Processed or Ultra-Processed?

photo credit | gourmetmetrics

The best lasagna I ever ate was home made. Even the pasta! 100 grams durum semolina flour and 1 egg, diligently hand mixed, kneaded, then rolled into thin sheets with this cool little pasta machine I brought back from Rome one year. Pelati, canned whole peeled Italian tomatoes, olive oil, some garlic and onion, fresh basil and parsley, gently boiled down into a traditional marinara sauce. Fresh ricotta cheese. A mixture of ground beef and pork browned and seasoned. Layer by layer all that deliciousness was carefully arranged in my pan and baked to perfection in the oven. It was incredibly delicious! 

My home made masterpiece was a spontaneous event. I don’t even remember following a recipe although I had a general idea of ingredients before I set out. But I’ll never do it again. Why? Because the process took one whole day!

When I serve a lasagna these days, my choices are store prepared or store bought off the shelf. I’ve had good lasagnas, but I’ve never found a replacement that matches the taste of that lasagna I made myself. Not at least until recently …

Rao’s Made for Home, the same folks who produce a wicked good Marinara sauce, has gone into the frozen entrée business and one of their offerings is Meat Lasagna. 

Pre-prepared meal entrées are often disappointing because they are ultra-processed formulations of inferior ingredients intended to displace real food. Convenient yes. Delicious no. Never as good as the dish they intent to replace. But hope springs eternal, especially after a year of pandemic isolation, so I decided to give it a try. 

What a pleasant surprise!

What truly amazed me was the quality of the pasta. The taste and consistency of those sheets of lasagna actually reminded me of that lasagna I made by hand. It’s an amazing accomplishment because Rao’s Made for Home lasagna is a manufactured product, so by definition it’s both an industrial formulation and ultra-processed. Or is it ultra-processed?

INGREDIENTS

The ingredient list reads like a recipe for home made lasagna: Italian Whole Peeled Tomatoes (Tomatoes, Salt, Basil Leaf), Ricotta Cheese, (Milk [Whole & Skim], Vinegar, Salt), Pasta (Durum Semolina), Water, Beef, Mozzarella (Pasteurized Part Skim Milk, Cheese Cultures, Salt, Enzymes), Pork, Romano Cheese (Pasteurized Cow’s Milk, Cheese Cultures, Salt, Enzymes), Onions, Olive Oil, Egg, Salt, Spices, Garlic, Onion Powder, Garlic Powder. 

The ingredients are recognizable. And the label is beyond clean because no additives of any kind are listed. What isn’t on the label is as significant as what is. No modified corn starch, no natural flavor, no carrageenan, no gums. No messy additives to clean up!

The ingredients are top quality. Whole peeled Italian tomatoes are listed instead of tomato paste or purée. Fresh ricotta cheese instead of dry curd cottage cheese. And olive oil instead of canola or soybean oil.

Bronze cut does not appear in the ingredient list but the words can be found on the back of the box on the right panel. “Snuggled between every layer of bronze cut pasta …”. Those words bronze cut pasta are significant and may explain why the Rao’s lasagna reminded me of my hand rolled sheets.

Pasta has been made in Italy since the 13th century, but up until recently it was mixed and cut by hand. Manufacturers today use an industrial process called extrusion. The dough is mixed then forced through a mold or “die” which forms the familiar shapes we find on the grocers shelf: orecchiette, penne, lasagna. Most modern producers coat their dies in Teflon producing a smooth shinny pasta. Using bronze is the traditional method but its use fell out of favor because Teflon is cheaper. 

NUTRITION

Using current nutrient reductionist criteria, lasagna is not a healthy choice. Whether frozen and re-heated, served at the Olive Garden, or prepared at home with hand rolled lasagna sheets and carefully sourced ingredients, lasagna gets classified as “empty calories”. Too many grams of saturated fat and too many milligrams of sodium. 

There are other ways to think about what’s healthy and widen the focus however. Like ingredient quality. Or degree of processing.

TASTE

So why does the Rao’s lasagna remind me of my home made lasagna. Maybe it’s because of the whole peeled tomatoes or the fresh ricotta? Or maybe the bronze cut sheets of lasagna? Or maybe the olive oil? It’s not cold-pressed extra-virgin, but at least the oil is pressed or centrifuged from olives instead of rape seed or soybeans. 

Because taste is 100% subjective, I don’t know if you would like the lasagna as much as I did but two facts are indisputable. The lasagna is made with quality ingredients. And it costs twice as much as its competitors. 

SO IS RAO’S LASAGNA  PROCESSED OR ULTRA-PROCESSED?

There’s an argument to be made for either side. As per this 2019 commentary:  Ultra-processed foods are not ‘real food’. As stated, they are formulations of food substances often modified by chemical processes and then assembled into ready to consume hyper palatable food and drink products using flavours, colours, emulsifiers and a myriad of other cosmetic additives. 

The product is a formulation that is industrially made and mass produced. That’s why the product will taste exactly the same every single time. These are characteristics it has in common with Twinkies, Oreos, and Doritos.

However, the ingredients are real food. I’m being subjective here, but I don’t see the ingredients listed on the label as food substances. Or as Michael Pollan puts it “food-like” substances. Rao’s lasagna uses precisely the ingredients that I would use to make lasagna at home. No additives needed. No flavors, colors, emulsifiers, or any other cosmetic ingredients. Just real food.

I want to classify the product as processed because the taste is clean and the list of ingredients is simple and straightforward. But I can’t ignore the technological sophistication which guarantees that taste will be consistent in every box. So there you have it. Is Rao’s meat lasagna processed or ultra-processed? It all depends …

Bottom line, there are some wrinkles in the NOVA food classification system which will be need to be ironed out.

 

Where’s the Apricot?

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My favorite dried apricots are moist, flavorful, sweet, and the color of rusty golden brown. A perfect balance to a handful of dry roasted unsalted nuts.

Dried apricots are whole fruits with the water removed. They are flat, but still recognizable as apricots. Some products, like my favorite KIND bar, list apricots as an ingredient but when you open the package and look for the apricot, all you find is gooey sticky stuff.

That observation inspired this month’s post. Minimally processed versus ultra-processed. My favorite KIND bar versus a handful of dried apricots and nuts.

INGREDIENTS

Minimally processed dried apricots come in two colors. Rusty golden brown and vibrant orange. Most commercial dried apricots have been treated with sulfur dioxide, an additive that lightens the color, softens the texture, and extends shelf life. I prefer the darker color, however. They are harder to find but the taste is more complex and nuanced.

A dried apricot, whether sulphured or un-sulphured, still looks like an apricot. There’s an argument to be made that sulphured apricots are ultra-processed, but un-sulphured apricots clearly meet NOVA guidelines for minimally processed food.

My choice of nuts to compliment the apricots is whole dry roasted unsalted mixed nuts (almonds, walnuts, hazelnuts, pecans, macadamia). Ingredient count is 2 to 6 depending on if you count the mixed nuts as a single ingredient or if you count each kind of nut as a separate ingredient.

My KIND bar has more ingredients. Lots more ingredients. Listed in descending order by weight, I count 13: peanuts, almonds, glucose syrup, honey, apricots, sultana, rice flour, dates, flax seed, soy lecithin, sugar, sea salt. Two of these ingredients count as markers of ultra-processing:  glucose syrup and soy lecithin.

I can also see pieces of nut. But where is the apricot?

All I can see is that sticky gooey stuff holding the nut pieces together. The technical name for the sticky gooey stuff is a slurry and the slurry in my KIND bar must be a combination of purée fruits (apricots, sultanas, dates), added sugars, some starch, and an emulsifier.

Please don’t think I’m picking on the daring of the healthy snacking crew. A KIND bar is one of my favorite ultra-processed foods. When I’m on the run, it’s the first thing I reach for. KIND is also the company that successfully challenged the FDA’s criteria for healthy when the company filed a Citizen Petition back in 2015.

NUTRIENTS

Both the bar and the fruit & nuts are energy dense.

• 4.5 calories per gram for the KIND bar (10% water). An individually wrapped bar that weighs 40 grams clocks in at 180 calories.

• 4.2 calories per gram for a handful of dried un-sulphured apricots & mixed nuts (24% water). One handful of an equivalent weight of dried apricots and mixed nuts clocks in at 168 calories.

Both have similar nutrient profiles. KIND has a few more grams of protein; my handful of apricots and nuts a few more grams of fiber.

Both have an equally favorable fatty acid ratio.

TASTE

The KIND Fruit & Nut bar is dense and chewy. Peanut predominates and I can taste that sweet, fruity slurry. I can’t however taste or see an apricot.

An un-sulphured apricot, a pecan, and a walnut half are also dense but not as chewy or sticky or sweet as the bar. The nuts add crunchy, the sweetness is softer, more nuanced, and clearly apricot.

BOTTOM LINE

The price of a KIND bar varies significantly. The bar I used for taste comparison cost $1.50 at my local supermarket. An equivalent weight for a handful of un-sulfured apricots and mixed nuts is about $1.00.

A handful of fruit and nuts is a great snack to have in your pocket because it requires no refrigeration. But it does require planning and some prep time. KIND bars are ubiquitous and available everywhere.

The taste difference between the bar and a handful of nuts and apricot is dramatic. Which tastes better? That’s a question best left to the eater. Taste is 100% subjective, so the only person you can make that decision for is yourself.

Twinkie Addendum

photo credit | gourmetmetrics

A couple of threads fell into place recently as I continue to explore the NOVA food classification system. And that send me out looking for Twinkies.

The first thread came by accident. I found myself listening to a previously recorded presentation at Google headquarters in California by New York based writer, editor, and publisher Steve Ettlinger. He was in California discussing his book, Twinkie, Deconstructed: My Journey to Discover How the Ingredients Found in Processed Foods Are Grown, Mined (Yes, Mined), and Manipulated into What America Eats. Published in 2007, the book is a fascinating exploration of the multitude of weird, unrecognizable ingredients used in modern food processing. 

The second thread fell into place when I discovered a recipe for homemade Twinkies does actually exists. About a decade ago, Jennifer Schihauser, a NYT journalist, developed a series of articles around the concept “If I make it myself, it’s not junk” and one of her recipes was for making Twinkies at home.

With a Twinkies formulation in one hand and a recipe for a homemade version in the other hand, I can actually do an “apples to apples” comparison between a formulated product and an equivalent homemade version. That was the third thread falling into place. I have what I need to count ingredients / markers of Ultra-Processed food (UPF) and compare nutrition stats. 

I needed to go out looking for Twinkies to get a label, always the best way to get the ingredient list. Product formulations change so the best source of data is always the current product label. Besides, I’ve never tasted a Twinkie so I was curious. I figured I should at least have a bite.

Using the ingredient list from the Twinkie’s wrapper and the Jennifer Schihauser recipe, I was ready to begin.

Running the numbers was easy because I’m in the business of recipe analysis. For guidance on the NOVA food classification system, however, I selected 2019 commentary Ultra-processed foods: what they are and how to identify them to serve as my reference guide.

INGREDIENTS & UPF MARKERS

Flour. Butter. Sugar. Eggs. Those are the primary ingredients listed in the homemade version. All familiar, recognizable ingredients. Besides the basics, the recipe also calls for salt, milk, vanilla, cream of tartar, heavy cream, and Marshmallow Fluff. That’s a total of 11 ingredients. 

The formulated Twinkie is manufactured with mostly unfamiliar ingredients. To my eye, they look like deconstructed fragments. Examples are high fructose corn syrup or dextrose or hydrogenated tallow, mono and diglycerides, polysorbate 60, soy lecithin. 

I counted 7 primary ingredients plus an additional 22 listed on the label as <2% by weight and felt comfortable tagging 18 as UPF markers.

What counts as a marker? As per my NOVA reference document, markers can be 1) “food substances not usually found in the home kitchen like high-fructose corn syrup or 2) “cosmetic additives” like flavors, colors, emulsifiers, sweeteners, or thickeners. Note that salt and sugar get a pass because NOVA classifies them as processed culinary ingredients.

NUTRITION STATS

Both homemade and formulated versions are intense concentrations of fats and sweetness with little positive nutrient benefit. And both versions are calorie dense. 

Nutrients per serving size is the best metric for checking how much you’re actually eating, but comparing nutrients in similar products needs a different metric. My choice for this type of comparison is the calorie density scale which reflects nutrient values by weight. Think of the calorie density scale as a sort unit price for nutrients.

The homemade Twinkie is 3.6 calories per gram. The formulated product is 3.4 calories per gram. To put these calorie density numbers in context, Doritos scores 5.1 on the calorie density scale whereas a Chipotle Beef Burrito will clock in at about 1.8 calories per grams.

Both recipe and formulation have comparable amounts of total fat but homemade Twinkies have a significantly higher concentration of saturated fat. No surprises here. Butter is the only fat called for in the recipe and butter is notoriously high in saturated fatty acids. 

The formulated Twinkies use a combination of animal fat (tallow) and seed oil (cottonseed oil) which results in less saturated fat and more unsaturated fat.

Both recipe and formulation are intensely sweet. Sweeteners in one form or another comprise about 40% by weight. Homemade uses granulated sugar plus some marshmallow fluff. The formulation lists sugar, high fructose corn syrup, and dextrose. 

Sodium is not significant for either version but it’s worth noting there’s more in the formulation than the recipe.

TASTE IS 100% SUBJECTIVE

The final thread fell into place when I tasted the Twinkie. Actually better than I expected but still too sweet for my taste.

WHY BOTHER?

It’s takes many hours to source and study the NOVA research, to count ingredients and identify the markers, and to compare nutrition stats. Here’s why I believe my time was well spent:

  • I learned that nutrients are easier to count than ingredients or UPF markers, especially hard was deciding which additives were “cosmetic” and which were not. Difficult and inconclusive.
  • Simplistic pronouncements by food pundits, corporate marketeers, or social influencers are misleading. NOVA is a sophisticated concept. Selecting a couple of buzz words may sell books or products but does a disservice to consumers.
  • Expanding my NOVA analysis skills is a good investment of time. My sense is we’ll be having more serious discussions about degree of processing in the coming years.

So do I plan to do more apples-to-apples comparisons between a formulation and a recipe? You bet I do.

 

 

Rethinking Fat, Sugar, and Salt.

photo credit | gourmetmetricsphoto credit | gourmetmetrics

The corona virus pandemic has sent us to our homes and forced us to cook. No one knows yet how many will continue once pandemic policies are relaxed, but some will. If you are one of those hungry folks who only recently has discovered the joys of cooking, please read on.

Being new to cooking probably means you grew up in a culture that measures healthy in nutrients. Nutrients like fiber and protein are good. Nutrients like fat, sugar, and salt / sodium are bad. Food is fuel and energy is measured in calories. Superfoods like cauliflower or kale make headlines but nutrients and calories remain the dominant metric for measuring healthy. 

I know all this because I get paid to run nutrition stats for websites, book editors, and federally sponsored institutional foodservice.

These nutrient centric one size fits all guidelines were built with the best of intentions on a foundation of sameness, similarity, conformity, and uniformity. And that is the reason why so many food focused folks like chefs, food writers, and home cooks have problems with the guidelines.

Flavor is what counts at their table. They know for instance that roasted cauliflower is more delicious than steamed cauliflower. They know fat carries flavor and salt is a powerful flavor enhancer. 

As a home cook and RDN, I too am critical of the guidelines. My views are divergent, divergence being the rejection of sameness, similarity, conformity, and uniformity. I was lucky. Growing up in California meant eating fresh seasonal fruits and vegetables all year long. Living in France for several years meant honing my cooking skills and developing my culinary palate. I learned to eat before I started my nutrition studies so I knew what delicious tasted like before I learned how to count nutrients and calories.

Having one foot in nutrition stats and the other in home cooking gives me a unique perspective because I know down to the gram and the milligram when the meals at my table are guideline compliant and when they are not. From a nutrient compliance perspective, my pattern is mixed.

Detailed below are some stats I ran before the pandemic. The stats reflect aggregate nutrient values for the meals I cook at home.

✅Sodium is a nutrient to avoid and salt enhances flavor.  Because I cook from scratch and salt to taste, sodium is within acceptable range. 

✅Fiber is a beneficial nutrient. Because we eat so many vegetables and legumes, fresh seasonal fruits and whole grains, fiber is always well represented at my table.

✅Sugar is the new toxic nutrient. Natural sugars appear on my table as fresh seasonal fruit. Added sugars appear as home baked cookies, my signature pumpkin pie, or some of my other favorite home baked desserts. Sugar is within acceptable range.

✅Protein is adequate to meet nutrition need and comes from both animal and plant sources. Our portions are guideline compliant but smaller than what most of my fellow Americans expect to see on the plate.

❌Fat used to be the toxic nutrient. And my pattern has been consistently out of compliance for 25 years. My stats reflect calories from total fat is 35% to 40%. Our Dietary Guidelines set a 35% limit and the most recent World Health Organization Guidelines set a 30% limit. Olive oil is central to my cooking and is considered a healthy fat but I have a very generous hand. Milk and cheese are full fat. Nuts are part of our daily pattern. 

Being a registered dietitian and deciding to follow a divergent pathway puts me in an awkward position. If I were willing to reduce my use of olive oil, to use fat free dairy, to eat more carbs, and to develop a taste for skinless boneless chicken breast, my pattern would be optimal. Since I’ve never felt comfortable telling others to follow guidance I don’t follow myself, I prefer working in recipe analysis.

The stats I run for institution foodservice and book editors are nutrient focused because nutrients remain the standard protocol. But things are changing.

Nutrition science is wicked hard. Truth be told, significant disagreement currently exists among nutrition researchers about what is and is not healthy. The old nutrient focused paradigm that I learned in the early 1990s is cracking at the foundation. Seismic shifts are traumatic. The ground needs to stabilize before a new foundation can be built. Something will coalesce but no one knows yet, when a new paradigm takes form, if we’ll be counting nutrients or foods or patterns or all three.

Culinary divergence in a nutrient obsessed food world is stressful, liberating, and in my humble opinion necessary.

Stressful because we want to do the right thing but we’re not sure yet what the right thing is. Liberating because we have more freedom to be creative and to experiment. Necessary because we need to put the joy back in eating.

These are exciting times to be writing about food and nutrition. These are also exciting time to be learning how to cook.

 

Quarantine Cooking and Emotional Eating

“Like most humans, I am hungry. Our three basic needs, for food and security and love, are so mixed and mingled and entwined that we cannot straightly think of one without the others. So it happens that when I write of hunger, I am really writing about love and the hunger for it…” 

― M.F.K. Fisher, The Gastronomical Me, 1943

Those words were written nearly 80 years ago. Now fast forward to today. 

The corona virus has arrived in New York and we’ve been staying at home for over a month. Shopping the center of the isle is back in fashion. My colleagues are writing helpful posts about managing cravings and focusing on healthier options. Comfort food sales are booming.

The pandemic has entered our lives and our kitchens. We are all hoping a new normal will be as bright and sunny as my lovely flowers, but no one knows for sure. Our future is uncertain.

Staying home, being unemployed, home schooling your kids – whatever your current situation is, I am sure that you’re as hungry for food and love and security as I am. 

About a decade ago, I was the dietitian tasked with setting up the nutrition component for a bariatric wellness program to help overweight folks loose enough weight to qualify for bariatric surgery. Most of my understanding of emotional eating comes from the work I did for that program. 

My approach to promote self awareness was the self-care acronym HALT. I did private one on one sessions and participated in weekly group sessions with a physical therapist, social worker, psychologist, and me an RDN. 

HALT for those not familiar with the acronym = Hungry, Angry, Lonely, Tired.

For the last couple of weeks, those words are reflecting how many of my fellow New Yorkers are feeling. Those words reflect how I am feeling too. If I turn to food for comfort, does that make me an emotional eater? Because if it does, I am guilty as charged and need treatment. 

So what is that treatment? Redirect cravings, identify triggers, and separate them from food.

I’m not sure that treatment works today and am obsessed with the observation, made nearly 80 years ago, that food and security and love are inseparable.

Before the corona virus arrived, dietitians like me and my colleagues characterized emotional eating as the enemy. Today we are dealing with a new enemy and as we are learning, this virus is a serious threat to our security and well being.

And I am having a moment of significant personal doubt.

Maybe we’ve been going at this emotional eating thing from the wrong direction. Maybe we humans are not as good as we thought we were at separating our hearts from our stomachs.

Before I became a dietitian, I was a home cook. My Tantôt Brieux taught me to make crèpe at the age of 5 and I’ve been hooked ever since. From milking a cow in British Columbia to private cooking for a couple of years in Paris, culinary curiosity and culinary passion have formed my approach to food.

During the last month that I’ve been staying at home, I’ve cooked every night. I’ve spent more time at table with people I love and care for and experienced food and love and security coexisting in positive balance.

No one knows yet what will evolve over the next couple of months or years. The virus will claim its victims. The world may or may not fall into economic recession. Social distancing will likely remain at least for a year or so. Life will go on.

But I am seriously questioning the conventional approach to emotional eating.

Rethinking exactly how we do that is best left to psychologists but let me say this to my fellow dietitians. 

Let’s not be too hasty to reduce hunger down to the physiological need for fuel and nutrients. And let’s not be too quick to assume those who seek comfort during stressful times need tips and treatment plans. 

Reducing healthy down to a couple of nutrients is insane. 

Reducing emotional eating down to triggers and cravings may be equally insane.

Looking at meat through rose colored glasses.

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Plant-based is in. Red meat is out. 

Momentum has been building for more plants over the last decade but this year looks like the year plant-based will go mainstream. As more climate related  catastrophes are attributed to a carnivorous lifestyle, darker and more ominous predictions regarding the evils of meat eating will likely continue through 2020. Penance for our sinful climate ways. 

There’s nothing new about the assault on red meat. The first official iteration was nutrient focused and appeared in 1980 with the publication of our first set of dietary guidelines. Guideline #3 reads “Avoid too much Fat, Saturated Fat, and Cholesterol”. Or as the phrase has evolved over the decades, choose lean meat.

Recently, however, red meat has been targeted for different reasons. Environmental and animals rights activists have joined forces to condemn red meat as climate unfriendly and inhumane. These activists are a small percentage of the population but their collective voice is shrill and aggressive. Both groups promote a plant-based plate.

So you may be wondering what inspired a flexitarian like me to put on rose colored glasses and take a peek at red meat in the first place.

It all started with NOVA, a new kind of food classification system, developed about a decade ago in Brazil by a group of academics, that groups foods by degree of processing instead of by nutrients. Foods look remarkably different viewed through a NOVA lens. Especially meat. 

By dividing food into four groups, NOVA allows a single food to be viewed from four distinct perspectives depending on the degree of processing.

Freshly slaughtered and chilled meat is considered minimally processed. Contrary to the prevailing nutrient based perspective, the NOVA classification has a place for meat on the plate independent of fat content. Freshly slaughtered and chilled meat can keep company with other minimally processed foods like fresh fruit and vegetables, nuts and legumes. Wow! That is what I call a revolutionary thought.

The second NOVA group is for processed culinary ingredients like salt, sugar, and oils. Included in this group are traditional animal based fats like butter and lard.

Meats become processed when they are preserved using traditional  techniques like salting, drying, curing, or smoking. NOVA does recommend restraint, but acknowledges the deliciousness of traditional preparations. Examples of traditional processed red meats include corned beef, jerky, prosciutto, dry cured Virginia hams. Other equally delicious non-plant members of this processed foods group are salt cod, smoked salmon, canned fish.

To be classified as ultra-processed, the fourth NOVA group, red meat needs to be pre-prepared, re-formulated, or modified. Examples of ultra-processed meat products are frozen pepperoni pizza, fast food burgers, deli cold cuts, reconstituted meat products like hot dogs, LFTB (lean finely textured beef). 

Making a pizza at home using fresh ingredients and traditionally cured cheese or sausage is classified as processed. Prepackaged frozen pizza manufactured and marketed for convenience gets the ultra-processed classification. 

There’s plenty of controversy surrounding the NOVA classification system.  The groups are squishy and subjective. Lines of demarcation are not clearly defined. Many of my fellow analysts, used to working with thousands of precise nutrient based food codes, dismiss NOVA as unprofessional. Their dismissal is understandable.

So why bother taking a peek you may be asking? Because food is so very much more than the sum of its nutrient parts and over the last 40 years we’ve all been conditioned to look at food through a narrow precisely defined reductionist lens. 

Changing focus and looking through the NOVA lens let’s us take a step back. And by taking a step back from the plate, we get a different perspective. It’s easier to see the food and harder to scrutinize nutrients. Even a flexitarian like me has come to appreciate meat in new ways. Remember, it’s just a peek.

Rethinking Healthy

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Here’s the menu for a delicious, somewhat indulgent celebration meal I shared with family and friends in December. 

The meal reflects my kind of healthy. At least my kind of healthy before I decided to become a dietitian and learned how to measure healthy in grams of fat.

Over the last three decades we’ve been taught that palatability and healthy are polar opposites. Stealth health is a term still used today with regard to food. In other words, many people still believe that if food is obviously healthy, it’s not to be trusted.

That polar divide dates back to the 1990s. Research was going on prior to that date linking dietary fat to heart issues, but implementation didn’t happen until 1990.

That was the year congress passed the NLEA (Nutrition Labeling and Education Act). I was totally unaware that anything important had happened when I started my nutrition studies in 1993, the same year the Nutrition Facts Label appeared on packaged products. Buried under layers of regulatory cement, the new law contained austere nutrient-based criteria for healthy. Initially, the criteria were only applicable to packaged goods but by the end of the decade, the damage was done and the word healthy was successfully redefined as low fat.

The only items on my Christmas menu that qualify as healthy using these austere criteria are the baguette, the steamed rice, and the clementines. 

Low-fat is healthy dominated the first decade of this century. According to NBC news, when a group of researchers set out to understand the views of executives at major U.S. restaurant chains regarding the addition of healthy options to their menus, they were able to determine why by ensuring anonymity to the executive’s interview.

“If we put something on the menu and say it’s healthy, it’s the kiss of death,” one executive told the researchers.

The kiss of death was not limited to restaurant food. The first time I ran numbers on a mix of fresh mesclun with vinaigrette dressing, I discovered to my horror that my salad couldn’t qualify as healthy either. Too much fat. And too much saturated fat.  Olive oil has a higher fraction of saturated fatty acids than walnut or avocado or some of the other wonderful oils that can be used for a vinaigrette. In other words, my salad was even more unhealthy because I used olive oil.

Healthy as low-fat remained set in regulatory cement for 25 years. In 2015, however, something happened. That was the year the FDA sent a warning letter to the manufacturer of KIND BARS.

Most of the errors were minor technicalities except for one major misbranding error. The FDA requested that the manufacturer remove the word healthy from the label. The bars identified were made with nuts and because nuts are high in fat, the gram values exceeded those austere criteria set back in 1990.

KIND BARS complied but decided to file a citizen’s petition asking the FDA to re-evaluate. And the FDA agreed. The agency acknowledged the science related to recommendations for intake of dietary fats had evolved and, as per a 2016 guidance document, stated its intention to exercise enforcement discretion on an interim basis shifting the focus away from limiting total fat to encouraging unsaturated fats.

Et voilà. With the stroke of a bureaucratic pen, my menu got healthier. The menu as a whole just meets the current level 35% calories from total fat and my green pea soup, green beans, and rapini now meet this interim FDA criteria for healthy.

About the same time that the FDA published their interim guidance, a group of academic researchers working out of a university in Brazil published a document that took a completely different approach to healthy. 

Nutrition researchers and policy professionals in this country are used to breaking foods down into smaller and smaller components. Researchers have worked hard to develop hundreds of thousands food codes. Using these food codes, policy professionals can manipulate foods precisely and accurately in every conceivable combination of nutrients, micronutrients, or any other component.

The Brazilian academics reversed the process. They took a step back and developed a system that consolidated foods into only 4 groups: Unprocessed / Minimally Processed; Processed Culinary Ingredients; Processed Foods; Ultra-processed Foods. They called this food classification system NOVA.

Most chefs, home cooks, and food writers relate immediately to NOVA. Working with intact foods every day and thinking about food as a whole comes easy. A whole onion. A whole egg. A whole piece of Clothbound Cheddar.

My dietitian colleagues struggle with NOVA because they have been trained to think about food differently.

Dietitians are taught to think about food as nutrients. Onions are low in calories and contain no fat. Eggs are high in cholesterol. And even an artisan hand crafted cheese is high in saturated fat. In their view, NOVA seems crude, simplistic, and downright unprofessional.

Sometimes I feel like I’m caught between two coasts. I understand why NOVA upsets my zealous colleagues but I love the approach. 

And I love looking at my menu through the NOVA lens. Carefully sourced fresh ingredients. Enough salt, sugar, and fat to ensure palatability. Lots of freshly cooked vegetables and fresh fruit.

Here’s how my menu breaks down. All aromatics (onion, celery, carrot), garlic, fresh herbs, rapini, green beans, and clementines are obviously raw, minimally processed and belong in Group 1. Not so obvious foods included in Group 1 would be lamb shanks, spices, dried split peas, whole milk plain yogurt (pie crust), fresh egg (pumpkin filling), basmati rice, and refined wheat flour.

Olive oil, salt, butter (pumpkin filling), and sugar are classified in Group 2 as processed culinary ingredients. Canned whole tomato, canned pumpkin, and Bordeaux rouge are classified as processed foods and placed in Group 3. Only the mass-produced packaged baguette, the prosciutto, and the Armagnac are candidates for ultra-processed or Group 4.

And I’ve ended up coming full circle in my belief about healthy. It’s not that nutrients aren’t important. Nutrients are very important. But in the process of drilling down deeper and deeper, something basic has been forgotten. Let’s hope that something basic has not been lost.

Looking at the plate through a NOVA lens is a gentle reminder that food is more than the sum of its nutrient parts. And that palatability and healthy don’t have to be polar opposites.

What section of the supermarket do plant based meats belong in?

photo credit |gourmetmetrics
photo credit |gourmetmetrics

The food scene is changing fast. Plant-based products have arrived and they are disruptive. They don’t fit in the usual slots. It’s not the first time rapid change has disrupted our food supply and it probably won’t be the last, but each time a disruption occurs, our sense of normal needs adjusting.

I posed this question in a couple of forums. Where should a supermarket put a product that is engineered to taste like ground beef but manufactured from pulverized plants and here’s what came back.

EMOTION OUTBURSTS

Plant-based meat analogs evoke passion ranging from evangelical ecstasy to visceral derision.

For true believers, the promise of phasing out livestock production is an absolute good for our health, the planet, sustainability, and the welfare of animals. For many others and for a variety of reasons, replacing real meat with fake meat is misguided. One particularly caustic commentator suggested putting the product in the pet food section because the texture of pulverized plants is the same as canned dog food.

PRAGMATIC SUGGESTIONS

The vegan/vegetarian section would be a logical place and that was the section I checked first. Nothing new. No faux burgers. Just the usual collection of traditional veggie burgers.

Meat analogs can’t go in the organic food section, at lease now yet. The first generation meat analogs don’t meet the USDA organic criteria. One brand even proudly lists the use of two genetically engineered components.

A section dedicated to sustainability might be a candidate for meat analogs. Climate change activists believe red meat is bad for the planet and ruminants like beef and dairy cattle are a big contributor to global warming. But that position is controversial and other groups, especially the regenerative agriculturists, disagree.

Business decisions get made based on many factors and it appears manufacturers have pushed hard to get their meat analogues into the meat department. And that’s exactly where I found the package. Beyond Meat Burgers were right next to the grass-fed burgers in the frozen meat section.

FOOD 2.0

Food 2.0 was the most creative response I received. As technology continues to disrupt the food section, supermarkets will respond as best they can. Food 2.0 is as good as any catch word to describe the brave new world of food tech that we have just entered. The FDA has cleared both major meat analog manufacturers for retail sale and that means a tsunami is about to hit the supermarket floor.

Many of my fellow dietitians have concerns about the healthiness of meat analogs because they are highly processed. I share that concern but to date there’s no good evidence that ultra-processing per se is unhealthy. Lots of speculations and gut feelings but no hard evidence except for one study published this year which established a correlation between a diet of ultra-processed foods and weight gain.

So what should we do while we wait for more evidence?

My plan is moderation. I’m okay with a meat analog from time to time, but my gut isn’t used to high tech food and I see no reason to change right now. So for the time being, the proteins you will find on my plate most days will be lentils and chickpeas and 100% grass-fed beef.

Biscotti, NOVA, and Common Sense.

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Who doesn’t like a good biscotti? It’s sweet and nutty and soft when made with enough butter, but firm enough to dunk in coffee. Pictured above are my favorite off the shelf biscotti. Biscotti aren’t healthy, but that’s not why I like them. This traditional Italian delicacy is concentrated sugars and refined carbohydrates softened with butter. Totally unhealthy and completely delicious.

Trying to make them at home is complex. Most recipes use a standard set of ingredients consisting of sugar, flour, nuts, and baking powder. Some recipes call for eggs, others call for butter, still others call for oil. Some even call for dried fruit like the cranberries in my favorite biscotti. No matter which combination of ingredients, however, there is one feature that all biscotti have in common. They are twice baked. And twice baked is too complex for my simplistic mind, so I have become a connoisseur of off the shelf.

Like all packaged cookies my biscotti are ultra-processed. Maybe if I baked them at home with carefully sourced ingredients I could get away with dropping the ultra … but just maybe.

How do I know? Because NOVA says so.

SO WHAT’S NOVA?

NOVA is new way to classify food. It’s a system that examines the extent and purpose of food processing. Originally developed in Brazil, the concept is gaining traction in other South American countries, Canada and France.
 NOVA characterizes ultra-processed foods as industrial formulations made with many unfamiliar ingredients not commonly used in kitchens. These foods are manufactured and designed to be profitable, convenient, and hyper-palatable.

My favorite biscotti fit the description. They are palatable and very tasty. The ingredient list looks mostly familiar with the exception on malted barley flour. But when I check ingredient lists for other brands, I do find suspicious additives like soy lecithin, palm kernel oil, mono- and di-glycerides, natural flavors to name a few.

The product is an industrial formulation. Otherwise, my biscotti would not taste exactly the same every time. The product is convenient too saving me the time and trouble of twice baking every single batch I mix up.

So now what?

NOVA is not well known here in the states but that may be changing. We Americans are big consumers of ultra-processed products, well over 50% by most counts. Our voracious consumption is causing concern among some of my fellow dietitians. Many nutrition commentators agree that a food pattern based on minimally processed real food is the best option but I’ve yet to find anyone willing to commit to a percentage.

As for me, I know that my gut is happier when I eat less highly processed foods. But that’s a personal testimonial and anecdotal evidence doesn’t count for much. So …

IN MY HUMBLE OPINION

Proponents of an evidenced based approach to eating don’t give much credit to common sense. Those folks are scientists and view common sense much the same way as Albert Einstein “… the collection of prejudices acquired by age eighteen.” Science moves methodically and slowly and nutrition science is wicked hard. Like a never ending story, the facts of today are subject to change based on new findings tomorrow.

But since we need to make eating decisions every day with or without evidence, sometimes that collection of “prejudices” is all we’ve got. We put something the plate every day. We can’t just stop eating while science is still working things out.

So let’s be patient and let science do its thing. Let’s enjoy our biscotti without fear or worry. We have no common food culture to reference, but we do have our gut and our own common sense. One biscotti will hopefully not be a problem. Eating the whole package should give you a stomach ache.

Does healthy come in one size that fits all?

photo credit | gourmetmetrics
photo credit | gourmetmetrics

When it comes to automobiles, maybe we could get by with one size fits all. Wasn’t it Henry Ford who said we could have any color you want as long as it’s black. But imagine how miserable we’d be if everyone had to fit their feet into the same shoe size?

Now there are some obvious differences between food and shoes. But when it comes to size and shape, food and shoes have more in common than you might think.

Consider this recent dinner I put together. A modest piece of beef tenderloin. Sliced savoy cabbage, shallot, and green peas braised in olive oil and stock. Steamed Yukon gold potato. Add a Guinness stout to accompany the meal followed by fresh pineapple, a couple of walnuts, and a small square of very dark chocolate.

Et voilá. A plate that manages to be non compliant with every healthy dietary model.

Compared to Dietary Guideline recommendations, my plate falls short. No bread or rice or pasta on the plate. A beer instead of a glass of milk. And too many calories from fat (>35%) and saturated fat (>10%).

Vegan activists will come after me because I put a piece of meat on my plate.

Keto enthusiasts love no carbs on the plate but will ask why no cream or butter or coconut oil.

Globalists who promote the planetary health or flexitarian diet, will be upset because my serving of beef is so big, my serving of nuts is so stingy, and there’re no whole grain.

It used to bother me that my usual pattern is non-compliant but I’m getting more comfortable with the idea. Being out of step with a vegan or Keto approach is one thing. Being out of step with dietary guidelines or planetary health is quite another however.

Why was I bothered? Because I’m a nerdy dietitian who studied nutrition, appreciates the need for evidenced based science, and supports the concept of a healthy eating pattern. But my numbers still never fit a conventional model.

So that brings me back to shoe sizes. Before industrialization, if you were lucky enough or rich enough to own a pair, your shoes were custom made. In today’s world the best a shoe manufacturer can do is offer many different sizes and styles. Then it’s up to us, the shoe wearing public, to find shoes that fit.

Maybe that same logic works for food choices too. As a committed omnivore in love with all things vegetable, fruit, legume, and whole grain, my pattern has fewer carbohydrates and more fats than the one size fits all dietary guidelines. And if I think about guidelines as guiding principles instead of regulatory mandates, my pattern looks a lot healthier.

My doctor is okay with my health stats. And my gut is happy with my food choices. So I’ve decided to stop being bothered because my pattern is not a perfect fit.

So you see, finding the right dietary pattern really is like shopping for shoes. You keep trying on different patterns until you find the one that’s the best fit for you.