The primary underlying issue driving negative health outcomes is energy toxicity, or excess energy intake.

“what you're dealing with is just extra energy because regardless because people will say well you know we did the the food guide pyramid and people did it and everybody got sicker people kind of did it they they didn't really do it because the food guide perit also said exercise and reduce your calorie consumption um so yeah they they add in more carbohydrates but they really didn't decrease their fat intake either uh and so yeah as we added more calories we had more of these problems”