Retrospective #2: Nutrition 101: A Primer on the Fundamentals of Nutrition

Food has three principal nutrients, called Macronutrients. They are: Fat, Protein and Carbohydrate, hereafter sometimes referred to as “carbs.” All of the energy derived from food comes from these three components.

Foods also have non-caloric nutrients, namely vitamins and minerals, or Micronutrients, as well as water and ash. In addition, foods have essential but not yet well understood (or discovered) Phytochemicals, such as antioxidants.

The energy content of either a gram of protein or a gram of carbohydrate is four (4) calories. The energy of a gram of fat is nine (9) calories, making it thus more than twice as “dense” in calories as either protein or carbs. A gram of ethyl alcohol in an alcoholic beverage has seven (7) calories but, alas, no nutrient value, hence “empty” calories.

Most “sugar-free” candies and “energy bars” contain “sugar alcohol,” which does not elevate blood sugar levels, making them tempting to diabetics. They do, however, raise blood insulin levels, because the body senses sweet.

The total available energy of a food is therefore the sum of the products of the weight (in grams) times the calories per gram of each of its macronutrients. If you wanted to do the math (or use a software program) you could calculate how many calories of each macronutrient, and the total percentage energy in calories, are contained in each portion of food. But for this primer, it is only necessary to establish an understanding of the basic science.

If you are interested in healthy eating and a long life, you should be informed about the macronutrient distribution and balance of your diet. It was not so in the Paleolithic Era, referenced in the 1^st installment. It was then just about survival. It was through “survival of the fittest” and that we learned what to eat to be healthy and evolve.

Almost half a century ago in the U. S., some big-government advocates thought that heuristic learning (by trial and error) was fraught with too much risk. That’s when politicians and public health officials decided to get involved in establishing Dietary Goals (1977), and later Dietary Guidelines (1980) for Americans. The HHS/FDA created these standards and later the “Nutrition Facts” panel that is on all manufactured and processed food.

This is known today as the “Standard American Diet,” or SAD, for short, prophetically. It contains a “% daily value” (previously the “Recommended Daily Allowance”) for carbs, for an adult woman, of 300 grams (x 4 calories per gram = 1,200 calories, or a whopping 60% of a 2,000-calorie diet). The “daily value” for protein is 50g (x 4 = 200 calories or 10% of 2,000 kcal). And the “daily value” for fat is 65g (x 9 = 585 calories or +/- 30% of a 2,000 kcal. diet.

This means that our government currently, to this day, recommends that an American woman eat a diet comprised of 60% carbs, all of which break down to “sugars” in the blood. Simultaneously, beginning in 1980, most of us have become fatter, and many of us have become Type II diabetics (like me). Does anyone see a correlation here? Does anyone think maybe this is a vast public health experiment gone wrong? Many people now agree. It was a mistake.

But I don’t blame our doctors. For more than 50 years – longer than the entire time that virtually any doctor still in practice has been working – the prevailing wisdom passed down from the powers-that-be has wavered but little. The sources of information that the medical practitioner has relied on are, writ large, our public health officials and, derivatively, the practitioner’s medical community, through their specialty practice standards, medical journals and conventions, and the ubiquitous pharmaceutical salesperson. For the most part, practicing physicians were not trained much (if at all) in nutrition, except for basic biochemistry; they have had little time to “bone up” on an area that isn’t being pushed by big pharma because there is no money to be made in nutrition. So, I do not blame the clinician for treating symptoms of disease by prescribing medications. I sympathize with (most of) them. They are stuck in the status quo of the mainstream mantra and, and the dictates of government regulations, insurance, and reimbursement policies. They are unable to turn around in the face of these compelling drivers.

This suggests to me that it may be time for the patient to assume some responsibility and take charge of his (or her) own health.  What you eat is up to you. It’s in your hands. You can do it, if you take the trouble to “bone up.”