Balanced choices for balanced diets
The shopper’s dilemma
What should I eat to keep a healthy weight, gain energy, focus, age well and prevent cardiovascular diseases?
How do I make sure that I get the right intake of vitamins, minerals and other micronutrients, eat natural, eat less meat, eat more fiber, do not eat refined sugars and saturated fats?
These are the kind of questions that, consciously or unconsciously, pop up in our minds when we decide what to have for breakfast, lunch or dinner and, most importantly, when we are in in front of a supermarket shelf.
The straight answer is far from being simple as we need to consider factors such as lifestyle, age, health conditions, but also price, taste, convenience, nutritional benefits etc.
Noisy guidance?
Over the years, many popular diet trends such as low carb, high-fat-low-carb, Atkins or ketogenic diets have tried to provide partial simple solutions to complex issues.
Given the relentless increase of food related diseases/conditions (obesity/overweight, high blood pressure, type 2 diabetes, heart disease, heart attacks, stroke) and the impact on public health and on national health systems, many countries and health institutions are trying to help people making informed choices and divert their behaviours towards healthier habits.
UK led the way applying a model developed by the UK FSA (Food Standard Agency) balancing the contribution made by less healthy features such as high concentrations of simple sugars, saturated fats, salt and energy density, versus healthier high content of fruit and vegetables, fiber and protein. Foods with a final score ≥4 and drinks with a final score of ≥1 are classified as less healthy, therefore recommended to be consumed at a lower frequency. Based on the FSA model, UK government introduced restrictions to promotion and placement in retail stores of products scoring above the thresholds (HFSS).
The French government selected a traffic light system, the Nutri-Score, also based on the FSA model, to be applied on a voluntary basis, followed by other EU countries.
Despite all the efforts to make it objective and comprehensive, there is a lot of discussion about Nutri-Score/HFSS not taking into account vitamins, minerals and other functional ingredients as well as the size of packaging or glycemic index.
Actually, the main issue is not the system itself, but its mis-use/misunderstanding: consumers choosing only A/B score products, will not have a balanced diet if they just avoid/demonize high scoring products that are intended to be reduced, not totally removed from the diet. The same applies for those who use the Yuka app rating.
The new paradigm: ultra-processed food
A hot topic spread around in the last few years, and recently skyrocketed, is ultra-processed foods (UPF): the rule of thumb laying behind, is that the more food is processed and/or the higher is the number of ingredients, the more it is likely to be unhealthy. That can apply in many cases, but it is far from being a clear and effective guidance for consumers: most of them are not able to clearly distinguish what is UPF from what is not. The NOVA classification developed by University of São Paulo in Brazil, makes things much clearer, however, does not consider the nutritional value of food as HFSS and Nutriscore do.
Another controversy is that all the UPF classifications (~7–8 models) are based on observational studies that are actually able to demonstrate the correlation between UPF based diets and certain diseases, but they can’t tell what exactly has caused that health outcome. In other words, there is no evidence that a product that is healthy according to HFSS/Nutriscore can correlate to health issues if ultra-high processed.
Product belonging to categories like meat alternatives, microwaveable meals, low fat yogurts, sandwich meats, cereals, protein bars etc. that are usually considered UPF, are often designed to provide the right amount of nutrients in a balanced diet and/or to address specific needs, fortified foods being a clear example of that.
A recent study showed that children microelement intake comes mainly from UPF (75% Iron — 45% Zinc).
Final remarks
- Despite all the noble efforts that have been made to provide clear and simple advice, there is still a lot of confusion that does not help consumers to make informed choices.
- Low income and time starving consumers will easily choose cheap and convenient products, trading off with nutrition. Moreover, lifestyle and cultural changes such as the decline of home cooking and healthy models (i.e. Mediterranean diet) as well as the increase of sedentary life are also impacting the way consumers shop and consume food products.
- Food manufacturers indeed are challenged on certain categories, however, there is a huge market opportunity to be taken in terms of innovation for those how are able to build their competitive edge developing great tasting, affordable, convenient, healthy food. This becomes even more relevant if we consider the impact on the food market of obesity/appetite suppressing drugs.
- People need clear — yet non simplistic — specific guidance: we need to stay away from general rules and solve trade-offs, taking into consideration what is needed based on our lifestyle, age, sex, conditions. Demonizing food categories creates more confusion than awareness.
