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Thursday, May 30, 2013

Nutritionism Anecdote

Aside from it's obvious function as a means of delivering nutrition, food has a greater role in society as a means of communication and building bonds. This duality shapes many different social mores, and colors an often unspoken judgement: is a substance medicine, food, or poison?

Of course, almost anything is all three depending on the dosage and circumstance. In a sense, how much a particular food item or practice is prized or despised sits in how they blur the lines of these categories. When transferred into the category of poison (or at least, a disgust object), people go through unusual lengths to avoid it - take for example the explosion of BPA-free or gluten-free items. The latter category is almost laughably comical; the issue of gluten sensitivity affects a small fraction of the general population, but the fad to avoid it as a modern scourge results in bizarre dietary contortions. Most of it, of course, because these folks require eating the same wheat enriched diet only without the gluten - eating one's (gluten-free) cake and having it, too, so to speak.

But then, there is the nebulous world of dietary supplements. Not considered a drug, dietary supplements are governed by a different set of rules from conventional food (as per the US Food and Drug Administration). As worded, the manufacturer is responsible for the safety of a supplement, and the FDA can only act after it has reached the market. Culturally, the general populace embrace supplementation as a kind of nutritional talisman to head off dietary misbehavior - parent make their kids take multivitamins, students voluntarily quaff high caffeine products to stay awake, and athletes consume expensive products with dubious scientific reproducibility, and backed only by anecdotal testimony. Supplements are taken voluntarily as food, to treat a potential illness - and is a multi billion dollar business the world over.

The objectionable thing with supplementation is how rife the practice is with pseudoscience (cherry picking of evidence, scientific obfuscation, dubious credibility), but the subject of predictive nutrition is a complex one. Take, for example, the common body building supplement L-carnitine. It's a non-essential amino acid already found in meat, and as such, is thought to be generally safe to megadose with. But that doesn't take into account what our gut bacteria does to it. Bacteria convert L-carnitine to a compound known as TMAO, which is biochemically linked to the progression of artherosclerosis. You can buy pills of the stuff as health food, pop them without medical supervision, maybe get bigger (?) - but we have reproducible scientific evidence that you are actually feeding your gut bacteria with L-carnitine - and they're pooping out stuff that can promote heart disease.

In general, in the modern world of food, choice is abundant, and using supplements as a crutch is a bad idea, and not a substitute for smart selection of a range of food sources to promote a healthy lifestyle.

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