Behavior / Diet

Simplifying our Rules

Image taken from recently read yet another research study finding that dietary sodium intake has very little effect on an individual’s blood pressure over time, in line with a growing body of evidence refuting dietary salt as an important factor in hypertension (except for a small portion of hypertensive adults who suffer specifically from salt-sensitive hypertension). Guidelines establishing quantifiable targets for optimal health, such as those for recommended physical activity, disease management, and nutritional intake, have grown ever-more complicated as research surrounding these recommendations reflects the imprecise nature of science and data.  Now, health guidelines exist for a good reason, particularly when they create measurable objectives that can be assessed and managed on a state and federal group level to estimate health and programmatic effectiveness. But at some level, have many guidelines  become onerous for the individual? Do all the health, dietary, physical activity, and disease management guidelines and numbers really inform our behaviors, or do they simply confuse and overwhelm us?

I started thinking about this after I read Aaron Carrol’s article entitled “Simple Rules for Healthy Eating,” in which the author establishes his non-scientific, moderate rules for eating well. A similar article by Michael Pollan several years ago contains an interactive reader graphic that illustrates quotes regarding readers’ personal advice surrounding food and healthy eating. This made me wonder if, at some point, we’ve all kind of “blanked out” when it comes to food, exercise and nutrition guidelines, choosing instead to adhere to our own set of informal rules to help us choose a healthy lifestyle. So, out of curiosity, I polled my colleagues for their insights about food, diet and eating, collecting such thoughts as:

Abs are made in the kitchen.
Eat right, exercise regularly, die anyway.
Eat to live, not live to eat.
Don’t eat anything bigger than your head.
You can eat anything from the sea except the cow that fell in.
If you can’t pronounce it, don’t eat it.

Interestingly, everyone that I talked to had a phrase or set of phrases that loosely defined their dietary ideology, most involving concepts such as moderation, fulfillment, whole foods, restraint, mind-body connection, and enjoyment. And, while everyone in this admittedly healthy cohort knew various versions of dietary and physical activity guidelines, few (okay: none) attempted to quantify their daily intake and activity in order to meet the numerical targets outlined in various guidelines. This begs the question: is there a disconnect between science and practice here? If what we need, want and actually follow are qualitative rules that simply help us follow a general practice regarding lifestyle, then are clinicians and researchers producing stringent diet and activity guidelines that are by nature going to fail the individual? If you look back at the 1917 U.S. Food Administration guidelines you may agree…


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