TheWesternDietandDiseasesofCivilization

Theincreasedphysicalandpsychologicalrisksassociatedwiththeconsumption
ofrefined,processed,andsugaryfoods

KarenEisenbraun
November13,2011
Nat309:TopicsinHolisticNutrition

TheWesternDiet

1. INTRODUCTION
Thewesterndietcharacterizedbyhighquantitiesofsimplecarbohydrates,processedfoods,and
factoryfarmedmeathasbeenassociatedwithahostofmajorchronicdiseases,manyofwhichare
uniquetocivilizedcultures.Inhabitantsoftraditionalculturesthatmaintaintheirtimehonoreddiets
tendtoberelativelyfreeofthese"westerndiseases,"anddevelopthemonlyafteradoptingadietthat
ismorewesternized.
InInDefenseofFood,MichaelPollandescribeshowagroupofoverweightanddiabeticAborigines
agreedtoreturntotheirtraditionalhomelandandtraditionalwaysofeating,toseeiftheirhealth
problemsmightbereversed.SincerelocatingtosettlementsnearthetownofDerby,Australia,theyhad
becomeoverweightanddevelopedmetabolicsyndrome,aconditionassociatedwithdiabetes,obesity,
heartdisease,highbloodpressure,andcancer.Researchersattributedtheirhealthproblemstoadiet
highinrefinedcarbohydratesandaprimarilysedentarylifestyle.
Duringtheirsevenweekstayinthebush,theAborigineshadnoaccesstoprocessedfoods;theywere
completelyreliantonfoodstheyhuntedandgatheredthemselves.Theirdietconsistedoftraditional
foodssuchasfish,shellfish,birds,kangaroo,yams,figs,andbushhoney.Thiscontrastedstarklytothe
westerndiettheyhadbeeneating,whichconsistedmainlyof"'flour,sugar,rice,carbonateddrinks,
alcoholicbeverages(beerandport),powderedmilk,cheapfattymeat,potatoes,onions,andvariable
contributionsofotherfreshfruitsandvegetables'thelocalversionofthewesterndiet."(Pollanpgs
8687)
Afterthesevenweekexperiment,nutritionresearcherKerinO'Deareportedthatallsubjectshadlost
weightandexperiencedsignificanthealthimprovements.Theirtriglyceridesandbloodpressurehad
fallen,andthemetabolicabnormalitiesassociatedwiththeirdiabeteshadeitherimprovedorresolved.
Pollannotesthatthesediseasesofcivilizationobesity,diabetes,heartdisease,hypertension,and
certaindietrelatedcancershavelongbeenrecognizedasproductsofthetypicalwesterndiet,but

TheWesternDiet

O'Dea'sstudywasthefirstthatshowedthesehealtheffectscanbereversedbyareturntotraditional
huntergathererdiets.
Thefollowingstudiesexaminevariousaspectsoftraditionalandindustrializeddiets,includingthe
effectsofthesedietsonpsychologicaldisordersinwomen.

2. ORIGINS AND EVOLUTIONS OF THE WESTERN DIET: HEALTH IMPLICATIONS FOR THE
21ST CENTURY
This2005report,publishedintheAmericanJournalofClinicalNutritionandheadedbyDr.Loren
CordainProfessorofHealthandExerciseScienceatColoradoStateUniversityandauthorofThePaleo
Diet,oneofthepreeminentbooksonancestraldietsexaminessevencrucialdietarychanges
introducedsincetheriseofagricultureandanimalhusbandry:glycemicload,fattyacidcomposition,
macronutrientconsumption,micronutrientdensity,acidbasebalance,sodiumpotassiumratio,and
fibercontent(Cordain).Cordainarguesthatthesechangesoccurredtoorecently(approximately10,000
yearsago)forthehumangenometoadapt,andthattheyarethecauseofmanyofourdiseasesof
civilization.

2.1. Overview
Cordainbeginsbyexaminingnutritionalcharacteristicsofbothmodernandpreagriculturaldiets.He
identifiesfivefoodgroupsthatwouldnothavebeenavailabletopreagriculturalhomininsyetnow
makeup72.1%ofthetotaldailycaloriesconsumedbyallpeopleintheUnitedStates:dairyproducts,
cereals,refinedsugars,refinedvegetableoils,andalcohol.(SeeTable.)Combinationsofthesefoodsalso
makeuptheprocessedfoods(cookies,cake,bakedgoods,crackers,chips,pizza,softdrinks,candy,ice
cream,etc.)thatareubiquitousintheAmericandiet.Themoderndietalsocontainshighlevelsofsalt
andfattydomesticmeatsfoodsthatwerenotapartofancestraldiets.

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Table:IndustrialEraFoods
Foodorfoodgroup

Percentageofdailyenergy
intheU.S.diet

Dairyproducts(milk,cheese,butter,other)

10.6

Cerealgrains(wholegrains,refinedgrains)

23.9

Refinedsugars(sucrose,highfructosecorn
syrup,glucose,syrups,other)
Refinedvegetableoils(saladandcookingoils,
shortening,margarine)

18.6

Alcohol

1.4

17.6

2.2. Methods
TheAmericanJournalofClinicalNutritionreportreviewed172differentarticlesandstudieson
ancestraldiets,theevolutionofthewesterndiet,andWesterndiseases,whichwerepublishedbetween
1967and2004.Topicsrangedfrom"Dietandnutritionofhuntergatherers"to"Saltandgastrointestinal
cancer."

2.3. Results
CordainetalconcludedthattheprevalenceoftheabovefoodsinthemodernWesterndietisdirectly
linkedto"diseasesofcivilization"suchasobesity,type2diabetes,hypertension,coronaryheartdisease,
andhighcholesterol,aswellascommonWesternhealthconditionssuchasacne,polycysticovary
syndrome,certaincancers,andskinconditions.Thestudystatesthat"dietrelatedchronicdiseases
representthesinglelargestcauseofmorbidityandmortality."Althoughrareornonexistentinhunter
gathererculturesandthosewhomaintaintraditionaldiets,thesediseasesarepresentin5065%ofthe
adultpopulationinwesterncultures.

2.4. Analysis
TheAJCNreportisremarkablythoroughinitsanalysisofthedifferencesbetweenancestraldietsand
themodernWesterndiet.Lessattentionispaidtothecharacteristicsofancestraldietsthantoevidence

TheWesternDiet

thatIndustrialerafoods(dairyproducts,refinedgrains,refinedsugars,refinedvegetableoils,fatty
meats,salts,andcombinationsofthesefoods)arerelativelynewtothehumandiet.Insomecases,
thesefoodswereintroducedwithinthepasttwocenturies,suchashighlyrefinedgrainflours.The
reportshowsconvincingevidencethatthereisnosingledietaryelementthatcanbelabeledasthe
causeofchronicdisease(suchassaturatedfat),butratherthatWesterndiseasesaretheproductofa
combinationofdietaryelements.Nospecificancestraldietisdefinedoridentifiedasbeingtheidealdiet
forallcultures.

3. NON-TRADITONAL WESTERN DIETS

ThisreportbyElizabethLipski,PhD,CCN,waspublishedinNutritioninClinicalPraticeandtakesa
closerlookatthehealthbenefitsandcharacteristicsofseveraltraditionaldiets,includingTohono
O'odhamIndians,EskimosinLadrado,theMaoriinNewZealand,GaelicinOuterHebrides,andthe
HunzaintheHimalayas.Lipskinotesthat"wheneverpeoplelivingtraditionallymeshwithwestern
culture,noninfectiousdiseasesofmodernculturesoonfollow"(Lipski).

3.1. Overview
Lipski'sreportoffersareviewofthedietsandhealthstatusofvarioustraditionalculturesaroundthe
world.ShecitestheworkofAlbertSchweitzer,WestonPrice,andotherswhostudiedthedietaryhabits
andhealthstatusofindigenouspopulationsintheearlierpartofthetwentiethcentury.Physiciansliving
ineasternandcentralAfrica,Australia,NewZealand,thesouthernPacific,andotherisolatedregions
sawfewornoinstancesofdentalcaries,cancer,heartdisease,appendicitis,diverticulitis,diabetes,
infectiousdisease,andothercommonmaladiesintheWest.Manyofthesesourcesreportedthatthe
healthofthenativesdegeneratedwhenintroducedtoEuropeandiets.

3.2. Methods
Using60differentarticlesandstudies,Lipskiexaminesearlyobservationsaboutthehealthof
indigenouspopulations,contemporaryresearchonindigenousdiets,traditionalcookingmethods,

TheWesternDiet

functionalfoodsintraditionaldiets,andthetrendtowardsincreasedhealthwhentraditionaldietsare
restored.

3.3. Results
Lipskinotesthatalthoughtraditionaldietsvariedwidely,nearlyalltraditionalculturesusedcooking
methodsthat"enhancedigestionandnutrientavailability,"suchassoaking,fermentation,pounding,
andsprouting.Useoftraditionalcookingmethodsdecreasedwhenafamily'swealthincreased.
Traditionalculturesalsoemployedtheuseof"folkfunctionalfoods"formedicinalandhealing
properties.Shecitesseveralstudiesthatobservedimprovementsinhealthafterthereturntoa
traditionaldiet,includingO'Dea'sstudyofthetenAustralianAborigines.Asimilarstudyofoverweight
HawaiianswhoreturnedtoatraditionalHawaiiandietfor21dayssawsignificantimprovementsin
weight,glucoselevels,serumtriglyceridesandtotalcholesterollevels,andsystolicbloodpressure.

3.4. Analysis
Lipski'sresearchsupportsPollan'sposition,asstatedinInDefenseofFood,thattraditionaldietsvary
widelyintheirnutritionalcomposition,yetarealleffectiveatsafeguardingagainstthediseasesof
moderncivilization.However,returningtoatraditionaldietisnotalwaysfeasible.AsLipskinotes,
traditionalfoods,skills,andpractices"areslowlyvanishingastheeldersdie."Althoughsome
populationsunderstandtheroleoftraditionalfoodsinpreventingorimprovingdiseasestates,many
havelostaccesstotraditionalfoodsortheknowledgeandskillstoidentifyorpreparethem.Inother
cases,traditionalfoodshavebecomemorecontaminatedwithmercury,pesticides,andother
pollutants,asisdemonstratedbytheArcticDilemma,wheretraditional,highfatfoodsareless
beneficialthantheyoncewereduetoenvironmentalcontaminants.Thechallenge,then,istodetermine
howtoincreasetheavailabilityofunpollutedtraditionalfoodsinbothtraditionalandmoderncultures.

TheWesternDiet

4. ASSOCIATION OF WESTERN AND TRADITIONAL DIETS WITH DEPRESSION AND

ANXIETY IN WOMEN
AlthoughthetypicalWesterndietiscommonlyrecognizedasafactorinhealthconditionssuchas
obesity,cardiovasculardisease,obesity,andtype2diabetes,lessscientificevidenceexistsonthe
relationshipbetweendietandpsychologicalhealth.Authorsofthisstudy,whichwaspublishedinthe
AmericanJournalofPsychiatry,notethatdietaffectsbiologicalprocessesthatinfluencepsychological
health,includinginflammation,brainplasticityandfunction,thestressresponsesystem,andoxidative
processes(Jacka).Studyauthorsalsonotethatpreviousstudiesexaminingtheassociationbetweendiet
andpsychologicalhealthfocusedonindividualnutrientsorfoodgroups,whichprovideanincomplete
pictureoftheeffectsofdietonmentalhealth.

4.1. Overview
Ratherthanfocusingonindividualnutrientsorfoodgroups,theAmericanJournalofPsychiatrystudy
examinedtheeffectsofhabitualdietqualityonmentalhealthinmorethan1,000Australianwomen
betweentheagesof20and92.

4.2. Methods
Studyparticipants,whowererandomlyselectedfromthepopulation,wererequiredtocompletea
comprehensivefoodfrequencyquestionnaireandthe12itemGeneralHealthQuestionnaire(GHQ12).
HigherscoresontheGHQ12indicatemorehealthproblems.Forthepurposeofthestudy,"traditional"
dietarypatternsweredefinedasthosehighinfruits,vegetables,meat,fish,andwholegrains;"western"
dietswerethosecomposedmainlyofprocessedorfriedfoods,refinedgrains,andsugar.
Participantsalsounderwentaclinicalinterviewtoassesspsychologicalhealth,withresearchers
interestedinthehighprevalencementaldisordersofmajordepressivedisorder,mildchronic
depression,andanxietydisorder.

TheWesternDiet

4.3. Results
Resultswereadjustedforage,socioeconomicstatus,education,andhealthbehaviors.Traditional
dietswereassociatedwithlowerratesofdepressionandanxietydisorders,andbetterdietquality
furtherdecreasedtheriskofpsychologicalsymptoms.Participantseatingawesterndietexhibited
higherGHQ12scores.Thewesterndietwasalsoassociatedwithanincreasedriskofmajordepression
ormildchronicdepression.Studyauthorsalsonotedthat,duetoadjustmentsforoverallcaloricintake,
theamountofunhealthyfoodmaybemorerelevanttopsychologicalhealththanthatamountasa
percentageoftheoveralldiet.
Althoughtraditionaldietsareassociatedwithbetterpsychologicalhealth,theassociationdoesnot
provecausation.Theauthorsrecommendfurtherstudiestoruleoutreversecausalityandconfounding.

4.4. Analysis
Whilefurtherresearchisnecessarytoprovecausation,studyauthorsnotethattheresultsare
consistentwithotherresearchthatshowsassociationsbetweenhabitualdietqualityandmedical
outcomes,includingriskofmajorchronicdiseasessuchascardiovasculardiseaseandcancer.Individuals
sufferingfrompsychologicalissuesorthosediagnosedwithdepressionoranxietydisorderswouldbe
prudenttoincreasetheirintakeoffruitsandvegetablesanddecreasetheirconsumptionofprocessed,
refined,andsugaryfoods.

5. CONCLUSION
Healthrisksassociatedwiththetypicalwesterndietareundeniablyextensiveandsevere;however,a
transitiontoamoretraditional,plantbaseddietisproblematicformanypeopleduetohighercosts,
limitedaccesstounprocessedfoods,orfoodinsecurity.Inaddition,problemssuchastheArctic
Dilemma,inwhichtraditionalfoodsareincreasinglycontaminatedwithenvironmentalpollutants,
compoundthedifficultyofsourcinghealthy,wholefoods.

TheWesternDiet

Adoptingasetof"foodrules"suchasthoseoutlinedinInDefenseofFoodcanassistwiththe
transitiontoahealthierdiet.Buyingwholegrainsinbulkandbuyingproduceinseasoncanhelpkeep
foodcostsdown.Whileorganicproduceispreferabletoconventionallygrownfoods,conventional
produceisstillpreferabletorefined,processedfoods,andindividualscanreducetheirexposureto
chemicalsandpesticidesbychoosingproducewiththelowestpesticideresidues,suchasasparagus,
sweetpeas,mangoes,andcantaloupe(EnvironmentalWorkingGroup).
Improvementsinnutritionaleducationarecriticaltoeffectingamovementtowardshealthierdietary
habits.Ninein10Americanssaytheirdietishealthy,accordingtoaConsumerReportsHealthpollfrom
early2011,butonlyaquarterlimittheamountoffatandsugarintheirdiet,andonlyonethirdof
participantsreportedeatingfiveormoreservingsoffruitsandvegetablesdaily(Mann).Thediscrepancy
revealsalackofunderstandingaboutwhatconstitutesahealthydiet,whichputspeopleatriskofmajor
chronicdiseaseandpsychologicalproblems.
Individualswouldalsobewisetoignoredietaryfadsandtrendsandremaindubiousabout"new"
scientificresearchregardinghealthydietaryhabits.AsPollanillustrates,emergingresearchespecially
thatwhichrelatestospecificnutrientsorfoodgroupsoftenonlycreatesmoreconfusionsurrounding
healthyfoodchoicesandcaninfactleadtomorehealthproblems.Perhapsthemostimportantfood
rulestofollowaretoavoidprocessedfoodsasmuchaspossible,choosingfoodswithfeworno
ingredients;keepthedietsimpleandchoosequalityfoodsoverquantity;andtofocusthedietonwhole
fruitsandvegetables.Or,asPollanputsitinInDefenseofFood,"Eatfood.Nottoomuch.Mostly
plants."

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10

REFERENCES:
Cordain,Lorenetal(2010)."OriginsandevolutionoftheWesterndiet:healthimplicationsforthe21st
century."TheAmericanJournalofClinicalNutrition.
http://www.ajcn.org/content/81/2/341.long
EnvironmentalWorkingGroup:Shopper'sGuidetoPesticidesinProduce
http://www.ewg.org/foodnews/summary/
Jacka,Feliceetal(2010)."AssociationofWesternandTraditionalDietswithDepressionandAnxietyin
Women."AmericanJournalofPsychiatry.
http://ajp.psychiatryonline.org/cgi/content/full/167/3/305
Lipski,Elizabeth(2010)."TraditionalNonWesternDiets."NutritioninClinicalPractice.
http://ncp.sagepub.com/content/25/6/585.full.pdf+html
Mann,Denise(2011)."AmericansSayTheirDietisHealthy,butIsIt?"WebMDHealthNews.
http://www.webmd.com/foodrecipes/news/20110104/americanssaytheirdietishealthybutisit
Pollan,Michael(2008).InDefenseofFood.