From Adequate Nutrition to Optimum Nutrition

Research in human nutrition over the past four decades has led to many discoveries as well as a comprehensive understanding of the exact mechanisms behind how food nutrients affect our bodies. As I discuss in my video Reductionism and the Deficiency Mentality, however, the “prevalence of epidemics of diet-related chronic diseases, especially obesity, type 2 diabetes, osteoporosis, cardiovascular diseases, and cancers, dramatically increases worldwide each year.” Why hasn’t all this intricate knowledge translated into improvements in public health? Perhaps it has to do with our entire philosophy of nutrition called reductionism, where everything is broken down into its constituent parts; food is reduced to a collection of single compounds with supposed single effects. “The reductionist approach has traditionally been and continues today as the dominant approach in nutrition research.” For example, did you know that mechanistically, there’s a chemical in ginger root that down-regulates phorbol myristate acetate-induced phosphorylation of ERK1/2 and JNK MAP kinases? That’s actually pretty cool, but not while millions of people continue to die of diet-related disease.

We already know that three quarters of chronic disease risk––diabetes, heart attacks, stroke, and cancer—can be eliminated if everyone followed four simple practices: not smoking, not being obese, getting a half hour of exercise a day, and eating a healthier diet, defined as more fruits, veggies, and whole grains, and less meat. Think what that could mean in terms of the human costs. We already know enough to save millions of lives. So, shouldn’t our efforts be spent implementing these changes before another dollar is spent on research such as figuring out whether there is some grape skin extract that can lower cholesterol in zebra fish or even trying to find out whether there are whole foods that can do the same? Why spend taxpayer dollars clogging the arteries of striped minnows by feeding them a high cholesterol diet to see whether hawthorn leaves and flowers have the potential to help? Even if they did and even if it worked in people, too, wouldn’t it be better to simply not clog our arteries in the first place? This dramatic drop in risk and increase in healthy life years through preventive nutrition need not involve superfoods or herbal extracts or fancy nutritional supplements—just healthier eating. When Hippocrates supposedly said, “Let food be your medicine and medicine be your food,” he “did not mean that foods are drugs, but rather, that the best way to remain in good health is to maintain a healthy diet.” (Note: Hippocrates probably never actually said that—but it’s a great sentiment anyways!)

The historical attitude of the field of nutrition, however, may be best summed up by the phrase, “Eat what you want after you eat what you should.” In other words, eat whatever you want as long as you get your vitamins and minerals. This mindset is epitomized by breakfast cereals, which often provide double-digit vitamins and minerals. But the road to health is not paved with Coke plus vitamins and minerals. This reductionistic attitude “is good for the food industry but not actually good for human health.” Why not? Well, if food is good only for a few nutrients, then you can get away with selling vitamin-fortified Twinkies.

We need to shift from the concept of merely getting adequate nutrition to getting optimal nutrition. That is, we shouldn’t just aim to avoid scurvy, but we should promote health and minimize our risk of developing degenerative diseases.

Bringing things down to their molecular components works for drug development, for example, discovering all the vitamins and curing deficiency diseases. In the field of nutrition, “[h]owever, the reductionist approach is beginning to reach its limits.” We discovered all the vitamins more than a half-century ago. When is the last time you heard of someone coming down with scurvy, pellagra, or kwashiorkor, the classic deficiency syndromes? What about the diseases of dietary excess: heart disease, diabetes, obesity, and hypertension? Ever heard of anyone with any of those? Of course we have. Yet we continue to have this deficiency mindset when it comes to nutrition.

When someone tries to reduce their consumption of meat, why is “where are you going to get your protein?” the first question they get asked, rather than “if you start eating like that, where are you going to get your heart disease?” The same deficiency mindset led to the emergence of a multibillion-dollar supplement industry. What about a daily multivitamin just “as ‘insurance’ against nutrient deficiency?” Better insurance would be just to eat healthy food.


Professor Emeritus T. Colin Campbell wrote a Whole book about this issue, and I’m looking forward to doing many more videos on the topic.

So, where do plant-eaters get protein? Check out Do Vegetarians Get Enough Protein? to learn more.

The concept of optimal, rather than merely adequate, nutrition is illustrated well in this video about fiber: Lose Two Pounds in One Sitting: Taking the Mioscenic Route.

Other videos on reductionism include

In health,
Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Knowingly and Secretly Deciding to Put the Buying Public at Risk

The processed food industries now use tactics similar to those used by cigarette companies to undermine public health interventions.

In 1954 the tobacco industry paid to publish the ‘Frank Statement to Cigarette Smokers’ in hundreds of U.S. newspapers. It stated that the public’s health was the industry’s concern above all others and promised a variety of good-faith changes….The ‘Frank Statement’ was a charade, the first step in a concerted, half-century-long campaign to mislead Americans about the catastrophic effects of smoking and to avoid public policy that might damage sales.” As a result, millions of lives were lost during decades of lies and deceptive actions. In the hope that food industry’s history will be written differently, researchers spotlighted important lessons that can be learned from the tobacco experience.

 As I discuss in my video, Big Food Using the Tobacco Industry Playbook, the “processed food industries use tactics similar to those used by tobacco companies to undermine public health interventions. They do this by distorting research findings, co-opting policy makers and health professionals, and lobbying politicians and public officials.” In his book about his fight with the tobacco industry, former FDA commissioner David Kessler recounted similar strong-arm tactics used by the meat industry to try to squash nutrition regulations.

The Supreme Court’s Citizens United decision allowing corporations to spend unlimited amounts on political ads during election campaigns could make things even worse by working against candidates who support public health positions.

 “Another similarity between tobacco and food companies is the introduction and heavy marketing of ‘safer’ or ‘healthier’ products. When cigarette sales dropped…[due] to health concerns, the industry introduced ‘safer’ [filtered] cigarettes that gave health-conscious smokers an alternative to quitting,” and sales shot back up. Ironically, the filters originally had asbestos in them.

Cigarette ads have proudly proclaimed that the brands they were promoting had “less nicotine, “less tar,” and even “reduced carcinogens”! And, how could anything be bad for you if it is “100% organic,” as another ad promoted?

Today, leaner pork or eggs with less cholesterol may be the food industry’s low-tar cigarettes. Indeed, food industry ads and the messages they tout can be head-scratchers. “A KFC ad campaign depicted an African American family in which the father was told by the mother that ‘KFC has 0 grams of trans fat now.’ The father, in the presence of children, shouts, ‘Yeah baby! Whoooo!!’ and then begins eating the fried chicken” by the bucketful.

What about cereal companies touting all of the whole grains in their Cocoa Puffs Brownie Crunch? Fruit Loops “now provides fiber” was the message emblazoned on its packaging.

A U.S. District Judge overseeing a tobacco industry case put it well: “‘All too often in the choice between the physical health of consumers and the financial well-being of business, concealment is chosen over disclosure, sales over safety, and money over morality. Who are these persons who knowingly and secretly decide to put the buying public at risk solely for the purpose of making profits, and who believe that illness and death of consumers is an apparent cost of their own prosperity?’ Above all, the experience of tobacco shows how powerful profits can be as a motivator, even at the cost of millions of lives and unspeakable suffering.”


I know some people don’t like my “political” videos and wish I’d stick to the science, but it’s impossible to understand the disconnect between the balance of evidence and dietary recommendations without understanding the impact of commercial influence. See, for example, these videos:

In health,

Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live, year-in-review presentations: