There’s no conspiracy against healthy eating

R.F.K. Jr.’s favorite mitochondrial dysfunction book is full of surprisingly banal advice — and weird lies about American health care

MoMo Productions

Like many normal people, I was taken aback by Health Secretary Robert F. Kennedy’s claim that he can diagnose mitochondrial dysfunction in children by glancing at passersby. Kennedy said during a press conference that “I’m looking at kids while I walk through the airports today, as I walk down the street, and I see these kids that are just overburdened with mitochondrial challenges, inflammation. You can tell it from their faces, from their body movement, and from their lack of social connection.”

How can he possibly do that? X-ray vision?

Courtesy of actual medical doctor Rachael Bedard’s great explainer for The Argument, I came to understand that Kennedy is paraphrasing arguments pioneered by Dr. Casey Means in her book “Good Energy: The Surprising Connection Between Metabolism and Limitless Health.” I suspect these ideas were conveyed by her brother, Calley Means, a top Kennedy aide.

You’re not supposed to judge a book by its cover, but I do think it’s fair to judge a book at least a little bit by its title, and my initial reaction was that it doesn’t seem at all “surprising” to suggest that there’s a link between metabolism and health. In fact, “Diet and exercise are important determinants of health” is probably one of the most widely known facts about biology. Certainly more people know that than can tell you what a mitochondrion is.

But Means challenged me to actually read the book before judging, and so I did. My verdict after finishing: It’s bizarre.

In the early 18th century, people thought that fire occurred because phlogiston was released into the air in the presence of heat. This is, of course, totally at odds with our modern understanding of fire. Still, if you asked a guy in the early 18th century to build a fire, he could do it, despite this misunderstanding of the basic physics. In fact, the average fire-building competency in the early 18th century was almost certainly dramatically higher than it is today since that was the main way to cook and stay warm. The scientific microfoundations of combustion are just not that relevant to building a fire.

By the same token, if you approach Kennedy’s statement in the spirit of Kuhnian acts of radical translation, he’s basically saying that he sees a lot of kids who are overweight and/or seem easily winded. And he’s right! I see the same thing, and current levels of childhood obesity are well-documented.

In the Means framework, obesity is by definition mitochondrial dysfunction, so you can, in fact, diagnose it by eyeball. Crucially, Means isn’t arguing that the real solution to metabolic issues is some kind of targeted intervention that pinpoints the mitochondria. The key advice dispensed in “Good Energy” is that to maintain mitochondrial health and avoid chronic disease, you should … eat a healthy diet consisting primarily of whole foods, exercise regularly, get a good night’s sleep, minimize consumption of drugs and alcohol, and try to reduce stress.

To the best of my knowledge, this is good advice, and its goodness doesn’t hinge on whether any of this stuff really mediates mitochondrial function. In fact, nothing the book says about organelles or metabolic health is all that interesting.

Rather, what’s striking about the book is Means’s blatantly untrue claims about the American government and medical establishment.