Rethinking Healthy

photo credit | gourmetmetrics

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.

Getting the most out of nutrition stats.

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I love to eat and I love to cook, but when I’m not in my kitchen cooking up a storm, I’m sitting at my desk running nutrition stats.

My clients are editors for website recipe collections and cookbooks. The preferred format is a listing of nutrients per serving which roughly match the Nutrition Facts Label.

Like my colleagues who work in the consumer packaged goods industry, I’m dedicated to providing the most accurate analysis possible given the vagrancies of ingredient data sourcing and the lack of clarity in certain ingredient listings.

I’d like to believe cooks, recipe developers, and consumers pay as much attention to the stats I produce as I pay to accuracy. But I have my doubts.

The label as currently formatted is hard to understand even for me and I’m an expert. The data is good but the format is dense and unfriendly. As one perceptive observer has said, the current label is still a work in progress.

The current nutrition stats approach sends a message that healthy can be reduced to a couple of nutrients. That is not a helpful message. However, nutrients remain important and the stats work well to size a portion or to calculate a ratio.

Research on new formats in this country and elsewhere is ongoing and it’s likely we will see a more intuitive, interpretive, or holistic format at some point in the future. But for now we need to use what we’ve got, so let me share with you some observations.

CHECK CALORIES FOR PORTION SIZE

Rigid calorie counting is out, but portion sizing is always useful for individuals. I know for example that a 600 calorie plate is plenty for me. I do enjoy meals over 1000 calories from time to time. Sometimes a lot over but I need a good reason. Like a celebration meal or dinner out at one of our favorite Manhattan restaurants.

Calories are my metric of choice for portion sizing. Very useful when scanning a restaurant menu or for assessing portions for a new recipe.

CHECK RATIOS FOR NUTRIENTS

Ratios are a quick and easy way to compare two nutrients. And because a ratio is not dependent on a serving size, a ratio remains constant regardless of how much or how little ends up on the plate.

• Calorie Density. The calorie to gram ratio tells you how many calories per unit of weight. Cookies have a high calorie density where as a mixed greens salad olive oil & vinegar dressing has a low calorie density.

• Salt. The ratio of sodium to calories is an easy way to determine sodium concentration. This ratio is especially useful when you check out a packaged product or a restaurant menu item. Canned soups have a high sodium ratio. My homemade legume soup has a lower sodium ratio.

• Fiber. The fiber to carbohydrate ratio helps you figure out if a product or a menu item is a good source of fiber. 100% whole wheat bread has a high ratio for fiber. Pop Tarts have a low ratio.

• Healthy Fats. The fatty acid ratio tells you which fatty acids predominate. Unsaturated fat is considered healthy but the status of saturated fat remains controversial. I prefer whole milk to skim milk and always choose whole milk yogurt and cheese. Many nutrition researchers and dietitians recommend limiting saturated fats as do the current dietary guidelines, but I continue to opt for a good honest cheese like the St André pictured above.

AN INTERPRETIVE LABEL

The next generation of nutrition labels will be more personalized and more intuitive. We will probably see more color coding and more logos. This type of labeling is already being used in some European and South American countries.

In the meantime, nutrient ratios, calories per serving, and lots of good old fashioned common sense are out best option.

 

 

Healthy means one thing to cooks and something different to a recipe analyst like me.

photo credit: gourmetmetrics
Chicken Platter | photo credit: gourmetmetrics

Feast your eyes on a gorgeous Brune Landaise, a slow grow (110 days) heritage breed chicken raised in rural Pennsylvania. I took the picture recently at a Manhattan restaurant and even with the addition of vegetable sides, it’s not your classic picture of healthy eating.

HEALTHY MEANS DIFFERENT THINGS TO DIFFERENT PEOPLE.

Roast chicken is a healthy alternative for carnivores when they get tired of steak. If you’re a vegan however roast chicken is unhealthy or immoral. And probably both. These are subjective opinions based on two different belief systems.

Enter the nutrition researcher. These folks have been taught to measure healthy in grams and milligrams. Personal anecdotes and opinions are suspect. Research and evidence are what count. Now the scientific method is by natures reductionist and that’s not necessarily a bad thing. The problem is that scientists sometimes forget that the whole can be more than the sum of its measurable parts. And so sometimes do recipe analysts.

THE NUTRITION FACTS

I ran the numbers for roast chicken based on my own recipe for a modest serving size (2 pieces or about 6 ounces). Calories 370, Fat 22 g, Saturated Fat 6 g, Sodium 560 mg, Carbohydrates 0 g, Fiber 0 g, Sugars 0 g, Protein 39 g.

If you have a hard time finding meaning in the numbers, you’re not alone. I know what all the numbers mean, I’m a dietitian, and I have a hard time too. Facts are important and we don’t want to ignore them. But nutrition researchers are coming to realize, facts are not enough.

My most brilliant research colleagues are currently doing just that — developing algorithms for putting the parts back together. Similar research is going on in Europe, South America, and Australia.

PUTTING ISOLATED NUTRIENTS BACK IN THE CONTEXT OF THE WHOLE PLATE

Chefs and home cooks and food writers know intuitively that food is more than the sum of its nutrient parts.

Nutrition researchers and dietitians and recipe analysts dedicate their lives to understanding those nutrient parts.

Both perspectives are valid. But that hasn’t made it any easier for cooks and recipe analysts to discuss what’s healthy and what’s not healthy.

Here’s a small taste of what lies ahead for recipe and menu analysis when we widened the lens and look at food through both perspectives.

Using a narrow lens, roast chicken isolated and alone provides excellent protein but comes with saturated fat. My zealous colleagues, with the best of intentions, solved the problem by removing the skin. As a result, skinless boneless breast became ubiquitous.

When we widen the lens by adding a green salad, two vegetable sides, a piece of French bread, and a glass of Bordeaux, the dynamics change. The same excellent protein remains, but now we find 40% that plate is vegetables and those grams of saturated fat are nicely balanced by unsaturated fatty acids.

A hybrid perspective meets the objective demands of the analyst. Being a dietitian by trade but a foodie at heart, I find the hybrid perspective helpful because it more reflects my standards of healthy better than a more narrow reductionist view.

Only time will tell however if a hybrid perspective will be useful to chefs, home cooks, and food writers.

Here’s the secret to a great ratatouille.

Photo Credit: Pexels

Every August I make ratatouille. Zucchini is still coming in. Tomatoes and peppers are bursting on the scene. Fresh garlic and fragrant basil are in season and abundant.

JULIA KNEW THE SECRET.

I made my first ratatouille to rave reviews using a Julia Child recipe. Her version was spot on because she knew the secret so I just did what she said and used a generous hand and the best olive oil I could afford.

Julia made her mark in the 1960s and 1970s so she missed a head on collision with the fat phobic era that gripped our nation starting mid 1980s.

DECADES OF FAT PHOBIA IMPACTED RECIPE DEVELOPMENT.

By the time I went back to school to study nutrition in 1993, low fat was firmly entrenched. Manufacturers had already jumped on this bandwagon as noted in an article from 1993 in the The Washington Post. It took a little longer for recipe modification to take hold however.

In October 1998,  Eating Well a magazine dedicated to healthy eating published a recipe for ratatouille. Enough olive oil was removed to get the calories from fat down to 33%. In other words about half the amount of olive oil as Julia called for in her recipe.

The most austere recipe I pulled up searching for low fat ratatouille was from 2008. This recipe substituted cooking spray for olive oil and successfully reduced the calories from fat down to an austere level of 10%.

LOW FAT HITS VEGETABLES ESPECIALLY HARD.

That’s because vegetables by weight are mostly water and water has no calories. Vegetables have lots of positives like fiber, some protein, sometimes sugars, and a rich array of vitamins, minerals, pigments, phytonutrients. Just not many calories.

Fats like olive oil are calorie dense so when the oil gets added to eggplant, zucchini, peppers, and tomatoes — all of which have practically no calories — of course most of the calories will come from fat. A well crafted ratatouille clocks in between 60 TO 70% calories from fat.

WE NEED A BETTER SCORING SYSTEM.

Vegetables, some of the healthiest foods out there, got punished when salt and oil were added just because vegetables are so low in calories. With all due respect to our regulatory officials, there has just got to be a better way

So I decided to keep an eye out for a better scoring metric. I discovered some research done at Oxford a decade or so ago that counts both negatives and positives. Then I adapted this approach to my own recipe analysis.

Ratatouille tastes much better made with salt (40% sodium) and lots of olive oil (13% saturated fat). Sodium and saturated fat currently count negative.

Ratatouille is mostly eggplant, zucchini, peppers, and tomato by weight (over 90%). Vegetables, protein, and fiber currently count positive.

The negatives are about equal to the positives with a slight edge to positives and that sounds healthy to my simplistic mind.

AUGUST IS MY MONTH FOR CELEBRATION.

August is the optimal month for ratatouille. August is the month Julia was born. And August is the month I finally figured out how to score ratatouille healthy.

There are so many classic recipes for ratatouille available via the internet. You can find Julia’s recipe here. And Alice Water’s recipe here. And the recipe from The Kitchn here.

Or you message me via LinkedIn or Facebook and I’ll send you my recipe.

Here’s why indulgence has a place at my table.

photo credit: gourmetmetrics
Omelette plated with greens and cannelloni | photo credit: gourmetmetrics

An omelette is my go to meal when I’m hungry, pressed for time, and feel like indulging myself.

Pictured above is a quick and dirty meal I put together a couple of weeks ago. Bitter greens and cannelloni beans mixed with calamari, restaurant leftovers from a meal the night before, filled up half the plate so all I did was make the omelette.

My meal was delicious. Greens and legumes fall into the healthy column, but I’m wondering about that omelette …

First cholesterol and now veganism.

Since the 1970s, we’ve been told to avoid foods high in cholesterol and egg consumption has taken a major hit. In 2015, cholesterol was removed as a nutrient of concern and the 2015 Dietary Guidelines say eggs are now okay with this disclaimer. Eggs like all animal based proteins should be consumed in moderation.

Vegans take that advice one step further.Eating an egg is as bad as smoking cigarettes.” That claim was made in a recent Netflix movie funded and produced by folks promoting veganism. What the Health got mixed reviews but vegan messaging tends to be aggressive and the message is clear — eating eggs is not okay.

Does anyone think eggs are healthy?

An Organic egg farmer in New Hampshire recently filed a citizens petition asking the FDA to allow them to label eggs healthy based on the revised guidance issue by the FDA. The petition points out that the fatty acids in an egg are predominantly unsaturated.

Eggs do have an impressive nutrient profile. Excellent protein with all essential amino acids, a favorable mixture of saturated and unsaturated fatty acids, and a very impressive list of micro- and phyto-nutrients.

So what is it — are eggs healthy or unhealthy?

Here’s the problem. Eggs are a mixed bag and making an omelette with butter or oil and salt adds more variables to the bag.

My omelette has strong positives. Complete protein plus all those other micro nutrient benefits.

And my omelette has strong negatives. Saturated fat, calorie density, and sodium.

Here’s why I use the word indulgent.

Swinging back and forth from one extreme to the other is not helpful. We need a better approach. Some kind of hybrid system that scores the omelette as a whole.

Towards this end, an approach developed in the UK and recently implemented in France has potential. The metric is weight based and positives are balanced against negatives to come up with a single score. I’ve adapted this approach for recipe analysis. When I ran the numbers, my omelette got more negatives than positives.

Actually got a lot more negatives than positives and that’s why I use the word indulgent.

Some final thoughts on healthy.

• Nutrition research is constant and ongoing. Saturated fat and sodium score negative because current guidelines from both the US and EU recommend moderation. Both nutrients however remain controversial in some research circles. Especially the complex issue of saturated fats.

• Ingredient quality and degree of processing aren’t scored. Pastured local eggs, California certified olive oil, and home cooking add value for me but are not part of the scoring metric. And because I value home cooked from whole minimally processed foods, delicious indulgent is okay at my table as long as I source my own ingredients and make it myself.

• Putting my omelette, or any other meat based protein, on the same plate as greens and legumes makes the whole plate healthier.

Reducing a radiantly complex plate of food down to a couple of nutrients is insane.

Photo Credit: gourmetmetrics
Salade Composée | photo credit: gourmetmetrics

That’s not to say that nutrients aren’t important. Because they are. They’re very important. But nutrients are only one of many parts to a complex story.

Take my beautiful salade composé pictured above. There is so much more going on than a string of numbers can communicate.

NUTRIENTS

Let’s look at the nutrition facts first: 660 calories, 48g fat, 8g satfat, 660mg sodium, 30g carbohydrate, 8g fiber, 6g sugar, 26g protein.

INGREDIENTS

Here is the list of ingredients: arugula, chickpeas, tuna, cucumber, tomato, egg, farro, red cabbage, parsley. All artfully arranged or “composed” on plate and generously dressing with a classic vinaigrette.

Those chickpeas were home cooked with salt from a heirloom variety. But I had many other options. Canned, drained, or rinsed. And how old were the chickpeas because age really does make a difference when you’re cooking chickpeas from scratch.

The tuna pictured above is Tonnino, a branded product imported from Italy. Again, there are many options to choose from. Is it domestic or imported. Line caught or net caught. Skipjack or yellowfin or albacore or one of the lesser known species. Jared or canned or fresh.

As for the vegetables, one thing for sure is they were imported from some warmer part of the country because here in the northeast planting doesn’t get started until May. Probably not USDA organic either because my Italian green grocer believes “organic” is a scam and tells me his customers don’t want to pay extra for the label.

Eggs are from pastured hens that are free to roam, weather permitting. The farro is grown here but I’ve used farro imported from Italy and it’s very tasty. Finally my classic vinaigrette is made with a certified branded dated olive oil from California and a distinctive sherry vinegar imported from Spain and salt.

Ingredients always generate so many questions and it’s hard to believe your choice of ingredients doesn’t impact the healthiness of the plate independent of those nutrition facts noted above.

SO WHAT EXACTLY MAKES A PLATE HEALTHY?

That’s a good question and the answer all depends on who is looking at the plate.

If you’re the FDA, you’ll gauge “healthiness” on milligrams of sodium, the ratio of saturated fatty acids to unsaturated fatty acids, and the respective percentage contributions of certain essential nutrients to established reference values per day. I understand how to run those stats and am happy to explain the calculation in detail.

If you’re the USDA, you’ll gauge “healthiness” on cups of vegetables, ounces of protein, grams of saturated fatty acids and milligrams of sodium with bonus points for whole grains and fish. Again, I know how to run those stats and can explain in detail.

I’m just not sure, however, that explaining in detail is helpful. I’ve tried in the past and most folks go glassy eyed.

And I’m also not sure my explanations answer the question of whether of not the plate is healthy. The folks who believe low fat is healthy won’t like the fact that 65% calories come from fat and 11% calories come from saturated fat. Vegans won’t think the plate is healthy because of the tuna and egg. Carnivores won’t think it’s healthy because there’s no meat.  Keto enthusiasts will reject the plate because of the grain. The organic crowd will reject the plate because my vegetables are conventional. So you see, it all depends.

Maybe someday researchers will figure out how to reflect all the radiant complexity in my salad with a single healthy symbol. But for now it makes more sense to my simplistic mind to source my ingredients carefully, go with my gut, check the nutrition facts, and retain at all times a healthy dose of common sense.

Rethinking healthy starts with rethinking nutrients.

 

Green Salad with Shrimp | photo credit: gourmetmetrics
Green Salad with Shrimp | photo credit: gourmetmetrics

This year looks to be pivotal for rethinking healthy. At the highest governmental level, the FDA has committed to release new guidelines for label claims. As the FDA commissioner put it earlier this year:

“Healthy” is one claim that we believe is ripe for change … Traditionally, we’ve focused primarily on the nutrients contained in food in considering what is healthy. But people eat foods, not nutrients. This is why we’re asking the important question of whether a modernized definition of “healthy” should go beyond nutrients to better reflect dietary patterns and food groups …

Emphatically my answer is yes.

An FDA mandate for nutrient claims only covers consumer packaged goods. And maybe even restaurant menu labels at some point in the future. But what the FDA decides makes a packaged food healthy permeates the general food ecosystem. When FDA defined healthy in the early 1990s as low fat and low sodium, low fat reigned supreme for a decade.

Nutrients are important. No argument here on that point. As a dietitian and culinary nutritionist, I spent a couple years learning just how important they are. But so is food. And taste. And culture. And tradition. Not to mention enjoyment. So I applaud the decision to acknowledge that food is as much a part of a healthy pattern as nutrients. Defining healthy as the sum of the nutrient parts is called a reductionist perspective.

The problem with a reductionist perspective.

Reducing a food to the sum of its nutrient parts tends to skewer the meaning in a negative direction. Especially when, as was the case in the 1990s, healthy was defined in terms of 4 nutrients to avoid:  sodium, cholesterol, total fat, saturated fat.

Now feast your eyes on my shrimp and greens salad pictured above. Note the variety of vegetables on the plate: a generous handful of arugula, a dark green vegetable, some radicchio, a couple of small tomatoes, and some sliced scallions. The greens make up the bed for those lovely freshly steamed wild caught North Carolina shrimp.

Remember that under the original concept of healthy, food did not count. Well, those pristine steamed shrimp are salty. All shrimp are salty. Shrimp live in the sea and the sea is salty. When healthy was measured by counting milligrams of sodium per 100 grams, shrimp are automatically knocked out.

Remember too under the original concept, palatability did not count. Salads taste better when they are served well dressing, but a couple of tablespoons of fine olive oil and sherry vinegar added too much fat and saturated fat.

In other words, the only way to make this plate healthy under the original concept was to remove the shrimp, hold the vinaigrette, and serve the greens naked.

This reductionist view of healthy did a lot of damage. Is it any wonder so many folks rejected such a austere approach and labeling a food healthy became the kiss of death?

What a difference a couple of decades makes.

A lot has changed since 1994. That’s the year the Nutrition Labeling and Education Act became law and the draconian nutrient content claim for healthy was cast in regulatory cement.

In 2016, The FDA released a preliminary working document indicating their thinking on revising the nutrient criteria for labeling food healthy.

Use of the Term “Healthy” in the Labeling of Human Food Products: Guidance for Industry.

And with the release of the most current Dietary Guidelines in 2015, a healthy pattern took precedence over unhealthy nutrients.

Previous editions of the Dietary Guidelines focused primarily on individual dietary components such as food groups and nutrients. … The 2015-2020 Dietary Guidelines provides five overarching Guidelines that encourage healthy eating patterns, recognize that individuals will need to make shifts in their food and beverage choices to achieve a healthy pattern, and acknowledge that all segments of our society have a role to play in supporting healthy choices.

So what do these changes mean for my shrimp and greens salad?

Bottom line is that my simple little salad of greens, tomato, shrimp, and vinaigrette just got a whole lot healthier.

Thanks to revised thinking from the FDA, the ratio of saturated to unsaturated fats is now more important than just the grams of saturated fatty acids. Olive oil, although it does contain a significant franction of saturated fatty acids has a stellar ratio of almost 6 to 1.

And thanks to the Dietary Guidelines, the pattern and the whole plate are now important. Food counts and you get bonus points for more fish like shrimp and more dark green vegetables like arugula.

We’re not there yet, but my sense is we may actually be moving in the right direction.