“You are what you eat” is not just a motivational poster in your health class. It is chemistry. Every Red Bull, Twinkie, and pizza roll you eat literally becomes your blood, your brain tissue, your skin. Live on soda and Doritos and you are basically a vending machine with legs. When people say “balanced diet,” they do not mean balancing a doughnut in each hand. They mean your neurons need more than neon snack dust to function.1
- Percentage of U.S. adults who fail to eat enough vegetables: 911
- Pounds of added sugar consumed annually by the average American: 1262
- Nobel Prizes awarded for building your brain out of Pop-Tarts: 0
- Probability your mitochondria are working on a class-action lawsuit: 100 percent
Empty Calories: All the Buzz, None of the Brains
Empty calories are the diet version of clickbait. They look fun, they give you a quick rush, and then they leave you dumber and more depressed than before. Soda, candy, fried dough, you get the sugar high, your brain gets nothing.
Brains are high-maintenance. Omega-3s build neuron membranes.3 B vitamins manufacture neurotransmitters.4 Leafy greens keep memory sharp.5 Trade those for energy drinks and snack cakes, and you get mood swings, anxiety, and an attention span shorter than a TikTok clip of a squirrel.
- Risk increase of depression in teens who live on junk food: up to 80 percent6
- High schoolers who slam at least one sugary drink every day: 65 percent7
- Problems solved by Skittles: 0
- Likelihood your neurons are Googling “How to transfer hosts”: very high
Why the Government Plays Sneaky Chef
Public health eventually gave up on waiting for people to eat sensibly. Instead, it just started fixing the food supply.
- Fortified: adding nutrients never there (Vitamin D in milk to stop rickets)8
- Enriched: putting nutrients back after processing stripped them out (iron in flour)9
- Fluoride: dumped in water because fixing nationwide cavities cost more than a space program10
These were not theory. They were panic moves against very real epidemics. In the early 20th century, inland America was a “goiter belt” with neck lumps the size of grapefruits. Salt iodization began in 1924.11 Within a decade, goiter rates collapsed by 90 percent.12 IQ scores in deficient regions jumped by a full standard deviation.13
Grand Rapids, Michigan tried fluoride in 1945. Fifteen years later, its 30,000 schoolchildren had 60 percent fewer cavities than nearby kids.14 Suddenly the rest of the country wanted in because a nation of toothless teenagers was not a great look.
In 1998, folic acid was added to flour and cereal. Neural tube defects like spina bifida dropped by 35 percent almost overnight.15 Canada saw a 46 percent reduction.16 The U.S. still prevents about 1,300 birth defects a year with this boring miracle.17ChangeListener
- Drop in goiters after U.S. salt iodization: 90 percent12
- IQ points saved nationwide: millions13
- IQ points lost explaining iodization to Uncle Rick at Thanksgiving: infinite
- Number of dentists who cried tears of joy after fluoride: all of them, every single one
What Happens When Governments Do Nothing
When officials back off, old diseases come roaring back like sequels nobody asked for.
In sub-Saharan Africa, where salt is not consistently iodized, children still grow up with goiters, lower IQ, and developmental delays.18 In Afghanistan, anemia in women is among the highest in the world because staple foods are not fortified with iron.19 In U.S. cities that remove fluoride, kids develop 25 percent more cavities than their peers.20
- Children worldwide with preventable brain impairment from iodine deficiency: 18 million18
- Pregnancies affected by neural tube defects in the U.S. before fortification: 4,100 annually15
- Pirate-era diseases on standby for their comeback tour: scurvy, rickets, pellagra
- Probability your great-grandpa fought both World War I and rickets simultaneously: uncomfortable to consider
How the U.S. Stacks Up (Mediocre Is Our Brand)
The U.S. is better than some, worse than others. We fluoridate water, we enrich flour, we add Vitamin D to milk. But we also flood the food supply with high-fructose corn syrup like it is our national identity.
About 74 percent of Americans drink fluoridated water, similar to Ireland and Singapore.21 Less than 10 percent of European Union countries fluoridate, though some fluoridate table salt instead.22 Roughly 90 countries mandate flour fortification.23 Costa Rica went full overachiever and fortifies rice, sugar, and milk too.23 The U.K. stalled until 2021, costing thousands of babies their shot at a healthy start.24
- Percentage drop in neural tube defects in Canada after folic acid fortification: 4616
- Birth defects prevented annually in the U.S. thanks to fortification: 1,30017
- Countries mandating flour fortification: about 9023
- Odds your breakfast cereal has done more for public health than Congress: approaching certainty
Why People Reject It (Spoiler: It’s Not Science)
Resistance usually comes down to trust issues. Fluoride sounds like a Marvel villain. Fortification sounds like dystopian government meddling. People hear “chemical” and think “poison,” ignoring that water, oxygen, and literally their own skeletons are chemicals.
Europe calls fluoridation intrusive, so it pays for universal dental care.22 The U.S. cancels fluoride and shrugs while cavities skyrocket.20 Ten percent of Americans think fluoride is dangerous.25 Ninety-seven percent of scientists disagree.25 Meanwhile, TikTok influencers peddle “natural toothpaste” recipes that would make a medieval barber-surgeon blush.
- Americans who believe fluoride is unsafe: 10 percent25
- Scientists who say it prevents cavities safely: 97 percent25
- TikTok coconut oil toothpaste tutorials: infinite, all shot in suspiciously clean kitchens
- Chance your dentist screams into a pillow after every patient says “I don’t use chemicals”: 100 percent
Food, Fascination, and Food Deserts
Food is not just survival. People are endlessly fascinated by it, and they are also painfully clear about what they will or will not put in their mouths. Kale smoothies? Maybe. Crickets? Probably not. That mix of curiosity and stubbornness makes food one of the most personal parts of public health.
But fascination is not the same as access. Entire neighborhoods exist where fresh produce, whole grains, or lean proteins are nearly impossible to buy. These are called **food deserts**, and they are linked with higher rates of obesity, diabetes, and diet-related disease.26 Solutions include investing in grocery infrastructure, subsidizing fresh food markets, and rethinking how zoning laws favor fast food over healthy options.26
If food is our most universal language, the more we can share it across neighborhoods, cultures, and classes, the better we will all be. Sharing food is not just hospitality. It is survival, equity, and connection.
- U.S. census tracts classified as food deserts: about 6,50026
- People living in them: more than 19 million26
- Probability your local gas station has more candy than fruit: absolute certainty
- Odds humanity gets along better if we eat together more often: higher than kale’s popularity deserves
The Bottom Line: Pay Now or Suffer Later
These interventions are not glamorous. They are not Instagram-worthy. They are **boring, invisible wins**. But they prevent millions of cavities, birth defects, and cases of intellectual disability every year. They were not dreamed up in labs to control the masses. They were invented because kids were growing goiters, babies were being born with preventable conditions, and dentists were tired of forging metal in people’s mouths like medieval blacksmiths.
Skip them, and you do not get freedom. You get rickets, scurvy, and children with the medical problems of Victorian chimney sweeps. You are what you eat. And thanks to public health, even if you insist on being 40 percent Dorito, you at least get a side of vitamins with your freedom fries.
- Probability rickets becomes “retro chic” if fortification ends: disturbingly high
- People nostalgic for goiters: 0
- Future historians who will thank boring food policies: every single one
- Calories burned arguing about fluoride on Facebook: 2, not worth it
- Estimated time before someone suggests essential oils can cure iodine deficiency: already happened
And because food is everyone’s business, I’d love to keep this conversation going. Feel free to jump into the comment section here, visit me at www.boulderpsychiatryassociates.com, or just stop by if you are in town. Boulder is a beautiful place, and food is even better when it is shared.
References
- U.S. Department of Agriculture, Dietary Guidelines for Americans, 2020–2025. Washington, D.C.: USDA, 2020, p. 45. ↩
- Centers for Disease Control and Prevention, “Sugar-Sweetened Beverage Consumption Among Adults,” MMWR, Vol. 70, No. 3, 2021, pp. 91–96. ↩
- Hibbeln, J. R. et al., “Seafood Consumption, the DHA Content of Mothers’ Milk and Prevalence Rates of Postpartum Depression,” Journal of Affective Disorders, Vol. 69, 2002, pp. 15–29. ↩
- Kennedy, D. O., “B Vitamins and the Brain: Mechanisms, Dose and Efficacy,” Nutrients, Vol. 8, No. 2, 2016, p. 68. ↩
- Morris, M. C. et al., “Consumption of Green Leafy Vegetables and Age-Related Cognitive Decline,” Neurology, Vol. 90, No. 3, 2018, pp. e214–e222. ↩
- Jacka, F. N. et al., “Association of Western and Traditional Diets with Depression and Anxiety in Women,” American Journal of Psychiatry, Vol. 167, 2010, pp. 305–311. ↩
- CDC, “Youth Risk Behavior Surveillance — United States, 2019,” MMWR Surveillance Summary, Vol. 69, No. 1, 2020, pp. 1–83. ↩
- Holick, M. F., “Vitamin D Deficiency,” New England Journal of Medicine, Vol. 357, No. 3, 2007, pp. 266–281. ↩
- U.S. Food and Drug Administration, “Enriched Flour and Fortification Standards,” Federal Register, 21 CFR §137.165, 1996. ↩
- McDonagh, M. S. et al., Systematic Review of Water Fluoridation, York: NHS Centre for Reviews and Dissemination, 2000, p. 27. ↩
- Marine, D., and O. P. Kimball, “The Prevention of Simple Goiter in Man,” Archives of Internal Medicine, Vol. 44, No. 2, 1929, pp. 274–304. ↩
- Hetzel, B. S., The Story of Iodine Deficiency: An International Challenge in Nutrition. Oxford: Oxford University Press, 1989, pp. 88–94. ↩
- Field, E., R. Glennerster, and S. Nazneen, “Salt Iodization and the Rise in IQ,” NBER Working Paper No. 19233, 2013, pp. 12–15. ↩
- Dean, H. T., “Fifteen Years of Community Water Fluoridation,” Public Health Reports, Vol. 72, No. 5, 1957, pp. 492–493. ↩
- Centers for Disease Control and Prevention, “Recommendations for the Use of Folic Acid,” MMWR, Vol. 47, 1998, pp. 1–14. ↩
- De Wals, P. et al., “Reduction in Neural-Tube Defects after Folic Acid Fortification in Canada,” New England Journal of Medicine, Vol. 357, 2007, pp. 135–142. ↩
- Crider, K. S., et al., “Folic Acid Food Fortification — Its History, Effect, Concerns, and Future Directions,” Nutrients, Vol. 3, 2011, pp. 370–384. ↩
- UNICEF, The State of the World’s Children 2019: Children, Food and Nutrition. New York: UNICEF, 2019, pp. 102–107. ↩
- World Food Programme, “Afghanistan: Nutrition Country Profile,” WFP Report, 2018, pp. 5–9. ↩
- Neidell, M., “Public Health Effects of Dental Care Fluoridation in the United States,” Journal of Public Economics, Vol. 92, 2008, pp. 224–245. ↩
- CDC, “2018 Water Fluoridation Statistics,” National Center for Chronic Disease Prevention and Health Promotion, 2019. ↩
- Petersen, P. E., and B. Lennon, “Effective Use of Fluorides for the Prevention of Dental Caries in the 21st Century,” Community Dentistry and Oral Epidemiology, Vol. 32, No. 5, 2004, pp. 319–321. ↩
- Food Fortification Initiative, “Global Progress on Flour Fortification,” Atlanta: FFI Report, 2020, p. 3. ↩
- Wald, N. J. et al., “Folic Acid Fortification in the United Kingdom: Time to Act,” Journal of Medical Screening, Vol. 15, 2008, pp. 1–3. ↩
- American Dental Association, “Fluoridation Facts,” Chicago: ADA Press, 2018, pp. 21–25. ↩
- Walker, R. E., Keane, C. R., and Burke, J. G., “Disparities and Access to Healthy Food in the United States: A Review of Food Deserts Literature,” Health & Place, Vol. 16, No. 5, 2010, pp. 876–884. ↩
