Meeting for Dinner in the Tower of Babel

I trust you know the story of the Tower of Babel, and that the enterprise did not end well. It was, in fact, a disaster of Biblical proportions.

There were two things conspiring against the venture from the start, in addition to gravity. Let's call them: (1) overreaching; and (2) a failure to communicate. The same ominous baggage seems to encumber our discussions of nutrition these days. We are, potentially, meeting for dinner in the Tower of Babel with, I fear, a predictable outcome.

I will elaborate.

1. Overreaching

In the case of the Tower of Babel, calamity resulted from the hubris of humans, reaching for the heavens. In the case of public health, calamity has resulted from the hubris of humans reaching for some privileged truth about nutrition.

In what has become a decades-long debacle, each self-appointed Messiah of mealtime tells us the new, absolute "truth" about nutrition. In the process, they are of course obligated to throw their immediate predecessor under the bus -- or on the pyre.

There are two critical problems with this "out with the old absolute truth, in with the new absolute truth" approach to nutrition, in addition to the fact that it's nonsense. The first is that there are many ways to eat badly, and a sequential focus on one nutrient, ingredient or theory at a time invites us to explore them all. That's just what we are doing -- with our proliferating scars from coronary bypass and bariatric surgery to show for it.

To be a bit more specific about this: "Cutting fat" would have been fine if the message had been about foods and the overall diet, rather than distilled down to a nutrient. What was really intended was: Eat more naturally wholesome foods that are natively low in fat, and by the way, lower your dietary fat intake as a result. Had we ever eaten more spinach, rather than lots of Snackwells, things would have turned out fine. Alas, we did not.

The current reaction to this is not the sensible one -- that Snackwells were never part of dietary advice in the first place. The reaction is that the advice was wrong, and we should do a 180, and embrace a diet of more meat, butter and cheese. The only problem with that is...everything. There is no evidence of health benefits from such a diet, only evidence that it may not be worse than a diet composed mostly of refined starch and added sugar. In addition, it is calamitous for the climate, the environment and our fellow species. Other than that, it's a terrific idea.

The second is that when every new dietary prophet proclaims the heresy of the last, the public eventually comes to distrust us all. There are only so many times we can hear, "Everyone you thought was an expert up until yesterday is a moron, and I am the only one who knows the truth!" before anybody with half a wit starts to wonder: What if YOU are a moron, too? Since you came along today to refute everything before you, maybe somebody will come along tomorrow to point out why you are wrong. Probably best that I not trust anybody, and just keep eating bacon-stuffed sugar donuts.

This over-reaching has reached new (read: ominous) heights in the immediate aftermath of the release of the report of the 2015 Dietary Guidelines Advisory Committee. I have addressed that topic already, and my strong support for the report, so we may move on.

2. Failure to Communicate

We are failing to communicate in just the same two ways that doomed the tower of Babel. First, everyone is talking, but no one really understands. And second, the lack of understanding propagates distrust where there could very well be consensus.

What taunts me most about our decades-long dietary impasse, and the sequence of public health boondoggles it has propagated, is that it is all based on illusion. The illusion, propagated by various entities for profit, including Big Food, Big Marketing, Big Media and miscellaneous big egos drawn into the cabal, is that nutrition science is unclear, unreliable and in constant flux; and that no two nutrition experts agree about much of anything. We scientists have to some extent aided and abetted this misperception by showcasing our disagreements, and saying little about the rest.

The rest, very well represented in this year's DGAC report, is a massive, global consensus about the fundamentals of healthy eating predicated on a stunningly large, diverse and robust base of scientific evidence, and stable over decades and across continents.

Really. I know first hand.

I was not, of course, directly involved in the Tower of Babel debacle; I was only in high school at the time. But we may infer that all involved may have agreed on the fundamentals of both architecture, and the project. But they didn't find common language, did not establish common cause and did not map out common ground, and the result was a massive pile of rubble and a whole lot of casualties.

The same scenario is playing out in modern nutrition, but this time, I do have a seat at the table. The impression conveyed by mutually exclusive lexicons is that you must choose between the quality of calories, and the quantity; you must choose to cut fat or carbs.

But few of the world's nutrition experts do either. Most of us know that the best way to control the quantity of calories, which does count, is not to count -- but to choose our calories from high-quality foods. Most of us avoid "bad" fats (trans fat, most saturated fat) and "bad" carbs (refined white flour, added sugar) by eating good foods. By working closely in many capacities with many of the foremost nutrition authorities around the world, I can tell you that almost all of us eat more like one another than almost any of us eats like the "typical" American.

This is true even at the extremes of the spectrum: knowledgeable vegans eat a wide variety of plants direct from nature; knowledgeable Paleo dieters eat a wide variety of plants direct from nature, some the same and some different from the vegans, and in addition, eat the flesh of wild (or at least free-ranging) animals who, in turn, ate a variety of plants direct from nature. There is nothing on the menu that glows in the dark in either case.

I feel a bit as if I am at the Tower of Babel construction site, and for whatever reason, I am the one guy who understands what everyone is saying. It turns out they are saying much the same thing, variations on the theme of Michael Pollan's famous exhortation: "Eat food, not too much, mostly plants." There are some differences of opinion about details, of course, and some debate about just how much "mostly" ought to be. But still, good diets and expert opinion about them around the world are more alike than different.

The only trouble with this massive, global consensus is that it is invisible, or willfully concealed by the forces of profit-over-public-health. I am doing something about that, and you can help. The GLiMMER Initiative, and the True Health Coalition that supports it, is intended to provide a home to all of us who want to speak the same language about diet and health. You can join us, and help spread the word. It's a good word, in a language we all speak.

Acting as if any one study changes everything we thought we knew in an entire field is, at best, overreaching; a product of folly or greed, and fraught with peril. The notion that every incremental advance in our understanding of nutrition refutes what we thought we knew before is belied by the stability of basic nutrition science and sense alike, stable for decades and more, and reliably translating around the world into years added to lives, life added to years.

The failure, spanning those decades, to eliminate as much as 80 percent of the world's sad, and growing burden of chronic disease -- heart disease, cancer, stroke, diabetes, dementia and more -- is not for want of knowledge, but for want of making good use of what we know. Years and lives are being squandered for want of recognizing common cause, and common ground.

Our tower stands on that patch of ground. Whether we find ourselves buried in rubble, or reaching new heights, will depend largely on whether we choose to trust the stable weight of evidence, or to tip with every headline. It will depend on whether we choose the din of competing claims, or common cause.

It's time for dinner. The restaurant is on the top floor of our tower. The good news? The food is fine, and there's a great view from altitude. The bad news? It's a long way down. I hope we choose accordingly.

David L. Katz, MD, MPH, FACPM, FACP, is the founding director of Yale University's Prevention Research Center; President of the American College of Lifestyle Medicine; Editor-in-Chief of the journal, Childhood Obesity; Chief Science Officer for NuVal LLC; and director of the Integrative Medicine Center at Griffin Hospital. A clinician, researcher, author, inventor, journalist, and media personality, Dr. Katz is the recipient of numerous awards and recognitions, including an honorary doctoral degree; widely supported nominations for the position of U.S. Surgeon General; recognition by Greatist.com as one of the 100 most influential people in health and fitness in the world for the past 3 years; and inclusion by LinkedIN as one of the original 150 INfluencers. He has authored over 200 scientific papers and chapters, 15 books, and well over 1,000 columns and blogs- with a resulting social media following of roughly 500,000. A two-time diplomate of the American Board of Internal Medicine, and a board-certified specialist in Preventive Medicine/Public Health, he is recognized globally for expertise in nutrition, weight management and the prevention of chronic disease. Dr. Katz has delivered addresses in numerous countries on four continents, and has been acclaimed by colleagues as the "poet laureate" of health promotion.