Wellness Is Mostly an Expensive Fantasy
"If it requires moon dust and dropping a grand a week at Whole Foods, it's out of reach."
Shayla Love; Carolyn Laggututa / Stocksy
Fighting Words is a column in which writers rub you the wrong way with their unpopular but well-argued opinions on fitness, health, nutrition, what have you. Got something to get off your chest? Send your pitch to firstname.lastname@example.org.
As a science writer, I have a hobby that I keep under wraps: I'm a wellness junkie. Most of the people I follow on Instagram are food or "wellness" bloggers, or "influencers," who promote "clean" food products and restaurants, and create plant-based recipes. They try out new fitness classes, eat smoothie bowls every morning, and advocate for cleaner eating and living overall.
My slide into the wellness world was gradual. I've been a vegetarian for over a decade, and after finding out I was lactose intolerant, made the switch to fully vegan. That's the diet that makes me feel the best and have the most energy, and the one I love to cook and eat. But as any vegetarian or vegan will tell you, it's not an easy world to be plant-based in.
Go to any restaurant and the menu will usually have only one or two items free of animal products. Food that I've lovingly cooked for family gatherings has been mocked and criticized, without being tasted. When I've reluctantly told friends, acquaintances, or colleagues that I don't eat meat, seafood, or dairy (hiding the word vegan like a dirty secret) I've had these arguments thrown back at me too many times to count: "But what about bacon?" "What about protein?" "Plants have feelings too."
And yet, the reason I don't eat animal products has very little to do with morality. It has a large part to do with the environment, and an even larger part to do with health. Americans are sick and overweight, and it's partially because of what we're eating. Most Americans exceed the recommendations for added sugars, saturated fats, and sodium and about three-fourths of the population don't eat enough vegetables or fruits. We are plagued by chronic diseases like type 2 diabetes, heart disease, stroke, and obesity. More than one-third of Americans are obese, and there isn't a single state that has an obesity rate below 20 percent.
The wellness community was a place I could turn to, where people were excited about making desserts without refined sugar, cookie dough from chickpeas, eating big fresh salad bowls, and creating food products with ingredients that were as minimally processed as possible. I genuinely love eating a bright green smoothie bowl for breakfast every day, and these ladies on Instagram mirrored my enthusiasm. I had found my people.
Slowly, though, something began to creep into my sacred wellness world. I ignored it at first, becoming a cafeteria-wellness follower. I picked only what I liked: the encouragements for women to be strong not skinny, to fill each meal with fresh fruits and veggies, to take time for self-care, and support small companies with healthy products. I passed over what I didn't like: the pushing of supplements, adaptogens, odd restrictive dietary trends, and the subtle rejection of western medicine and science in favor of more "natural" remedies.
Then, about a month ago, the American Heart Association published a report on the health risks associated with saturated fats, and included coconut oil on its list of the worst offenders. The paper said it had a higher percentage of saturated fat than butter or lard, and referenced studies showing that coconut oil increases LDL cholesterol—the bad kind of cholesterol that is associated with heart disease. Coconut oil does raise good HDL cholesterol too, but at best, just enough to break even. Other unsaturated fats, like olive oil, not only increase HDL, but lower LDL.
Coconut oil has long been one of the stars of the wellness world, with claims that it does all sorts of things from immune boosting, digestion aiding, fat burning, and more. The "scientific" explanation was that coconut oil was made from medium-chain triglycerides, so it was processed in the body in a different way. As Stat reported, this myth originated in two studies from Marie-Pierre St-Onge, a professor of nutrition at Columbia University. In her research, participants ate meals specially prepared with 100 percent medium chain fatty acids, and found that their overall fat levels were reduced, and that it helped them burn energy. But, the coconut oil that you buy at the store is only about 10-15 percent medium chain fatty acids, and that percentage isn't thought to be enough to outweigh the risks. Even though coconut oil is "clean" and a "whole food," it's just another source of high saturated fat content.
When the paper came out, I made a mental note to stop cooking so much with coconut oil and switch back to olive oil. I presumed to see that same reaction online. I was wrong. Most bloggers I followed either outright ignored the AHA study, or grudgingly acknowledged the findings but brushed it off. A few said that the AHA was wrong. I saw many bloggers holding on to the MCT explanation—even when it was not true.
Coconut oil is okay in moderation—I don't mean to demonize it. The AHA says we should limit our saturated fat consumption to 13 g per day, which is about a tablespoon of coconut oil. But recipes and products being created and touted by those in this world are still dripping in coconut oil, as the "healthy" fat of choice. As a consumer buying products in the wellness world, or making recipes from their blogs, I would be eating way more than my fair share of it, without trying.
"People take these things as if there is no debate, it's almost like a religion," says Timothy Caulfield, professor of law and the School of Public Health at the University of Alberta who has spent his career studying science policy. He's been an outspoken voice against "celebrity" and pop culture health claims; his most recent book is called, Is Gwyneth Paltrow Wrong About Everything?: When Celebrity Culture and Science Clash. I called him up to talk over some of the troubling trends I had seen in the accounts I was following online.
Caulfield thinks what influencers recommend and say about health has a lasting impact. Seven out of ten people still think that coconut oil is a health food, and that could mean not just eating it in moderation, but by the spoonful—and often. "This is a really good example of how the wellness community has kind of won," Caulfield says. "Let's be honest, it won." These messages can trickle down into more serious examples, too. Caulfield thinks that the anti-vaccination movement has roots in the wellness movement, because of the belief that there is some element of "unnaturalness" to it.
Around the same time the AHA paper came out, I was pursuing a skin care line that I saw on Instagram, Primally Pure. On their home page it reads, "Nature is Smarter Than Science." At first, I found this statement hilarious, then, horribly depressing. This phrase so perfectly encompassed the ideological clash I had been struggling with. The wellness community claims that they are "natural" and everything else outside of it is not—including science, which I define as the explanation of nature. After reading those five words, in combination with the coconut oil debacle, the wellness community came crashing down around me.
"I don't think there are two sides," Caulfield says. "I think that's a false dichotomy that the wellness industry has done a very good job of using. Almost every science person that I've had an opportunity to work with is completely onside with the idea of prevention, and health promotion. That is not a wellness thing. They do not own that idea. But they've done a really good job of owning that, of creating this false dichotomy, and that has been one of the most effective marketing tools that they've used."
How did I, a firm advocate of evidence-based practices, get so swindled? The problem with the wellness community, as Bee Wilson notes in her excellent Guardian article, "Why We Fell For Clean Eating," is that at its root, there are nuggets of truth. There isn't a dichotomy between "naturalness" and science, but it's true that our doctors are woefully undertrained in nutrition.
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Frank Hu, a professor of nutrition and epidemiology at Harvard T.H. Chan School of Public Health, who does research on diet, nutrition, and lifestyle and prevention of chronic diseases, says that there is an "urgent" need for nutrition to be integrated into the medical curriculum and health professional training. He thinks there is a move towards incorporating the two, but we're still at the early stages. Without it, the public's only exposure to dietary recommendations can be confusing media reports that tell you wine is good for you on Tuesday and say it will kill you on Thursday.
"Sensational headlines have made it seem like nutrition science is so shaky that nutrition experts really don't know what they're talking about," he says. "This is really not true; the basic tenets of a healthy diet are pretty well established and there is a good consensus about those tenets. Healthy dietary patterns usually include minimally processed plant foods, such as fruits and vegetables, nuts, seeds, and some animal products, especially seafood, and poultry, and a relatively small amount of red meat."
Hu says you can achieve a healthy diet several different ways. In the 2015 Dietary Guidelines Advisory Committee scientific report that Hu helped write, they recommended multiple healthy eating patterns including vegetarian, vegan, or as someone who eats a moderate amount of animal products.
Isn't this what my wellness community was promoting? Not really. The natural remedies and health and lifestyle tips from the wellness community go way beyond eating plants. Perhaps the most infamous come from celebrity sources, like Gwyneth Paltrow's website Goop. Goop has made false claims that bras could cause breast cancer, that Epstein-Barr viruses cause 95 percent of thyroid conditions, that tampons are dangerous, or that intentionally getting stung by bees could be a beauty treatment.
Their most recent product was a jade egg. "The strictly guarded secret of Chinese royalty in antiquity," which "harness the power of energy work, crystal healing, and a Kegel-like physical practice. Fans say regular use increases chi, orgasms, vaginal muscle tone, hormonal balance, and feminine energy in general." Goop says that the "Jade eggs' power to cleanse and clear make them ideal for detox," and list them on their site's store for $66.
Jen Gunter, an OB/GYN and pain medicine physician, has taken a stance against the variety of products and practices on Goop. As she wrote in response to the jade egg post: "Pelvic floor exercises can help with incontinence and even give stronger orgasms for some women, but they cannot change hormones. As for female energy? I'm a gynecologist and I don't know what that is!?"
She also says that jade is porous, which could allow bacteria to get inside and could be a risk factor for bacterial vaginosis or even toxic shock syndrome. Pelvic floor muscles are not meant to contract continuously, and she's had patients whose incorrectly done Kegel exercises have led to pelvic pain and pain with sex. The punchline? Goop still sold out of jade eggs.
When I heard about the jade egg, I tried really hard to divorce it from the wellness community that I followed online. But Goop also promoted a lot of products that I've been turning a blind eye to: adaptogenic mushrooms, like reishi and cordyceps, super food supplement blends like "spirit dust," or "moon dust," alkaline diets, detoxes, and bullet proof coffee. These supplements and diets have little to no evidence backing them up, but because they're "natural," they're being touted as cure-alls.
"I think we should be very cautious, everyone should be very cautious about these claims about the health benefits of these supplements," Hu says. "The evidence is very sparse and to a large degree it's almost like the individuals believe in the benefits of the supplements or the herbs they're taking, rather than based on objective and peer reviewed scientific evidence.
Some of the supplements are contaminated with impure ingredients, harmful ingredients, I think that can be dangerous. Supplements aren't regulated by the FDA, and while I'm all for having ginger tea when your stomach is upset, the plethora of other herbs and oils on the market are a wild card. It's hard to accurately know what dosage is in them, or what other chemicals and herbs make them up.
James Loomis, an internal medicine doctor in Washington, DC, doesn't recommend all these various herbal supplements for his patients. I sought him out because he works at the Barnard Medical Center, which integrates nutrition and prevention into its practice. I thought, if anyone would be responsibly giving out supplements, it would be him. He is a strong advocate for plant-based diets after going vegan in 2011, losing 60 pounds, and seeing his overall health improve dramatically. He does give B-12 to his vegan patients, and regularly monitors Vitamin D levels. "And the rest, I don't prescribe at all," he says.
Caulfield says that the problem with making wellness a lifestyle rather than a simple diet of mostly plants is that it makes it harder to access. If being healthy means buying more apples and spinach a week, great. If it requires moon dust and dropping a grand a week at Whole Foods, suddenly it's out of reach.
"I get upset that this wellness industry is leveraging the truth about how to live a healthy life in order to make money," he says. "I think their message confuses the simple truth about how we are supposed to live a healthy lifestyle. Research that has shown that pushing organic foods and raising fear about pesticides causes people in low-income families to eat less fruits and vegetables. That's a terrible outcome, and that's an outcome of the wellness community."
He thinks that Paltrow, who at her core is just pushing a healthy lifestyle, sullies the overall message because it's always wrapped in a blanket of pseudoscience, and it's often a really expensive blanket.
"There are no secrets," he says. "You don't smoke, you exercise, you eat lots of fruits and vegetables, you get a good night's sleep, you try to maintain a healthy weight, and you love somebody. That's about it. You can package it any way you want, and that's what the wellness industry tries to do. But just because you're against pseudoscience, doesn't mean that you're against the clear health prevention health promotion facts, the truth."
So what's a plant-loving person to do? Despite all my conflicted feelings, I don't want to unfollow all my wellness accounts on Instagram. I still enjoy seeing the recipes and pictures of healthy foods, and feeling the enthusiasm and support for healthier eating. The answer might not be another diet or lifestyle, but a major overhaul in the food industry.
"Our food system is in desperate need of reform," Wilson wrote in her Guardian piece. "There's a danger that, in fighting the nonsense of clean eating, we end up looking like apologists for a commercial food supply that is failing in its basic task of nourishing us. Former orthorexic Edward L Yuen has argued—in his 2014 book, Beating Orthorexia—that the old advice of 'everything in moderation' no longer works in a food environment where eating in the 'middle ground' may still leave you with chronic diseases."
My personal wellness addiction doesn't mean I have the wool over my eyes, necessarily, but that I wish for a future with good food for all, zucchini noodles be damned. Until then, I'm finally admitting that the wellness world is mostly fantasy. Or as Wilson calls it, "a dysfunctional response to a still more dysfunctional food supply: a dream of purity in a toxic world."
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