An article was recently published in The Hill entitled Nutrition: The national security threat no one is talking about that I feel compelled to comment on. Even though at least one of the authors is an esteemed medical professional in the armed forces, I think the article fatally misconstrues how the health and fitness challenges we face in the military intersect with politics thereby totally missing the big picture. That said, I suppose I might as well start at the beginning.
Dumb Title
The title explicitly states this is a problem that no one is talking about. In reality, the issue of decreasing population health and eligibility for military service has been a topic of interest for at least the last two decades. For example, here’s a 3 star general giving a TED talk about this exact topic over 10 years ago. It has 3 million views:
Around the time of this video the Army was heavily invested in promoting the Performance Triad consisting of exercise, sleep, and yes, nutrition. More recently the Army has invested billions of dollars into H2F which will ultimately result in the majority of Brigade Combat Teams having an entire team of nutrition experts (two registered dieticians and 1-2 nutrition techs). Finally, on the logistics side efforts are being made within the Army to update the long standing “Go For Green” initiative that color codes foods based using a performance framework while working to implement “Action Menu” items that include higher quality (and higher protein and lower calorie) main courses to be made available in Dining Facilities. Everyone serious knows nutrition is a problem and that solving this problem will be a challenge. Things that “no one is talking about” get entire Army staffs working on solutions and billion dollar budgets. Stating outright that nobody is talking about the problem with all of this going on didn’t instill great confidence that I’d find any valuable insights in the remaining 600 or so words.
Misdiagnosing The Problem
There is clearly a problem with the American population and obesity. It is obvious to anyone who looks at the numbers that this has dramatic impacts on the pool available for military service. What isn’t so obvious is exactly why. The authors of this op-ed are apparently confident we can lay the blame on outdated government nutrition guidelines. From the article:
The U.S. military follows the Dietary Guidelines for Americans that continue to recommend low-fat, high-carbohydrate foods. The guidelines impact everything from school lunches to military rations. Americans have been encouraged to follow these guidelines for decades yet struggle to stay healthy. If the Dietary Guidelines considered individuals with diet-related disorders or diseases, they would have to explore additional dietary patterns and expand their review to include the latest science. We could finally begin to move the needle.
Do these dudes really believe that anyone gives a shit about government dietary guidelines anymore? The government is never going to develop guidelines that effectively promote health. Government and politicians don’t benefit from a healthy populace. They benefit from a populace dependent upon the mass consumption of products provided by their biggest donors in Big Pharma and Big Food. The current guidelines exist as they do secondary to industry and ideology. Bypassing such concerns, the authors continue:
A well-constructed lower-carbohydrate diet, defined as no more than 130 grams of carbohydrates daily, can help people lose weight and prevent and reverse certain chronic diseases such as metabolic syndrome or type 2 diabetes. Yet there is no option for a low-carbohydrate eating pattern in the Dietary Guidelines despite many peer-reviewed scientific publications supporting its effectiveness.
Of course low carbohydrate diets can be effective. So can high carbohydrate diets. High protein diets. High fat diets. Intermittent fasting. Herein lies the problem with focusing on guidelines: they will never be sufficient. Optimal diet depends heavily on goals and preferences which vary drastically between individuals. For someone trying to minimize the accumulation of muscle mass in order to win marathons, a low carbohydrate diet can be very effective. If you want to build muscle mass, however, this is not typically an effective strategy.
If you’re a family physician running an ultra-marathon, muscle mass in the upper extremities and trunk is a liability. If you’re a tactical athlete, this simply isn’t the case. What are your goals? What are your values? Let the answers to these questions frame what nutritional strategy is most appropriate for you. The amazing thing about this is that you don’t need to wait for the government to change policy to get started. At least for now, we’re allowed to decide what we put into our mouths in most circumstances. If you’re in the Army, there are actually people working to provide greater flexibility to reach whatever goals you may have by improving the quality and selection of food available in your local dining facility. If you’re looking for ideas on where to start, I did write an article outlining my understanding of nutrition.
The Government Can’t Help
The authors conclude their article with a call for Congressional action:
Now is the time for Congress to pass legislation that would expand the Dietary Guidelines for Americans to include recommendations for people with diet-related diseases.
I disagree. There will never be a time for that. If Congress does anything they should immediately discard dietary guidelines of all kinds allowing all government programs the decentralized control over menus and recommendations they need to best provide for the populations they serve. Centrally developed guidelines only guarantee that lobbyists are able to easily inject self-serving line items into whatever ultimately gets passed and make developing optimal solutions with any given budget more difficult to achieve. If government simply provides the flexibility to those in the health promotion and nutrition spaces to match the right food in the right amount to the right person at the right time, we’ll have everything we need to execute.
Agreed both ad nauseum and infinitum. The military and government will not be the ones to solve this problem, a bottom-up culture of like minded professionals will. Until you can tell your buddy "Really? Burger King AGAIN for lunch?!" and he actually changes his ways, not much is going to get fixed top-down.
However, there are better things that could feed into this from the top. Look at how we train Soldiers right now. If the training methods demanded that people eat to perform their best, they would have to do so. But the truth is that junk food is high octane crap for people exhausted from running so much. The ready-to-go line in the DFAC is the longest line, even when the Soldiers are strapped for time to eat. If they'd rather eat a burger and fully-leaded green Monster, it seems like they're willing to make sacrifices to do so (not to mention their budget). The culture from the bottom looks like the only way.
Being a reformed ultra-runner, I can say you're also correct that the training goals matter. How many people have we seen get a MSK injury and get fat afterwards because they kept their diet the same as when the infantry made them run 30 miles per week (thus leading to the injury). It's a fucked up sort of self-licking ice cream cone. Until the impact of the education (more than the info itself) gets to Joe, nothing the experts or Sergeants or regulations or even Generals is going to change a damn thing. Horses being led to water.
This probably sounds more like commiserating with you than providing anything meaningful, but thank you for giving me an outlet for this topic either way.
While agreeing with everything else, it seems reasonable to me to put quite a bit of blame on official government food pyramids and plates. These recommendations have spread all over and definitely change what people eat. The drop in trust of government and official scientists may have the salutary effect of reducing automatic acceptance of bad advice.