Eatin’ Like In Sweden

Today the nutrition community is all in a frenzy over the release of the highly anticipated (and overdue) Dietary Guidelines for Americans, 2015. [I like that they tried to hide their tardiness by calling this 8th edition the “Dietary Guidelines for Americans 2015-2020.” Maybe they were hoping to buy themselves another year or two?] While the nutrition community and pundits will debate the effectiveness or science base or applicability of the updated Guidelines, I’ve decided for the time being to defect to Sweden – dietarily, anyway.

Don’t get me wrong, I have a deep respect for the Dietary Guidelines process and how it will be applied in nutrition policy. And I will pore over the 2015 revision in due time and make my own conclusions about those. But I can’t help but think that we could do a much better service to health professionals and the general public with simple guidelines. Like this one-minute summary of the Swedish Dietary Guidelines:

Key messages from the Swedish dietary guidelines

Here’s why I like it:

• The messages are clear. Have more of this, less of that, and make better choices like these.
• The messages are positive. There’s no language like “never” or “don’t” as in “don’t eat sweets.” Because let’s face it, we all like to treat ourselves every so often (just not too often).
• The messages imply that all foods are in relation to one another…and that’s how we eat. We tend to get stuck on the notion of an “ideal” diet. But the fact is, we’re all human and we all have different ways we approach food – and likely different ways we metabolize food. The best approach I think is to consider individual food items in relation to one another.
• This takes a mindful approach to food, which is key to healthy eating. Making food decisions, a person could take this tool and think to themselves: could I add more broccoli to this meal? Should I have a glass of wine with dinner tonight given I had two glasses last night? That’s being mindful and thoughtful about what you eat when you’re eating. Even the healthiest eater could likely stand to eat more vegetables and less salt. Show me someone – anyone – who is counting up all their sodium values from Nutrition Facts labels to ensure they’re staying within their 2,300 mg daily limit. Right…I thought so.

I applaud the 2015 Dietary Guidelines Advisory Committee on its science-based review of the latest evidence and for compiling its tome of a recommendation to the U.S. Department of Health and Human Services and the U.S. Department of Agriculture. And I appreciate the time and effort taken by our government officials to take those recommendations into consideration as they set nutrition policy. But next time, can’t we just keep it simple, like the Swedes? Tack.

 

Photo credit, cover photo: by Carlos Porto. Published on 13 June 2010
Stock photo – Image ID: 10017690

MyThoughts about MyPlate

Today, Agriculture Secretary Tom Vilsack, along with First Lady Michelle Obama and Surgeon General Regina Benjamin, unveiled the new icon replacing the food pyramid, which first debuted in 1992. These icons are designed to translate the complex Dietary Guidelines into a simple, “how-to” guide for following a healthier diet. The most recent pyramid, unveiled in 2005 as MyPyramid, was widely panned by health professionals as too complex and not user-friendly.

The new icon is called MyPlate, and is a simplified version of the recommendations laid out in the Dietary Guidelines. I applaud the USDA and Obama administration for choosing a straightforward design which applies more directly to the act of eating. But I am concerned that the icon has been oversimplified. That said, here are “MyThoughts” about MyPlate:

Likes –

• The name: ChooseMyPlate. “Choose” implies empowerment, and that the responsibility for eating healthfully (and making behavior changes) ultimately resides with the individual.  “My” is a carryover from MyPyramid, which were actually 12 individualized pyramids based on age, sex and activity level. The “my” is a nod toward one’s individual dietary needs:  while the elements of every person’s plate would be the same, a toddler’s plate would look different from an adult male’s plate.
• It can apply both to a single meal as well as an overall diet, and just by a quick glance you get the main message of: make half of what you eat fruits and vegetables – slightly more veggies than fruits. I also like how exact measurements have been left off the icon…that the different food groups are really more or less relative to one another.
• The “Milk” group is back to being categorized as “Dairy,” which is a little more accurate about the foods you’d find in the group, such as yogurt and cheese. Calcium-fortified soymilk is also in this group, and while technically not a dairy product it is often a dairy substitute.
• The plate design makes it easier to visualize what to put on your plate at a meal. Many RDs, myself included, use a plate technique with clients to educate about portion and food groups. HOWEVER, many people are still eating meals on the go – in the car, in a carry-out bag or in some other convenient form – such as a sandwich. Using a plate approach still requires some imagination for translating the actual food one is eating into these categories.
• While there was a lot of discussion about physical activity no longer represented on the icon, I’m OK with that. This is meant to be a representation of how people should eat – other behaviors such as physical activity and practicing food safety principles can be a separate conversation.

Dislikes –

• Dairy appears to be an afterthought, and not a main component in one’s diet. Also, its shape is different from the others, making it difficult to envision how much dairy relative to other food groups a person should eat.
• “Protein” is ambiguous to the average American. Why they chose to do away with the more descriptive “Meat and Beans” group is beyond me. Protein is a macronutrient, whereas fruits, vegetables, grains and dairy are all foods. I’m glad they didn’t rename the grains group “Carbohydrates”!
• Fats have been excluded. Will this icon send an inadvertent message that fats don’t belong in our diets? The fat-free craze of the 1980s was a diet disaster and should not be repeated. People are still learning that certain fats do deserve a place in our diets, such as oils, seeds and nuts.
• Non-plateable foods such as soups, cereals and mixed dishes will be hard to translate into the new plate model. Consumers will need to “deconstruct” their foods to see how it fits into their daily needs.
• The plate represents an ideal – as it should – but it excludes other foods people eat, including items addressed in the dietary guidelines such as foods with added sugar and alcohol. Granted, MyPyramid also didn’t address these foods in the icon, either. While such foods/drinks should be limited and need not be a part of a person’s everyday diet, we cannot simply ignore these foods and pretend they don’t exist, particularly if we’re going with an icon we hope people will apply to their everyday dinner plates.

In general, I think the new icon is a good starting point to help consumers think about what they eat in a single eating occasion and as a whole. But it should not exist in isolation. Registered dietitians still need to translate what the icon means and apply it to individuals to help them meet their healthy eating goals.

If you’re interested in starting a healthy eating plan, let’s make an appointment! I work with individuals and families on adopting healthier lifestyles, weight loss and general wellness. Check out my website at http://www.enlightennutrition.com/ or contact me for more information.

Oh… “natural”

Yesterday I decided to treat myself to a rare manicure/pedicure and to try out a new-ish place near my home. I seriously doubt I’ll be going back. Not only do I have cuts in my cuticles, but this was the only nail salon I’d ever been to that didn’t have a wide selection of mindless magazines (yes, I love celebrity gossip but I limit my rag reading to airports, nail salons and the People magazine feed on my yahoo page). So, stuck in a vibrating massage chair that was making my pregnant belly a bit nauseous and in a dead zone of cell phone range so I couldn’t catch up on facebook or tweet away my boredom, I found myself stuck watching the television mounted on the wall almost directly in front of me. Typical of Saturday afternoon nail salon options, this TV was tuned to a station that was airing infomercial after infomercial. I was mildly amused by the SINGLE PIECE OF GYM EQUIPMENT that you need to use JUST 6-8 MINUTES A DAY (hey, if Chuck Norris, Christie Brinkley and Steve Guttenberg say it worked for them…) and the 9-CD set of the greatest love songs ever recorded – all from the 1950s that could be mine, and if I call in the next 10 minutes… But then I really started to get annoyed when the information for a pain remedy came on.

This paid advertisement was done interview-style with two jock-looking middle-aged guys. The interviewer had a mildly Boston accent, but he barely got in a word edgewise over his interviewee, a “well-known health and wellness expert” (someone I’d never heard of) who wouldn’t stop raving about this product that supposedly cured his decades-long bout with pain as a result of a childhood surgery, his stint as an American Gladiator, and so on. The story goes that one day this guy was complaining about his pain to a friend, when a woman out of nowhere came up to him and said, “you gotta try this.” After protesting that he’d already tried everything, he told the lady he’d try her pill. After 2-3 weeks of taking this pill from a stranger and feeling no different, one day he realized he was sleeping better and, gosh darn it, he had no more pain. Now, I’m not sure I’d be so trusting of a stranger handing me pills I’d never heard of before, and then taking them daily for weeks at a time, but logical arguments have no place in infomercials.

What apparently sets this particular pill apart from the others he’d had tried is that it was totally natural, did not have claims that other, gasp, DRUGS, carry with them and so forth. In fact, he harped about all-natural, bashed pharma, and spoke about God and fate and so on. He was actually somewhat convincing, which was both scary and making me angry.

The problem with this infomercial – and in general with taking things at face value – is that this story is completely one-sided and so completely distorted the facts. Let’s break down two of the most egregious points:

1. This product is all-natural, with ingredients created by God, so it’s better than pharmaceutical treatments. WRONG. There are plenty of things found in nature – even things that seem to be edible – that are in fact very poisonous. Look at Arsenic, an element found on the periodic table (doesn’t get more basic than that). Or holly berries – look luscious but are toxic. Or oleander – a beautiful flower that is completely poisonous…even burning it can cause damage to one’s lungs.

2. Pharmaceuticals have terrible side effects – just watch the commericals…it’s laughable. Some even say this drug can result in death! That’s because the pharmaceutical industry, which is heavily regulated by the Food and Drug Administration, is REQUIRED to disclose all potential side effects uncovered after rigorous, years-long research. Supplements and herbal remedies such as this product have no such oversight. It’s truly buyer-beware.

Why did this infomercial strike such a nerve, and why am I devoting space to it on a nutrition-focused blog? Well, because I see similar waves of righteousness when it comes to food. More and more products in the marketplace are touting labels such as “all-natural” and the like. And while natural may be great, that doesn’t necessarily mean it’s better. Also, unlike “organic,” the adjective “natural” has no formal definition and is not regulated by government agencies (in comparison, in order for a product to carry an “organic” label, it must meet certain stringent requirements by the USDA, and other front-of-label claims must meet FDA labeling requirements).

I’m also sensitive to the issue given the recent discussions by an FDA advisory panel about artificial dyes in food. This will be the subject of another post, but to preview my initial feeling about this debate and last week’s outcome – I’m very concerned that we’re too quick to give health halos to “God-grown” food and disregard manufactured food. Thanks to the industrial revolution and advances in food manufacturing, we can have loaves of bread (tastier than chewing on a wheat kernel), homogenized and pasteurized milk and milk products (I for one would rather not suck directly from a cow’s teat), and other creature comforts that are actually good for you despite being milled or manufactured in a processing plant. We have also made huge public health strides by reducing instances of birth defects thanks to fortifying enriched wheat products with folic acid, and reducing preventable mental retardation due to iodide deficiency by adding iodine (another periodic table element) to salt.

While I don’t argue that a fresh picked apple is more nutritious than a vitamin-c-enriched fruit roll-up, or that we shouldn’t question current policies due to new advances in research, I do feel like we all need to take a big, deep breath, stop pointing fingers at “bad” industry/government and instead do the best you can with the information you have today. Trust the experts who make it their jobs to learn more about food, health and safety – not the stranger who hands you a miracle pill – and do your own research as well. And just because it came from the Earth doesn’t necessarily mean it’ll keep you healthy.