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.

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.

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.

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 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.

Will 2018 be the year I can finally eat healthy?

 

Chicken Tagine | photo credit: gourmetmetrics
Chicken Tagine | photo credit: gourmetmetrics

Healthy eating has been in a state of transformation now for the last couple of years. It’s hard to date exactly when the sea change started but we’ve gradually been moving away from low fat, restrictions, and deprivations.

During the 1990s healthy really was synonymous with low fat, restrictions, and deprivations. That was decade when restaurants stopped using the word because they quickly determined that labeling a new menu item heart healthy or low fat was the kiss of death.

Home cooks and creative chefs have probably never paid all that much attention to nutrition guidelines and, just between you and me, I never cooked low fat at home even though I did my nutrition studies during the 1990s. But mainstream Americans embraced carbohydrates and sugar and cut out the fat.

I knew things were happening in the academic community when I started seeing studies like these here and here and here.

And if I were asked to provide pivotal dates, I would cite the publication of the 2015-2020 Dietary Guidelines because of the implicit acknowledgement that the sum may be greater than its individual parts.

Previous editions of the Dietary Guidelines focused primarily on individual dietary components such as food groups and nutrients. However, people do not eat food groups and nutrients in isolation but rather in combination, and the totality of the diet forms an overall eating pattern.

Or perhaps the FDA decision to exercise enforcement discretion as the agency reviews labeling criteria for manufacturers who want to label their products healthy.

But when I see a statement like the one below from a restaurant consulting group suggesting deprivation and restriction need no longer be a necessary component of healthy eating, I begin to think 2018 may actually be the year when the pieces fall into place. Healthy Dining is a San Diego based restaurant consulting group. Here’s that quote from the CEO from a recent blog:

There’s a new trend in healthy eating and restaurant dining, and it is leaving behind restriction and deprivation in favor of savoring great meals at restaurants that support a healthy lifestyle.

So you may be wondering what all this has to do with my lovingly prepared and very tasty chicken tagine pictured above?

Well let me explain. Even by current liberalized criteria, my tagine is not technically healthy.  Despite using quality ingredients and significant amount of vegetables to compliment the chicken thighs, my cooking uses more olive olive than is currently recommended.

Since the 1990s when those draconian criteria were cast in regulatory concrete, many of my zealous colleagues have dutifully taken classic recipes like the one I used for the tagine and made adjustments to the proportions to restrict fat, saturated fat, and sodium.

Relief is in sight however. To their credit, the FDA has acknowledged the need to revise that criteria. And I say congratulations. Maybe a little late, but better late than never …

What will the new criteria look like?

Hopefully a better way to asses the food and nutrition values of a dish like the one pictured above. We need a scoring system that awards points for making half the plate vegetables plus positives like fiber and protein. Then we need that same scoring system to balance those positives against sodium and saturated fats.

The unintended consequences of buying labels instead of food.

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Was visiting one of my favorite foodie stores in the Catskills last weekend and as I walked through the produce aisle I happen to notice the apples. Now this is the beginning of a glorious apples season in New York State. Local production is varied, delicious, plentiful, and available during the next couple of months.

The store prides itself on being a “health food” store and is a stickler for organic certification. But I figured they would also bring in local product if only as a gesture of good will. To my utter amazement, there were no New York State apples. Just USDA Organic apples from, would you believe it, Argentina!

That means the store choose to import an apple from Argentina which is over 5,000 miles away instead of carrying a locally grown apple. And that got me to thinking about what happens when folks make decision on what to eat based on the label instead of based on the apple.

That apple pictured above was from last fall. I can’t remember the varietal name but I do remember how delicious it tasted last fall I took the picture first because the apple looked so fresh and shiny. I don’t remember if the grower had bothered to get USDA Organic Certification. In fact I don’t care. I value local over USDA organic so I select growers and farmers carefully but best practice is more important to me than a particular certification.

Besides I also know that pests and weeds are a fact of farming life, so you have to do something to protect the crop. Organic certification does not mean no pesticides or herbicides. It just means the pesticides or herbicide used are natural and not synthetic. I also know that eating more apples is better for your health independent of an organic certification.

The orchard were I bought that apple has been selling apples for 10 generations which suggests these folks are seasoned and experienced. Ten generations ago, everyone farmed organically because there were no synthetic products. Organic certification on the other hand is really the new kid on the blog. State certifications started gaining prominence starting in the 1960s and USDA process verification started in the early 1990s.

Since the organic certification process is expensive and time consuming, many small scale growers and farmers don’t have the manpower or the discretionary dollars to get the certification. And since pests and weeds are a fact of farming life, everyone needs to use some sort of protection.

It really is a matter of trust. And in the best of all possible worlds we wouldn’t need to choose and we could have both. But sometimes you do have to make a decision. Some of us have more trust in an impersonal label or a certification. Others like me have more trust in the people do the farming or growing. At least choosing between an Argentinian apple and a local New York State, at least you’re still eating an apple. A whole fresh piece of fruit with all the attributes of an apple.

There’s a more sinister consequence of buying labels instead of food. Imagine a fresh apple versus apple juice. Or a fresh apple versus versus a packaged consumer goods apple product. Most would agree that a fresh apple is more nutritious than an ultra-processed apple snacks made from dried apple powder and sugar even if the label says the product is natural, gluten free, and nonGMO verified.