Finding the Balance

How do we minimize the risks in our diet and balance them with the benefits?

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door dietAt the end of last year, reading in a Swiss dietetic magazine on recent dietary trends such as “Vegan” and “Paleo”, I was struck by a quote from the author of a cookbook entitled The Paleo Code: “Raw milk products containing all enzymes and nutrients are okay. Pasteurized milk however is a dead food”. For me this quote reflects the ignorance and arrogance of so many food quacks and romantic nutritionist living in the global north at the expense of advancements in science and technology.

I sympathize with concepts of the proponents of Paleolithic nutrition (based on vegetables, fruit, nuts, roots and meat) to potentially reduce non-communicable disease risk and, particularly vegetarian diets that include eggs and dairy, but not vegan diets for children. Particularly reducing meat consumption in the developed world has significant (health) benefits for individuals, society and the planet. In marked contrast, in the developing world, young children and women from impoverished communities would greatly benefit from increased nutrient-dense animal food consumption. Interestingly, Michael Pfeiffer from the Medical School Charité in Berlin (Germany) recently stated in an interview, that children raised on a vegan diet may be shorter (stunted) than normal.

There are some meat manufactures in Germany who are now making fake schnitzels and sausages from soya, quorn or egg protein. What is interesting is that these product innovations have become their fastest growing segment and they are almost unable to meet the increasing consumer demand, despite their being more expensive than real meat. I believe such products have an overall positive effect on planetary health. Back in the 1980s, when I was a student, I made my first acquaintance with what was then called TVP (textured vegetable protein) made from soya protein. Taste and mouth feel certainly didn’t make it a product that people aspired to eat. But new developments in food technology have enabled us to come a long way in making plant-based alternatives and novel protein sources more like meat. Some may not yet be ready for ‘Bug burgers and cricket crepes: Britain’s first insect restaurant opens in Wales’, as the Telegraph headlined at the end of October. But a savory snack made from crickets by a US-based entrepreneur that I recently tried, was certainly very tasty. Indeed, use of insects for food and feed production has a long tradition in many parts of the world and is currently a rapidly growing market segment.

Food technology, from its early days, has always been striving to make food safer and more nutritious and Harvard anthropologist Richard Wrangham even hypothesized in his book, Catching Fire: How Cooking Made Us Human, that consumption of cooked food contributed to the evolution of modern man. The control of fire for the specific purpose of cooking goes back hundreds of thousands of years and could certainly be considered the first food technology successfully applied by mankind. It has been forgotten that pasteurization of milk largely contributed to bringing down tuberculosis (TB) in Europe after World War II. In Europe, in the 1930s and 40s, the transmission of Mycobacterium bovisfrom cattle contributed significantly to human tuberculosis – this remains a reality and a problem in many parts of the developing world. You don’t want to contract pulmonary TB and most certainly not spinal TB – trust me I have seen cases in Indian hospitals, and the images still haunt me. Today one can still read faded plates on German barn doors that read ‘Officially recognized tuberculosis-free livestock’. Technology, hygiene, packaging and strict quality assurance and control have enabled us to safely eat delicious cheese such as Camembert, Emmental and Roquefort that in their traditional recipes rely on the use of raw milk. Yet, even in countries with the highest standards in food production, we still hear about foodborne diseases such as Salmonella, Shingella, E. coli and norovirus. Poverty and poor nutrition literacy in the developing world, however, often does not allow for the luxury of choosing between eating treated and untreated dairy products. Here food preparation often happens under difficult hygienic conditions and as such significantly contributes to malnutrition as a result of diarrhea, endemic environmental dysfunction and toxins.

In a recent report, the WHO assessed the burden of foodborne diseases, caused by bacteria, viruses, parasites, toxins and chemicals. The numbers are horrifying – each year as many as 600 million people or almost 1 in 10 people globally are affected and become sick as a result of consumption of contaminated food. And almost half a million (420,000) people die. Yet again, the most vulnerable are children under the age of 5 years, with a death toll of 125,000.

In developing countries, despite improvements and largely due to a lack of human resources and finance, many food companies (especially the smallest) are often poorly equipped to produce food that meets the required safety standards. Where improvements have been seen, has been in basic food technology, applications such as milling of grains and oil seeds, and sugar and salt production. Interestingly, the resulting staple foods (flour, vegetable oil, sugar and salt) have been used for food fortification, which has become a real public health success story in the reduction of micronutrient deficiencies. However, there is also concern by some policy makers that multiple micronutrient intakes from fortification, supplementation and micronutrient powders may expose some vulnerable groups to intakes of micronutrients above what is considered to be safe.  Just as risks are accepted in medicine, they are also a necessity in business, yet it seems there is an increasing trend to demand zero risk when it comes to food and nutrition. This is impossible. We take risks every day, unconsciously or consciously – eating street food or driving a car.

It is imperative that we change our thinking to accept tradeoffs even in food and nutrition. We must harness the observational wisdom of generations – fermentation does not only help make beer and wine, it also increases nutrient content and preserves food during time of abundance for hungry seasons. We must also apply new science and technology to bring about improvements in human nutrition and so also health and ultimately prosperity. But, we must do both responsibly – minimizing the risks and balancing them with the benefits.

‘Science and technology revolutionize our lives, but memory, tradition and myth frame our response.’ – Arthur M. Schlesinger

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