All Foods Don't Fit
A Reply to Food Freedom Dietitians
I’ll start this by saying I love dietitians, I think their work is essential in the vast sea of misinformation online.
Over the years my perspective has changed. I went from vehemently attacking HAES and intuitive eating to adopting a more mindful attitude toward nutritional science.
I don’t believe in shame or blame for a person’s predicament as far as weight loss or gain will lead to meaningful changes, I think the current obsession with “personal responsibility” is toxic in the fitness space, I believe the emphasis on health behaviors is powerful, and I also think all foods CAN fit to an extent.
However, where we probably differ is in the fact certain foods and food ingredients should be limited to a great extent across the population while other foods should be adopted more.
The Dietary Guidelines
The USDA dietary guidelines gives nutritional recommendations, targets, and insights for the United States.
The guidelines are crafted by experts in the field of nutrition who search the scientific literature far and wide for their recommendations.
You can read the document here, but the main fact is most Americans do not consume enough fruits, vegetables, or whole grains.
In fact, Americans tend to overconsume three key ingredients:
Saturated fat
Added sugar
Sodium
Obviously, heavily ultra-processed foods tend to be high in all three ingredients while not being really nutritious. We should cover aspects of these ingredients and why they should be limited in the diet.
Americans Should Limit Saturated Fat Intake
The average American consumes more than 10.7% of their caloric intake from saturated fat. This goes against typical dietary guidelines which recommends to consume less than 10% of total caloric intake from saturated fat.
Why should we limit saturated fat?
Saturated fat is shown to increase LDL cholesterol more than monounsaturated fat and polyunsaturated fat.
LDL cholesterol has shown to be a causative factor for athrosclorsis, plaque in the arteries.
We also have strong evidence replacing saturated fat with polyunsaturated fat decreases risk of CVD.
This is essential considering heart disease has a major burden in developed nations, particularly in the United States. Therefore, reducing dietary constituents which can lead to worse cardiovascular outcomes is important.
While saturated fat can “fit” into someones overall dietary pattern it should be reduced as much as possible.
Added Sugar and Calories
The vilification of sugar is well known and documented in the nutrition space.
Sugar aka sucrose is made from fructose and glucose. A basic understanding of metabolism tells us sucrose whether from a candy bar or an apple metabolizes the same in the body regardless.
The difference is the context of the foods that contain sucrose. A candy bar isn’t quite nutritious, but an apple contains essential vitamins/minerals and fiber.
This does not mean a candy bar cannot “fit” into a persons overall diet, but foods containing added sugar should be limited. These foods are typically candies, baked goods, and sugar sweetened beverages.
We know sugar in of itself isn’t dangerous from a metabolic perspective, but the added calories it provides can lead to issues with cardiometabolic outcomes.
For instance, it is really easy to overconsume calories when chugging down soda and juice. These added on calories from the added sugar can lead to increased weight gain which is associated with worse glucose control, more free fatty acids in the blood, and other issues.
Therefore, added sugar should be cut down quite a bit in a persons overall diet. The dietary guidelines recommends less than 10% of calories per day should come from added sugar.
High Salt Intake
Majority of Americans do not meet the sodium intake suggestion of lesson than 2300 mg. This lack of adherence to the recommendations can have a negative impact on the health of numerous people.
High sodium intake is linked to hypertension which is a major factor for future heart disease events and risk.
Now, there are claims that low sodium intake as much as high sodium intake leads to increased mortality, it is plotted in the research as an infamous J shaped curve.
However, the measurements used in research greatly impacts the outcome. If researchers used single collections of urine to estimate sodium intake the J shaped curve emerges, but is multiple 24 hour collections are used a more linear path emerges.
We also see from an hunter-gatherer perspective, tribes which consume low to no salt did not have increased risk of hypertension.
The fact of the matter is Americans consume too much salt and should be consuming relatively lower amounts.
Ultra processed foods tend to be high in salt, especially those high in preservatives. This does not mean we should demonize these foods but we might want to reconsider how much sodium is in the food we are eating and how that impacts blood pressure.
Final Take
The dietary guidelines suggest an overall dietary pattern high in fruits, vegetables, legumes, lean meats, nuts, and whole grain. I am not going to strawman food freedom dietitians by suggesting they’re not promoting a dietary pattern like this.
Nevertheless, we need to question the idea that “all foods fit”, yes all foods can in theory fit and we should take into consideration everyone’s means. A person dealing with poverty might not be able to consume high quality nutritious foods, others may not have access, some people might not have time, and other barriers get in the way.
But in order to address these inequalities in the nutrition space we need to note not all foods can or should fit if we want to promote health across a population.
We should fight for access, options, and more fair/reasonable systems. We should also fight against the influence of multinational food corperations, food insecurity, poverty, and inequality.
Dietitians should see beyond “food freedom” and start thinking “food equity”.