July 19, 2025 • 12 mins
The history of nutrition science in the US suggests that MAHA would make more sense without the ‘A.’
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Episode Transcript
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Speaker 1 (00:00):
Were Americans ever Really Healthy? By Fay Phlamm read by
Bob Danielson. In the early years of the twentieth century,
American doctors recommended three heavy meals a day, laden with meat, steaks, roasts, bacon,
and ham, but the influencers of the day took a
contrarian view. They advocated lighter eating or vegetarianism, sometimes flaunting
(00:25):
their own physical fitness to bolster their cause. More than
a century later, the same debates are still raging, but
the party lines are more complicated. Doctors have embraced lighter eating.
Influencers exist for every lifestyle choice under the sun, and
US public health departments are overseen by their own influencer,
(00:45):
who touts the health virtues of beef fat and shows
off his physique. Robert F. Kennedy Junior's role as Secretary
of the U S Department of Health and Human Services
has brought his often contrarian views in direct conversation with
government policy, as encapsulated in the initiative known as Make
America Healthy Again. Kennedy's opponents focused mostly on his history
(01:08):
of anti vaccine rhetoric, but food makes up a bigger
part of the MAHA agenda. A part that isn't always
far removed from mainstream science. In a report on children's
health released in May, the Maha Commission outlined a goal
of reducing chronic disease and obesity, devoting the most substantial
section to the prevalence of ultra processed foods, fast food,
(01:29):
convenience food, packaged food, and junk food. The report stresses
the health harms of industrially produced ingredients oils, refined sugar,
synthetic food, dyes and artificial sweeteners, flavors, emulsifiers, and preservatives.
The scientific mainstream also points to the harms of ultra
processed food and sugar, but is less confident of the
(01:50):
harms of additives. Maha, however, would make a lot more
sense without the a for again, because there is no
past era in which we were arragons of health, no
Eden too, which we can return. A journey into history
shows that public health officials have long scared people about malnutrition, overnutrition, fat, cholesterol, germs, spices,
(02:12):
and most new foods introduced by immigrants, often claiming to
follow the science. Influencers of various stripes have pushed back,
sometimes to later be vindicated and other times to be
remembered as quacks. It's not hopeless. Under all the fads
and waves of fear, science has continued to progress toward
a better understanding of the human body and the way
(02:34):
food affects our health. But progress has taken some wrong turns,
and food companies have repeatedly latched onto weak or distorted
scientific evidence to influence consumers. Figuring out what to eat
is further complicated by our personal and cultural relationships with
food and the lack of any single right answer. Thus,
to be healthier going forward, we might benefit from a
(02:57):
look at attempts to make Americans healthier in the past,
the rise of home economics. The data show clearly that
Americans are less healthy today. In one obvious way, Obesity,
rare until about nineteen seventy, now affects more than forty
percent of the adult population. Over the past fifty years.
There has also been a sharp increase in type two diabetes,
(03:19):
for which obesity is a risk factor, as well as
asthma and autoimmune diseases. There's no question that our diet
is contributing to the problems of obesity and chronic disease,
but which aspects of our diet are the problem history
shows nutrition experts have steered us wrong before. One of
the biggest food related public health blunders was in the
(03:40):
late and nineteenth century. According to the book Revolution at
the Table by food historian Harvey Levenstein, scientists in Germany
had recently discovered that food was mostly made up of water, protein, fat,
and carbohydrates, with a few minerals whose function they didn't understand,
They figured out that the fat and carbohydrates provide energy
(04:01):
measured in units of calories. Armed with this knowledge, a
group of experts from elite university set out to help
families in America's struggling working classes to spend less on
food by getting more calories for their buck. What those
experts didn't know was that to survive, humans need not
only calories, but numerous trace elements, minerals, and what would
(04:23):
later be dubbed vitamins. The would be food reformers told
people to load up on white bread and the fattiest
cuts of pork, and to avoid fruits and vegetables because
they were low in calories. These experts, whose field had
been dubbed home economics, started an institution in eighteen ninety
four called the New England kitchen, where they prepared what
they thought were nutritious meals and sold them cheaply to
(04:45):
working class families with the intention of educating them on
how to eat. One of the leaders of this nutrition
reform movement, Edward Atkinson, was also trying to sell the
world on a clunky slow cooker he invented called the
Aladdin Oven, so most of the day dishes used it.
They included stews, corn and clam chowders, creamed codfish, pressed meat,
(05:06):
corn mush, boiled hominy, oatmeal mush, and baked beans. According
to Levenstein, the endeavor failed because the food was bland,
and because many Eastern European, Italian, Jewish, Irish, and Portuguese
Americans preferred their own cooking traditions. The New England Kitchen
closed after a few years, but the episode revealed the
pitfalls of scientists attempt at food reform, which continue in
(05:29):
other forms today. A bit of scientific knowledge isn't always
superior to centuries of folk wisdom worked out by millions
of people in their daily struggle to survive, Levenstein writes,
between nineteen hundred and nineteen thirty, scientists recognized some of
those trace elements, coined the term vitamins and identified the
major ones whose deficiency was leading to common diseases scurvy,
(05:52):
vitamin c rickets, vitamin D, and pelagra niacin. Still, in
Levenstein's account, home economists, acting as food police continued to
act on prejudice against immigrants and their food customs, such
as using spices and garlic. Among the misguided convictions, the
experts thought spicy Mexican food caused alcoholism, criminal behavior, and
(06:16):
revolutionary tendencies. In the early twentieth century, experts were still
concerned with malnutrition and thought it was safest to eat
a high protein, meat intensive diet. Several influencers made a
case against this, including businessman and adventurer Horace Fletcher, who
advocated for eating far less protein than doctors thought was healthy.
(06:36):
Fletcher gained fame for advising people to chew food hundreds
of times until it liquefied, an act that helped him
slim down in which became known as Fletcherism. As a
fifty somethingter, Fletcher proved his vigor by climbing all eight
hundred ninety six steps to the top of the Washington
Monument before running back down Fletcher's chewing practice was taken
(06:56):
up by vegetarian influencer John Harvey Kellogg, who ran the
Battle Creek Sanitarium, a sort of health spa for the
rich and famous. It was there that Kellogg's brother Will
Kellogg invented cold breakfast cereal in the form of corn flakes.
Americans loved the crunchy flakes for their convenience and because
they came in clean packaging that made them feel safe
(07:16):
from a newly understood terror known as germs. Corn Flakes
and the many cereals that followed got an even bigger
health halo in the nineteen fifties thanks to a health
scare over fat that is still playing out between Maha
contrarians and the mainstream, a heart attack on a plate.
It started with a fear of heart disease, which rocketed
(07:38):
from the fourth leading cause of death in the US
in nineteen hundred to the number one killer by nineteen fifty.
Looking for a culprit, physiologist Ansel Keys made the observation
that some Mediterranean countries had lower rates of heart disease
and also ate less fat than Americans. By the late
nineteen fifties, Keys had done more research and concluded that
(07:58):
heart disease was caused by saturated fat, found mostly in
animal products and named for the lack of double bonds
between carbon atoms. Each carbon atom is saturated with hydrogen.
This discovery turned the American attitude toward diet upside down.
Beef was transformed from the pride of the American table
into a one way ticket to the cardiac ward. Levenstein writes,
(08:21):
anything with cheese, butter, or cream was seen as a
heart attack on a plate. When a French scientist pointed
out that people in his country ate much more saturated
fat than Americans and at much lower rates of heart disease,
the public health establishment tried to explain this so called
French paradox by extolling the near magical property of red wine,
(08:41):
a notion debunked by subsequent research. There were other ideas
out there explaining the increase in US heart disease, says
Nina Taisholes, who chronicled the fat scare in her twenty
fourteen book The Big Fat Surprise. Some pointed a finger
at smoking, then wildly popular. Others blamed sugar consumption, air
pollution from car exhaust. It's not obvious why the government
(09:03):
and the public latched onto saturated fat as the prime suspect,
considering it had been a major part of the human
diet for thousands of years. But Keyes was a factor,
a forceful and determined personality. He traded on his political
connections and sought to discredit scientists who disagreed with him.
When President Dwight Eisenhower suffered a heart attack, his personal
(09:24):
physician became convinced that Keyes had the answer. Tischels notes
that the scrutiny of saturated fat also gave advertisers an
opportunity to sell American women on industrial substitutes for their
old cooking staples butter and lard. William Proctor and James Gamble,
a candle maker and soap manufacturer, respectively, teamed up to
(09:45):
produce a large substitute from the cotton seeds that the
cotton industry was discarding, essentially inventing a new food from
non food substances. Introduced to consumers in nineteen eleven, it
was called Crisco and was advertised as cleaner and more
modern than large margarine, a cheap substitute for butter. Followed
by the nineteen forties, housewives were so keen on it
(10:07):
that the butter industry fought back with regulations. By the
nineteen nineties, evidence was growing that public health leaders had
made a terrible mistake. Margarine and crisco contain a form
of fat called trans fat that differs from what we
get from natural sources. Studies started to show that trans
fats raised the risk of heart disease and Alzheimer's disease.
(10:28):
The harms were much worse and more clearly proven than
anything that could be attributed to saturated fat, evidence that
kept building in the early years of the twenty first century.
The debate about fat continues today. The US banned trans
fats in twenty eighteen, but scientists and influencers are still
divided about the remaining industrial fats vegetable oils also known
(10:49):
as seed oils, and public health advocates continue to urge
people to avoid full fat dairy products, even though some
direct comparisons suggest that substituting low fat or no non
fat products makes people less healthy healthier than ever. Throughout
all this back and forth, Americans did see steady gains
in what is arguably the most important health outcome, the
(11:12):
average life expectancy. In the US was around forty five
in the nineteenth century, a byproduct of many children dying
from infectious disease. According to Harvard University historian of science
Alan Brandt, by twenty fifteen it had shot up to
almost eighty thanks to improved access to vitamins and minerals, antibiotics, sanitation,
and vaccines. Saving all those children has turned out to
(11:35):
be a much easier task than reforming our diet to
prevent chronic disease. The causes of those childhood deaths were
more clearly understood. By contrast, scientists are still struggling to
understand the root causes of heart disease, or why its
prevalence rose so steeply between nineteen hundred and nineteen fifty.
One ironic factor is the larger number of older people
(11:55):
now that we've mitigated infectious disease and vitamin efficiencies. The
role of smoking is also much clearer now than it
was fifty years ago. Given all these uncertainties and the
long history of accidental nutritional misdirection, the MAHA movement is
right to be skeptical of mainstream nutritional advice, but not
because science isn't progressing. Scientists discovered safe and effective vaccines
(12:19):
that have vastly improved our health. Scientists have allowed us
to almost eliminate vitamin efficiencies. Americans are healthier today than
they've been since the country was founded. Even if there's
plenty of room for improvement. Science is not broken. It's
just slow, subject to temporary setbacks, and often abused by
politicians and advertisers. Nutrition is complex, personal, and profitable, a
(12:45):
perfect combination for misinformation and mistrust. It's reasonable to want
to remain vigilant, but our collective quest to be healthy
is a matter of pressing forward, not romanticizing the past.
Were Americans ever Really Healthy? By Fay Phlamm read by
Bob Danielson. In the early years of the twentieth century,
American doctors recommended three heavy meals a day, laden with meat, steaks, roasts, bacon,
and ham, but the influencers of the day took a
contrarian view. They advocated lighter eating or vegetarianism, sometimes flaunting
(00:25):
their own physical fitness to bolster their cause. More than
a century later, the same debates are still raging, but
the party lines are more complicated. Doctors have embraced lighter eating.
Influencers exist for every lifestyle choice under the sun, and
US public health departments are overseen by their own influencer,
(00:45):
who touts the health virtues of beef fat and shows
off his physique. Robert F. Kennedy Junior's role as Secretary
of the U S Department of Health and Human Services
has brought his often contrarian views in direct conversation with
government policy, as encapsulated in the initiative known as Make
America Healthy Again. Kennedy's opponents focused mostly on his history
(01:08):
of anti vaccine rhetoric, but food makes up a bigger
part of the MAHA agenda. A part that isn't always
far removed from mainstream science. In a report on children's
health released in May, the Maha Commission outlined a goal
of reducing chronic disease and obesity, devoting the most substantial
section to the prevalence of ultra processed foods, fast food,
(01:29):
convenience food, packaged food, and junk food. The report stresses
the health harms of industrially produced ingredients oils, refined sugar,
synthetic food, dyes and artificial sweeteners, flavors, emulsifiers, and preservatives.
The scientific mainstream also points to the harms of ultra
processed food and sugar, but is less confident of the
(01:50):
harms of additives. Maha, however, would make a lot more
sense without the a for again, because there is no
past era in which we were arragons of health, no
Eden too, which we can return. A journey into history
shows that public health officials have long scared people about malnutrition, overnutrition, fat, cholesterol, germs, spices,
(02:12):
and most new foods introduced by immigrants, often claiming to
follow the science. Influencers of various stripes have pushed back,
sometimes to later be vindicated and other times to be
remembered as quacks. It's not hopeless. Under all the fads
and waves of fear, science has continued to progress toward
a better understanding of the human body and the way
(02:34):
food affects our health. But progress has taken some wrong turns,
and food companies have repeatedly latched onto weak or distorted
scientific evidence to influence consumers. Figuring out what to eat
is further complicated by our personal and cultural relationships with
food and the lack of any single right answer. Thus,
to be healthier going forward, we might benefit from a
(02:57):
look at attempts to make Americans healthier in the past,
the rise of home economics. The data show clearly that
Americans are less healthy today. In one obvious way, Obesity,
rare until about nineteen seventy, now affects more than forty
percent of the adult population. Over the past fifty years.
There has also been a sharp increase in type two diabetes,
(03:19):
for which obesity is a risk factor, as well as
asthma and autoimmune diseases. There's no question that our diet
is contributing to the problems of obesity and chronic disease,
but which aspects of our diet are the problem history
shows nutrition experts have steered us wrong before. One of
the biggest food related public health blunders was in the
(03:40):
late and nineteenth century. According to the book Revolution at
the Table by food historian Harvey Levenstein, scientists in Germany
had recently discovered that food was mostly made up of water, protein, fat,
and carbohydrates, with a few minerals whose function they didn't understand,
They figured out that the fat and carbohydrates provide energy
(04:01):
measured in units of calories. Armed with this knowledge, a
group of experts from elite university set out to help
families in America's struggling working classes to spend less on
food by getting more calories for their buck. What those
experts didn't know was that to survive, humans need not
only calories, but numerous trace elements, minerals, and what would
(04:23):
later be dubbed vitamins. The would be food reformers told
people to load up on white bread and the fattiest
cuts of pork, and to avoid fruits and vegetables because
they were low in calories. These experts, whose field had
been dubbed home economics, started an institution in eighteen ninety
four called the New England kitchen, where they prepared what
they thought were nutritious meals and sold them cheaply to
(04:45):
working class families with the intention of educating them on
how to eat. One of the leaders of this nutrition
reform movement, Edward Atkinson, was also trying to sell the
world on a clunky slow cooker he invented called the
Aladdin Oven, so most of the day dishes used it.
They included stews, corn and clam chowders, creamed codfish, pressed meat,
(05:06):
corn mush, boiled hominy, oatmeal mush, and baked beans. According
to Levenstein, the endeavor failed because the food was bland,
and because many Eastern European, Italian, Jewish, Irish, and Portuguese
Americans preferred their own cooking traditions. The New England Kitchen
closed after a few years, but the episode revealed the
pitfalls of scientists attempt at food reform, which continue in
(05:29):
other forms today. A bit of scientific knowledge isn't always
superior to centuries of folk wisdom worked out by millions
of people in their daily struggle to survive, Levenstein writes,
between nineteen hundred and nineteen thirty, scientists recognized some of
those trace elements, coined the term vitamins and identified the
major ones whose deficiency was leading to common diseases scurvy,
(05:52):
vitamin c rickets, vitamin D, and pelagra niacin. Still, in
Levenstein's account, home economists, acting as food police continued to
act on prejudice against immigrants and their food customs, such
as using spices and garlic. Among the misguided convictions, the
experts thought spicy Mexican food caused alcoholism, criminal behavior, and
(06:16):
revolutionary tendencies. In the early twentieth century, experts were still
concerned with malnutrition and thought it was safest to eat
a high protein, meat intensive diet. Several influencers made a
case against this, including businessman and adventurer Horace Fletcher, who
advocated for eating far less protein than doctors thought was healthy.
(06:36):
Fletcher gained fame for advising people to chew food hundreds
of times until it liquefied, an act that helped him
slim down in which became known as Fletcherism. As a
fifty somethingter, Fletcher proved his vigor by climbing all eight
hundred ninety six steps to the top of the Washington
Monument before running back down Fletcher's chewing practice was taken
(06:56):
up by vegetarian influencer John Harvey Kellogg, who ran the
Battle Creek Sanitarium, a sort of health spa for the
rich and famous. It was there that Kellogg's brother Will
Kellogg invented cold breakfast cereal in the form of corn flakes.
Americans loved the crunchy flakes for their convenience and because
they came in clean packaging that made them feel safe
(07:16):
from a newly understood terror known as germs. Corn Flakes
and the many cereals that followed got an even bigger
health halo in the nineteen fifties thanks to a health
scare over fat that is still playing out between Maha
contrarians and the mainstream, a heart attack on a plate.
It started with a fear of heart disease, which rocketed
(07:38):
from the fourth leading cause of death in the US
in nineteen hundred to the number one killer by nineteen fifty.
Looking for a culprit, physiologist Ansel Keys made the observation
that some Mediterranean countries had lower rates of heart disease
and also ate less fat than Americans. By the late
nineteen fifties, Keys had done more research and concluded that
(07:58):
heart disease was caused by saturated fat, found mostly in
animal products and named for the lack of double bonds
between carbon atoms. Each carbon atom is saturated with hydrogen.
This discovery turned the American attitude toward diet upside down.
Beef was transformed from the pride of the American table
into a one way ticket to the cardiac ward. Levenstein writes,
(08:21):
anything with cheese, butter, or cream was seen as a
heart attack on a plate. When a French scientist pointed
out that people in his country ate much more saturated
fat than Americans and at much lower rates of heart disease,
the public health establishment tried to explain this so called
French paradox by extolling the near magical property of red wine,
(08:41):
a notion debunked by subsequent research. There were other ideas
out there explaining the increase in US heart disease, says
Nina Taisholes, who chronicled the fat scare in her twenty
fourteen book The Big Fat Surprise. Some pointed a finger
at smoking, then wildly popular. Others blamed sugar consumption, air
pollution from car exhaust. It's not obvious why the government
(09:03):
and the public latched onto saturated fat as the prime suspect,
considering it had been a major part of the human
diet for thousands of years. But Keyes was a factor,
a forceful and determined personality. He traded on his political
connections and sought to discredit scientists who disagreed with him.
When President Dwight Eisenhower suffered a heart attack, his personal
(09:24):
physician became convinced that Keyes had the answer. Tischels notes
that the scrutiny of saturated fat also gave advertisers an
opportunity to sell American women on industrial substitutes for their
old cooking staples butter and lard. William Proctor and James Gamble,
a candle maker and soap manufacturer, respectively, teamed up to
(09:45):
produce a large substitute from the cotton seeds that the
cotton industry was discarding, essentially inventing a new food from
non food substances. Introduced to consumers in nineteen eleven, it
was called Crisco and was advertised as cleaner and more
modern than large margarine, a cheap substitute for butter. Followed
by the nineteen forties, housewives were so keen on it
(10:07):
that the butter industry fought back with regulations. By the
nineteen nineties, evidence was growing that public health leaders had
made a terrible mistake. Margarine and crisco contain a form
of fat called trans fat that differs from what we
get from natural sources. Studies started to show that trans
fats raised the risk of heart disease and Alzheimer's disease.
(10:28):
The harms were much worse and more clearly proven than
anything that could be attributed to saturated fat, evidence that
kept building in the early years of the twenty first century.
The debate about fat continues today. The US banned trans
fats in twenty eighteen, but scientists and influencers are still
divided about the remaining industrial fats vegetable oils also known
(10:49):
as seed oils, and public health advocates continue to urge
people to avoid full fat dairy products, even though some
direct comparisons suggest that substituting low fat or no non
fat products makes people less healthy healthier than ever. Throughout
all this back and forth, Americans did see steady gains
in what is arguably the most important health outcome, the
(11:12):
average life expectancy. In the US was around forty five
in the nineteenth century, a byproduct of many children dying
from infectious disease. According to Harvard University historian of science
Alan Brandt, by twenty fifteen it had shot up to
almost eighty thanks to improved access to vitamins and minerals, antibiotics, sanitation,
and vaccines. Saving all those children has turned out to
(11:35):
be a much easier task than reforming our diet to
prevent chronic disease. The causes of those childhood deaths were
more clearly understood. By contrast, scientists are still struggling to
understand the root causes of heart disease, or why its
prevalence rose so steeply between nineteen hundred and nineteen fifty.
One ironic factor is the larger number of older people
(11:55):
now that we've mitigated infectious disease and vitamin efficiencies. The
role of smoking is also much clearer now than it
was fifty years ago. Given all these uncertainties and the
long history of accidental nutritional misdirection, the MAHA movement is
right to be skeptical of mainstream nutritional advice, but not
because science isn't progressing. Scientists discovered safe and effective vaccines
(12:19):
that have vastly improved our health. Scientists have allowed us
to almost eliminate vitamin efficiencies. Americans are healthier today than
they've been since the country was founded. Even if there's
plenty of room for improvement. Science is not broken. It's
just slow, subject to temporary setbacks, and often abused by
politicians and advertisers. Nutrition is complex, personal, and profitable, a
(12:45):
perfect combination for misinformation and mistrust. It's reasonable to want
to remain vigilant, but our collective quest to be healthy
is a matter of pressing forward, not romanticizing the past.
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