Contributions by Naureen Hunani, RD and Julia Lévy-Ndejuru, B.A. Psychology, B.Sc. Dietetics (completing)
I am a dietitian and I admit that I was very dismayed to read that Canada’s Health Minister is encouraging warning labels be slapped on the front of food packages. This may seem odd since a dietitian’s role has been traditionally seen as an advocate for “proper” or “healthy” eating. However, simply put- these sorts of initiatives do not improve healthy eating NOR are the nutrients they imply are “bad” actually harm our health to the degree that they’ve been promoted.
I reached out to fellow dietitians and gentle nutrition advocates to see if I was the only one horrified at the idea that after mandating calorie counts on food on menus, the fear mongering is going further with front of packaging warning signs on perfectly safe and healthy foods.
Do warnings lead to changes in our food choices?
The number of factors that influence our food choices is enormous: taste, budget, convenience, cultural background, food availability, one’s ability to cook/prepare, past experience & memories of food, etc (see this article for a full list). Health is only ONE of these influencers, and due to lack of research, we are not even sure where it ranks. Some studies have found that taste of food is the most influential determinant of food choice (1, 2). The European Food Information Council states that nutrition knowledge and good dietary habits are not strongly correlated. Unfortunately, research for how much health knowledge has an influence over our food choices is extremely hard to find.
There is plenty of research on influences other than health on our food choices that have a greater impact. For example, being more mindful, in general, is associated with increased physical activity, increased fruit and vegetable intake, improved self-efficacy, less impulsive eating, reduced calorie consumption, and healthier snack choices. (3, 4). Put this together with the results from multiple studies showing that mindfulness training results in improved nutrient intake, and the case for promoting mindful or intuitive eating based eating (rather than rule based eating or specific nutrient guidelines for eating) has been made. Perhaps a front of package warning sign reminding clients to slow down and enjoy the food would be more efficient at actually improving health.
Being more mindful, in general, is associated with increased physical activity, increased fruit and vegetable intake, improved self-efficacy, less impulsive eating, reduced calorie consumption, and healthier snack choices.
Naureen Hunani, RD who specializes in family nutrition, does not believe this initiative will change how families shop. She states that “Putting warning labels on food is not the solution Canadians need to achieve optimal health. It is time we look at the bigger picture and dig deeper into barriers that prevent us from reaching optimal health. Children and adults who are food insecure are at higher risk for developing chronic illnesses. Do all Canadians have equal access to wholesome food is the question we should be asking ourselves… I am personally startled by food prices in grocery stores especially during our fall/winter months. Paying fifteen dollars for a bag of grapes or seven dollars for cauliflower is a very common occurrence. I can say with confidence that many Canadians just cannot afford to pay these prices as 4.9 million of us live in poverty and 1/8 Canadians struggle to put food on their tables.”
Food is to be enjoyed and not used just as fuel.
Julia Lévy-Ndejuru, B.A., dietetics student and blogger, suggested that the people don’t usually choose to eat foods containing saturated fat, sodium or sugar (the nutrients these warning labels are warning us about) solely for physical health reasons- but for the enjoyment and satisfaction they deliver therefore the goals of this initiative may be lost.
Julia is referring to the fact that food serves many purposes- not just to fuel our cells. It is an important source of pleasure, a way to connect with others and honor our food traditions. When we focus only on eating for health, we are ignoring basic human instincts and other normal reasons for eating. As the author of Body Kindness, Rebecca Scritchfield, RD states, “the art of eating well encompasses much more than the nutritional value of the food that ends up on our plate”. Rebecca goes on to say that “satiety, the natural feeling of fullness that signals the time to stop eating, is partially determined by the enjoyment of eating”.
On that same note, it turns out that enjoying your food is likely better for you than feeling guilty for eating it. And these warning labels will inevitably evoke guilt.
When we enjoy what we eat, we feel more satisfied and end up eating a portion of food that is more in line with our actual hunger.
When we enjoy what we eat, we feel more satisfied and end up eating a portion of food that is more in line with our actual hunger. This is outlined in Dr. Linda Bacon & Lucy Aphramor’s book Body Respect. The authors state that “Hunger, fullness, and enjoyment signals provide a much more accurate monitor of your caloric and nutrient needs than calorie counting – and better support health and healthy weight regulation”. It is important to note that knowing the calories of a food is the same kind of information as knowing the amount of a certain nutrient- such as saturated fat, sugar and salt. So, using these characteristics to judge what and how much food to eat, without tapping into your hunger, fullness and enjoyment cues, does not lead to ultimate health.
The presence or absence of one nutrient does not determine the healthiness of a food.
Food choices count for only a fraction (less than 25%) of what determines our health and the idea that front of packaging warning labels will make a dent in our population’s health is ridiculous.
Science cannot always to boiled down to an accurate sound bite. There is only so far science can be simplified before it becomes wrong or turns to bad science. The healthiness of a food is not only based on the amount of saturated fat, sugar or salt it contains and stating so is to ignore the science. We already have lots of information on a food package regarding nutrition- it is called the nutrition facts table. It allows nutrients in a food to be compared to other, similar products. It does contain a lot of information since determining the healthiness of a food based on how much or little of a nutrient contains is complex- as it should be. Most all foods have an array of necessary nutrients as well as some we want to avoid eating in large quantities. For example, if one product may have less saturated fat but is higher in sugar, how does one choose? Would front of packaging warnings help with these types of decisions?
We already have lots of information on a food package regarding nutrition- it is called the nutrition facts table.
I believe consumers ALREADY have a good sense of what foods provide a lot of necessary nutrients and which foods are meant more for enjoyment (vs physical health benefits). The bigger question is WHY are consumers choosing one food over another. We’ve had decades of nutrition promotion campaigns touting the benefits of fruits, vegetables, whole grains, etc and yet Health Canada believes we are still struggling with food choices. Perhaps the method of how we talk about foods is flawed. In fact, many studies suggest that without addressing the “why” regarding food choices, and focusing on the “what” to eat, very little is understood about individual food habits. (5, 6, 7)
Also, assuming that the amount of one particular nutrient will have a great impact on our health is erroneous. Let’s not forget that our health is not determined by one ingredient or one meal but by our choices over many weeks and months.
All of my co-writers as well as science can agree that warning signs on dairy products is on the wrong side of science. This is because dairy products have numerous beneficial nutritional properties and research is now suggesting that not all saturated fats are made equal. In fact, research has shown that saturated fats, especially those occurring naturally in dairy products are not to blame for heart disease. (8, 9, 10, 11, 12).
Dairy products have numerous beneficial nutritional properties and research is now suggesting that not all saturated fats are made equal. In fact, research has shown that saturated fats, especially those occurring naturally in dairy products are not to blame for heart disease
Shaming foods and promoting fear of eating them does very little to reduce how much we eat of them.
Julia states that “giving more information about the ‘bad’ ingredients in foods only reinforces all or nothing thinking that is already prevalent. This dichotomous thinking promotes feelings of shame and deprivation, which often lead to eating “bad” foods past satiety.” This theory is well explained by Evelyn Tribole MS, RD and Elyse Resch MS,RDN, the authors of the book Intuitive Eating. They point out that avoiding a food (for almost any reason) leads to intense feelings of deprivation and more intense cravings. This is a natural reaction to restricting a food. When we limit the amount or type of food we allow ourselves to eat, it sets us up to want those same foods even more. And this phenomenon happens with most things in life, not just food. We want what we can’t have.
Naureen believes that “Our rigid way of looking at health and nutrition causes anxiety around food and may lead to disordered eating. It makes us mentally and physically ill as it doesn’t allow much room for flexibility which is the KEY for optimal health.”
Rethink warning labels for real health change
It appears that many of us non-diet dietitians and dietitians in the making, agree that in order to help people improve their health and well-being, Health Canada should use a more global approach looking at consumers’ habits and relationships with food rather than singling out nutrients.
An even wider look at the problem was suggested by Naureen- “we need to implement and promote policies which will help decrease the health disparities that exist amongst us. We need to provide better access to food/health care services and focus on both physical and mental health which is often overlooked. We should empower Canadians to make better health/lifestyle choices by implementing a positive marketing plan and not by fear-mongering and negative marketing of foods.”
Naureen Hunani, RD www.naureenhunani.com