The Medical-Pharmaceutical-Agricultural complex
Like the Military-Industrial Complex, but to make you fat and sick
A few years ago, the medical journal The Lancet published a report called EAT-Lancet on the intersection between food, the planet, and human health.
The report was an attempt to reconcile the challenges of feeding a future population of 10 billion humans a healthy diet within “planetary boundaries,” with the goal of bringing together “world leading nutrition, health, sustainability, and policy from across the globe.”
Any multidisciplinary collaboration like this is necessarily a huge undertaking. It’s hard to get a lot of experts in a room together to develop a coherent conclusion - it’s even harder when the subject matter is so cross-disciplinary and so important.
You can spend a lot of time critiquing the science here, but you honestly don’t have to dig very deep to see the flaws.
It seems pretty clear that the EAT-Lancet recommendations produce a diet that’s nutritionally deficient - the suggested diet doesn’t have anywhere near enough vitamin D, vitamin A, B12, potassium, retinol, iron, or omega 3 fatty acids.
And it also seems insane to recommend 8 teaspoons of added sugar everyday.
But the more fascinating thing to me is that when you dig into the the details of funding - strategic partners, engagement allies, and other corporate funding - you see that companies like Nestle, Danone, Novo Nordisk, Bayer, BASF, Kellogg’s, Unilever, and Pepsi are all behind the effort.
These big businesses here aren’t involved out of the goodness of their hearts.
The confluence of these groups - organized medicine, the pharmaceutical industry, and big food - has been termed the Medical-Pharmaceutical-Agricultural Complex. (I can’t remember where I first read this name, so I’m not giving credit to the person who coined the term.)
Agricultural here refers to the people who grow the commodity crops like corn, soy, and wheat that make up the majority of our caloric intake and companies that sell us the packaged and branded hyper-processed foods made from these crops.
It’s like the Military-Industrial Complex, but instead of influencing foreign policy so they can make money selling arms and aircrafts, the Medical-Pharmaceutical-Agricultural complex influences nutrition policy to selling you food, drugs, and procedures - making billions at the expense of your health.
The EAT-Lancet report has received a lot of criticism about the conflicts of interest inherent in these organizations partnering to recommend a diet that we should eat - and when you see flaws in the end result of their report, it’s not hard to see why some corners of the internet think there’s a conspiracy among these groups to keep people fat, sick, and medicated.
I care about this and I write about it because the root cause of most of the illness that I see comes down to a poor diet
I write about diet all the time in this newsletter because of the integral relationship between what I do all day at work - take care of patients who are sick from cardiovascular disease - with the foods that we put in our bodies.
The vast majority of work that I do would be eliminated if everyone avoided processed food and added sugar, didn’t drink juice or soda, didn’t smoke, and got regular exercise.
So I’m passionate about this topic because I see the ill effects of poor diet every single day of my life.
And the people who are the most impacted are the ones with low health literacy and limited socioeconomic means - crappy food is cheap and tasty.
Processed food is also easy to prepare and doesn’t take time to cook. You may have heard about the Time Tax, the way that bureaucratic burdens fall disproportionately on the poor - that certainly plays a role here.
But there’s also a Health Tax that you pay when you’re poor and lack health literacy.
You can predict the majority of health outcomes for a patient by knowing about their zip code - and after observing a lot of my patients across the socioeconomic spectrum and hearing about their lives, I am fully persuaded that a huge part of that is because of the food that they eat (which is what everyone around them eats).
A report like EAT-Lancet matters because its conclusions provide cover for big food companies (like the ones that sponsored the report) to healthwash their profitable processed food-like substances that get fed to the masses - the exact stuff that makes people sick and ruins their health.
Everyone in the Medical-Pharmaceutical-Agricultural Complex has a financial interest in people being sick
There’s big money here. Like really big money.
You’ve heard about how healthcare has been growing at a faster rate than the economy for quite some time - it’s now up to 20% of our national GDP. US healthcare spending is over $4 trillion per year. That’s $4,000,000,000,000, of over $12,000 per person.
And the vast majority of that money goes to Big Medicine and Big Pharma. The vast majority of the need for these things are driven by Big Food.
Medicine makes money when you spend time in the hospital, visit the doctors, and get tests and treatments.
Pharma makes money when you get sick and end up on their expensive drugs.
Big Food makes money selling processed, packaged, and branded food. It’s way more profitable to do that than by selling unprocessed real food that ends up being commoditized.
So forgive me if I think it’s sketchy when you have a report put out by a big medical journal (written by some of the biggest names in nutrition science) that’s supported financially by Big Pharma and Big Ag.
I’m not the only one who’s had this observation:
When I talk to my patients about this stuff, I sometimes feel like it’s the first time they’ve heard this information.
I know that most of the time it isn’t - teaching patients to eat unprocessed food is a mainstream message that most nutritionists know well and that many doctors are taught in obesity clinics.
But this simple and powerful message gets lost in the miasma of misinformation that can be weaponized by people who want to make you diabetic so they can sell you insulin.
It’s a conflict of interest that CVS can sell you the Pepsi that gives you diabetes and the medicine that helps to treat it.
Even if you’re healthy now, you should care about this stuff because it filters down into the messages you get about a “healthy diet”
And we’re all powerless to stop the tidal wave of misinformation - there are too many people with too many ideas and too much money involved.
It’s never going to feel like it’s simpler to eat a healthy diet, because the information onslaught is only going to get worse.
I hear a lot from my health conscious patients that they’re confused about what’s healthy. The reason that they’re confused is because of reports like EAT-Lancet and the crappy nutrition studies that form the bedrock of their recommendations.
The insatiable content need for “news” about our health is not going away any time soon.
There is a lot of money to be made my making things confusing - because when it’s confusing, you’re much more likely to end up sick, fat, and medicated.
So I write about these things to try to empower my audience.
And since no one is every going to clear things up - and the definitive studies to answer the question are never happening because they’re too expensive and too complicated - you need to be your own advocate here.
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