In 1934, a young German pediatrician named Hilde Bruch moved to America, settled in New York City, and was “startled,” as she later wrote, by the number of fat children she saw—“ really fat ones, not only in clinics, but on the streets and subways, and in schools.” Indeed, fat children in New York were so conspicuous that other European immigrants would ask Bruch about it, assuming that she would have an answer. What is the matter with American children? they would ask. Why are they so bloated and blown up? Many would say they’d never seen so many children in such a state.
Today we hear such questions all the time, or we ask them ourselves, with the continual reminders that we are in the midst of an epidemic of obesity (as is the entire developed world). Similar questions are asked about fat adults. Why are they so bloated and blown up? Or you might ask yourself: Why am I?
But this was New York City in the mid- 1930s. This was two decades before the first Kentucky Fried Chicken and McDonald’s franchises, when fast food as we know it today was born. This was half a century before supersizing and high- fructose corn syrup. More to the point, 1934 was the depths of the Great Depression, an era of soup kitchens, bread lines, and unprecedented unemployment. One in every four workers in the United States was unemployed. Six out of every ten Americans were living in poverty. In New York City, where Bruch and her fellow immigrants were astonished by the adiposity of the local children, one in four children were said to be malnourished. How could this be?
Fat in the Fifties by Nicolas Rasmussen
Obesity burst into the public consciousness in the years immediately following the Second World War. Around 1950, the US Public Health Service (PHS) issued a brochure on “the greatest problem in preventive medicine in the USA”: obesity. The life insurance industry, working in collaboration with the PHS and the American Medical Association (AMA), launched a national drive, proclaiming “Overweight: America’s No. 1 Health Problem.” And no wonder, given that insurance company data and some local health surveys suggested that more than a quarter of the American population was significantly overweight or obese. By the typical measure of the day, anyone 10 percent above the “ideal weight” for a given height fell into the category of overweight—the ideal weight being that which the insurance industry found to predict maximum longevity. Those 20 percent overweight were classified as obese. The danger of excess weight was grave, because it was the leading predictor of heart disease, the nation’s top killer. […]
Stroke, cancer, and, most of all, heart disease leaped to the forefront as causes of death.20 By 1920 heart disease had taken the lead as the top cause of death; by the end of the decade, based mainly on evidence developed by Dublin and other insurance industry statisticians, health policy analysts came to believe that heart disease was also catching up with tuberculosis in terms of its total financial burden on the nation (despite the fact that heart disease tended to kill its victims later in their wage-earning years). Imposing double the economic burden of cancer, which would soon become the second greatest cause of death, heart disease had unquestionably become Public Health Enemy Number 1 by 1930. […] The [early 20th century] findings indicated a clear association between overweight and excess mortality. […] In 1930, Louis Dublin used this type of information as the basis for a groundbreaking actuarial study that specifically correlated overweight with heart disease.
There is a comedy sketch, This is Your Brain After Thirty, from the group It’s a Southern Thing. It is a parody of a pharmaceutical commercial. And the target audience is Millennials who are now feeling the evidence of growing older. The voiceover begins, “Are you in your 30s? You may not feel old. But you don’t exactly feel young, either.” Then it presents three characters with their symptoms:
Person 1: “Sometimes I walk into a room and completely forget what I walked in there for.”
Person 2: “I can’t remember my own phone number. And I’ve had the same number for ten years.”
Person 3: “I know I had supper last night. I clearly don’t skip meals. But for the life of me, I can’t remember what I ate.”
The voiceover continues with the official diagnosis. “Then you might be suffering from Thirties Brain.” There is nothing quite as comforting as having a label. That explains everything. That’s just what happens when one reaches old age in one’s thirties. Yeah, that’s completely normal. Don’t worry, though. “It’s not your fault,” reassures the voice of authority. More info is then offered about it:
“It’s a common condition that affects millions of people. People who are old enough to take their 401(k) seriously, but not quite old enough to enjoy eating at Golden Corral. It’s not your fault. Your brain is too full of useless knowledge, now. Why remember your own phone number, when you could retain every word of the 2001 hit “Drops of Jupiter” by Train? Thirties Brain can make even the most simple conversations feel exhausting. But as soon as it feels like you can think clearly again, your brain stops working again. If this sounds like you or someone you love, then ask your doctor about our new twice-a day…”
Of course, this is just comedy, but it’s funny for the very reason so many can relate to the experience. In becoming part of popular culture, it’s being normalized. That is rather sad when one thinks about it. Should we really be normalizing early onset neurocognitive decline? What they are now jokingly calling “Thirties Brain”, would not long ago have been called “Fifties Brain” or “Sixties Brain”. Indeed many serious health conditions like Alzheimer’s used to be entirely identified with old age and now are increasingly being diagnosed among the young (when we were kids, Alzheimer’s would sometimes be called Old Timer’s disease). The same is true of type II diabetes, which originally was called adult onset diabetes because adulthood was typically the age of diagnosis. These conditions are part of metabolic syndrome or metabolic dysfunction that involves insulin resistance as a key component.
Also common in metabolic syndrome is obesity. It instantly stood out that each actor in the parody commercial were all quite overweight to the point of being obese. Yet obesity also has been normalized, particularly in the South where it’s rampant. Obesity involves inflammation throughout the body, as inflammation is also seen in the brain with Alzheimer’s (along with depression, etc); and inflammation is related to autoimmune disorders, from multiple sclerosis to rheumatoid arthritis. Body fat is an organ, like the liver, spleen, or thyroid. And, in particular, body fat is key to the functioning of the hormone system. Hormones like insulin don’t only regulate appetite and glucose but also a number of other interlinked systems in the body. That is why metabolic syndrome can manifest as numerous health conditions and diseases. And that is why metabolic syndrome is the main comorbidity of COVID-19 and other infectious diseases.
If you’re experiencing “Thirties Brain”, you should take that as a serious symptom to be worried about. It’s an early sign of health decline that is only going to get worse, unless you change your diet and lifestyle. People typically have metabolic syndrome years or even decades before finally being diagnosed with a disease that doctors recognize, something like diabetes or cardiovascular disease. But it can often be easily reversed, particularly if caught early. Unfortunately, few Americans realize that this is a public health crisis and one that is entirely preventable. Many experts have predicted that healthcare costs are going to continue to skyrocket, as it eats up more of the national GDP and causes widespread medical debt.
This could end up an existential crisis for our society. That is what happened during the World War II draft. The United States Military suddenly realized so many young men were severely malnourished: “40 percent of the raw recruits drafted by our military proved to be so malnourished that they could not pass a physical and were declared unfit for duty” (Stephen Yafa, Grain of Truth, p. 17; quoted in Malnourished Americans). After the war, there was a public campaign with nutritional fortification of food and meal programs in schools, along with official dietary recommendations. It was also a time when obesity was finally seen as a public health crisis (Nicolas Rasmussen, Fat in the Fifties: America’s First Obesity Crisis).
At present, the military is once again acknowledging that this is a serious problem (Obese Military?). By law, the U.S. military is required to serve food that conforms to the U.S. dietary guidelines. Yet, despite military personnel having high levels of exercise, obesity is also increasing in the military. As research has shown, even when caloric intake and exercise is controlled for, the standard American diet (SAD) is obesogenic (Americans Fatter at Same Level of Food Intake and Exercise). But, on a positive note, the military is beginning to recognize the cause of the problem. They’ve determined the link the diet soldiers are being given. And research on soldiers has shown a ketogenic diet will help with fat loss.
The fact is the consumption of saturated fat has declined ever since, back in the 1930s, industrial seed oils replaced animal fats as the main source of fatty acids in the American diet. Likewise, beef intake has dropped about as low as it was in the first half of the 20th century, after a brief period of peaking out in the 1970s (Diet and Health, from John Hopkins Center for a Livable Future). Meanwhile, what has risen in the American diet, besides industrial seed oils, are mostly plant foods: vegetables, fruits, fruit juices, soda pop, grains, rice, legumes, nuts, and seeds. The only animal foods that have seen a significant increase are fish and chicken, the two supposedly healthy meats. That is the modern SAD diet that has led to the sudden appearance of “Thirties Brain”. Welcome to the new normal!
To make a related point, this health decline can’t be blamed on a factor like behavior, no matter how much lifestyle is implicated as well — you can’t outrun a bad diet, as some say. The young generations have become quite health-conscious, but it’s simply the health advice they’ve been given is wrong. Young adults are eating more supposedly healthy foods than did people in the past, including with rising rates of plant-based diets: Mediterranean, vegetarianism, veganism, etc. Also, when younger, Millennials (and Generation Z) had lower rates of teen sexual activity, alcohol consumption, and drug use. As observed elsewhere, one could call them prudes (Rate of Young Sluts) or at least that used to be true. But something has definitely changed that is now affecting their behavior.
Some countries that with more alcohol and tobacco usage than the US are, nonetheless, healthier (France, Germany, etc). Limiting ourselves to the US, consider the residents of Roseto, Pennsylvania in their having been studied from 1954 to 1961. At the time, they were the healthiest population in the country, despite being quite fond of drinking and smoking, not to mention their love of processed meat and saturated fat like lard (Blue Zones Dietary Myth). So, a recent slight shift of drinking and smoking among Millennials also ends up being a non-explanation. It’s more likely a result of declining health than a cause, and hence the reason to describe it as self-medication. Or, more generally, the addictive mindset isn’t limited to addictive substances; and, besides, drug use is nothing new (The Drugged Up Birth of Modernity).
Anyway, keep in mind that these Millennial rates of substance abuse are still lower than was seen, for example, among Generation X that had far fewer health problems at the same age, even with GenXers being the most lead poisoned living generation. Something unique is going on right at present and it’s hard to explain it with anything other than a ultra-processed diet high in carbs and industrial seed oils. Back when the first wave of GenXers hit their thirties in the mid-1990s, no one was talking about “Thirties Brain”. And neither did it come up with the prior generations. We are complaining about U.S. presidents of the Silent Generation (Donald Trump and Joe Biden) in their seventies who have obvious neurocognitive decline, but that is a vast difference from one’s thirties.
To put that in further comparison, there was a discussion of health in terms of running. It was part of an argument that humans evolved for running. This is supported by the fact that persistence hunting (i.e., running game down) is one of the oldest and most widespread hunting techniques, as it requires almost no technology other than something to club or stab the animal to death after it collapses from heat exhaustion. The human body seems extremely well-adapted to long-distance running, especially in heat; and this also seems closely linked to the predilection for ketosis (Human Adaptability and Health). What is relevant for our discussion here is that hunter-gatherers reach their peak aerobic health in their fifties. The average middle-aged hunter-gatherer can outrun the average eighteen year old hunter-gatherer. Up into old age, hunter-gatherers can keep up a fast pace with others who are much younger.
Think about how many middle-aged or older Americans who could do the same. Unsurprisingly, hunter-gatherers likewise have very little of the diseases of civilization. Obesity, of course, is almost unheard of among them. The have what is called a long healthspan where most people live healthily into old age and suddenly die without any lingering sickness or long periods of degeneration. In such a healthy society, they likely wouldn’t even understand the concept of “Thirties Brain”.
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Some might think Millennials are being unfairly criticized. That is not the intention. This health decline hardly began in recent decades. Weston A. Price and others were talking about it in the early 1900s. There was even a growing debate about it in the century before that, Heck, all the way back in the 1700s, people were recommending specific medical diets for obesity and diabetes, as it was already being observed that they were becoming more common. The only difference is that we are finally hitting a point of extreme consequences, as diseases of old age are now prevalent among the young, sometimes in early childhood.
We write posts like this with genuine concern and compassion. We are not disinterested observers, much less see ourselves as standing above these problems with condescension. It’s all rather personal. Though relatively healthy in many ways, we have experienced serious neurocognitive and mental health issues since our own childhood. And we suspect we previously were suffering from metabolic syndrome, if not yet diagnosed with any particular disease. To be specific about the point made in the parody video, we have experienced our own equivalent of “Thirties Brain”, as we had a memory-related learning disability that was diagnosed in third grade. For our entire lives, we’ve struggled with memory recall.
So, personal concern is underlying our public worries; magnified by the fact that our nieces and nephew span across the generations of Millennials and GenZ, allowing us to observe firsthand the health issues involved. From our own experience, we know what it’s like to be addicted to carbs and to suffer the consequences. We know what it’s like to struggle with serious mental illness, specifically depression with suicidal ideation, since young adulthood. It saddens us immensely to think that large numbers of Millennials will begin having so many harsh problems this early in life. That is a plain shitty situation, and Millennials did nothing to deserve it. Like the rest of us, they were simply born into this society with its food system and dietary recommendations.
For the most part, the majority of Millennials and other Americans have basically been doing what they were told is healthy. They don’t realize that what has been normalized should not be taken as normal because very few of them have anything to compare against. It’s not like most of us have ever lived among hunter-gatherers to realize how far human health has fallen. Even the traditional rural diet and lifestyle has mostly slipped from living memory. Certainly, hunting and fishing have become uncommon. Getting ultra-processed food from a grocery store or restaurant is simply what people do now.
“On the basis of evidence now accumulating, vegetables and fruits were not always an integral part of the European diet. Prior to 1800, vegetables and fruits were not esteemed but rather looked down upon. It has only been over the past two centuries that these two critical foods have come into vogue. First, they had to be accepted by a growing number of medical men and observers. Then, once licensed as edible foods, vegetables and fruits, starting with the potato, actually did make their way into every man’s diet. And by the end of the nineteenth century, these rich sources of carotene and Vitamins A, C and E became so universal that Europeans now forgot that a hundred years earlier these foods had barely been consumed.”
There is a piece from The Atlantic about weight loss, The Weight I Carry. It’s written from a personal perspective. The author, Tommy Tomlinson, has been overweight his entire life. He describes what this has been like, specifically the struggle and failure in finding anything that worked. One has to give him credit for trying a wide range of diets.
It was sad to read for a number of reasons. But a point of interest was a comment he made about carbs: “I remember the first time carbohydrates were bad for you, back in the 1970s. The lunch counter at Woolworth’s in my hometown of Brunswick, Georgia, sold a diet plate of a hamburger patty on a lettuce leaf with a side of cottage cheese. My mom and I stared at the picture on the menu like it was a platypus at the zoo. We pretended to care about carbs for a while. Mama even bought a little carbohydrate guide she kept in her pocketbook. It said biscuits and cornbread were bad for us. It didn’t stay in her pocketbook long.”
That is what I’ve read about. Into the 1970s, it was still well known that carbs were the main problem for many health problems, specifically weight gain. This was part of mainstream medical knowledge going back to the 1800s. It was an insight that once was considered common sense, back when most people lived on and around farms. Everyone used to know that how cattle were fattened for the slaughter was with a high-carb diet and so the way to lose weight was to decrease carbs. There was nothing controversial about this old piece of wisdom, that is until the government decreed the opposite to be true in their 1980s dietary recommendations.
The sad part is how, even as this guy knew of this wisdom, the context of understanding its significance was lost. He lacks an explanatory framework that can sift through all the bullshit. He writes that, “I’ve done low-fat and low-carb and low-calorie, high-protein and high-fruit and high-fiber. I’ve tried the Mediterranean and taken my talents to South Beach. I’ve shunned processed foods and guzzled enough SlimFast to drown a rhino. I’ve eaten SnackWell’s cookies (low-fat, tons of sugar) and chugged Tab (no sugar, tons of chemicals, faint whiff of kerosene). I’ve been told, at different times, that eggs, bacon, toast, cereal, and milk are all bad for you. I’ve also been told that each one of those things is an essential part of a healthy diet. My brain is fogged enough at breakfast. Don’t fuck with me like this.”
His frustration is palpable and reasonable. But I notice all that gets left out from his complaints. A low-carb diet by itself very well might feel impossible. If you aren’t replacing carbs with healthy fats and nutrient-dense whole foods, you will be trying to swim upstream. Carbs is used by the body as a fuel. Take it away and you better give the body a different fuel. And after a lifetime of nutrient deficiency as is common in modern industrialization, you’d be wise to rebuilding your nutritional foundations.
That is the failure of the deprivation model of diets. They eliminate without offering any good advice about what to add back in. The advantage of traditional foods and paleo is that they are less diets in this sense. They are simply seeking scientific knowledge based on how humans live in traditional communities in the world today and how humans have lived going back to the ancient world and beyond. The point is finding what naturally works for the human body, not forcing restrictions based on ideological demands. If a diet feels like a constant struggle, then you are doing something wrong. For most of human existence, the vast majority of individuals maintained a healthy body weight with no effort whatsoever. The epidemic of obesity is extremely and bizarrely abnormal. Obesity indicates something is seriously out of balance, specifically with insulin sensitivity and the related hormonal hunger signals. Deprivation simply antagonizes this state of disease.
We already know that the ketogenic diet is the most effective diet for weight loss. Not only in the losing part but also in maintaining one’s optimal weight. No other diet decreases hunger and eliminates cravings to the same extent. More generally, a recent study showed that a low-carb diet beat a low-fat diet in burning fat, even when protein and calories were exactly the same in both groups. This possibly indicates that, as some have speculated, a diet low enough in carbs may increase metabolism in burning more calories than one is consuming. Then when you reach your preferred weight, you can add back in some calories to attain an equilibrium. This is apparently the one thing the author didn’t try. He did try the South Beach diet, but it is only moderately low-carb and unfortunately is also low-fat, a bad combination — this diet, for example, recommends low-fat milk which is not only eliminating the needed fats but also the fat-soluble vitamins, especially in the form of dairy from cows that are pastured/grass-fed.
The author is trapped in the dominant paradigm. He doesn’t need to “Eat less and exercise.” And he recognizes this is bad advice, even as he can’t see an alternative. But he should look a bit further outside the mainstream. On a ketogenic diet, many people can lose weight while eating high levels of calories and not exercising. It’s more of a matter of what you eat than how much, although in some cases where there are serious health problems as is typical with lifelong obesity more emphasis might need to be given to exercise and such. But the point is to find foods that are satisfying without overeating, which generally means healthy fats. Your body gets hungry for a reason and, if you don’t feed it what it needs, it will remain hungry. Calorie counting and portion control won’t likely help anyone with long term weight issues. It will just make them frustrated and hangry, and for good reason. But when the old patterns repeatedly fail, it is best to try something new. Sadly, the author’s conclusion is to more fully commit to the old way of thinking. His chances of success are next to zero, as long as he continues on this path.
It’s an obesity mindset. The individual blames himself, rather than blaming the bad advice. He just needs more self-control and less gluttony. This time, he tells himself, it will work. I doubt it. I hope he doesn’t spend the rest of his life on this endless treadmill of self-defeat and self-blame. Life doesn’t need to be so difficult. Rather than losing weight, he should focus on what it takes to be and feel healthy. But it is hard to convince someone of that when their entire identity has become entangled with obesity itself, with their appearance as judged by the same society that gave the bad advice.
I remember the first time carbohydrates were bad for you, back in the 1970s. The lunch counter at Woolworth’s in my hometown of Brunswick, Georgia, sold a diet plate of a hamburger patty on a lettuce leaf with a side of cottage cheese. My mom and I stared at the picture on the menu like it was a platypus at the zoo. We pretended to care about carbs for a while. Mama even bought a little carbohydrate guide she kept in her pocketbook. It said biscuits and cornbread were bad for us. It didn’t stay in her pocketbook long.
I’ve done low-fat and low-carb and low-calorie, high-protein and high-fruit and high-fiber. I’ve tried the Mediterranean and taken my talents to South Beach. I’ve shunned processed foods and guzzled enough SlimFast to drown a rhino. I’ve eaten SnackWell’s cookies (low-fat, tons of sugar) and chugged Tab (no sugar, tons of chemicals, faint whiff of kerosene). I’ve been told, at different times, that eggs, bacon, toast, cereal, and milk are all bad for you. I’ve also been told that each one of those things is an essential part of a healthy diet. My brain is fogged enough at breakfast. Don’t fuck with me like this.
Here are the two things I have come to believe about diets:
1. Almost any diet works in the short term.
2. Almost no diets work in the long term.
The most depressing five-word Google search I can think of—and I can think of a lot of depressing five-word Google searches—is gained all the weight back. Losing weight is not the hard part. The hard part is living with your diet for years, maybe the rest of your life.
When we go on a diet—especially a crash diet—our own bodies turn against us. Nutritional studies have shown that hunger-suppressing hormones in our bodies dwindle when we lose weight. Other hormones—the ones that warn us we need to eat—tend to rise. Our bodies beg us to gorge at the first sign of deprivation. This makes sense when you think about the history of humankind. There were no Neanderthal foodies. They ate to survive. They went hungry for long stretches. Their bodies sent up alarms telling them they’d better find something to eat. Our DNA still harbors a fear that we’ll starve. But now most of us have access to food that is more abundant, cheaper, and more addictive than at any other time in human history. Our bodies haven’t caught up to the modern world. Our cells think we’re storing up fat for a hard winter when actually it’s just happy hour at Chili’s.
Even worse, when people succeed at losing a lot of weight, their bodies slam on the brakes of their metabolism. […] Other studies had already shown that the body’s metabolism slows down as people lose weight, which means they have to eat fewer and fewer calories to keep losing. But this study showed that, for the contestants who lost weight quickly, their metabolism kept slowing even when they started gaining weight again. Basically, however fat they had been, that’s what their bodies wanted them to be. […]
“Eat less and exercise.”
That’s what some of you are saying right now. That’s what some of you have said the whole time you’ve been reading. That’s what some of you say—maybe not out loud, but you say it—every time you see a fat person downing fried eggs in a diner, or overstuffing a bathing suit on the beach, or staring out from one of those good-lord-what-happened-to-her? stories in the gossip magazines.
“Eat less and exercise.”
What I want you to understand, more than anything else, is that telling a fat person “Eat less and exercise” is like telling a boxer “Don’t get hit.”
You act as if there’s not an opponent.
Losing weight is a fucking rock fight. The enemies come from all sides: The deluge of marketing telling us to eat worse and eat more. The culture that has turned food into one of the last acceptable vices. Our families and friends, who want us to share in their pleasure. Our own body chemistry, dragging us back to the table out of fear that we’ll starve.
On top of all that, some of us fight holes in our souls that a boxcar of donuts couldn’t fill.
My compulsion to eat comes from all those places. I’m almost never hungry in the physical sense. But I’m always craving an emotional high, the kind that comes from making love, or being in the crowd for great live music, or watching the sun come up over the ocean. And I’m always wanting something to counter the low, when I’m anxious about work or arguing with family or depressed for reasons I can’t understand.
There are radical options for people like me. There are boot camps where I could spend thousands of dollars to have trainers whip me into shape. There are crash diets and medications with dangerous side effects. And, of course, there is weight-loss surgery. Several people I know have done it. Some say it saved them. Others had life-threatening complications. A few are just as miserable as they were before. I don’t judge any people who try to find their own way. I speak only for myself here: For me, surgery feels like giving up. I know that the first step of 12-step programs is admitting that you’re powerless over your addiction. But I don’t feel powerless yet.
My plan is to lose weight in a simple, steady, sustainable way. I’ll count how many calories I eat and how many I burn. If I end up on the right side of the line at the end of the day, that’s a win. I’ll be like an air mattress with a slow leak, fooling my body into thinking I’m not on a diet at all. And one day, a few years down the road, I’ll wake up and look in the mirror and think: I got there.
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