Notes on Engineering Health, November 2020

Thoughts for Food

Although the maxim “Let food be thy medicine, and let medicine be thy food” is generally agreed to be an apocryphal quote by Hippocrates, there are good reasons why it still resonates as an immutable truth. Looking at the healthcare industry from a standpoint of health—as we try to do at Digitalis—regularly brings us back to nutrition as a key pillar of a healthy life. In particular, our attention this month was attracted by a number of studies carefully looking at large datasets that highlight again the key importance of diet and nutrition.  

A large (over 65 million participants worldwide) study published in The Lancet earlier this month compared height and body-mass index trajectories for school-aged children and adolescents in different countries. The height and BMI trajectories over age and time were highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks based on diet. By many measures, the population in the US is the unhealthiest of any high-income country and diet makes a real difference. In an enlightening article in STAT news, the authors, Rahman and Rees, expose the failings of the American food system by citing new data from the CDC and propose a few avenues to fix it including refocusing federal research on nutrition, making healthy food more affordable, and educating doctors more rigorously about nutrition. These solutions are public health measures and while they don’t always require engineering or enabling technologies, they are essential tools in a broad arsenal to promote health. 

Alongside these public health measures, some more dieting recommendations came from a study published in PNAS showing that macronutrient supply is a strong predictor of mortality in different age classes. The idea is that each age of life require different supplies of macronutrients - in early life, equal amounts of fat and carbohydrate are predicted to improve survival, while later in life, reducing fat in exchange for carbohydrates is associated with the lowest rates of mortality. 

Despite the growing knowledge-base indicated by the studies, the search for the perfect diet that will pave the way for a lengthy life devoid of chronic diseases is still an elusive pursuit for scientists, clinicians, and food makers alike. Although it sounds like hard advice on the day before Thanksgiving, for now we’ll repeat what seems to be the current scientific consensus as brashly summarized by Michael Pollan: "Eat food. Not too much. Mostly plants." Happy holiday.

Jonathan Friedlander, PhD & Geoffrey W. Smith