Meals With Mephistopheles

I don't appreciate the whole free will thing, but I am stuck with it. If you want to play let's make a deal, I'm ready any time. The future's on the menu, and I can really cook. So dinner is at my place, and I'll save you a seat at the table. As for saving anything else -- well, I guess that all depends upon your appetite.
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Pleased to meet you; won't you guess my name?

I have a deal for you. You can eat whatever you want and never have to worry about gaining weight or getting chronic disease -- but you will have to shave some years off of the life expectancy of your children. (If you don't have children, skip to my next offer.) Any takers?

Here's another offer. You can do likewise -- eat what you want, be lean and vital- but you have to agree to consign to the oblivion of extinction within your lifetime the following creatures: tigers, polar bears, elephants, gorillas, orangutans, rhinos, sea lions, and most whales. Looks as if lions might hang in there a bit longer, but tigers and bears- oh, my. They have to go. Deal?

One more, just in case you are unusually fussy. Eat what you want -- and don't sweat the life expectancy of your children, or the irrevocable (in any time frame that matters to humans) loss of miscellaneous furry creatures (and their less loveable, non-furry counterparts). However, you have to agree that the only way your grandchildren can visit either Los Angeles or Manhattan will involve wearing scuba gear. Come on, this one has to be tempting?

If not, I am obviously talking to the wrong people. The people who run the world seem perfectly content to broker terms of their meal plan with yours truly. They are, amazingly, also amenable to fretting about carbon in the atmosphere, while agreeing to funnel new reserves of carbon into the atmosphere. It's a mad world, but that has always been an asset when shopping for souls.

Actually, I lied. That can't surprise you much; the tendency comes with the pitchfork. Or maybe it's the tail...

It turns out that even if you agree to mortgage your children to pay for your fun, point the finger of doom at creatures who have as much right to the planet as you do, and dump a few of your planet's major cities into its increasingly acidified oceans -- you actually don't get to stay lean and healthy after all by eating whatever you want.

It turns out, too bad for you, that kicking cans down the road and off a cliff and into the sea may kick you in the can while you're at it. Eat whatever you want, and there's a good chance you will be fat and sick as you consign the planet to hell (great neighborhood, by the way) in your hand basket.

I can't help but enjoy your recent preoccupations with meat, butter, and cheese. For one thing, I love watching you spin in circles, replicating the follies of history. It's just funny. Well, sad, really -- but to me, sad is funny. Spin on, dear nincompoops.

For another, I'm into devastation. So the "let's eat the planet" cabal is my kind of party. I'm in.

But, if I may wax slightly paternalistic for a moment- it's almost hard to believe how benighted you people really are. The evidence is overwhelming that you could have both longevity and vitality with plant-based diets that would, into the bargain, go a long way toward staving off environmental calamity. You even have evidence that all of the people in the world today enjoying the longest lives and best health are eating just such diets. And yet, you dither, and bicker. I love it! I love you. How can I not? You are my minions.

Is there even a legitimate debate here? I don't care, but perhaps some of you do- so for those of you in that tedious group: not really.

Of course, you can keep propagating studies to propagate confusion, and I hope you do. If I were in charge of biomedical research, I could guarantee perpetual confusion. I begrudgingly concede I could scarcely do a better job than you.

For instance, a recent study (I read a lot; plenty of time on my hands) reaffirmed the association between saturated fat intake, atherosclerosis, and eventual premature death from heart disease among Australian women. I couldn't have designed a better rebuttal myself than a study showing no association between saturated fat intake and cardiovascular mortality in Norwegian men and women.

Is this because of some mischievous biological distinction between Australians and Norwegians I have kept from you? Nothing of the sort! It's the classic instance of getting no clarifying answers to obfuscating questions. The Norwegian study looked only at variations in death rate in accord with variations in saturated fat consumption, only among people who already had established coronary disease. If you study only people in a plane crash, and find that survival does not vary with daily step count, I'm not convinced that disproves the relevance of walking for the population at large. But what do I know? I'm no epidemiologist, although I do have some leasing space from me. Moving on.

You might, as some of you do, invoke your Stone Age heritage as the basis for going the other way, the "more meat, butter, cheese" way. But there were no Stone Age dairy farms, so at least have the cogency to trim your list to: meat. No butter, no cheese -- if "Paleo" is your dietary Polaris.

Frankly, there are few things I enjoy more than watching your delusional gyrations; it's excellent spectator sport. And that's just what those of you who wave the "Paleo" flag above your bacon-cheeseburger minus bun are providing. We've already established there was no Stone Age cheese -- and yes, I was there. There was no domestic cow or pig meat, either. Other than that, you're firing on all cylinders -- and burning petroleum, which I put there for you after using an apple for a test run.

There are, of course, some few of you with actual expertise in Stone Age living, who manage a modernized, sanitized (i.e., no bugs, or human flesh) approximation of a Paleo diet with verisimilitude. But such a diet can only be for the few. With more than seven billion of you (for me to torment), you need a much larger planet to make hunting and gathering the once and future norm. Good luck with that.

The bottom line is that there is one, well-established way to eat that is associated with decisive health benefit in a vast array of studies; decisive benefit in real world populations; benefit for the planet; and a viable future for your children. Personally, I hope you will ignore that compelling reality, and continue to bicker, dither, and opine. It's a recipe for calamity, and I'm lovin' it.

In any event, it's your choice; I don't appreciate the whole free will thing, but I am stuck with it. If you want to play let's make a deal, I'm ready any time. The future's on the menu, and I can really cook. So dinner is at my place, and I'll save you a seat at the table. As for saving anything else -- well, I guess that all depends upon your appetite.


David L. Katz, MD, MPH, FACPM, FACP has clearly been hacked, and has no idea how this got into his blog account. If he were here, though, he would tell you what he really thinks.

Director, Yale University Prevention Research Center; Griffin Hospital

Editor-in-Chief, Childhood Obesity