What Is Quality? (Part 2)
Note this piece is a continuation from Part 1
"Quality is not an act, it is a habit."
- Aristotle per Will Durant’s The Story of Philosophy (1926)
In order to make an educated guess on the quality of our nutritional intake, I believe we need to exhibit trust on several levels:
Trust in ourselves that we can delight in the occasional indulgence within a balanced diet that meets our needs over a long period of time (perhaps an entire lifetime)
Trust in science that researchers may begin to understand how various compounds affect our long-term health and inform our decisions
Trust in whoever is providing us our nourishment
A large body of literature has focused on 1) and 2) while I have found only a few unbiased books on 3)1. To put a finer point on 3), how can we evaluate and navigate the modern food system in the US?
For all the anti-establishment rhetoric getting amplified since COVID, I’m surprised there is not more questioning of the various regulatory bodies tasked with ensuring the population’s nutritional well-being2. Similarly, questioning the large pharmaceutical companies is currently in vogue while nowhere near the same level of scrutiny is focused on the largest food and beverage companies – are they all that different?
In the unique case of personal care products, I suspect that most consumers believe that a government agency (FDA) is actively testing and monitoring the numerous chemicals found in everyday skin and hair formulations. That is not actually true3. A non-profit, EWG, has even gone as far as hiring a staff of scientists and researchers to test and score everyday chemicals we use on our bodies. The results can be surprising. For example, the ubiquitous baby laundry detergent Dreft scores an F.
Who can we trust?
America is becoming a land of extremes, even when it comes to food. Whether it is the carnivore diet, the vegan diet or the keto diet, it seems as if everyone is selling whatever worked for them or their relatively small group of patients (with the compulsory before and after photo).
My hypothesis is that quality is not about extreme dietary or macronutrient restriction, but rather it is about the consistent pursuit of nutritional value from the foods and beverages we regularly consume4. For those in pursuit of quality, research outlined in previous posts suggests any changes should be i) subtle and ii) sustained over a long period of time5.
As I outlined in Part 1, determining nutritional value is extremely difficult over the long-run, but it is not impossible. Researchers are slowly understanding the complex functions of our body, and there are some strong probabilities emerging around how regularly consuming certain substances can positively or negatively impact health.
Nutrition is highly personal and a sustained period of trial and error (perhaps including help from a trained nutritionist), over multiple months or years, may be the only true way to learn what is right for our bodies. I am certainly no doctor nor nutritionist – rather, I’m an investor seeking to be as informed as possible and share my thoughts publicly.
Can people understand nuance anymore?
Sugar has become public enemy #1 for good reason. It’s ubiquitous, inexpensive and consistently delivers joy to sweet tooths worldwide like myself. It is almost certainly a major culprit in our obesity6 and diabetes epidemics. Sugar is found in both simple forms (e.g. fructose or glucose from fruits) and more complex forms (e.g. starches from grains, potatoes, or rice). Here comes the nuance. Sugar alone may not be the sole culprit7.
Recent research has indicated that “ultra-processed food”, often laden with sugar and a vast number of fillers not found in common kitchens, may actually be the cause of a rapid increase in obesity and metabolic disorders worldwide8. The hypothesis is that ultra-processed food causes people to eat more calories than they otherwise would if they prepared or cooked their own food, independent of sugar or carbohydrate’s percent of the overall calories consumed. The hypothesis was supported by a landmark study published in July 2019 by Kevin Hall at the National Institute of Health (NIH)9. A rarity in nutrition research, the study controlled for exercise (and other typical confounding variables) by having all 20 participants stay confined to an NIH building for one continuous month.
Warnings aside, how does this square with my point in Part 1 about common errors of generalized nutrition guidance? Well, if you exercise like a long-distance runner or cross-fit junkie, then a regular habit of Coke classic or a twinkie is unlikely to have a long term impact.
It’s not the cow, it’s the how
Wading into a much more controversial area, I have been fascinated for years by the public discussion around consuming meat in the US. It feels starkly binary, as if eating meat is either all bad or all good. We can no longer see the gray area, which I propose is where all the value actually resides.
For example, the difference between regularly consuming low quality and high quality beef may have significant implications for our health. Grass-fed, grass-finished regeneratively farmed beef (or even better, wild game) is highly likely to be an extremely nutritious source of calories10. The diversity of nutrients consumed by the animal on pasture, per Fred Provenza’s research highlighted in Part 1, may play a major role. Conversely, a grain-fed cow confined to a feedlot, kept alive by antibiotics, may be so unhealthy that it can lead to negative health effects in humans11.
Since an animal concentrates its nutritional inputs in its tissues, there is a further magnifying effect of input quality when the meat is consumed by humans12. This holds true for all animals including chicken, pigs and fish. Grass-finished beef may taste meaningfully more gamey or chewy than lower quality corn-finished meat, but therein lies the personal trade-off between taste, nutritional value, and price. Taste is personal!
A similar important gray area exists within fats. In the last 20 years, fat has climbed its way back from being public enemy #1 – largely as a result of science correcting erroneous research by Ancel Keys in the 50s and 70s13. Currently, there is a large amount of research focused on the potential negative effects of seed oils (primarily canola)14 and the potential positive effects of healthier fats like ghee, avocado oil, fish oil, MCT oil and olive oil. This debate has bled into the plant-based meat category. The vast majority of plant-based meats like Beyond Burger have canola oil (or another seed oil) as a main ingredient, along with other fillers found in highly processed food. This is in stark contrast to a plant-based meat option like Abbot’s which only uses whole food ingredients mixed with pea protein and olive oil15.
I often hear rebukes of plant-based products such as “I stick to the natural stuff because all those fake milks and meats are just chemical trash.” There may be some truth to this claim for lower quality plant-based products, but what this viewpoint misses is the pervasiveness of chemicals (antibiotics, hormones, pain relievers, tranquilizers, chemical-laden feed) being regularly pumped into the vast majority of animals to fatten them up in the months prior to human consumption.
Is a quest for quality innate?
When guests visit my home and observe my pantry and refrigerator, I often receive some version of this remark, “Wow, you have a whole lot of stuff I’ve never heard of before.” As highly social beings that evolution has crafted to “fit in”, we sometimes forget that our modern diet may be vastly more limited than our ancestors.
In Yuval Noah Harari’s Sapiens (2015), he summarizes research examining a period of ~100,000 years, during which our hunter gatherer ancestors ate a wide variety of plants and animals on the move. A key conclusion is that the world-class adaptability of homo sapiens may have been a key reason why the species persevered over other human-like species such as Neanderthals. This hypothesis also may explain why hunter gatherer skeletons indicate a healthier lifestyle versus static agricultural cultures consuming a less diverse diet, all else being equal.
This book reference is in no way a veiled attempt to promote the ‘paleo diet’. Rather, it is to question whether a sustained period of trial and error, sampling a wide variety of foods and beverages, is a modern luxury or a key source of human vitality.
In my next post, Introducing Quality Distributions, I offer a simple framework for assessing the quality of individual products.
For a good summary of the research evaluating high vs low quality foods see Food: WTF Should I Eat? (Hyman, 2018). What to Eat (Nestle, 2007) is helpful although now somewhat dated. Dirt to Soil (Brown, 2018) is a helpful primer on the regenerative agriculture movement. The Dorito Effect (Schatzker, 2015) and Ultra-Processed People (van Tulleken, 2023) are focused on processed food.
A notable exception is former Congressman Tim Ryan from Ohio (2003-2023) who included the food system as a key pillar of his 2022 Senate campaign
For a longer discussion, see Taste is Personal. To summarize, a subtle and sustained change allows our taste-brain-gut axis time to adjust.
For a summary of recent research on the impact of ultra-processed food, see Ultra-Processed People (van Tulleken, 2023)
See here and here the NIH research published in 2019. “This is the first study that shows causality: ultra-processed food causes people to consume calories and gain weight. If you remove those ultra-processed foods and give them the same calories, they report liking the food just as much, yet they lose weight, and they eat fewer calories.”
See here and here for research supporting this claim. Note that the vast majority of “grass-fed” beef in the US is actually grain-finished on a feedlot for the cow’s last 3 to 8 months. This includes the vast majority of “grass-fed” collagen in the US. See here a letter to the USDA by 3 leading grass-fed certification companies asking to address this misclassification issue. Regarding wild game, see here (axis deer) and here (boar) for reliable sources.
Not all processed food is bad food. If high quality ingredients are processed without extreme heat or chemical additives, then the result may very well be healthier than some “natural” products.