The way we talk about nutrition in this country is absurd. And you only need to look as far as Brazil to understand why.
Yesterday, a US-government appointed scientific panel released a 600-page report that will inform America's new dietary guidelines. These guidelines only come out every five years, and they matter because they truly set the tone for how Americans eat: they're used by doctors and nutritionists to guide patient care, by schools to plan kids' lunches, and to calculate nutrition information on every food package you pick up, to name just a few areas of impact.
But this panel and their guidelines too often over-complicate what we know about healthy eating. They take a rather punitive approach to food, reducing it to its nutrient parts and emphasizing its relationship to obesity. Food is removed from the context of family and society and taken into the lab or clinic.
Brazil, on the other hand, does exactly the opposite. Their national guidelines don't dwell on nutrients, calories, or weight loss. They don't jam foods into pyramids or child-like plates. Instead, they focus on meals and encourage citizens to simply cook whole foods at home, and to be critical of the seductive marketing practices of Big Food.
The approach is so refreshing that it has attracted praise from critics like Marion Nestle and Yoni Freedhoff, and when you contrast the Brazilian method with the American way it's not hard to understand why.
America's punitive approach to food
Reading through the new document that'll feed into the forthcoming US dietary guidelines, you stumble on phrases like "shortfall nutrients," "overconsumed nutrients", and "nutrients of public health concern." There are good foods and enemy foods.
In the new recommendations, for example, the panel suggests that we can now embrace cholesterol-laden fare like eggs after years of shunning and that coffee and moderate alcohol can be part of a healthy diet. ("Go ahead and make that omelet," the LA Times suggested.) Red meat gets a bit of a beating (a fact some will surely quibble with given the evidence that suggests red meat in moderation is just fine for many of us). Overall, the emphasis is on nutrients and specific food groups, not meals.
In other words, food isn't discussed in terms that relate to how people actually eat or think about how they eat. Interestingly, the panel was also trying to get across the message that people should consume more vegetables, fruits, and whole grains, and less sugar and processed food. They say they want people to focus on dietary patterns, not on nutrients and food groups. But in 600 pages that essentially do the opposite, that message is lost or at best confused.
Brazil, where "eating is a natural part of social life"
To fully understand the absurdity of the food situation in America, let's turn back to Brazil. Brazil is clearly a very different context than America. The country has only relatively recently emerged as a global economic force, and under-nutrition is still as much a concern as the rising obesity problem. But it's a fascinating country when it comes to health and it's probably exactly their emerging status that has forced them to be smarter about food and nutrition.
Brazil only got universal healthcare in the late 80s, which means they were able to build a system that learned from many of the mistakes other industrialized nations made and have now entrenched. They have some of the best electronic medical record coverage in the world, for example, they have family health teams in many of the most remote areas of the country, and they reached their UN millennium development goals early, dramatically reducing infant mortality in the country through a series of creative programs that got moms and babies to be healthier.
In 143 pages, the Brazilian health ministry also lays out what may be the most intelligent food guide in the world. Here are some highlights from an English translation:
- On whole foods: "Make natural or minimally processed foods the basis of your diet. Natural or minimally processed foods, in great variety, mainly of plant origin, are the basis for diets that are nutritious, delicious, appropriate, and supportive of socially and environmentally sustainable food systems."
- On salt, sugar and fat: "Use oils, fats, salt, and sugar in small amounts for seasoning and cooking foods and to create culinary preparations. As long as they are used in moderation in culinary preparations based on natural or minimally processed foods, oils, fats, salt, and sugar contribute toward diverse and delicious diets without rendering them nutritionally unbalanced."
- On processed foods: "Because of their ingredients, ultra-processed foods — such as packaged snacks, soft drinks, and instant noodles — are nutritionally unbalanced. As a result of their formulation and presentation, they tend to be consumed in excess, and displace natural or minimally processed foods. Their means of production, distribution, marketing, and consumption damage culture, social life, and the environment.... Ultra-processed foods are formulated and packaged to be ready-to-consume without any preparation. This makes meals and sharing of food at table unnecessary. Ultraprocessed foods can be consumed anytime, anywhere, often when being entertained or when working, walking in a street, driving, or talking on a phone."
- On eating as a social experience: "Clean, quiet, and comfortable places encourage attention to the act of eating mindfully and slowly, enable meals to be fully appreciated, and decrease overeating.... Humans are social beings. Eating together is ingrained in human history, as is the sharing and division of responsibility for finding, acquiring, preparing, and cooking food. Eating together, with everything that is involved with eating, is part of the evolution and adaptation of humanity and the development of culture and civilisation. Eating together is a natural, simple yet profound way to create and develop relationships between people. Thus, eating is a natural part of social life."
The "golden rule"
All this amounts to the Brazilian food guide's "golden rule," which you'll note reads like something in a Michael Pollan book:
"Always prefer natural or minimally processed foods and freshly made dishes and meals to ultra-processed foods. In other words, opt for water, milk, and fruits instead of soft drinks, dairy drinks, and biscuits, do not replace freshly prepared dishes (broth, soups, salads, sauces, rice and beans, pasta, steamed vegetables, pies) with products that do not require culinary preparation (packaged soups, instant noodles, pre-prepared frozen dishes, sandwiches, cold cuts and sausages, industrialised sauces, ready-mixes for cakes), and stick to homemade desserts, avoiding industrialised ones."
America really needs to follow Brazil's lead. Nutrition science is notoriously flawed. We're also learning more and more that our genes play a big role in how food impacts our bodies, and that one individual's best diet is another person's worst.
There are truly only a few evidence-based nuggets that we can all agree on: we can stand to eat more vegetables, fruits, and whole food, and fewer added sugars and processed foods. We also know that people typically consume about 20 to 40 percent more calories in restaurants than they’d eat at home. Brazil got these simple truths. Why can't America?
h/t Yoni Freedhoff who suggested I look at Brazil's amazing guidelines.