Feast your eyes on this plate of perfectly roasted chicken. What’s your reaction? There’s no right or wrong reaction, just please keep this in mind, how you react is an indicator of how you relate to food.

Cooks think flavor first. Home cooks or chefs focus on that delicious crispy skin anticipating the tender flavorful meat beneath.

Dietitians on the other hand think nutrients first. So, after checking the internal temperature, many of my zealous colleagues will remove that crispy delicious skin before taking the first bite.

It shouldn’t come as a surprise that dietitians and cooks have a hard time planning a healthy meal together. Cooks look for healthy ingredients. Dietitians look for healthy, or more often unhealthy, nutrients. Both perspectives are valid, but the partnership is antagonistic from day one.

Being both dietitian and home cook, I face a dilemma on a regular basis.

Linn Steward is a follower of this blog. We met electronically when she contacted me regarding one of my posts. We agree in some areas and disagree in others—most notably on the NOVA classification of ingredients which she embraces as a cook and I abhor as a food scientist. I turned to Linn in her role as a RDN to help describe what it takes to pronounce a food or a meal healthy. Fortunately, I got more than what I asked for! I encourage my readers to check out her blogs at gourmetmetrics.com.

Healthy Food

Growing up in California set my expectation for abundant seasonal fruits and vegetables. I was practicing farm to table long before that phrase became trendy.

Healthy for me always meant ingredient quality and an absolute commitment to freshness, seasonality, shopping specialty stores, butchers, fishmongers, and open-air farmers markets as the season permits.

As long as the ingredients were freshly prepared and carefully sourced, I assumed I was putting a meal on the table that was healthy. Then, as a French major in college, I spent a year in Bordeaux and was privileged to extend my stay for a couple of years which included a two-year engagement private cooking for a lovely lady who lived in a suburb on the outskirts of Paris.

Planning a meal around a roast chicken in those days always required finding a good bird, a robust little raptor bred for flavor, allowed to forage and dig worms, and by today’s standard slow to reach market weight.

As for the rest of the meal, I looked for something refreshing and crisp like a salad for openers. A crisp escarole salad with pear and Parmigiano was always appreciated. Then for sides, maybe braised red chard and little steamed potatoes.

Celebration meals require a real dessert and roast chicken is always worth celebrating. One of my favorites was a French dessert called clafoutis, a creamy eggy compromise between a custard and fresh fruit, cherries in the summer and apples in the winter.

My goal in returning to school to study nutrition was to complement all the good recipes I had collected with nutrition data. But I was totally unprepared for the results when I ran my first set of nutrition stats.

Unhealthy Nutrients

With the passage of the NLEA (Nutrition Labeling and Education Act) in 1990, the word healthy was officially defined as a nutrient content claim and therefore subject to regulatory control. Manufacturers could not use the word on food packages unless certain nutrient values for fat, saturated fat, cholesterol, sodium, and certain micronutrients were met.

My nutrition education started in 1994, one year after the FDA mandated implementation of the Nutrition Facts Label.

Becoming a dietitian taught me how to measure healthy in grams of fat and milligrams of sodium. And I was appalled just how unhealthy that roast chicken dinner was using the original nutrient focused criteria detailed in the 1990 NLEA.

Over the next two decades, the public was educated to believe healthy was synonymous with low-fat. The FDA controlled the use of the word up until 2015. That was the year FDA asked KIND BARS to remove the word healthy from the label because almonds are high in fat. KIND filed a citizen’s petition and, in 2017, the FDA acknowledged that the word healthy needed redefinition.

Debbie Downers

Dietitians have developed a bad reputation in the culinary world. Cooks and chefs know folks care more about food than nutrients, but because of our training we dietitians tend to just focus on the nutrients and forget about the food.

Nutrient compliance requires that all boxes be checked. Let me explain by detailing the roast chicken meal from a nutrient compliance perspective. Using parameters set by current dietary guidelines and without getting too lost in nutrient weeds, let’s take a look at how that 980-calorie roast chicken meal breaks down. Compliance is marked  ✅ Non-Compliance is marked ❌

Protein – 47 grams / 19% calories ✅

Carbohydrate – 99 grams / 39% calories ❌

Added Sugars – 16 grams / 6% calories ✅

Total Fat – 47 grams / 42% calories ❌

Saturated Fat – 12 grams / 10% calories from ❌

Sodium – 772 milligrams / 0.8 grams per 1000 calories ✅

Dietary Fiber – 14 grams / 14 grams per 1000 calories ✅

Some nutrients like fiber, sodium, added sugar, and protein are compliant. Other nutrients like total fat, saturated fat, and carbohydrates require adjustment.

Much of the work I do for my clients entails just this sort of re-engineering. So, trust me when I tell you that bringing a meal into nutrient compliance requires uncompromising alteration.

 The Healthy Kerfuffle

By acknowledging the KIND petition, the FDA placed the word healthy in regulatory limbo. I would argue the word has been in free fall ever since.

As part of their redefinition process, FDA asked for comments. My professional association (Academy of Nutrition and Dietetics) submitted their comments in 2017 and included a nicely phrased summary of how the public perceives the word healthy:

Several practice groups noted at the outset that the public’s broad familiarity with the term “healthy” is both helpful and unhelpful to its use as a nutrient content claim. The term is seemingly well-understood, yet it has an amorphous “we know it when we see it” essence to it. Not only does “healthy” lack a specific, common definition, but the definitions are not universal or objective; what is healthy for one person is not necessarily healthy for another person with unique, individualized health concerns.

The reductionist nutrient approach to healthy that I was taught in the 1990s has also come under scrutiny. Darius Mozaffarian* put it nicely in this 2018 article:

Recent advances in nutrition science have shown that foods and diet patterns, rather than nutrient focused metrics, explain many effects of diet on non-communicable disease.

A joint initiative by the CIA and the Harvard TH Chan School of Public Health called Menus of Change has also become an important player on the healthy eating scene. Now in the seventh year, this initiative for the food service industry promotes a vision for integrating nutrition with environmental stewardship and is redefining healthy to mean more plant-based foods and fewer animal-based foods.

Where to Land?

Reducing healthy down to a couple of nutrients may be insane, but that doesn’t mean nutrients aren’t important. It’s complicated so let’s take another look at the roast chicken meal.

The meal is vegetable and fruit rich. Little steamed potatoes taste very good straight up. The salad uses pears and the dessert is apple based. Note that salads and greens both benefit from fat preferably from good olive oil, considered a healthy fat.

Note too that the sodium value for the meal is compliant. Meals that are freshly prepared with good ingredients don’t require large amounts of salt to taste good. Cooks love salt for good reason. Good cooks also know that it doesn’t take much, just a kiss here and a couple of pinches there.

As for roast chicken, celebration meals will always be welcome at my table but other tradeoffs are acceptable. A smaller portion counts as a compromise. And so does less frequent. Celebration meals are occasional events, not meant to be everyday occurrences.

Real desserts don’t need to be everyday events either. I got in the habit of eating a fruit after the meal during my private cooking days and it’s a habit I brought with me when I returned to the States. Serving more fresh seasonal fruit adds sweetness without added sugars.

Because the word healthy is still in free fall, it’s hard to say exactly what it means today or what it will mean when it comes back down to earth. One thing is certain, when FDA finally re-defines the word for labeling purposes, that action will never have the same impact on public perception that it did in the 1990s.

Good health is always important. And so good nutrition. And environmental sustainability. And delicious food. And the pleasure and comraderie of breaking bread with friends and family at table.

So what’s healthy? It’s complicated and that’s just the way it is.

* Dean and Jean Mayer Professor at the Tufts Friedman School of Nutrition Science and Policy, and Professor of Medicine at Tufts Medical School

Next Week: I was a food technologist: A chronicle from teen-age to new age by Aaron Brody

GOURMET METRICS Linn Steward RDN, Culinary Nutritionist

Linn is a registered dietitian with experience in both clinical nutrition and corporate wellness. She owns Gourmet Metrics LLC and currently runs nutrition stats for website recipe collections, cookbook editors, and food writers. She has also cooked privately in Paris, worked on a farm in British Columbia, and earned a Masters in Comparative Literature from Berkeley. She blogs and tweets about food, regulatory issues, food labels, and home cooking.