by Marion Nestle
Apr 17 2012

Do We Need Better Advice About Eating Well? I Vote Yes.

The New York Times asked me, among others, to contribute to its  Room for Debate blog on the question of whether anyone could possibly need to hear one more word about what constitutes a healthful diet.  Here’s my two-cents’ worth:

Better Information and Better Options

Of course Americans need more information about eating well. Otherwise we wouldn’t have an obesity problem. In my daily teaching and contact with the public, I hear endless confusion about what to eat.

People are bombarded with conflicting advice, much of it from sources with a vested interest in selling particular foods, supplements or diet plans. Nutrition studies tend to focus on single nutrients, making their results difficult to apply to real diets. No wonder people have a hard time knowing what or whom to believe.

This is too bad, really. The basic principles of healthy eating could not be easier to understand: eat plenty of vegetables and fruits, balance calorie intake with expenditure, and don’t eat too much junk food.

If such principles seem hard to follow, it is surely because of how they affect the food industry. Balancing calorie intake often means eating less, but doing so is bad for business. Food companies must do everything they can to sell more food, not less.

So they make foods available everywhere — even in drug, book and clothing stores — and in very large portions. Few people can resist eating tasty food when it’s right in front of them. Large portions alone explain rising rates of obesity: they encourage people to eat more calories but to underestimate what they have eaten.

Healthy eating requires a food environment that makes it easier for everyone to make better choices. It also requires a food system that makes it cheaper to buy fruits and vegetables than less healthful foods, so everyone can afford to eat healthfully. Fix the farm bill!

  • Dan C

    I completely disagree with the premise that “Of course Americans need more information about eating well. Otherwise we wouldn’t have an obesity problem.”

    I know when I was over 300 and eating Pizza and Fast Food, I knew they weren’t good for me, but I really didn’t care. I think the notion that perfect information cures obesity is just wrong on the face of it.

    IMO, the Obesity problem is more like an addiction problem than anything else. Folks know Heroin isn’t good for them, but some folks still shoot up. Much like Alcoholics or other drug abusers, some folks are just more prone to addiction than others. It isn’t lack of information pushing the obesity epidemic, it’s an environment of cheap and addictive calories, and basic food reward hardwiring in our brains and hormone systems.

  • Louisa

    I agree with Dan C. It seems preposterous to me to keep thinking that more information is going to solve anything. I’m at the low end of obese myself, and for heaven’s sake, I’m a nutrition major. Most people I know who have dieted off and on their entire lives know more about nutrition than my skinny classmates. If knowledge alone were enough to solve the problem, we wouldn’t have one. We also wouldn’t have people who smoked, people who drank too much, or people who did hard drugs, but we do, because knowledge isn’t a very good predictor of behavior. I’m not sure what the answer is to the obesity epidemic (and I don’t think we should even be calling it that- obesity isn’t a disease, but a symptom. Might as well have a “fever epidemic”) but it isn’t more education alone.

  • http://www.breastcancerdefense.com Natalie

    Very well said Marion. In response to the other comments, of course – knowledge alone cannot fix the problem, but think of the flip side. What if there was no one out there promoting a healthy diet? Where would we be then? I believe knowledge is very powerful – though it may not provide an immediate solution, it opens up doors and helps those that are ready and willing to take action.

  • http://www.dynamicbalancenutrition.com Laurel Blair, NTP

    What an absurd conclusion! First of all, the information we are bombarded with about “healthy eating” is totally bogus, for the most part. People don’t want to eat healthy because they believe it means skim milk, soybean oil, lean meats (if any), tofu, and humongous plates of veggies! It’s enough to send practically anyone running for the phone to order a pizza.

    Folks, let’s think about this for a second. Back when heart disease was a RARE condition (along with cancer, obesity, and diabetes), did we drink skim milk, or 2% milk? No, we did not. Actually, on the homesteads and family farms that were much more common back then, the farmers would give the skim milk to the pigs to fatten them. They knew that whole milk doesn’t work to fatten hogs, but skim milk works great! My grandmother grew up on a farm and that is what they did. People back then used butter and lard for cooking. For meat, they mainly used pork. Tofu and fake meats did not exist in the United States. Seed oils were practically non-existent. Nobody thought about removing the fat from their meat for health reasons! People only ate vegetables that were locally available and seasonal, or those that had been preserved through fermentation. They didn’t have salad greens, broccoli, and bell peppers available year round!

    I think most people are painfully aware of what the government and media says constitutes a “healthy” diet. They just don’t want to eat a diet that is so austere, so bland and boring! I remember feeling so frustrated back when I tried to eat “healthy”. I would be just starving, and I would eat a huge bowl of beans, rice, and vegetables. Then I would feel bloated and overly full. Then a little later on, I would get a craving for ice cream so strong I simply could not resist, and I would binge out. Oh, and even later on, I would get severe stomach cramps and diarrhea/constipation/IBS. Over time, this unenjoyable cycle led me to gain 35 pounds, even though I got plenty of exercise.

    Now I eat a small bowl of chicken or beef stew made with homemade bone broth and with plenty of fat, or some whole milk organic yogurt, or bacon and eggs, and I feel great! I never crave ice cream anymore because my body is getting the fats it needs already. IBS symptoms are completely gone. Digestion is perfect. Energy is up. Oh, and I lost a bunch of weight. It’s a much nicer way to live. I actually enjoy eating now! And I’m so much healthier than I was back when I ate the politically correct version of “healthy eating”.

    So the moral of the story is that people do need better advice about healthy eating – but it needs to be DIFFERENT advice! The advice we have been given since 1977 (which is when the government started telling us what to eat, and also when obesity rates began to rise – coincidence? I think not!) has completely and totally failed. In fact, it has made us way less healthy. Let’s all stop listening to people who clearly do not have our best interests in mind.

  • http://www.FeedYourHeadDiet.com Ken Leebow

    Re: Few people can resist eating tasty food when it’s right in front of them.

    To combat the above-stated problem two issues must be addressed:

    1. Satiety – every time you eat, think in terms of satiety. Few discuss it, but there’s only two nutrients that provide the feeling of satiety.

    2. Taste – You must identify foods with health benefits that taste great. Instead of the advice … eat more fruits and vegetables, we need to identify incredible (and usually simple) recipes that include more fruits and veggies.

    Once you identify the methodology to address those two words (one concept), you have a fighting chance to fend off the onslaught of the horrific American food system.

    Ken Leebow
    http://www.SatietyandTaste.com

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  • B.

    The advice I ever received was from Michael Pollan-don’t eat anything your grandmother, or great-grandmother for the younger set, wouldn’t recognize as food.

  • http://www.tipsonhealthyliving.com/ Val @ Tips on Healthy Living

    What about the fact that packaged foods and fast food are often cheaper than buying fresh produce and meat? Not to mention the price of organic food.

    Dan C makes a valid point. In terms of education, perhaps what’s lacking is not the knowledge of what food is healthy but what is a healthy portion or what are the healthy fats your body does need?

  • Amy

    I have to agree with Laurel on this one. It isn’t a lack of information that is causing the obesity epidemic. I believe it’s more that the information we’ve been given is completely incorrect. Low fat dairy, overly lean CAFO raised meats are not part of a healthy diet! Calories in / Calories out is a false message. Not all calories are equal.

    Let’s get back to whole foods raised sustainably.

  • http://foodiesarsenal.com Todd

    Really good thoughts… I agree. I think it’s tough to eat right not only in the face of conflicting advice and recommendations, but also the inherent messages of how foods are packaged and portioned. “Serving sizes” for nutrition labels are often comically undersized, and the actual serving that the packaging and portions seem to suggest is deceptively large.

    I hadn’t thought about how nutrient studies are so disconnected with a holistic explanation of balanced diet, but I think that’s an interesting point as well. It would be great to have more suggestions on how to cover multiple bases at once when it comes to improving our intake of various nutrients.

    Thanks– really cool thoughts.

  • Erika Lindgren

    Laurel-

    If you thought a healthy diet was “bland and boring” you weren’t doing it right. I am so tired of people thinking eating healthy means food that tastes like cardboard. There are these lovely things called spices that humans have been using for millenia. Most people who have trouble with a “healthy” diet tend to always eat the same thing where variety- in any diet- is key. Those farmers you reference were probably much more active than the average American today (some may also have had a shorter life expectancy since the average life span for Americans has increased over the 20th century). By the way, never had problems myself with constipation on a vegan diet, that only comes from eating meat with its lack of fiber. And I too am much more healthy than I was when I ate the type of diet you describe above (which shows you how far you cannot go on purely anecdotal evidence). That said, everyone’s digestion and nutrient absorbtion works differently so not every diet works for everyone. And Nestle is not saying give up meat or dairy, she is saying eat less of it.

  • chuck

    hmmmm, great post. and i don’t say that much here.

  • Beenie

    Get some exercise everyday; don’t base your daily nutrition on junk food and soda; eat whole foods; pay attention to how much your eating throughout the day (preferably eat when you can actually pay attention to what you’re eating and just eat until your hunger is satisfied), and you’ll be fine. I lost nearly 30 pounds this way, with an omnivore diet (granted, an omnivore diet very heavy on leafy greens and vegetables because I love them). I don’t really pay attention to portion sizes. I just make a point to eat only when hungry and eat slowly and mindfully until satisfied, and I always wait at least 20 minutes to decide if I want second helpings of something. Learning to control your eating takes practice, and took me many failings and restarts to really learn how to do it and make it a habit.

  • http://www.thehealthyeatingguide.com/index.html Scott @ The Healthy Eating Guide

    Completely disagree with Dan et al … “I know when I was over 300 and eating Pizza and Fast Food, I knew they weren’t good for me, but I really didn’t care. I think the notion that perfect information cures obesity is just wrong on the face of it.”

    It’s not as black and white as “knowing what’s good for you.” The issue here isn’t offering “perfect information that cures obesity”; rather, it’s providing BETTER, easier-to-understand information for the mass public, which clearly has no notion of what eating healthy means, or doesn’t have the means to eat healthy.

    I agree that the environment of cheap and addictive calories is a large underlying factor here with the obesity problem, but to blame “the system” for your lack of motivation, given that you supposedly knew exactly what you were doing wrong, is a complete cop-out.

  • brad

    Knowledge alone does not change behavior (there is lots of evidence to back up this conclusion), but knowledge is an important part of the equation. Based on the well-researched and tested approaches described by Chip and Dan Heath in their book “Switch: How to Change Things When Change is Hard,” here are some tips that could be used to help Americans switch to healthier diets and lifestyles:

    1. Follow the bright spots: Find out what’s working and clone it. Study lots of people who lose weight and are successful at keeping it off, find out how they do it. (Almost any diet will work, but certain diets work much better for some people than others).

    2. Script the critical moves: Come up with ways to influence behavior at critical decision points: e.g., if you’re thirsty, drink seltzer instead of soda.

    3. Point to the destination: Give people a tangible goal to keep them going in the right direction. “You’ll look great at the beach,” or “You will fit into your wedding dress.” Or a photo of the person when they were thinner and healthier.

    4. Find the feeling: Motivate people emotionally, not just with knowledge. A photo of belly fat, a photo of all the sugar contained in a bottle of soda, etc.

    5. Shrink the change: Break down the change until it’s no longer so large that it’s overwhelming. If you have to lose 60 pounds, it’s a lot easier to shoot for losing 1 pound this week.

    6. Grow your people: Help people create identities of themselves as healthy individuals, instill a positive mindset. How to do this on a grand scale isn’t obvious, but the gist is that you’re more likely to be successful if you view yourself as successful. Small victories (losing a few pounds, successfully resisting a donut) add up to the conclusion that “yes, I can do this.”

    7. Tweak the environment: If your situation promotes unhealthy eating, change the situation (remove unhealthy foods from the house so they don’t tempt you, don’t carry change for the snack machine at work).

    8. Build habits: Maintain healthy eating and exercise long enough so they become your “new normal” and it feels strange to slip back into your old patterns. When you pass by a box of donuts and no longer feel even tempted to try one, you know you’ve arrived. It takes time.

    9. Rally the herd: Tell others about your success and help them follow your lead.

  • Ana

    From what I’ve seen, the majority of people don’t know what it means to eat healthy. What I mean by this is, they don’t know the basics of eating mostly fruits and vegetables and balancing out the rest. People think that if a box tells you is this many less calories and it has “healthy, lean or skinny” written on it, then it’s healthy.

    One of the biggest problems, IMO, is that most people today don’t remember how to cook or don’t know how to cook at all. If you cooked from fresh and whole foods, you’d know that’s is a lot cheaper to cook at home than to buy junk food for lunch and dinner everyday. Everything else falls will fall into place when people go back into the kitchen and return to making their own food.

  • Ana

    I want to add, exercise is important. I understand not everyone has to go to the gym or hire a personal trainer, but some people can bike, run or walk, skate, play tennis or basketball at home, catch with the kids, clean the house, garden–there are so many things that one can do besides sitting on the couch whenever you’re home. Every little bit counts towards increasing one’s metabolism.

  • http://mediterraneandiet.tv/ EdSanDiego

    Events, dear Professor, events.

    Which came first, the desire to overeat or the bloated food enviornment?

    If it’s the desire, you won’t get rid of the environment that serves it without root canal work on the triggers.

  • Margeretrc

    “What if there was no one out there promoting a healthy diet?” What did our forebearers do before the government decided to inform us as to what a “healthy diet” is? As Laurel said, they ate tried and true traditional foods that their ancestors had eaten before them. And they didn’t suffer the myriad of metabolic diseases that are common today. If there were no one out there promoting a healthy diet, we would be fine–just as the French are and other cultures that have not bought into (or heard of) the American version of what a supposedly healthy diet is. We are in trouble today precisely because the government decided to educate us all as to what is “healthy’ and what is not. Wish they had left well enough alone!

  • El

    The problem isn’t lack of information, it’s both the most prevalent source of the information (advertising, television shows) offering a quick fix for obesity and the willingness of human nature to accept that all they need is the quick fix. I agree that there are a lot of people who don’t “get” that eating largely processed foods doesn’t constitute a healthy diet, so yes, more promotion is needed. In light of the competition from the food industry it will be a long battle to make people realize that eating healthy means cooking, reading labels, limiting processed foods and portions.

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