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According the Future Its Due

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'Tis, as the saying goes, the season. As I write this, if not necessarily as you read it, 'tis the season of rhetorical flourish, soaring aspirations. Even if often wrapped in crass commercialism, or delivered in the lyrics of a particularly corny carol, the sentiments are real, the yearning -- perennial and fervent. We feel it always, I believe -- but only allow ourselves to express it so freely in this annual interregnum.

Yes, we want a world of peace and harmony. Damn it, we do! Yet, how elusive it is. And of course, the enemy to what we would so ardently celebrate, so eagerly bequeath to our children is... us. Who else?

As we revisit again this year the jarring contrast between what we desire and what we devise, images of Paris beckon. Paris, where terrorists so recently sprayed bullets and cast their fetid shadow over the City of Light. Paris, where only weeks later, a world of nations gathered to defend our common treasure from shortsighted profiteering and address climate change at last. The Paris Accord, though doubtless bedeviled by operational details, and perhaps somewhat too late, and almost surely too little, is historic just the same. And, whatever its deficiencies, so much better than discord.

How right, too, that Paris should symbolize the triumph of accord in the aftermath of mayhem born of discord, however murky and inscrutable its particular origins. In French, "I agree" is "d'accord," and the expression figures frequently in the flow of that mellifluous language.

Accord, then, is today's theme. There, and only there, resides the answer to these seasonal hopes. Only in unity is the strength to shrug off the discordant status quo that bides its time while we are busy buying presents.

The Paris Climate Accord shows the capacity of nations to agree on our common interest in the fate of the planet. Closer to home, we had a recent and vivid, if much humbler demonstration of the capacity of nutrition experts to agree on common interest in the fare on our plates.

The Oldways Common Ground conference was remarkable for the diverging implications of its product, and its process. The product, as in Paris, showed the possibility of accord at the outer limits of hope and expectation alike. The process showed how readily discord prevails when given the least quarter.

I have reflected on this recently, more than once. At times, of course, we truly disagree. We may disagree on what should be done, or even more likely, how. There is room for real disagreement. We can, as the saying goes, agree to disagree.

But we often fail even to agree to disagree, and disagree about disagreeing instead. And much of that deeper discord is the stuff of smoke and fog, shadow and misapprehension.

In the case of diet, all experts I've met around the world eat much more like one another than any eats like the typical member of their native population. Yet these same experts populate journals and airwaves alike with seemingly mutually exclusive claims. How can practice be so confluent, the related preaching so cacophonous?

For one thing, our answers follow our questions, and our questions are all too often the thin edge of a divisive wedge. In the case of guns, they pose as choices between rights and controls. In the case of climate they pose as choices between the environment and the economy. In the case of diet, they masquerade as choices between this claimant to the best diet laurels, and that.

The ramifications of our tendency to ask divisive questions in the first place are massively amplified in cyberspace, where anonymity and a boundless expanse serve to stoke our primal xenophobia, even as they embolden our stridor. Echo chambers prevail, empathy erodes, and extremes of opinion obscure the common ground.

But then there is this timely, seasonal reminder that we want that common ground. In the mists of Christmas future, we see our children playing together on it.

We see them healthy as well, of course. So it is genuinely meaningful and comforting to know that a who's who in lifestyle medicine around the world agree on how to make that most likely for their own children. It is meaningful and comforting as well that the communal recipe addresses the critical needs of our overtaxed planet.

There is massive environmental benefit in lifestyle as medicine. Water consumption to produce beef calories is in general an order of magnitude greater than that required to produce corresponding plant-food calories. Water consumption to produce soda pop, the drinking of which redounds only to the benefit of the sellers, is nothing less than astounding. In Marion Nestle's new book, Soda Politics, we learn that some 500 liters of water are consumed to produce one liter of Coke or Pepsi. We might all imagine dumping 499 bottles of water down a drain as the prelude to drinking one bottle of soda, and wince accordingly.

There is, in fact, a massive global accord about the fundamentals of healthy eating. Fortuitously, those same fundamentals are as germane to the fate of the planet, from aquifers to biodiversity, as they are to the fate of our families. The argument for a less processed, more plant-based diet is solid, and sound; rooted in science and sense; time-tested, and real-world relevant. The very formula that prevails for chronic disease reduction pertains to the preservation of planetary treasure. Beneath the veil of apparent din and discord, there isn't just accord; there is concordant accords across disciplines, and domains.

Using what we know about lifestyle as medicine, we can add years to lives, and life to years. We can, as well, contribute something substantive to the stabilization of climate, the sustainability of our food systems, and the defense of natural resources -- one thoughtfully provisioned plate at a time.

We are invited, then, to do all we can to ensure accord is on the menu. All that is required is the strength unique to unity. All that is needed is the declaration of common cause, on the solid substrate of common ground.

Alas, such things are easier said than done. But 'tis the season that invites us to indulge in our most hopeful reflections, and perhaps to recall that the best way to predict the future -- is to create it.


Director, Yale University Prevention Research Center; Griffin Hospital