Dear all:

I think the point that I have been trying to get across has crystallized -- that certain items in a diet may be necessary, but not sufficient for good health and this very much does depend on the environment.  

So, in responding to Deborah's comments about what happens in certain areas of the world where food choices are limited, my main point is that while one must eat enough REAL foods (as opposed to NONfoods) that alone may not be SUFFICIENT for good health.  

You can follow all of Micheal Pollan's rules (which I actually like) and still end up with an unhealthy diet.  I am not a big fan of the "Nutrification of Food" which focuses on individual nutrients, yet the science which looked at individual nutrients helped to reduce some of the more common nutrient deficiencies that occurred when we polished rice (beriberi), introduced corn as a monocrop (pellagra), explored the world in ships without fresh fruits and vegetables (scurvy) and migrated to areas where sunlight is restricted during months of the year (rickets), and populated areas where green leaves and orange vegetables and fruits are hard to grow and livestock have become depleted (xerophthalmia). 

At the same time, I would argue that nutrition is more than just the food you eat.  Any chef can tell you that how the food is presented and the environment in which you eat it matters to your perceptions and enjoyment of that meal.   

And in thinking about the gut -- there are many aspects to its health including the balance between inflammation and overgrowth of harmful bacteria, fungus and parasites.  As others have mentioned recently, malnutrition itself makes it hard for absorption to occur and severely malnourished individuals often must start to eat more calories slowly lest they trigger episodes of vomiting or diarrhea which will further exacerbate the malnutrition.

Sincerely, 
Susan E Burger, MHS, PhD, IBCLC

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