Registered Dietitian Brigid Titgemeier, MS, RDN, LD, IFNCP speaks passionately about the future of things that are irrecovably connected: our soil, our food, our bodies and our healthcare system...
As Wendell Berry famously said: “People are fed by the food industry, which pays no attention to health, and are treated by the health industry, which pays no attention to food.” The lack of attention the food industry pays to health goes beyond the health of individuals. It also encompasses the lack of concern for our planet, animals, and the climate.
For the last few decades, the food industry has been steadily producing cheaper, more highly processed foods that are grown on industrialized farms and destroy soil quality. These common farming practices decrease nutrients, increase toxic exposure, and lead our population to experience inflammatory consequences on the backend.
Our current healthcare system provides that inflamed population with pharmaceutical-focused interventions, most of which have a host of side effects. While the healthcare industry spends trillions of dollars that potentially conceal the inflammatory consequences of processed, industrialized food, the environmental impact is harder to conceal.
The Pandemic Exposes Healthcare & Farming Deficiencies
For the most part, our healthcare system dismisses the notion that nutrition and lifestyle play a role in our health or in our current pandemic. News outlets report daily on the urgency to expedite a vaccine, while the message regarding the need for nutrition and lifestyle interventions to create a healthier terrain has hardly been acknowledged. After five months of wide-spread lockdowns, the Centers for Disease Control and Prevention (CDC) voiced -- for the first time -- the importance of nutrition in one social media post and one paragraph on their website.
On July 12th, the CDC's social media ventured away from their usual topic of wearing a mask and social distancing and instead stated: “Focus on good nutrition as part of self-care during the #COVID19 pandemic. Certain vitamins and minerals may have effects on how the immune system works to fight off infections and inflammation. You can obtain these nutrients through #food.”
The research is clear that nutrition plays a very significant role in COVID-19 outcomes, as I have previously discussed at length in my practice. The CDC’s acknowledgement that nutrition is a factor means that there is scientific truth to that. The delay of nutrition information speaks to the unhealthy medical dependency that exists at the expense of patients’ health. The primary questions this stirs are: 1) why did they wait five months to mention nutrition and 2) why is there not a public health campaign to encourage people to eat more nutrient dense foods that stimulate a healthy immune system, lower inflammation and improve metabolic health?
COVID-19 and Factory Farming
Deficiencies within the large industrialized factory farming system have also been exposed. The industry has experienced ongoing problems and meat shortages due to working conditions in slaughterhouses. There is no shortage of animals that are on the farms. The hold up is the slaughterhouses and meat-packing plants that have been described as a breeding ground for spreading COVID-19.
As of May 2020, the CDC reported that approximately 4% of workers — 4,913 individuals out of 130,000 workers — at 115 meat and poultry processing facilities tested positive for COVID-19. The CDC reported “factors potentially affecting risk for infection include difficulties with workplace physical distancing and hygiene and crowded living and transportation conditions.” While crowding animals into confined, unsanitary conditions to be slaughtered on assembly lines is nothing new, the increase in disease transmission of COVID-19 is forcing people to question factory farming as the best option in the interest of animals, humans and the planet.
Decades of Deficiencies
In his book, The Disease Delusion, Functional Medicine pioneer, Dr. Jeffrey Bland highlights that the traditional medicine landscape (created after the Civil War) was an effective model for treating infectious diseases such as whooping cough and pneumonia. The popularization of Germ Theory influenced the thinking that sub microorganisms cause disease, meaning the body can be immunized against that particular infectious disease. This innovation helped increase the average lifespan of Americans from 47 in 1910 to over 78 years of age in 2017.
While this model helped treat many infectious diseases, it has not successfully served our modern, chronic disease-ridden terrain. There is no one specific cause of hypertension, for example, because hypdertension is not a sub microorganism that needs to be addressed. Common chronic diseases like heart disease and type 2 diabetes are multifactorial and can be driven by a variety of day to day choices that individuals make throughout a lifespan.
The average mortality rate is increasing, at the same time, morbidity rates and pharmaceutical interventions have skyrocketed. We are living longer, but the years lived are statistically less healthy. Some would say that this is tied to our conventional healthcare system's lack of focus on root causes of common health issues. Statistics show that:
+ Only 12.2% of adults in the United States are metabolically healthy, meaning they have a normal waist circumference, blood pressure, blood sugar, triglyceride levels, and HDL cholesterol levels and do not take any medication.
+ 6 in 10 adults in the United States have at least one chronic disease.
+ 4 in 10 adults in the United States have 2 or more chronic diseases.
Modern Agricultural + It's Human Impact
The direct impact of decades of industrialized agriculture on human health and farmlands is equally devastating. Our current system is set up to fuel chronic disease by supporting inexpensive production of processed foods, relying on monocultures dependent on the use of pesticides and chemicals, and lacking nutrient dense, diverse crop production.
Rodale Institute estimates that only 8% of farms produce more than four crops, which has led to a loss of diversity on American farms. The farming model that exists on 88% of farms is a monoculture model with farms specialize in growing a single crop. This decreases diversity and increases the need for chemical fertilizers and other inputs, in addition to degrading the soil. Farms are thus dependent on synthetic fertilizers, insecticides and herbicides while producing just a few commodities that are primarily used for processed foods, ethanol, and animal feed. The foods that are prioritized on farms are commodity crops such as corn, soybeans, wheat and rice. Approximately 3% of cropland is used for “specialty crops” which include fruits, vegetables and nuts.
In my opinion, in the last fifty years, our agriculture and healthcare practices have contributed to or have greatly participated in:
+ Industrialized farming practices with potentially harmful climate response, soil depletion issues and an increased intake of nutrient-poor foods. These practices can increase human exposure to toxic chemicals and environmental pollutants.
+ A food supply with a low priority on human health outcomes, potentially influencing chronic disease outcomes.
+ A medical landscape ill-equipped to treat common chronic disease, but focused on using the infectious disease model of targeting specific pathways using pharmaceutical interventions and dependency on medicine.
The Emergence of Regenerative Healthcare
One of my core philosophies is that “food is medicine”. If you take this adage one step further, it may be more accurate to say that “soil is medicine” since many of the benefits of food stem from the nutrients and microbes found in our soil.
The mission of Regenerative Healthcare, a concept introduced by the renowned Rodale Institute, brings the food as medicine concept full circle: from soil to food to human to hospital.
According to Rodale Institute, regenerative healthcare is defined as:
“A system where agriculture and healthcare work together for a prevention-based approach to human and environmental health. Rather than relying on toxic chemicals to solve agricultural issues and pharmaceutical interventions to manage disease, regenerative healthcare aims to prevent disease through an organic, whole foods, plant-forward diet that begins on farms that work in harmony with nature.”
The Rodale Institute's goal is to support the growth of more farms that are growing food by both regenerative and organic standards. Regenerative farming aims to restore the health and biodiversity of the soil by adhering to a high standard of land management such as crop rotations to sequester carbon in the soil, improve the water cycle, and prioritize animal welfare and fair working conditions for farmers.
Regenerative farms create a closed loop system by feeding the animals with crops from the farm, allowing the animals to create fertilizer and then using the fertilizer to grow crops and nourish the soil. They also use very little plowing, they conserve water, protect the topsoil with cover crops, reuse animal and vegetable waste that is given back to the land, and draw more carbon out of the atmosphere.
J.I. Rodale, founded the Rodale Institute 70 years ago because he was an early adopter of organic farming. His son, Robert Rodale, coined the term “regenerative organic” as a holistic approach to farming that marries the best of organic and regenerative practices. Organic regenerative agriculture are farming practices that eliminate the chemicals and GMOs and contribute to the health and biodiversity of the soil.
On Regenerative Healthcare
The concept of regenerative healthcare focuses on leveraging the benefits of organic regenerative farming to improve health amongst the population, create less of a burden on the healthcare system and become less dependent on pharmaceutical interventions as a population. The goal is to use nutrient-dense foods as medicine, improve soil health, decrease the human and environmental toxic burden and ultimately decrease rates of chronic diseases, autoimmune diseases, and mental health diseases.
The Cost of Inaction
So often, when it comes to organic regenerative farming, the immediate concern is increased cost. There are undeniably higher costs involved in such operations until policy changes are created to subsidize organic vegetables instead of high fructose corn syrup. But what we must consider is the cost of inaction.
Rodale Institute analyzed the changes in costs of healthcare and food over the last 60 years. They reported that in 1960, the US spent much more on food: $74.6 million, compared to healthcare, $27.2 million. This reflected a 3:1 ratio of money spent on food to healthcare. By 2017, this ratio shifted to 1:2 with $1.5 trillion dollars on food and $3.2 trillion on healthcare. We are spending more money on healthcare and less money on food and yet, despite our life expectancy increasing during the same period, our population’s health outcomes have not improved. In many cases, they have gotten worse. If we do not change the system, healthcare costs are expected to increase to $5.6 trillion per year by the year 2025.
While people are spending much less money on food, at the same time the money that is spent is distributed amongst a small number of large, powerful food companies that continue to threaten the viability of small farms. According to Food Fix by Dr. Mark Hyman, the food industry is a $15 trillion food monopoly that is composed of approximately 21 big food companies, 4 big seed companies (including Bayer and Chem-China), about 5 fertilizer companies, and 8 big agriculture companies. These companies drive much of the national public policies for food, published research and federal funding for food programs through lobby groups and alliances. Lobbyists for Big Food and Ag spent $500 million influencing the 2014 Farm Bill.
Consumers need to start paying attention to the influence of food industry corruption and consider the concept of True Food Costs. I was reminded of this concept by Dr. Mimi Guarneri, an integrative medicine cardiologist, at a conference in February. The food industry markets the cheapest, most affordable food. This is how they win. The true cost of food is deeper than the face value cost that is scanned on the barcode at the grocery store. The true formula is:
Cost of food at the grocery store + Cost of health implications + Planetary impact
You can save money upfront by choosing to purchase fast food meals instead of organic vegetables but the true cost of the fast food meal is dramatically more expensive when you account for the money that you may potentially spend on healthcare and pharmaceutical drugs for preventable chronic diseases and the financial impact on our climate. As someone with a Masters of Science in Public Health Nutrition, I understand that not everyone has the luxury to choose to pay now or pay later, but many do. The more people that choose to pay later, the more that everyone pays later in lives, taxes dollars, medicare costs, soil degradation and climate change.
The impact of inaction goes beyond financial implications. There are implications for the quality of life humans are capable of living and the health of the planet. Additional considerations include:
Air pollution
Antibiotic resistance
Toxic exposure from pesticides like Glyphosate, which was classified by the World Health Organization as a probable carcinogen in 2015
Water pollution
The destruction of soil biodiversity from monocropping and the use of pesticides and fertilizers
Soil being lost 10 to 40 times faster than it is being replaced
A decrease in the world’s insect species
Food with fewer nutrients that are required for a healthy immune system, lower inflammation, metabolic health, and cognitive function
Changes in an individual’s gut microbiome due to use of pesticides and decreased soil biodiversity
Increased greenhouse gas emissions
Investing in Organic Regenerative Healthcare
In order to change these statistics, there needs to be massive change in the way that we approach healthcare and agriculture and each of us must do our part to be part of the change. The cheap, pesticide and chemical laden processed food produced by industrial farming is a far cry from the way our ancestors ate. For as much as we may try, we can’t expect to successfully purchase cheap food and then make up for the inflammatory consequences on the backend with conventional healthcare interventions and pharmaceutical drugs.
The solution to improving health may very well be in spending more money on the way that food is grown, not on healthcare. The path to living a truly healthy and vibrant life and reversing climate change can only exist when you get to the root cause and go back to the basics of investing in food, quality soil, regenerative organic agriculture and the planet. We have the choice of paying now for food that is regeneratively grown or we may potentially pay more on the backend in healthcare. Our current culture has driven a "pay later" mentality.
As consumers, we must demand a shift in “business as usual” practices. There is so much power that we have as consumers and we cannot rely on farmers to change the system on their own. We must do our part to invest in these types of foods, advocate for policy change, share resources with friends and family, and spread the word to anyone who will listen.
Here are some of the best places you can start:
Vote by purchasing certified organic, regeneratively raised food.
Where you spend your money on food matters. Food that is grown in healthy soil may have more nutrients, biodiversity and health properties compared to food that is less lively. While organic is a good rule of thumb for decreasing your exposure to pesticides, herbicides, GMOs, and chemicals, it does not guarantee that the food was grown on a healthy farm that increased the biodiversity and health of the soil.
This is an important step for your own health and also as a way to vote with your fork and create change. Companies will not change unless they have financial incentive. General Mills announced in 2019 that they would commit to advancing regenerative agriculture practices on 1 million acres of farmland by 2030. They very recently launched a three year regenerative agriculture dairy pilot on 1.5 thousand acres in western Michigan. While supporting local farmers when possible is critical, companies like General Mills may aid in making these practices more affordable and accessible to the larger population.
Get out of the grocery store and get to know your farmers!
Sometimes small farms follow organic regenerative standards but they cannot afford to get the certifications of organic. There is an opportunity to try to talk to your farmers at farmers markets to find out what kind of practices they follow on their farm. If you have the ability to visit a farm in your area, that is also a great option. Some farms have their own websites and have drop in hours to pick up eggs, meat and vegetables from small sheds that are on the farm.
This is an amazing way to feel more connected to the food that you are eating. There is such a need for connection during these days of social distancing and connecting with the earth and where your food comes from may help you feel less alone.
Join a Community Supported Agriculture (CSA) Program.
CSAs are a great way to buy local and seasonal food directly from your farmer. Typically you buy into a CSA membership from a local program and in return, you receive a box of vegetables and other farm staples every week through one farming season. You can search for a program in your area at localharvest.org/csa/.
Compost at home and return vital nutrients to the soil.
The benefits of composting at home are two fold: decreasing waste and restoring the soil. It’s estimated by the Food and Drug Administration (FDA) that in the United States, between 30-40% of the food supply is wasted. Instead of contributing to these food waste statistics, purchase an at home compost to help reduce the food waste that is coming from your home.
Do more research.
I am a firm believer in the power of knowledge and education. We cannot turn a blind eye to the deficiencies that exist in healthcare, food and farming. There are clearly a lot of issues that we need to become more informed about so that we can participate in the movements that exist and continue to create new ones that help improve health on every level. I’ve listed some of my favorite resources on the topic below.
Work with a functional medicine dietitian to learn to use organic, whole foods to improve health and decrease dependence on prescription medications.
A large reason that food is left out of recommendations from many doctors is because medical students receive an average of 25 hours of nutrition education in medical school. Unless doctors are seeking information on their own time, they are not taught about nutrition and lifestyle interventions in their training. There absolutely needs to be more nutrition education in medical school so that doctors learn about creating health rather than solely treating disease.
A great option that exists for people is working with a functional medicine dietitian. Registered Dietitians receive six years of nutrition education between undergraduate and graduate studies, in addition to 1200 hours of dietetic clinical rotations. If you work with a dietitian that is board certified in integrative and functional nutrition, then they have advanced training in getting to the root cause of disease with nutrition and using food as medicine. If this is of interest, you can search the Integrative and Functional Nutrition Academy (IFNA) graduate directory to find a practitioner.
As Rodale Institute says, health begins with food and healthy food begins in the soil. If you are someone that has experienced the personal power of using high quality food as medicine or you had the unfortunate experience of getting sick due to the deficiencies of the food, farming and healthcare industry, it’s important to share your experience with others. Don’t undervalue your experience or your unique ability to encourage others to take responsibility for their health. Encourage others to commit to learning more about the food industry, farming practices, how food is grown and how we can each do our part to contribute to population and planetary health.
Additional Resources to Learn More
Food Fix: How to Save Our Health, Our Economy, Our Communities and Our Planet–One Bite at a Time by Dr. Mark Hyman Many of these ideas are outlined in Dr. Hyman’s new book, Food Fix. He has created a Food Fix Campaign where he has partnered with entrepreneurs and people previously working for the food industry to help change public policies.
Farmacology by Dr. Daphne Miller This is one of my top 10 favorite books that I read in 2013. Dr. Miller visits seven different family farms and connects the health of the farm with the health of consumers.
The Power of the Plate: The Case for Regenerative Organic Agriculture in Improving Human Health by Rodale Institute This article was inspired by the work at Rodale Institute who is a pioneer in regenerative organic agriculture and healthcare.
The Biggest Little Farm Documentary This documentary highlights the complexity of nature when a couple chooses to leave Los Angeles to move to a land that is utterly depleted of nutrients and suffering from a brutal drought.
The Chalkboard Mag and its materials are not intended to treat, diagnose, cure or prevent any disease. All material on The Chalkboard Mag is provided for educational purposes only. Always seek the advice of your physician or another qualified healthcare provider for any questions you have regarding a medical condition, and before undertaking any diet, exercise or other health-related programs.
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