The “SAD” vs. Real Food

“Real” foods are those largely missing from the Standard American Diet (SAD) with its strong association with our chronic disease pandemic. In a nutshell, Americans eat too much highly-processed food and animal products and too little whole fruits, vegetables, legumes, nuts and seeds.

The average U.S. intake of fruits and vegetables is about three-fold under what is recommended for health. Diets centered on whole (Real) foods are associated with lower: blood-sugar, serum-insulin, stress hormones, inflammation, and risk of disease.

Chronic Disease and the Standard American Diet (SAD)

Why is type-2 diabetes, acquired from diet and lifestyle, impacting the health of about 30-percent of U.S. adults, with another 12-percent in the “pre-diabetic” range? Why are over 40-percent of U.S. adults classified as obese (BMI over 30). Why do 38-percent of U.S. seniors having a kidney problem? Where do our alarming rates of cancer, heart disease, auto-immune disease, 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 genetic. Because a parent was type-2 diabetic or had coronary artery disease does not pre-dispose a child to the same; in fact, that would be very unlikely.

Our pandemic of preventable chronic diseases are associated with daily habits and passions, our stress-producing environment, and what we put in our body. These include diet, lifestyle and epigenetic factors. The term epigenetic means an unhealthy environmental condition produces an abnormal gene expression, but the condition is not solely caused by genes

In Diet, Drugs, and Dopamine, (2025), David A. Kessler, M.D., lists chronic “disease” conditions linked to obesity and blood-sugar problems. They are generally symptoms of an underlying problem of metabolism — a problem at the cellular level (described on the page Insulin and Metabolic Disease). They are linked to the SAD. To be clear, Dr. Kassler is referring to:

• 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 few tools to overturn this paradigm, but “moderation” and half-measures have failed. Why? Addiction! It’s the “devil in the details.” The SAD meals fire the dopamine neurotransmitter creating longterm dependency and the longer a person lives within that dependent state, the more challenging will be the condition to permanently overcome.

The phrase  “lifestyle modification” is used a lot on this website. Sadly, that approach to health and healing seems impossible for our disease-care system to monetize, so they depend on drugs. For reversing obesity, the new GLP-1 (glycogen-like peptide-1) drugs offer amazing hope for avoiding chronic disease in the face of chronic obesity — provided there is lifestyle modification. But there’s a catch. The GLP-1 medications alone are “forever drugs,” meaning you never get Big Pharma out of your body or your wallet.

Deadly chronic diseases like type-2 diabetes and heart disease CAN be reversed and the need for medications CAN be dramatically lowered, or eliminated, with serious lifestyle modification, but the phrase “your food addiction” is something that kids and adults are unlikely to hear from providers.

The current monthly cost for the GLP-1 drugs Wegovy, Ozempic 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 how “obesity is a pediatric disease.” Kessler was head of the U.S. Food and Drug Administration and served as dean of the medical schools at Yale University and the University of California, San Francisco. The current pandemic of chronic diseases, which often begin with childhood addictions that lead to obesity, bares some comparison with how Big Tobacco was found to be 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.”

Kessler postulates that “at least 200” known conditions are exacerbated, specifically, by dangerous visceral and liver fat — meaning fat above the belt line.

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

SAD by the Numbers

Because of its addictive nature, people arrive at the grocery store with a sound plan, but leave with something very different in hand, a little extra to fuel the needy dopamine receptors, you might say. The car swerves radically to the curb and you make an extra stop to check out the deli/hot case. Instead of an amazing fresh, large, healthy, sweet apple for a snack, you also leave the store with a cookie and a SSB.

Food vendors — whether super-stores or a food-truck — are now Hazardous Terrain for most consumers. The ultraformulated SAD products change human behavior with engineered, ultra-palatable calories derived from inflammatory refined grain, oil, sugar, emulsifiers — but lack whole plant fiber.  Why? Very simple — the high fiber meals, say, the hearty vegetable-rich soup or big salad packed with antioxidants are LOW CALORIE, so they don’t produce the dopamine response and relieve the craving behavior, the addiction. 

Version 2024

Dr. Michael Greger and his team at Nutritionfacts.org has cooked-down SAD 2024 to its essence.

• Over consuming refined plant products — nutrient stripped white flour, sugar, refined oils:
  57-percent of SAD calories
• Over consuming animal products — meat, poultry, fish, eggs, and dairy:
  32-percent of SAD calories
• Under consuming whole plant foods — whole fruit, vegetables, legumes, nuts, seeds, etc.:
  11% of SAD calories

(Source: Nutritionfacts.org, 2024)

What the numbers above mean is the disease-promoting U.S. diet is excessive in meat and animal products and the ultra-refined — but we eat about three-fold too few whole vegetables, fruits, grains, legumes, nuts seeds, and so forth. And because the SAD tucker is formulated to be addictive, SAD consumers consume too many calories.

Estimates are that from half to 70-percent of U.S. families build daily nutrition on the SAD system and the average U.S. citizen consumes just a fraction of recommended level of fruits and vegetables. (The U.S. recommended daily intake for whole plant fiber is: 25 grams for women and 38 grams for men).

Beyond nutrition, the addictive SAD system has a colossal and expansive impact on our economy, cultural, and social fabric, ranging from strip-malls and gas stations to time spent with family. Choosing processed foods shorten the time we share with loved ones — preparing, eating, and cleaning up. The SAD weakens family social interactions and builds in children the same unhealthy dietary habits. This system of faulty (or faux) “nutrition” is now central to “America.”

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.

In our “obesogenic environment,” the A1c number is something we all should know and, preferably, keep it low.

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.