The “SAD” vs. Real Food

A SAD Primer

Refined

“Whole” is uncommon for those families who choose the Standard American Diet (SAD). To characterize this unhealthy, modern eating pattern:

Nearly 60-percent of SAD calories come from refined plant derivatives — such as refined flour products, sugar, and cooking oil;

 

Only about 10-percent of SAD calories come whole plant foods — fruit, vegetables, legumes, nuts and seeds, and so forth;

 

The remaining one-third of SAD calories are from animal products.

Popular

Despite its association with excessive weight, eating disorders, and chronic diseases, the highly refined SAD-style is routine for around 50 – 75-percent of U.S. households. 

Deficient

In the U.S., the consumption of those healthy whole fruits, diverse vegetables, legumes, nuts, seeds, etc. — is about three-fold under what is recommended for health.The lack of whole plant ingredients means frequent deficiencies: in fiber, vitamins, minerals and disease-fighting antioxidants.

Current estimates suggest that fewer than one-in-ten Americans consume the recommended daily level for fiber — 14 grams for each 1000 calories (Women: 25 grams/day ave.; Men: 38 grams/day ave.) and most who are overweight are also deficient in one or more vitamins or minerals.

Profitable

Of course, America’s tens-of-thousands of unhealthy food products are quite profitable. After all, they’ve been formulated for shelf-stability and repeat sales. Conversely, diets based squarely on whole (Real) food — that treat “refined” as exceptional and uncommon, rather than the daily rule — will generally be associated with lower: body-mass, blood-sugar, serum-insulin, inflammation, and risk of disease.

Chronic Disease and the Standard American Diet (SAD)

Why is type-2 diabetes, a condition acquired mostly from diet and lifestyle, impacting 12-percent of U.S. adults, with another 33-percent currently in the “pre-diabetic” range? Why are over 40-percent of U.S. adults classified as obese (BMI over 30). Why do one-third of U.S. seniors suffer from chronic kidney disease? Where do our alarming rates of cancer, heart disease, auto-immune disease, and dementia come from?

Each person is unique, of course, but these astonishing rates of life-shortening chronic disease published by the U.S. Centers for Disease Control are not in our genes. A parent having type-2 diabetes or coronary artery disease does not pre-ordain their child suffer the same, yet they may.

Our pandemic of preventable chronic diseases are associated with daily habits, our environment, stress, and what we do with our body (or don’t do), and what we put into our body. There might be difficult-to-avoid environmental factors, like pollution. Personal lifestyle, diet, sleep, exercise, social connection, etc. are also “environmental” factors. These environmental conditions are epigenetic — “on-top-of-genes.” Epigenetic factors produce abnormal genetic expression. Epigenetic changes to the body may include disease — or disease remission — but are not caused solely by the involved genes, the DNA.

The remarkable national statistics above mean the U.S. populous — on average — has sky-high chronic disease risk. We also experience related financial insolvency at astronomical rates. The Scheinman Institute at Cornell University reports that two-thirds of all U.S. bankruptcies are tied directly to medical expenses — about 550,000 annually.

As they graduate, become wage-earners, and start families of their own, this untenable prevalence of chronic illness, foreclosure, lower earning power, and debility will capture many of today’s child. So, a profoundly important question for school-community leaders, teachers and parents is: “What are we doing about this slow-rolling health catastrophe and how are schools preparing my child to avoid the same?” Clearly, the current answer is not enough.

In Diet, Drugs, and Dopamine, (2025), Dr. David A. Kessler recognizes “at least 200” chronic disease conditions as being linked to blood-sugar problems and excessive weight. These easily measured symptoms are commonly associated to the SAD eating pattern — frequent snacks, long ingredient lists, ultra-processed, and excessive refined carbohydrate-and-fat-calorie intake. That same SAD menu will lack dietary fiber, vitamins, minerals, and disease-fighting antioxidants. (described in greater detail under Carbohydrate Foods and Health and  Insulin and Metabolic Disease).

To be clear, Dr. Kessler is referring to conditions such as:

• Arthritis
• Cancer
• Blood Clots
• Type-2 Diabetes
• Hypertension
• Heart Disease
• Vascular Dementia
• Stroke
• Sleep Apnea
• Kidney Disease
• Elevated “all cause mortality”
• Infertility/Erectile Dysfunction
• Multiple Sclerosis

Nature gives us a few tools to solve these challenges, but “moderation” and half-measures have failed. Why? There is a devil in the details. In a very ancient sense, a highly refined SAD meal — calorie-rich providing a sudden spike in blood-sugar — is like hitting the survival jackpot. All animal are designed to find food and overcome calorie scarcity, including humans. So, metabolically speaking our modern SAD landscapes have become an environmental hazard — the deli, grocery store, gas station, refrigerator, and so forth.

And now for that “devil.” Dopamine is a brain neurotransmitter integral to all addictive behavior. Be it to food, a romantic attraction, heroin, nicotine — dopamine action in the brain is part of these urges and conversations.  Mark Lewis, Ph.D elegantly challenges the long-held clinical diagnosis that addiction is a disease. Addictions may be extremely unhealthy and socially unacceptable, but a teen-age romance, a new mother’s attraction to her child — and crack-cocaine, nicotine, and highly caloric foods — all are based on the brain’s dopamine action (The Biology of Desire (2016), Mark Lewis, Ph.D).

In the face of these powerful brain messengers and a media environment awash in urgent prompts, the full “lifestyle modification” approach becomes extremely difficult to accomplish. Moreover, lifestyle modification is (apparently) unprofitable for the disease-care system. Their treatment protocols are firstly designed around costly drugs, not lifestyle change. For example, the new GLP-1 (glycogen-like peptide-1) drugs offer amazing hope for weight loss and greater health — provided the client dumps the SAD-style eating, boosts daily exercise, lowers stress, etc. and so forth. GLP-1 medications are “forever drugs.” You never get Big Pharma out of your body or your wallet. Should you stop taking them, the urge to overeat returns with the same tenacity.

Of course, the focus needs to be on PREVENTION, THRIVING and DISEASE AVOIDANCE; yet, chronic diseases like type-2 diabetes and heart disease CAN be reversed in some cases. The need for medications CAN be dramatically lowered, or eliminated, with serious lifestyle modification. Providers aren’t likely to speak the words “your food addiction” to kids or adults. 

The current monthly cost for the GLP-1 drugs —

Wegovy, Ozempic, Zepbound, and Mounjaro range from $950 to $1,400.

Obesity is a Pediatric Disease

Dr. Kassler describes in detail the addictive properties of the SAD (for all ages), but clarifies how “obesity is a pediatric disease.” Kessler was head of the U.S. Food and Drug Administration under presidents Obama and Biden and later in his career served as dean of the medical schools at Yale University and the University of California — San Francisco. The current pandemic of chronic diseases — which is associated with profitable SAD-style food “preferences” in childhood and lead to obesity — bares some comparison with how Big Tobacco was predatory and culpable in the deaths of millions of Americans over generations.

“[Obesity] is a pediatric disease not only because children suffer from it, but because it has been foisted upon them by the architects of our obesogenic environment, who have ensnared us for their own profit. While we cannot deny treatment to young people already affected, we equally cannot allow the medical and pharmaceutical community to convince us that the best way – the only way – out of this crisis is their way.

 

We need a multifaceted approach to deal with this catastrophe – one that potentially involves medications but with a view toward a future of maintaining our children’s health without them – an approach that doesn’t shame people for their choices, and that doesn’t lose sight of the larger systemic issues at play that desperately need to be addressed.”

(from: Diet, Drugs, and Dopamine, David A. Kessler, M.D. (2025) Flatiron Books — pg. 52)

As noted previously, Dr. Kessler’s summary is that “at least 200” known chronic disease conditions are exacerbated, specifically, by dangerous visceral and liver fat — meaning fat above the belt line.

Choosing Your Heart

Recently, a slim, muscular 76 year old man — someone who had reversed his heart disease with the love of a great cook and by switching to a very low fat, plant-based diet — told me, “You have to choose your heart!” Disease reversal through dramatic lifestyle modification, in effect, is the road less traveled. To learn about that, look for the jump-links on “Reversal” under the menu Fats, Oil, and Health.

This “road less traveled” has us confronting some serious internal and external demons. The ultra-processed foods with long ingredient lists (and some without) are engineered for addiction and repeat sales. Those without the long ingredient lists might include good ol’ sugar, white flour, salt, and refined oils — the home-made pie and ice cream. The muffin or chocolate chip cookie. The SAD ingredients are close at hand.

The daily intake of these addictive, highly processed, ultraformulated edibles trip-up the insulin system — which then throws off the balance between other energy-intake (eating) hormones. The upset directly produces addiction, overeating, and chronic disease. It’s now a widely-used convention to name this eating pattern the Standard American Diet, however a more appropriate description is the Standard American Addictive Diet (SAAD). For a greatly simplified description of the “hormone hack” that produces food-craving and overeating, see Insulin and Metabolic Disease (under the Food and Health menu).

Understanding “Real” Food

A diet of Real food focuses on whole grains (instead of finely milled), colorful vegetables, tubers with their skins (not French fries), whole fruits rather than juice-only, seeds, nuts, legumes, wholesome meat, poultry, fish, dairy, eggs, and so forth. YOU, a friend or loved one prepares a hearty, healthful meal! “Real” has few ingredients, a stark contrast to the SAD with long ingredient lists.

Real food won’t cause food craving, highjack your thoughts and feelings or push your buttons. Real foods can’t elevate your stress level or your waist measurement, the exact outcomes of the ultra formulated SAD products.

This behavior manipulation (repeat sales) is reflected in the labels and language. Professional food-designers knowingly boosted product palatability and engages craving/addictive behavior. They adjust calorie content with the goal of sales and shelf-stability, rather than consumer health. We don’t want that for our children or for ourselves!

While virtually every aspect of American life is impacted by this Colossus, there is good news about Real food: Real food produces satisfaction (satiety), is lower in calories, has higher nutrient density, and it is difficult for body and brain it to over-consume.

Learn more about the hemoglobin-A1c number under Insulin and Metabolic Disease — select the jump-link “Glycation — Gummy and Tangled.” 

To learn more about insulin resistance and “hacked” eating behavior, see my YouTube: Insulin Resistance and Food Craving.