According to the Australian Bureau of Statistics, only 1 in every 20 Australians consumes the minimum serving of vegetables per day. While over a third of our diet comes from packaged junk food. Nutrition based public education campaigns don’t work. Sure, most of us know what we are supposed to be doing – 5 serves of vegetables, 2 serves of fruit, some protein but not too much, and go easy on the fats – and so to some extent, the message has got through. But they haven’t worked in affecting change or establishing good routine behaviours.
What does the Government have to say?
Governments, past and present, say it is the individuals’ fault for ignoring some 40 years of public awareness campaigns. More than one former Prime Minister and/or Federal Health Minister have proudly proclaimed that the only person that should tell them what to eat is themselves and Governments have no place in restricting food choices. But it is not the fault of the individual. It is a consequence of the food environment in which education must compete against marketing practices that overwhelm the senses and fatigue even the most committed shopper. Messaging in both public health campaigns and marketing practices seem to be widely varied and misinforming in many cases. With some 2 in every 3 Australians overweight or obese, we need a more authorative and thorough approach to public health messaging than just being told what is good for us.
Why are we all so confused on what to eat?
Over the past 40 years there has been and continues to be a fundamental shift in our understanding of nutritional science. In the early days, a reductionist approach was embraced in which foods were identified by their individual nutrients. Such as, did they contain saturated fat or unsaturated fat? Are they high protein or low protein? The result of this approach was a re-conceptualising of food, not as food. But rather as a vehicle of specific nutrients resulting in what is termed nutrient based criteria. Foods were quickly classified good or bad for you on the basis of perhaps only one ingredient. With the most consumed products being made up of three or more ingredients today, this approach can skew the validity of what is healthy and what is not.
The Health Star Rating System
The popular Health Star Rating System (HSR) is derived from this more reductionist approach. Where the apparent health of a food is determined by an algorithm incorporating component ratios of certain ingredients and correction factors for different food categories. While this system relies on science and a few calculations, in no living system, has the accuracy of the star ratings been tested, examined and shown to be true. Controversially, in some studies where interventions were supposed to improve the health of participants, incidence of disease increased. There are many examples of where the HSR fails to meet its lofty advocacy as a universal indicator for healthy choices. Not least the automatic allocation of 5 stars to fruit juice which the World Health Organisation arguably classifies as a sugar sweetened beverage and recommends we avoid. However, if adequately explained, consumers may still be able to find some use in the HSR.
The Glycemic Index or GI
An alternative approach to understanding the healthfulness of some foods has been to focus on the carbohydrate content, both the quantity and quality. The early steps in this approach saw the creation and development of the glycemic index. In brief, members of the community would be asked to eat small portions of a test food and their blood glucose response would be monitored. On another day an equivalent portion of white bread or some other comparative food would be consumed and the relative difference in blood glucose response would be used to calculate the GI. The general belief being – the lower the GI the healthier it is for you.
Over the past 20 or so years, millions of dollars and hours of effort have gone into validating this tool as an indicator of the healthfulness of a product. At the same time however, shortcomings in the methodology and high variability between individuals has chipped away at confidence in this commonly advocated front of pack label.
What do we do now?
If the two most immediately recognisable and advocated front of pack labels for helping consumers make informed choices are of limited use – where does that leave us? Well one of the first things we need to recognise with approaches such as the HSR and the GI, is that they focus only on some of the components in a product. And not necessarily the food, in the context of our daily lives and how we eat. Food is greater than the sum of its individual parts.
When we look beyond our borders we see a vastly different approach to “dietary guidelines”. For example in Brazil, there is no singling out of saturated fat, carbohydrates or even alcohol. Rather there are steps towards a healthy diet focussing on the avoidance of ultra-processed foods. They encourage planning, developing and sharing cooking skills and eating in social contexts. It is out of Brazil that the NOVA food classification was borne. A system that has both excited nutritional science in providing a whole new scope of data to play with but more importantly has provided community members and public health advocates with a simple enough guide to improving diets – focussing on food processing.
The systems and messaging in place in our modern society that were designed to aid in making healthy lifestyle changes when it comes to our diet are confusing and outdated. The government needs to take a new approach in advocating healthy lifestyle changes, like Brazil’s NOVA classification, where emphasis is put onto advocating for healthy food choices according to food proccessing standards without isolating a particular food group.
Dr. Kieron Rooney completed his PhD in the Department of Biochemistry, within the Faculty of Science at the University of Sydney. Kieron’s primary interest focuses on conducting research and using this research to educate others on how what we eat, influences our metabolism.