I recently read Josh Ozersky’s Time Magazine article,” Good Food and Fat: Are Chefs to Blame for Obesity?” (May 18th, 2011, http://tinyurl.com/3nf76uz ). Unlike Paul Bocuse, who recused himself from the question by declaring himself no doctor; I, being both a chef and a doctor, feel obligated to attempt an answer. Implicit in this query is the challenge chefs have in providing us the delectable experience we demand without being the cause of our suffering. In medicine we refer to this as a narrow therapeutic window. Filling this prescription is exactly what I and many other chefs have been addressing over the last several years. In response to this conundrum I developed the Grassroots Gourmet Philosophy to Eat Well and Live Better. The foundation is the Path of The Three Be’s, three simple steps; Be aware and avoid the call of the junk food siren; Be fresh and Be on time and in proportion. Simple, but not always easy.
As a physician, I took The Hippocratic Oath. But as a Chef, I also follow another of Hippocrates’ dictums:”Let Thy Food be Thy Medicine, and Thy Medicine be Thy Food.” In short, we ARE what we eat, but we are also MORE than what we eat. The consumption of food has moved beyond ingesting for sheer nutritional value. It must taste good. The enjoyment of food is something that feeds our souls. It is something shared and something deeply personal all at once. It is a lot like love and just as complex.
As complicated as those realities are, the story of obesity and its relation to food, and in particular the food crafted by chefs, foodies, gourmets and home cooks, is even more byzantine. First, our measure of obesity, the Body Mass Index (BMI), is not even a direct measure of fat. It does not take into account the amount of lean body mass. Interestingly, although no one ever mentions it, there is increased mortality at very low measures of BMI not explained by cancer or other wasting conditions. It is a “J” shaped curve, not a linear relationship. Assuming, for argument’s sake, that BMI is the standard (although waist circumference as a measure of visceral adipose tissue (VAT) correlates much better with morbidity and mortality) there are many other variables that have been associated with the development of obesity. Conditions such as genetics, maternal weight gain and birth weight, physical exercise, basal metabolism, and many others have all been implicated in the causality of obesity. There was an interesting study identifying a lack of sleep as one of the most potent predictors of obesity. Important to note, none of these are directly food, let alone chef, related.
Adding to the mix is the method of dining that has become prevalent today. Over 50% of every food dollar is now spent dining out. The majority of that is prepared, processed and adulterated food. The “fast food” and chain dining establishments arrange food for assembly. They don’t employ chefs to carefully seek out fresh, vibrant nutritious ingredients. They employ minimum wage assembly line workers at a grill and deep fryer to assemble orders. These orders prey on hard wired behaviors to seek out sugar, salt and fat. This fast food dining has created a culture of addiction in which salt, sugar and fat are desired and sought after like a junkie scoring a fix. The difference between assembled pre-manufactured food and a carefully and freshly constructed meal is like the difference between slugging antifreeze to quell your need for alcohol and enjoying a fine wine tasting.
But it is not just sugar, salt and fat that makes something “bad.” Great chefs use all three ingredients all the time. But they wield them like a great surgeon uses a scalpel; precise, directed and limited for maximum benefit. We actually need these nutrients. We need some fats, for example; which is why they are called essential fatty acids. The cold hard parboiled truth is that fat consumption has actually decreased in America over the last several decades. Despite this, the rates of obesity, diabetes and chronic health conditions have continued to spiral upward. The latest scapegoat to be picked out of the usual suspects is carbohydrates. Yet again blanket condemnation misses the mark: the amount of carbohydrate consumption today is no different in the US than in the early part of the century when these conditions were much less prevalent. What has changed is the percentage of highly processed and refined carbohydrates that we consume as a portion of our diet. Quality is every bit as important as quantity in the equation.
What is the answer? I believe Good Food and Chefs are the answer, not the problem. Blaming chefs and good food for obesity is like blaming an attractive woman for being pretty. The answer is in understanding the variables of the equation and what we have control over. We need to understand the consequences of food choices. We have to care about our food. Chefs like Emeril Lagasse, Gordon Ramsey, Eric Ripert, Thomas Keller, Daniel Boulud and legends like Jacques Pepin, Julia Child, Paul Bocuse among a host of others are the answer because they create a passion for fresh, nutritious and real food. Educators like Chef Jamie Oliver and writer Michael Ruhlman and TV celebrity Alton Brown are the answer because they show us how we can get it done for ourselves.
And Tony Bourdain? He of pithy and piquant observation and commentary. Well, we need him more than ever because he speaks the Truth. That’s not just good food for thought, that’s the right medicine.