Nutrition Viewpoint

Consider this statement: "Nutrient benefits can be difficult to define in pharma-styled disease-reduction models." Amen.

In a special edition on risk communication, FoodNavigator.com briefly examined how communication is challenged when highly inconclusive and contradictory data surround a single ingredient or food. Recently, we have seen this phenomenon with sodium, and controversies remain ongoing over saturated fat, high-fructose corn syrup and calcium - just to name a few.

Unfortunately, though it is at the core of dietetics practice, we have not yet discovered the solution to this communication dilemma. Most consumers do not respond to contradictions and competing theories with, "No problem. That's just the evolutionary nature of scientific discovery." Rather, they want answers - now.

I think one of the biggest challenges that dietetics will face in the future is establishing and maintaining authority amidst the ever-increasing cacophony of scientific findings in nutrition - a cacophony fed by the continuous loop of more research, more media and more interest in health.

Instinct tells me the answer to this communications challenge rests in three principles: scientific context, individuality and professional judgment. It is up to us as nutrition professionals to be the voice of authority - to help not only consumers but also other health professionals, media, and the food industry develop a mindset that demands scientific findings be viewed in context and disallows over-generalizations that undermine productive, individual decision-making.

Stay tuned for more on this subject. In the meantime, if you have any thoughts you would like to share, please comment.

When finding enough food is the issue, making healthy food choices becomes a moot point. So let's start the conversation at the beginning -  with the food supply.

As the world becomes a smaller place, food insecurity in our own backyard (including middle-class backyards) and on the other side of the world is no longer somebody else's problem. It's is a global threat. Hunger destabilizes governments, weakens societies and undermines human capacity for learning and progress.

I believe that we, as nutrition professionals, must broaden our "systems thinking" to include the very real problem of food insecurity - from lack of food to lack of healthy food options, and everything in between.

In early May, the Ford Foundation, Bill & Melinda Gates Foundation, William & Flora Hewlett Foundation, David and Lucile Packard Foundation, W.K. Kellogg Foundation, McKnight Foundation, Rockefeller Foundation and Walton Family Foundation launched AGree, an initiative designed to address the long-term food and agriculture policies confronting this country and the world.

Solutions to the problems we face in this arena require best-in-class research, comprehensive analysis and dialogue across multiple sectors, including health and nutrition. One of AGree's leaders, Dan Glickman - former Secretary of the U.S. Department of Agriculture under President Bill Clinton and a former 18-year Kansas congressman promises that AGree "will elevate the agriculture and food policy conversation . . . [and] will make it clear to leaders and policymakers that, while difficult, solving food and agriculture issues is of utmost importance and can help solve other pressing problems including public health and the need for economic growth."

I think this initiative is one to watch - both for what it can accomplish toward refining and accomplishing its mission and for the strategic collaboration model it creates. Why can't we take three of the world's most threatening, co-dependent problems - hunger, public health and economic stability - and integrate them into a solution? I think we can, and I believe nutrition is the common denominator.

Late last week, the Interagency Working Group on Food Marketed to Children issued proposed principles for voluntary industry regulation of food marketing directed at children under 17 years old. The 2009 American Recovery and Reinvestment Act (health care reform) and the 2009 Omnibus Appropriations Act (H.R. 1105) called for establishment of this working group, which is composed of members from the Food and Drug Administration, the Centers for Disease Control and Prevention, the Department of Agriculture and the Federal Trade Commission. The working group was tasked with researching and recommending standards that consider, "calories, portion size, saturated fat, trans fat, sodium, added sugars, and the presence of nutrients, fruits, vegetables and whole grains."  

No one can argue with the fact that we have a responsibility to fight this nation's obesity crisis by helping children select healthy foods. In fact, all sectors of society - parents, schools, communities, health care professionals, media and industry - play a role in teaching children how to eat all foods, including those that may be considered special treats. Research and our experience to date demonstrate that this issue is very complex; there is no easy fix.

What concerns me about this latest volley in the battle against obesity is the apparent supposition that food companies are inherently irresponsible and require government policing. An uninformed person reading the interagency group's report would walk away with the impression that the food industry has done nothing to ensure responsible marketing to children, when in truth, food manufacturers have already curtailed advertising of their least healthful products to kids. (See recent Grocery Manufacturers Association survey here.) In addition, in recent years, food companies have changed the recipes of more than 20,000 products to reduce calories, fat, sodium and sugar.

And if this is not enough, keep in mind the food industry's support of initiatives such as the First Lady's Let's Move campaign as well as the Healthy Weight Commitment Foundation and its predecessor the American Council on Fitness and Nutrition.

As nutritionist and dietitian who has spent her career in the private sector, I can assure you that food companies are not interested in marketing products to a burgeoning health-conscious segment of the population that doesn't want those products, nor are they interested in harming children! 

Finally, the interagency group's published document concludes with 30 questions that commenters are encouraged to use as guidelines for discussion. One of these questions really got my attention: ". . . If Congress were to enact them [these principles] into law, would such a law raise First Amendment concerns? If so, what are those concerns?"

You have been warned!

I just finished preparing a presentation for the California Dietetic Association. The National Cattlemen's Beef Association asked me to talk about the where the profession is headed in the future. I had to think very hard about what to say to a state association that has a history of producing so many of the profession's leaders.

I have spoken on this topic often in my career, but I think now is the time to take a deeper dive into what I see happening in food and nutrition. What must RDs do to have an impact on health and wellness in the decades to come? What can I tell my audience that they don't already know or haven't heard many times before? Should I share trend information, graphs and statistics? I thought not

I began to think of words we frequently use - for example, "food and nutrition expert." Well, today, everyone is a food and nutrition expert (or thinks they are). As is the case in many professions, dietetics faces a crisis in authority. Who is the respected, trusted, authentic, go-to food and nutrition authority?  What must the audience members listening to my presentation do to be unequivocally recognized as the food and nutrition expert?

I decided to discuss what I believe are imperatives for the dietetics profession: We must demonstrate value, examine our business models, collaborate strategically and communicate passionately as we take on the big issues that demand innovation and fuel a burgeoning national wellness movement. RDs can - and must - create this momentum.

To help illustrate my views on this topic, I drew inspiration from leaders of the past - going back to early scientists, women activists and even major reformers who served in the military. And I looked for synergy with other disciplines such as medicine, sociology, psychology and economics.

In future blogs, I will elaborate on these points, but right now, I wanted to begin sharing my readings with you. These are not sources dietitians would typically review, but taking a broad look at the world - past and present - is absolutely necessary if we are to make our mark on the future.

Meals to Come: A History of the Future of Food by Warren Belasco. University of California Press, 2006

"The Politics of Nutrition in North America," by Harvey Levenstein. Neuroscience and Behavioral Reviews. 1996. 26(1):75-78

Revolution at the Table: The Transformation of the American Diet by Harvey Levenstein. University of California Press, 2003

The Authenticity Hoax: How We Get Lost Finding Ourselves by Andrew Potter. Harper, 2010

The Wisdom of Crowds by James Surowiecki. Anchor, 2005

Wikinomics: How Mass Collaboration Changes Everything by Don Tapscott and Anthony D. Williams. Portfolio Trade, 2010

From Home Sister to Second Lieutenant: Army Dietitians in World Wars I and II by Patricia A.M. Hodges. Catawba Publishing, 2007

Government guidelines recommend that Americans lower calories, sodium and fat and increase fiber, calcium and other shortfall nutrients. These recommendations are often interpreted to mean "stay away from processed foods" - foods that are canned, frozen or packaged. Consumers rarely hear about the benefits of food processing. They are left with the belief that people who are committed to health eat only fresh foods - and, even more extreme, only locally grown fresh foods.

But let's think about our lifestyles. Is it realistic to eat this way? Is it essential to eat only fresh whole foods to be healthy? Availability, affordability, quality and safety issues add up to only one answer: No.

In fact, it would be far more beneficial to the consumer to abandon this binary good vs. bad point of view in favor of a complementary perspective. A century of transformative advances made in food science and technology allow us to produce an array of safe, nutritious, flavorful, convenient, cost-efficient foods. Working in tandem, processed and non-processed foods provide consumers a full range of choices.

Although they are rarely discussed in a positive light, food processing and packaging have clearly definable benefits for consumers:

·         Safety - Food processing removes health hazards associated with microbial pathogens. Processing operations dealing with raw food materials or ingredients carrying pathogens have significant controls and regulations to detect and inactivate food-borne microorganisms that can cause illness.

·         Quality - Food processing allows quality improvements to be made in a predictable and controlled way. Some processed products, such as canned and frozen fruits and vegetables, are often a better value than their raw counterparts and are available all year. For example:

·         Health and Wellness - Because of consumer demand for foods that promote health and wellness, manufacturers process foods to be low in calories, fat, sugar and salt and high in fiber to help people with chronic conditions such as heart disease, diabetes and hypertension.

In addition, without food processing, it would not be possible to meet the needs of contemporary urban populations in this country and around the world. These needs will grow only greater with time. Research confirms that people living on a low income have a less varied diet and thus poorer nutrient intake. Fortifying products and preserving nutrients through processes such as freezing enables those without access to a wide range of foods to gain better nutrition from the narrower range of foods available to them.

The bottom line for nutrition professionals: More information about modern food production methods and benefits is needed to help consumers make truly informed food choices from the wide variety of fresh and processed foods in today's marketplace.

Want to learn more? Here are some excellent resources that give you the whole story
on processed foods.

Institute of Food Technologists

Feeding the World Today and Tomorrow: The Importance of Food Science and Technology

International Food Information Council

Understanding Our Food Communications Tool Kit