I often write about the external factors that pose a threat to our health, including (but not limited to) Big Food's egregious advertising budgets, "healthwashed" and "farmwashed" food products and the litany of questionable chemical additives abundant in our food supply.
This time, however, I'm shining the spotlight inward, taking a look at pervasive, accepted and often times unquestioned concepts, ideas and beliefs within the nutrition field that are harmful because they stifle growth, critical analysis and dialogue.
1) "There is no such thing as junk food/there are no bad foods."
In very specific contexts (i.e., eating disorder recovery), I understand where this stems from -- strip away judgmental labels on food and bring it to its most basic function: nourishment. However, I'm increasingly seeing this message doled out by mainstream nutrition experts as a "takeaway" for the general public.
Let me make something very clear. If a client reports eating a king-size Snickers bar as a snack every day, a response of "Ew, why would you eat that?" is unprofessional, unnecessarily aggressive and in no way helpful. I do not condone belittling as a way to motivate.
However, the ultimate goal of a nutritionist or dietitian is to help people eat better. I am not a "weight loss-itian." I don't consider my job done simply because someone loses 10 pounds in two months. After all, weight loss can technically be achieved on an unhealthy diet.
In order to accurately promote health, I can't equalize the nutritional playing field and say something as disingenuous as "there is no such thing as junk food." Of course there is. Junk food makes people feel sluggish, tired and generally "not good." A breakfast of Oreo cookies and soda is a "junk-food breakfast," period.
Nutrition professionals need to recognize and capitalize on that. Telling someone an Egg McMuffin is not a "bad" choice because it contains protein from the egg and calcium from the cheese doesn't do anyone any favors. Dietary changes do not happen overnight and often occur gradually, but minimally processed whole foods should always be encouraged.
To my ears, "Everything in moderation!" is the equivalent of 600 fingernails on a chalkboard, plus the never-ending drip of a leaky faucet. "Moderation" is a meaningless term. Ask 20 different people what it means and you'll get 20 different responses.
"But that's the beauty of it -- each person can define it themselves!" some say. That doesn't sound like beauty to me. It sounds like chaos.
"Everything in moderation," is another way of unnecessarily and inaccurately equalizing all foods. It operates on the inane and utterly insane notion that peaches, Pop-Tarts, muffins, soda, lentils and tomatoes should all be approached the same way.
Three cups of mixed greens as part of a salad are not the same thing as three cups of chocolate pudding. A large Dunkin' Donuts Mountain Dew Coolatta should not be consumed with the same frequency as unsweetened green tea. Eating a pint of blueberries in one sitting is very different from eating a pint of Häagen-Dazs.
Nutrition professionals should not act like public relations experts for fast-food companies (not surprisingly, the fast-food industry loves "moderation" because it means their atrocious offerings can "be a part of a balanced diet"), especially at a time when the average American could seriously benefit from eating less fast food. This is not to say someone should be scolded for the occasional indulgence. However, we can not and should not deny that certain foods belong in the "eat always" category, others in the "eat sometimes" category, and others in the "eat rarely, if at all" category.
Some argue that if we do not preach moderation, we are setting the stage for unreachable perfectionism and eating disorders, an argument I find excessively melodramatic. Recommending that people shy away from fast food whenever possible is not about perfection. It's healthful and helpful advice.
3) "Healthy eater = red flag."
When I was in school, I recall many of my nutrition textbooks pointing out that vegetarians, vegans and "those who avoid certain food groups" must be warned that if they do not plan their diets adequately, all sorts of nutritional ills could befall them. Meanwhile, the average American on the omnivorous "Standard American Diet" falls short of the recommended intake of fiber and several minerals, including magnesium. Of course, this is not because omnivorous diets are inherently unhealthy, but because the majority of Americans eat highly processed foods with little nutritional value.
The "Vegans must plan their diets adequately or else!" operates under the beyond-elementary assumption that "meat = protein and iron," and "milk = calcium and vitamin D," and if you don't eat either of those two things, well, you've got your work cut out for you. Forethought, knowledge and planning are important for all eating patterns.
Similarly, the fact that someone chooses to avoid deep-fried food, soda or candy is not cause for alarm. People who eat healthfully should be encouraged, not told to, "Live a little."
4) "You have to be realistic."
This is often brought up by some nutrition professionals to justify their recommendations about making healthful choices at fast-food restaurants ("Just get the small size"). I'll admit it -- I used to think this way when I first started studying nutrition, before I counseled clients. I now see that the most satisfied individuals I have worked with are those who stepped outside their comfort zone. They aren't interested in learning how they can still go to the drive-through three times a week and making "lower-calorie choices." They want to truly learn about healthful eating.
We should not feel bad for gently challenging people. That leads me to a rather irritating "straw man" argument I often hear: "Not everyone is going to eat steamed kale and brown rice." As if the only options available to people were a quadruple Baconator burger from a fast-food chain or a bowl of steamed vegetables.
Similarly, the disturbing fact that it is now "the norm" to nuke dinner in the microwave or get takeout a few times a week does not mean we as health professionals should encourage that as long as portions are small. It has become the norm for Americans to have credit-card debt, but you'd be hard pressed to find a financial advisor who will say, "Eh, $4,000 in credit-card debt is no biggie. Most people have $20,000!"
Our public health situation is so fragile that bland toothless nutrition messaging will not do the trick. The American public deserves helpful and accurate information that can help guide them to health. Let's be part of a much-needed paradigm shift rather than fall back on outdated and reheated advice that serves little purpose.
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