 article published in Journal of the American Medical Association by Alfred Pennington, linking the rise in the prevalence of obesity in the US to the consumption of sugar and carbohydrates in general. His success with himself led him to experiment with the regime with his patients. Atkins was a doctor in Manhattan, where he lived until the end of his life in 2003. He died from the after-effects of a fall outside his home, after several days in hospital and weighing more than 100 kg. It is said that only 30 kg had been gained during his hospitalization, as a result of the fluid retention characteristic of when you switch back to eating carbohydrates.
But the prevalence of obesity continued to rise, in America and around the world, and the focus shifted to the fitness in the 80s. People started running and working out with Jane Fonda. The first fitness gurus appeared, such as Jack Lalanne, Bill Phillips and others who contributed greatly to myths that persist to this day. Like fasted cardio, for example. During this period, pressure from the medical community had results and stifled Atkins' revolutionary ideas for a while. O low-fat was back. The body standard of the time became the more athletic, curvy and toned model. In 1988, Operah Winfrey showed a 30 kg chunk of fat on her show, which represented the weight she had lost on a high-protein liquid diet. It went viral at the time, although she regained most of the weight she had lost shortly afterwards. A shocking minute of television that had an impact on Americans. The fat was "disgusting".
In the same decade, more attention began to be paid to sugar consumption, which was particularly high in soft drinks and breakfast cereals. The problem was so great that Jean Mayer, a renowned nutrition expert from Harvard, recommended that breakfast cereals be sold in confectionery shops and in the sweets areas of supermarkets. These were products with more than 50% of sugar content. In addition to Meyer, dentists were also warning about tooth decay, which was increasingly found in children, and even sending rotten teeth to those who could make a difference - politicians. The pressure paid off, and in 1985 the amount of sugar in cereals began to drop. Since the 1960s, expert opinion has been divided over which is more harmful - saturated fat or sugar. On one side we had Ancel Keys, on the other the doctor John Yudkin. Keys had more media weight and influence on public policy. But as with almost everything when there are two polarized opinions, the truth will lie somewhere in the middle and there is no single culprit. Americans were getting fatter because they were eating more and leading more sedentary lives. A truth that applies to the entire modernized world.
At the beginning of the 1990s, the prevalence of obesity was double that of the 1950s, despite all the miraculous weight loss strategies on offer. The body pattern maintained a trend towards thinness, which was more pronounced than in the golden years of the fitnessThe Atkins diet became fashionable again, in direct conflict with the American food pyramid that appeared in 1992. Barry Sears creates his "Zone Diet", advocating that all meals should have a fixed ratio of carbohydrates, protein and fat (40:30:30). Fitness continues to grow, with several gyms and health clubs emerging in the 80s-90s. Social networks didn't exist yet and the Internet was in its infancy. Some discussion forums were appearing, but communication was still mostly through magazines, television, books and radio.
The new millennium
The new millennium has brought the digital revolution. Discrimination against obese people is starting to be discussed more intensely and compared to racial discrimination. In fact, the figures even pointed to a greater impact in the workplace. Some are also protesting against the diet culture. To quote psychiatrist Thomas Szasz decades earlier, "We used to go after Jews, homosexuals, lunatics and drug addicts. Now it's the fat ones. We impose diets on them as part of a moral order." In 2013, the American Medical Association recognized obesity as a disease, allowing insurance to cover bariatric surgery. Until then it was considered an aesthetic issue. At the beginning of the 21st century, the most prominent diets were the Dukan and South Beach diets, both hyperprotein diets, Paleo diets and low-carb in its various forms. Juice detoxes have also started to appear more and more, or reappear, as strategies to purify and lose weight.
A good example of the cognitive dissonance in these diets is Paleo. Although it was popularized at the beginning of this century by Loren Cordain, with its peak in 2013, the concept came from the 1980s in the mind of Boyd Eaton, a radiologist who had an epiphany. Around 300 generations have lived from the Paleolithic to the present day. An eternity for us, but the blink of an eye on the evolutionary scale. There would have been no time to adapt to such an abrupt change in eating habits, and the key to putting an end to the rise in chronic diseases and obesity was to return to a diet close to our ancestors. Or what they thought they were, since it will be very difficult to know what they really ate back then. The fossil record is limited, we have some suggestive cave paintings, data from non-Westernized populations, and little else. But there would have been no agriculture, and cereal consumption would not have been a habit. Nor dairy products, since it would take a lot of courage to milk a wild buffalo. Perhaps this is one of the reasons why it is thought that the average life expectancy was no more than 30 years. The ancestral diet is not even agreed upon by experts. Christina Warinner, a biomolecular archaeologist at the University of Zurich, has a completely different opinion and debunked some misconceptions in a TED talk in 2013. There is no such thing as a Paleo diet. It was very different depending on the place, season and availability of food. Nor did it tend to be low-carb.
The 1970s onwards were very much marked by the orientation low-carband Paleo drank from its influence. Both currents evolved in parallel, until they became almost indistinguishable. It was acceptable for a Paleo to eat bacon fried in coconut oil, which no one in the Paleolithic would have tasted. Butter also began to be allowed, as long as it was from extensively farmed animals, and lard for cooking. Paleo desserts emerged, in which honey, agave or dates replaced conventional refined sugar. What do you mean Paleo desserts? The fallacy of "natural" was accentuated. If it exists in nature, then it's good for you. It is also in nature that we find some of the most powerful poisons. Not everything that is natural is good or acceptable. Not in what we eat, nor in our behavior. It's natural for a man to have several partners to increase his reproductive success in propagating his genes. But it is not acceptable. It is natural for us to segregate ourselves into ethnic groups and show aggression towards difference. But it is not acceptable. It's natural to eat raw ox testicles. But it's disgusting. In the early days of human evolution, people ate a certain way, not because it was better, but because it was the diet that was possible. What was available, when it was available.
In this digital age of easy access to information and misinformation, Google Trends is a good metric of public acceptance of a diet and food trends. In 2019 the low-carb has been dethroned by intermittent fasting, which remains the dominant trend today. As we've seen, it's not new and fasting has always been practiced for weight loss or spiritual upliftment. Studies on single-cell models, nematodes and mice have also suggested that intermittent fasting could increase longevity. What more could you want? A regime that promises to make you thinner and live longer. Very appealing and romantic because of the intrinsic link between suffering and purification. But when it comes to weight loss, science has made it clear that this is not a more effective strategy than continuous calorie restriction. Only as effective. As for longevity, nothing can be concluded.
Science continues to evolve, but in reinforcement of the importance of energy balance as the most important variable in weight loss. Kevin Hall's laboratory has done exceptional work in this regard, demystifying many of the concepts at the basis of the theory low-carb. But what gets through to the public are the most simplistic messages that offer a solution to a problem. Okay, it's the calorie deficit, but how do you do it? Preferably without starving yourself. In an attempt to demonstrate the concept, Mark Haub, a professor of nutrition at the University of Kansas, put himself on an 1800 kcal diet for 10 weeks. His needs were estimated at 2600 kcal, so he maintained a deficit of 800 kcal. He lost 12 kg, 8.5% of fat mass, his LDL-c dropped by 20%, and his triglycerides by 38%. So far, so good, were it not for his diet based exclusively on Twinkies, a type of stuffed cake that's very well known in the USA. What do you mean he lost weight and fat? The calorie deficit phenomenon. It's certainly not the most recommended diet, but the experience serves to put priorities in place. And if he loses weight eating Twinkies, you can lose weight eating bread, rice and pasta.
The last decade has seen a change in the way trends are set. Magazines, fashion and cinema have become less influential, and social networks dominate. Especially Instagram, launched just 12 years ago and very visual in nature, and more recently Tik Tok. People who previously didn't have so much media space have been able to create their own, and earn from it. Fame and money. Kim Kardashian, for example, has influenced both fashion and women's body standards over the last decade. She brought back voluptuous female forms, wide hips and slender waists, but now she's doing away with them again. She slimmed down to fit into her million-dollar dress for the MET Gala, with a diet low-carb I'm still on a happy and contented path with Ozempic. This is the medication she uses to lose weight, and she talks about it openly on social media. Is extreme thinness making a comeback? Celebrities and influencers dictate fashion and behavior. Let there be no doubt about that, for better or for worse. In 2013, there was an editorial in the New York Times about Angelina Jolie's preventive mastectomy, which warned against breast cancer. Two weeks after the publication, there was a 64% increase in BRCA1/2 genetic tests for risk assessment, and therefore a 3% reduction in mastectomies.
Instagram has over 200 million users. We are formatted to follow examples, compare ourselves with others, aspire to their perfect lives online. Because any virtual life is apparently better than a real one. The influencers become body models and lifestyleIt can be a source of motivation and information, feeding the desire to one day be like them too, and the frustration of not being able to be anything other than ourselves. Social media can undoubtedly be a source of motivation and information, but it can also be a catalyst for eating disorders, distorted self-image and low self-esteem. A Master's thesis published in 2017 assessed the impact of social media on users' emotional balance and perception of self-image. Half of the women surveyed admitted to feeling bad about their bodies when they see content from fitness and fashion on social media, and more than 70% said they often compare themselves with the models they follow. This is where the new standards are set, and I'm afraid not in a very positive way.
The cult of diets
After this cursory look at the history of diets over the millennia, one of the conclusions we can draw is that they are cyclical, ephemeral and opportunistic. They come and go according to the social and economic context of the moment. The science is clear. A diet will work to lose weight as long as it allows you to maintain the calorie deficit necessary for this to happen. Calories matter and, voluntarily or spontaneously, consumption will have to fall in order to lose weight. No matter how many twists and turns you take and how many crazy strategies you come up with, that's what it comes down to. The best diet will be the one that allows the best adherence and consistency over time. But in the midst of so much stupidity, don't fall into the other extreme of completely devaluing and antagonizing diets, and the importance of fighting obesity in order to reduce the associated risks. Nor is it wrong or illegitimate to lose weight for purely aesthetic reasons. Everyone knows themselves and is in charge of their own process.
But diets are now more than just a means of losing weight, and Atkins is perhaps one of the main culprits in promoting a regime, a way of eating, for life. People began to identify with the diet as part of a group. I am low-carb. I'm Paleo. I do intermittent fasting. One statement. At least for a while, until I realized that I'm nothing of the sort. I'm the result of a dynamic context, dictated by a mixture of physiological, socio-economic, cultural and environmental factors and the contingencies of the moment. There is no ideal diet that you can adopt. There is the possible diet, which fulfills an objective in a given context. We are able to thrive in a variety of environments, with a variety of eating habits. If science had conclusively proven that there was one ideal and most correct way to eat, none of this would be an issue. There would be no competitive space and no market for so many diets. The advocates of each one will invoke scientific evidence to support their claims, because science has replaced religion and tradition as the authority. Not science as a whole, but the data that interests them. Making physiological mechanisms and processes the outcomesthe outcomes. There is a natural tendency for a group that shares rituals or a dietary trend to overvalue certain foods that form the basis of their diet. To elevate them to the exceptional, almost divine. And it's not just in fad diets. We have olive oil in the Mediterranean diet, full of polyphenols, vitamin E, and healthy fatty acids, just like many other foods. Meat in the Paleo diet, and so on. In fact, attributing superpowers to foods is now more common than ever, but it's not a recent phenomenon. When Moses arrived in Cannan with the Hebrews, famine struck. They had nothing to eat and many blamed him for leading them into the abyss. At least they weren't starving in Egypt. God saves Moses from a riot by giving him what they called man huIt was a kind of honey-flavored flake that fell from the sky every night. For years this was the Hebrews' only sustenance, a divine food that gave them everything they needed to survive. A superfood. But the Hebrews are human. They got tired of eating the same thing every day, and they wanted meat. God got angry at their ingratitude and sent them meat, followed by a plague that struck all those who ate it. And they died.
We are programmed to seek variety as a sign of an abundant environment. And if there are resources, from a biological point of view it's the right time to build up reserves. Eating is a pleasure, which diminishes with the repetition of the stimulus. Less and less dopamine is released when searching for food and consuming the meal. More of the same. What we're not prepared for is an environment of continuous abundance, in which the reward, in this case food, requires no effort to find. Easy pleasure breeds addition. Pleasure is nothing more than a biological mechanism, conserved in animals, to promote a behavior that is essential for survival. Food as sustenance, and sex to ensure the continuity of the species. I'd like to take this opportunity to tell you a story that illustrates my point. Nobody knows if it's true, but all the neurobiology professors tell it. Calvin Coolidge was president of the USA between 1923 and 1929. On a visit to a farm with the first lady, they split into two groups. She went into the hen house and saw that the rooster kept "mounting" the hens. She asked, "Do you do this all day?". To which the guide replied "yes". "Tell that to Mr. Coolidge," she said. It was the President's turn to visit the hen house. "The first lady asked me to show you the rooster pecking the hens all the time," said the guide. "Always the same chicken?" "No." "Tell that to Mrs. Coolidge." Everyone understands the moral of the story, or has heard it with chickens, cows or any other animal. Monotony and restriction are against human nature. And therefore so is a diet.
In essence, a diet is a cult, as Fletcher wisely put it. It doesn't exist outside a social context. They are groups of people who share beliefs and rituals, closed, defensive and even aggressive towards outside influence. The appetite to create groups is part of human nature, and there's nothing wrong with that. The problem arises from the tension inherent in the object of the diet. Restriction and deprivation of some kind, which opposes the natural desire to eat everything we want. Food becomes intrinsically valuable. Right or wrong. Allowed or forbidden. We are right and they are not. Us and the others. They try to convince us that it's impossible to achieve full health without sharing their cult. But it is. The ideal, perfect diet doesn't exist. It's an illusion. There are many paths to full health and vitality, and be wary of anyone who thinks they have the hidden truth. The conversation is always the same. The result is always the same. If your goal is to lose weight, the diet will work as long as you maintain a calorie deficit. The rest is, as Buekens defines obscurantism, "a game of verbal smoke that suggests clairvoyance where none exists".
