Today’s Atkins diet and its low-carb cousins, including the South Beach Diet and the Paleo Diet, are modified versions of what our ancestors might have eaten prior to the Neolithic Revolution. Atkins perhaps erred too much toward protein in his effort to reduce carbohydrate intake—according to studies of modern hunter-gatherers, foraged plants usually make up the majority of the calories in the diet—but the focus on reducing processed carbohydrates seems to be in line with what we know about what our ancestors would have eaten. It wasn’t until the time of the Natufians that grain accounted for a significant fraction of the diet, and that was soon followed by cultivation, as we saw in the previous chapter. Contrast that with the modern diet, where almost all of our calories come from processed carbs and fat, and you can see how far we’ve strayed from a diet that worked very well for millions of years of hominid evolution.
Of course, starches are better for you than processed sugar. Although sugar extracted from sugarcane, native to New Guinea, has been used by cooks in Asia for thousands of years, the large-scale production of sucrose had to wait until the Industrial Revolution. Before that, Europeans had used honey as a sweetener, and the complex blend of sugars present in honey, as well as its vitamin, mineral, and antioxidant content, made it relatively healthful. It was also fairly rare and quite expensive, and was used as only a very small part of the diet. Industrially produced sucrose, on the other hand, contains nothing but sweet calories; it’s perfect for making desserts but adds nothing else to the diet, apart from calories. Industrial production made sugar cheap and plentiful, and soon it was being added to more than desserts.
In Fast Food Nation, Eric Schlosser describes the fiendishly complicated science of flavoring processed foods. Chemical additives, natural extracts, and sugar are all added to food products that once would have been consumed au naturel. Sugar, in particular, supplements the tastiness of certain otherwise “bland” foods—it is added to chicken nuggets, hamburger buns, and hot dogs in order to make them taste “better.” And don’t forget the ketchup—one-third of it is sugar. No wonder children love to slather it on everything from French fries to fish sticks. But it’s nothing compared to the humble milk shake, which contains massive amounts of sugar as well as a stunning array of added flavorings. “A typical artificial strawberry flavor, like the kind found in a Burger King strawberry milk shake,” Schlosser points out, contains these ingredients:
amyl acetate, amyl butyrate, amyl valerate, anethol, anisyl formate, benzyl acetate, benzyl isobutyrate, butyric acid, cinnamyl isobutyrate, cinnamyl valerate, cognac essential oil, diacetyl, dipropyl ketone, ethyl acetate, ethyl amylketone, ethyl butyrate, ethyl cinnamate, ethyl heptanoate, ethyl heptylate, ethyl lactate, ethyl methylphenylglycidate, ethyl nitrate, ethyl propionate, ethyl valerate, heliotropin, hydroxyphenyl-2-butanone (10 percent solution in alcohol), α-ionone, isobutyl anthranilate, isobutyl butyrate, lemon essential oil, maltol, 4-methylacetophenone, methyl anthranilate, methyl benzoate, methyl cinnamate, methyl heptine carbonate, methyl naphthyl ketone, methyl salicylate, mint essential oil, neroli essential oil, nerolin, neryl isobutyrate, orris butter, phenethyl alcohol, rose, rum ether, γ-undecalactone, vanillin, and solvent.
Extreme—yes. It’s only in the past few decades that science has been able to define the exact mix of artificial ingredients that fool the tongue into thinking it’s tasting a strawberry (heaven forbid we add real strawberries!). But sugar is the bigger culprit here, since it’s the most common food additive. The reason sugar is so suited to this purpose is that we are genetically programmed to enjoy its flavor. We have a particular taste receptor on our tongues that has been selected over millions of years of evolution to be excited by sucrose, fructose, and other sweet molecules. Why? Because when we were living as hunter-gatherers, long before the local fast-food restaurant existed, one way of telling whether something was good to eat was through its flavor. A bitter taste—which we also have a specific receptor for—meant the possibility of poisonous substances in the food. Think cough syrup or, for those of you old enough, paregoric; chemically intense substances can kill in large doses, so it pays to have a fail-safe mechanism to detect them and prevent us from eating too much of them. But sweet meant safe—think of ripe fruit. By adding sugar, the industrial food producers are tricking our tongues into thinking we’re stuffing into our mouths something that’s good for us. That’s why as children we universally like sweet food but typically develop a taste for bitter foods only much later in life. When was the last time your five-year-old asked for a piece of aged, smelly cheese or a shot of espresso? It takes time to develop the taste sensations that allow us to appreciate more than the dominant bitter flavor in these foods, and to realize that despite millions of years of evolutionary conditioning, they aren’t going to kill us. Sugar, on the other hand, hits us in our evolutionary Achilles’ heel, and we can’t resist its charms.
The ready availability of processed sugars and starches, coupled with an increase in fat consumption—fat being another evolved taste signal that food is “good”—has raised the number of calories in the typical Western diet by around 15 percent in the past forty years. Add to this a steady decline in the level of activity over the past century as cars have replaced walking and people have moved from jobs requiring physical activity to those that are more sedentary, and it’s no surprise that obesity rates have risen nearly tenfold during that time.
Clearly, we are experiencing an epidemic that ultimately has its source in our culture. The industrialization of food production and the reduction in human mobility are relatively recent phenomena, but the diseases that afflict us today are the results of a wave that started back in the Neolithic era. The farmers at Mehrgarh, with their widespread tooth decay, were an early indicator of what would come later. Agriculture—the first form of industrialization, in food production—and, later, mechanical industrialization were unstoppable forces that seemed to take on a life of their own. It’s as though agriculture were a virus, expanding in influence despite its negative effects on human health. And it’s just begun—diabetes is projected to be one of the major killers in the United States by 2050, and more than a third of the children born in the year 2000 will develop it in their lifetimes. Add this to hypertension and cancer and you have the three global killers of the future. According to the World Health Organization, noncommunicable disease will account for more than three-quarters of the global health burden by 2020, up from around half in 1990 and virtually none a few hundred years ago. A wave indeed, and one that is still building.
FIGURE 20: INCREASE IN THE PREVALENCE OF OBESITY OVER THE PAST CENTURY. FIGURE COURTESY OF LORENS HELMCHEN, WHO COMPARED UNION ARMY VETERANS OF THE CIVIL WAR TO MODERN AMERICAN MEN. NOTE THE USE OF THE LOGARITHMIC SCALE ON THE VERTICAL AXIS.
BACK TO TENNESSEE
All of this was passing through my mind as I walked around Dollywood in the heat of the Tennessee summer. The utter predictability of where we are headed in the next half century is perhaps the most surprising aspect. I’m reminded of a scene from the film A Fish Called Wanda where one of the characters is run over by a steamroller, even though he sees it coming from about a hundred yards away. He is frozen and apparently unable to move, and the steamroller slowly rumbles toward him, eventually flattening him into the pavement. The waves of disease set in motion by the Neolithic Revolution have this same sort of inevitability.
Ultimately, nearly every single major disease affecting modern human populations—whether bacterial, viral, parasitic, or noncommunicable—has its roots in the mismatch between our biology and the world we have created since the advent of agriculture. Malaria, influenza, AIDS, diabetes—all could only exist as significant global scourges in the modern world, with its high population densities, large populations of domesticated animals, and high levels of mobility. A sobering fact, and one that should give us pause as we think about the future we are creating today.
Transgenerational power, the notion that I introduced in the last chapter, whereby actions
taken today can produce effects that last for many generations, can be a very difficult force to predict, and it’s not always clear what waves will be created and where they will strike. For instance, who would have predicted that food-preservation methods using salt—brining and pickling—would have led to an epidemic of stomach cancer in the early twentieth century, which then, after the invention of refrigeration and a reduction in the consumption of salted food, became one of the rarer cancers in much of the world? Or that the development of the American suburb in the 1950s, intended to create a healthier lifestyle for working-and middle-class families by moving them out of crowded city centers and into open parkland on the urban periphery, would become a contributing factor in the obesity epidemic by producing longer automobile commutes to work? Looking to the future, what will be the long-term effects of having more people over the age of sixty than under the age of twenty, as happened in many western European countries—for the first time in human history—early in the new millennium? An increase in diseases of the elderly, surely, but also perhaps social unrest as the pension crisis hits and the shrinking pool of young workers is forced to bear the burden of caring for the older generation. Ultimately, though, these are relatively short-lived trends, playing out over the course of a couple of generations. What about trends that take place over hundreds or thousands of years—how can we make predictions about these?
What, for instance, are the long-term trends in human disease? We will look at some possibilities in Chapter 5, but for now we need to consider another growing trend: a different sort of disease, but one that is increasing at rates similar to that of diabetes. According to the WHO, mental illness will be the second biggest cause of death and disability by 2020. Yes, the second biggest, superseded only by heart disease. Over 400 million people around the world are afflicted by illnesses ranging from epilepsy to schizophrenia to depression. Suicide rates are climbing; over 1 million people every year take their own lives, more than are murdered or killed in wars. And which countries are leading the way, with rates of depression and anxiety that are unrivaled in the rest of the developed world? America and Japan—perhaps the most technologically advanced societies on the planet, and among the richest. Clearly, technology and affluence alone don’t make people happy. The alarming trend in declining mental health is what we’ll look at next.
Chapter Four
Demented
Few topographical boundaries can rival the frontiers of the mind.
—SALMAN RUSHDIE,
Imaginary Homelands
We all face the same way, still it takes all day.
—THE STEREOPHONICS,
“Traffic”
MARIA GUGGING, AUSTRIA
I stepped off line 4 of Vienna’s U-Bahn at the Heiligenstadt terminus and walked upstairs, out into the chilly November air. This underground railway stop is a busy transportation hub, with buses connecting the city to outlying areas, and commuters to-ing and froing in the gray morning light. I was immediately surrounded by people rushing to appointments or the shops, tugging coat collars up around their necks to keep warm. I was not here for a business meeting or to run an errand, though. Rather, I was headed into the northern Vienna suburbs on a somewhat unusual quest. After locating the right bus stand, I hopped aboard and paid, confirming with the driver in my rusty college German that the bus stopped where I needed to go.
The ride out of the city gave me time to emerge gradually from the touristy bustle of Mozart, Sacher tortes, and Viennese commuters. As the old Vienna Woods surrounded me and the villages rolled past—Kammerjoch, Leopoldsbrücke, and Klosterneuburg, with its massive castle looming over the road—I felt as though I was traveling back in time. After about half an hour I reached my destination, a small village named Maria Gugging.
The name Gugging is emblazoned in the mind of every Austrian, but not, perhaps, for the best of reasons. This is because Gugging is pretty much a one-shop town, like Cupertino, Anaheim, and Nashville. But unlike the hometowns of Apple, Disneyland, and country music, the business in Gugging is the human psyche. Maria Gugging is the home of the Lower Austrian Psychiatric Hospital. The hospital itself still evokes memories of an earlier, not-quite-so-enlightened time in the history of psychiatry—a time when there were hundreds of patients, sleeping fifteen or more to a room, with bars over the windows and only two doctors on staff. During the Nazi era, and in the early post–Second World War days, the aim was to remove “insane” people from the general population, to lock them away where they couldn’t do any harm to themselves or others. This goal has changed over the years as more sympathetic doctors have taken over from their less enlightened forebears. But walking the footpaths among the gray institutional buildings, especially on a cloudy late-fall day, I had a vague sense that the ghosts of lonely, tortured patients were watching me.
It was along one of these paths, about half a mile from the main gate, that I approached a smaller building nestled at the edge of the forest. I could tell that I’d reached someplace extraordinary because, uniquely among the buildings at Gugging, this one was covered in multicolored abstract art—a face here, a splash of seemingly random graffiti there, all rendered in a phantasmagoric, colorful style that created a vaguely childlike impression. It was this art, and the people who’d created it, that I was here to see.
Upon entering the building, accompanied by my guide, Nina Katschnig, I was confronted by one of the residents, who asked me for a cigarette. “They smoke too much, but what can we do?” she said, shrugging her shoulders. The man seemed disconnected from his surroundings, wrapped up in his own world, from which he emerged occasionally to exclaim or to ask a pointed question in guttural Austrian German. We walked on and entered a small kitchen area, where Nina introduced me to Dr. Johann Feilacher, a psychiatrist and artist, and the director of the building I was now standing in.
The Haus der Kunstler, or House of Artists, was created in 1981 as the Center for Art and Psychotherapy. The first residents at the center were eighteen patients from the hospital down the hill, a collection of schizophrenics, psychotics, and manic-depressives united by one thing: they were all very good artists. The goal of the center was to apply the theories of its founder, Dr. Leo Navratil. Navratil had come to the hospital as a psychiatrist in the 1950s, and during the late 1950s and early 1960s he began experimenting with art therapy, encouraging his patients to draw and paint as a form of treatment. After reading the books of the famous French surrealist artist Jean Dubuffet about the untrained art of children and the insane, Navratil contacted him about his own ongoing therapeutic work at Gugging. Encouraged by Dubuffet, he wrote the influential book Schizophrenia and Art, published in 1965.
Navratil thought that the minds of schizophrenics and other mentally ill people could provide an insight into the artistic process. He argued that schizophrenics are uniquely in touch with the font of creativity in a raw, untutored way that allows them to create “pure” art. According to Dr. Feilacher, who took over as director of the House of Artists in the early 1990s, after Navratil’s retirement, “Navratil believed that psychosis makes art—that every psychotic man or woman is an artist.” Navratil was clearly a man of his time, the 1960s and ’70s, with its emphasis on personal psychedelic journeys. The message that psychosis (whether drug-induced or not) can create art had an eager audience. The first public exhibition by the Gugging artists was in 1970, and after this their work became well known to the entire art world.
What actually goes on inside the heads of the mentally ill artists in Gugging is still the subject of much scientific debate. Some, though certainly not all, are schizophrenics. Navratil noted that some of them had low intelligence, often caused by brain damage in early childhood. Many had experienced extremely difficult upbringings, with poor educations and a history of neglect. This mistreatment is certainly a significant influence on their art, some of which is quite violent.
August Walla is an especially interesting resident, since he is one of the most famous of the
Gugging artists. Pieces of his work have sold for more than $10,000 and can be found in collections around the world. Walla lived with his disturbed mother and grandmother in a garden shed near the Danube for many years, collecting discarded items from the surrounding countryside and decorating the inside of the small building with fantastic paintings. There were never any male figures in his life, a conscious effort on the part of his mother to keep him isolated; as Feilacher explains, “His mother kept him as a child,” perhaps fearing for his safety if he strayed beyond the family’s odd, insular existence.
They lived in an open space of only about fifty square feet, with a cooking stove in the center surrounded by a mountain of rubbish. When Walla entered the House of Artists because his mother could no longer take care of him, she was admitted to the hospital down the hill. For his first ten years there, he refused to speak to any of the other residents, or to Dr. Feilacher, conversing only with his mother—a continuation of his fifty years of nearly total isolation from the rest of the world while living in the shed. During this time he also wrote on trees and decorated every space in his room—and eventually the outside walls of the building—with fantastic paintings, in a manic outpouring of creative energy. He remained, however, completely wrapped up in his insular family universe.
FIGURE 21: ADAM AND EVE IN PARADISE BY AUGUST WALLA.
When his mother died, at the age of ninety-seven, this changed abruptly. Suddenly Walla emerged from his shell and spent all day, every day, talking to anyone who would listen. He followed Dr. Feilacher around like a child for months, hounding him with an endless disjointed monologue. In effect, Dr. Feilacher, and then the rest of the inhabitants, replaced his mother. This manic phase, gradually less extreme as time wore on, lasted nearly ten years, until his death in 2001. Interestingly, during this part of his life Walla produced very little art of any substance—all of his great work stems from the earlier, insular period, as though the only way he could communicate with the world beyond his mother was by painting and drawing. Navratil felt that untrained artists such as Walla, cut off as they are from the rest of the world and oblivious to any notions of artistic training or concern for prevailing fashions, give an insight into the raw creative process. In effect, he said, insane people show us what we are all capable of if we can only throw off society’s constraints.
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