Remember the parable about the blind men and the elephant? When we consider our relationship to food, the situation is similar. Healthiness is the elephant. Food professionals are the blind persons. We can’t escape our education and background. Where do we focus our attention? What do we miss in the process?
Food scientists focus on a healthy diet. First comes protection from foodborne illness. To them a healthy diet balances nutrient adequacy without an overindulgence in calories. It is unfortunate that food science students seem to be getting less education in nutrition. A food ingredient marketer considers a balanced diet that also encompasses lifestyle, convenience, and affordability. A culinary nutritionist rejects the emphasis on nutrients. A food sociologist divides food types into healthy and unhealthy ones. Whole foods and homemade ones are healthy in general; processed foods are not.
FDA has defined a healthy food in terms of its nutrient content. The agency is reconsidering how to redefine it and approve the use of a healthy label on the front of the package. It appears that most of us have a concept of healthiness that we find hard to put into words. We believe what we are taught and what we read. As we get more into our professional lives, our reading gets more selective and exclusive. We become victims of confirmation bias. Our premises harden. Our suppositions become personal truths. This mental concept of healthiness becomes the basis for whether we consider a food, meal, or diet is healthy or not.
At what level do we assess healthiness? Do we assess each food, a meal, or an overall diet? Most food professionals who look at food healthiness zero in on the food itself. Each food fits within a spectrum from very healthy to not so much. NOVA lumps all foods into one of four categories. Group 1 (unprocessed or minimally processed foods) and Group 2 (processed culinary ingredients) are healthy. Group 3 (processed foods) are OK but should not be consumed on a regular basis. Group 4 (ultra-processed foods) are unhealthy and should be avoided. Profiling systems like Food Compass and Nutri-Score use algorithms to assess the healthiness of a food.
A step back on evaluating healthiness of food is the meal. Unless snacking, we eat food in the context of a meal. Does it make more sense to evaluate healthiness of individual meals rather than individual foods? Linn Steward thinks so. As a cook, registered dietitian, and a recipe analyst, she advocates balancing nutrients with palatability. If balanced and nutritious, a meal is more important than making sure every food meets a standard of health. I once had a student who reported eating nothing but grilled cheese sandwiches at every meal. It made his dietary assessment much easier, but eating a single food at each meal for a week is not a healthy practice.
Then there is an assessment of our diet. In America, a diet is something a person goes on to lose weight. Those diets tend to be very restrictive. They seek short-term pain for long-term gain. The healthiness of such a diet may be poor during its execution, but it should provide health benefits over time. When using the term diet, I consider all the food consumed over a specified period of time. It is the combination of all of those choices that constitute the healthiness of the diet. Because such an evaluation is less rigid, it allows for some foods that are on the lower end of the healthiness spectrum. It can also help people with disordered eating patterns hide their dietary difficulties. At what level, then, should we assess healthy eating?
Where do processed foods come in?
Not very high on most conceptions of healthiness. If nutrients matter, then fortification of bread and breakfast cereals makes them healthier. A more holistic view does not view them as any healthier after fortification than before. Adding niacin, a B vitamin, may even be contributing to obesity. Nutrients matter, but there is great suspicion cast on nutrients not a part of whole foods. Nutrients found in industrial formulations are sometimes add added to puff up a nutritional label.
Degree of processing is cited in the degradation of healthiness. The concept of intensity of processing differs between food scientists and public health advocates. Canning represents minimal processing to some, but heat required to kill harmful microbes degrades vitamins. Some view baking bread at home or in a corner bakery as healthy. Likewise, baking bread in a processing plant is not. Industrial formulations that combine more than five ingredients and contain food additives are not healthy by fiat. Home recipes that combine more than five ingredients and do not contain food additives get a pass. Fractionated, recombined ingredients like we find in alternative meat products are an anathema to health-conscious journalists. How could anything that unnatural be healthy?
Activists accuse practitioners of nutrition who emphasize the importance of nutrients of nutritionism. Nobody dies of scurvy anymore. Are our diets, thus, nutrient adequate? Are the daily requirements listed on product labels overstated? The side debates between defenders of processed food and their critics dance around these critical questions.
Processed foods provide harried, working mothers with affordable, convenient alternatives to homecooked meals. They don’t spoil as rapidly as most whole foods. Some processed products are high in sugar, salt, and fat. So are some home-prepared meals. Scapegoating processed foods doesn’t seem to be improving American healthiness. Maybe it is time to look beyond individual foods, meals, and diets to look at health in a broader context. Processed foods are trees. Home-cooked meals are trees. Ingredients are trees. Nutrients are trees. Healthiness is the forest. Let’s try to understand the forest and put our efforts there.
Next week: Analyzing Food Compass and other nutrient-profiling systems