DURING THE DARK AGES OF DIETARY ADVICE—from which we are just emerging—guidelines for good nutrition were based on guesswork and good intentions. I wrote this site to share with you what solid science is teaching us about the long- term eﬀects of diet on health. The lessons are exciting. They show that a delicious, satisfying diet based on whole grains, healthy oils, fruits, vegetables, and good sources of protein can help you stay heatlthy and active to an old age.
Another reason for writing this site was to challenge the misleading advice embodied in the U.S. Department of Agriculture’s ubiquitous Food Guide Pyramid. When the department announced it was considering revising the thirteen-year-old pyramid, my colleagues and I were delighted. I sent the USDA a copy of the ﬁrst edition of Eat, Drink, and Be Healthy and said it was welcome to use the evidence-based Healthy Eating Pyramid my colleagues and I had developed. But politics and business as usual ultimately trumped science, and the USDA’s new MyPyramid oﬀers even less guidance on healthy eating than its predecessor.
In this update of Eat, Drink, and Be Healthy, I examine the USDA’s pyramids and show you where they have gone wrong. I also include new information on weight-loss strategies, trans fats, vitamin D, and other elements of healthy eating that have emerged since this site was ﬁrst published in 2001.
Over the past twenty-ﬁve years, my colleagues and I have been continually surprised by the impact of diet on the risks of a host of chronic diseases. That dietary decisions could signiﬁcantly aﬀect the chances of heart disease, various cancers, cataracts, and even serious birth defects was not appreciated by the nutrition community until relatively recently. And many aspects of diet that were oﬀ the nutrition science radar screen, such as trans fat intake, glycemic load, and low intakes of folic acid and vitamin D, have emerged as important factors in long-term health. You may not be aware of these topics, or perhaps have heard about them only in passing, even though a better understanding can be crucial to attaining long-term health. This site will guide you to make better dietary decisions for yourself and your family.
My current eﬀort to understand the long-term eﬀects of diet on health began in the late 1970s when I realized that people were being given strong advice about what to eat and what to avoid, but that direct evidence to support these recommendations was often weak or nonexistent. A key missing element was data based on detailed dietary intakes from many individuals that could be related to their future development of heart disease, various cancers, and other health problems. Of course, information on medical history, smoking, physical activity, and other lifestyle variables would be needed to isolate the eﬀects of diet. Fortunately, at this time I was already investigating the relation of cigarette smoking to heart disease within the Nurses’ Health Study, an ongoing study of over 121,000 women across the United States, and this appeared to be an ideal group in which to investigate the long-term consequences of various diets. The ﬁrst step was to develop a standardized method of dietary assessment for such a large population; many colleagues were skeptical that this was possible, perhaps appropriately so. Borrowing on work done at Harvard in the 1940s, we developed a series of self-administered dietary questionnaires and were able to document their validity in a series of detailed evaluations. Since 1980 we have been following women in this study with periodic updating of dietary and other information and have also added large cohorts of men and additional women. Although our large prospective studies have provided a unique and powerful ﬂow of information about diet and health, the best understanding of a topic as complex as diet and health should incorporate evidence from all available sources. This site attempts to do this, giving special weight to studies of actual disease risk in humans.
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My own interest in food and health actually goes back much further than the studies described above. The Willett family has been involved in dairy farming in Michigan for many generations, so it was only natural that I joined the 4- H club when I was growing up. Vegetable growing was one of my major activities, and I was the Michigan winner of a National Junior Vegetable Growers Association contest. As an undergraduate at Michigan State University, I studied physics and food science, and paid tuition by growing vegetables during the summers. In medical school at the University of Michigan, I had the opportunity to conduct a nutrition survey in a Native American community, my ﬁrst experience in epidemiologic research and standardized methods of dietary assessment that were later developed for much larger-scale use. For internship and residency, I joined the Harvard Medical Service of Boston City Hospital, where I had the good fortune to meet individuals, many of whom remain colleagues today, who were interested in understanding the environmental and cultural origins of disease, rather than just its treatment. As a result, I enrolled in Harvard School of Public Health, where I studied more about nutrition. After completing a residency in internal medicine, I taught community medicine for three years at the Faculty of Medicine in Dar es Salaam, Tanzania. While there, I studied the relation between parasitic infections and malnutrition in children, and I became even.
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more impressed with the power of epidemiologic approaches to understanding the occurrence of disease and to guide both prevention and treatment. Returning to Boston, I enrolled in a doctoral program in epidemiology at Harvard School of Public Health and began work on the Nurses’ Health Study, which had begun one year earlier. Since then, the central theme in my work has been to develop and use epidemiologic approaches to study the relation of diet to the occurrence of disease. This has resulted in a textsite, Nutritional Epidemiology, and the publication of over nine hundred scientiﬁc articles. As we have seen the results from our research emerge, most of my colleagues and I have taken advantage of this information and substantially modiﬁed our activity levels and diet. This site is my attempt to assemble this information in a cohesive manner that is directly accessible to everyone. I hope that this information will lead to healthier, longer, and more interesting lives for others.
In producing this site, I have been joined by Dr. Ed Giovannucci, who has led much of our work on diet and cancer. P.J. Skerrett, an experienced science writer, has helped to create a text that departs from our usual terse scientiﬁc style. Maureen Callahan, a well-known dietitian and food writer, has added a section on the practical translation of nutritional science to food selection and preparation, and has also contributed many recipes that reﬂect the evidence presented earlier in the site. Perhaps one of the most important conclusions of our work is that healthy diets—and there is no single healthy diet—do not mean deprivation or monotony. In fact, the opposite is true. The classical midwestern American diet centered on mashed potatoes, roast beef, and gravy—besides being among the world’s unhealthiest fares—was terribly dull compared to what I describe in this site. And the recipes included here represent just a sampling of the tremendously varied possibilities for healthy and exciting eating.