Does healthy come in one size that fits all?

photo credit | gourmetmetrics
photo credit | gourmetmetrics

When it comes to automobiles, maybe we could get by with one size fits all. Wasn’t it Henry Ford who said we could have any color you want as long as it’s black. But imagine how miserable we’d be if everyone had to fit their feet into the same shoe size?

Now there are some obvious differences between food and shoes. But when it comes to size and shape, food and shoes have more in common than you might think.

Consider this recent dinner I put together. A modest piece of beef tenderloin. Sliced savoy cabbage, shallot, and green peas braised in olive oil and stock. Steamed Yukon gold potato. Add a Guinness stout to accompany the meal followed by fresh pineapple, a couple of walnuts, and a small square of very dark chocolate.

Et voilá. A plate that manages to be non compliant with every healthy dietary model.

Compared to Dietary Guideline recommendations, my plate falls short. No bread or rice or pasta on the plate. A beer instead of a glass of milk. And too many calories from fat (>35%) and saturated fat (>10%).

Vegan activists will come after me because I put a piece of meat on my plate.

Keto enthusiasts love no carbs on the plate but will ask why no cream or butter or coconut oil.

Globalists who promote the planetary health or flexitarian diet, will be upset because my serving of beef is so big, my serving of nuts is so stingy, and there’re no whole grain.

It used to bother me that my usual pattern is non-compliant but I’m getting more comfortable with the idea. Being out of step with a vegan or Keto approach is one thing. Being out of step with dietary guidelines or planetary health is quite another however.

Why was I bothered? Because I’m a nerdy dietitian who studied nutrition, appreciates the need for evidenced based science, and supports the concept of a healthy eating pattern. But my numbers still never fit a conventional model.

So that brings me back to shoe sizes. Before industrialization, if you were lucky enough or rich enough to own a pair, your shoes were custom made. In today’s world the best a shoe manufacturer can do is offer many different sizes and styles. Then it’s up to us, the shoe wearing public, to find shoes that fit.

Maybe that same logic works for food choices too. As a committed omnivore in love with all things vegetable, fruit, legume, and whole grain, my pattern has fewer carbohydrates and more fats than the one size fits all dietary guidelines. And if I think about guidelines as guiding principles instead of regulatory mandates, my pattern looks a lot healthier.

My doctor is okay with my health stats. And my gut is happy with my food choices. So I’ve decided to stop being bothered because my pattern is not a perfect fit.

So you see, finding the right dietary pattern really is like shopping for shoes. You keep trying on different patterns until you find the one that’s the best fit for you.

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Healthy means one thing to cooks and something different to a recipe analyst like me.

photo credit: gourmetmetrics
Chicken Platter | photo credit: gourmetmetrics

Feast your eyes on a gorgeous Brune Landaise, a slow grow (110 days) heritage breed chicken raised in rural Pennsylvania. I took the picture recently at a Manhattan restaurant and even with the addition of vegetable sides, it’s not your classic picture of healthy eating.

HEALTHY MEANS DIFFERENT THINGS TO DIFFERENT PEOPLE.

Roast chicken is a healthy alternative for carnivores when they get tired of steak. If you’re a vegan however roast chicken is unhealthy or immoral. And probably both. These are subjective opinions based on two different belief systems.

Enter the nutrition researcher. These folks have been taught to measure healthy in grams and milligrams. Personal anecdotes and opinions are suspect. Research and evidence are what count. Now the scientific method is by natures reductionist and that’s not necessarily a bad thing. The problem is that scientists sometimes forget that the whole can be more than the sum of its measurable parts. And so sometimes do recipe analysts.

THE NUTRITION FACTS

I ran the numbers for roast chicken based on my own recipe for a modest serving size (2 pieces or about 6 ounces). Calories 370, Fat 22 g, Saturated Fat 6 g, Sodium 560 mg, Carbohydrates 0 g, Fiber 0 g, Sugars 0 g, Protein 39 g.

If you have a hard time finding meaning in the numbers, you’re not alone. I know what all the numbers mean, I’m a dietitian, and I have a hard time too. Facts are important and we don’t want to ignore them. But nutrition researchers are coming to realize, facts are not enough.

My most brilliant research colleagues are currently doing just that — developing algorithms for putting the parts back together. Similar research is going on in Europe, South America, and Australia.

PUTTING ISOLATED NUTRIENTS BACK IN THE CONTEXT OF THE WHOLE PLATE

Chefs and home cooks and food writers know intuitively that food is more than the sum of its nutrient parts.

Nutrition researchers and dietitians and recipe analysts dedicate their lives to understanding those nutrient parts.

Both perspectives are valid. But that hasn’t made it any easier for cooks and recipe analysts to discuss what’s healthy and what’s not healthy.

Here’s a small taste of what lies ahead for recipe and menu analysis when we widened the lens and look at food through both perspectives.

Using a narrow lens, roast chicken isolated and alone provides excellent protein but comes with saturated fat. My zealous colleagues, with the best of intentions, solved the problem by removing the skin. As a result, skinless boneless breast became ubiquitous.

When we widen the lens by adding a green salad, two vegetable sides, a piece of French bread, and a glass of Bordeaux, the dynamics change. The same excellent protein remains, but now we find 40% that plate is vegetables and those grams of saturated fat are nicely balanced by unsaturated fatty acids.

A hybrid perspective meets the objective demands of the analyst. Being a dietitian by trade but a foodie at heart, I find the hybrid perspective helpful because it more reflects my standards of healthy better than a more narrow reductionist view.

Only time will tell however if a hybrid perspective will be useful to chefs, home cooks, and food writers.

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Will 2018 be the year I can finally eat healthy?

 

Chicken Tagine | photo credit: gourmetmetrics
Chicken Tagine | photo credit: gourmetmetrics

Healthy eating has been in a state of transformation now for the last couple of years. It’s hard to date exactly when the sea change started but we’ve gradually been moving away from low fat, restrictions, and deprivations.

During the 1990s healthy really was synonymous with low fat, restrictions, and deprivations. That was decade when restaurants stopped using the word because they quickly determined that labeling a new menu item heart healthy or low fat was the kiss of death.

Home cooks and creative chefs have probably never paid all that much attention to nutrition guidelines and, just between you and me, I never cooked low fat at home even though I did my nutrition studies during the 1990s. But mainstream Americans embraced carbohydrates and sugar and cut out the fat.

I knew things were happening in the academic community when I started seeing studies like these here and here and here.

And if I were asked to provide pivotal dates, I would cite the publication of the 2015-2020 Dietary Guidelines because of the implicit acknowledgement that the sum may be greater than its individual parts.

Previous editions of the Dietary Guidelines focused primarily on individual dietary components such as food groups and nutrients. However, people do not eat food groups and nutrients in isolation but rather in combination, and the totality of the diet forms an overall eating pattern.

Or perhaps the FDA decision to exercise enforcement discretion as the agency reviews labeling criteria for manufacturers who want to label their products healthy.

But when I see a statement like the one below from a restaurant consulting group suggesting deprivation and restriction need no longer be a necessary component of healthy eating, I begin to think 2018 may actually be the year when the pieces fall into place. Healthy Dining is a San Diego based restaurant consulting group. Here’s that quote from the CEO from a recent blog:

There’s a new trend in healthy eating and restaurant dining, and it is leaving behind restriction and deprivation in favor of savoring great meals at restaurants that support a healthy lifestyle.

So you may be wondering what all this has to do with my lovingly prepared and very tasty chicken tagine pictured above?

Well let me explain. Even by current liberalized criteria, my tagine is not technically healthy.  Despite using quality ingredients and significant amount of vegetables to compliment the chicken thighs, my cooking uses more olive olive than is currently recommended.

Since the 1990s when those draconian criteria were cast in regulatory concrete, many of my zealous colleagues have dutifully taken classic recipes like the one I used for the tagine and made adjustments to the proportions to restrict fat, saturated fat, and sodium.

Relief is in sight however. To their credit, the FDA has acknowledged the need to revise that criteria. And I say congratulations. Maybe a little late, but better late than never …

What will the new criteria look like?

Hopefully a better way to asses the food and nutrition values of a dish like the one pictured above. We need a scoring system that awards points for making half the plate vegetables plus positives like fiber and protein. Then we need that same scoring system to balance those positives against sodium and saturated fats.

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Christmas Dinner 2017

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Pictured above is the center piece of my Christmas meal this year – a roasted rack of pork. You can see from the rib bones that the butcher has employed a presentation technique referred to as “Frenched” and the rack was roasted with the skin on. Those crusty squares you can see on the top are cracklings. They’re delicious. Almost as good as the tender juicy roasted pork.

A center piece needs to be carefully positioned with surroundings to be fully appreciated. Properly selected, the appetizer announces there’s more to come without being too filling or overwhelming. This year, I made an escarole salad with Forelle pear, walnuts, and Parmiggiano dressed with an apple-cider honey vinaigrette dressing. Cooling, refreshing, lightly salted and slightly sweet. A well positioned beginning for what is to come.

Moving on to the main course, let’s consider side dishes. This year, I selected winter greens and baked sweet potatoes. Rapini braised in olive oil and garlic is my dish of choice but not everyone has developed my taste for bitter greens so I always serve steamed green beans along side. I sliced the rack of pork between each rib bone, arranged the pieces on a serving plate with the sweet potato along side accompanied by the two bowls of greens. There was a moment of silent appreciation and then we dug in and I have to admit we did eat well.

To accompany the meal, we offered beer, apple cider, or a red Bordeaux.

The ending of a meal should never in my culinary opinion at least outshine the centerpiece. So I prepared an apple pudding, derived from one of my favorite French desserts – clafouti. And of course a dish of mandarin oranges from my beautiful California. No meal, even a celebration meal like Christmas, is complete for me without some seasonal fresh fruit at the end.

MEAL METRICS

The holliday season is a time for celebrations and my Christmas meal is my celebration of the season. From the beginning salad appetizer to ending piece of fruit, the meal clocks in just a little over 1400 calories.

Like all combination plates, a meal is a mixture of different foods some clearly more healthy than others.

The health promoting aspects of my meal are the abundance of vegetables and fruits (59% plant based by weight), good protein (74 grams), and beneficial fiber (71% Daily Value) from intact sources. On the not so healthy side, we note 21 grams saturated fats, 970 mg sodium, and 18 grams sugar.

Now what I would like to have is an algorithm that would balance the value of the healthy foods against the risks from the not so healthy components and seasonings. My thesis that is in the final analysis, the benefits outweigh the risks. Now I need to find my self algorithm that will do that kind of computation.

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OMG Did my Roast Chicken Just Get Healthier?

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Here’s a picture of my beautifully roasted chicken right out of the oven.

Now feast your eyes on that lovely crispy skin. Like my granddaddy always said “Skin’s the best part.” And my granddaddy was always right.

Not everyone agrees however. Many health professionals along with some of my zealous colleagues still advise us to discard the skin. Current USDA MyPlate handouts and the 2015 Dietary Guidelines continue to recommend “lean” proteins. And lean always means skinless chicken breast when referring to poultry.

Now I’m not sure how you’ve done it, but for me I’ve always served my roast chicken with skin intact. My foodie friends and the chefs I know also honor the whole bird. Besides being absolutely delicious, the skin protects the chicken as it roasts keeping the meat moist and flavorful.

Officially we’ve been a fat phobia nation for a while now. Back in 1980 when the first dietary guidelines were published, Guideline #3 said it all: avoid too much fat, saturated fat, and cholesterol.

But another 10 years passed before the Nutrition Labeling and Education Act of 1990 (NLEA) authorized the FDA to regulate labels for packaged foods and we actually start having food rules. Now I’m the first to agree that a few good rules isn’t necessarily a bad thing, but some of these rules like criteria required for labeling a food healthy were draconian.

Industry insiders used to joke that the surest way to guarantee a food offering failed was to label it healthy and health messaging started to develop a reputation as the kiss of death. Using low fat as the most significant market for a healthy food meant avocados were not healthy. Neither were nuts. And even a simple green salad vinaigrette dressing could not be labeled healthy.

Like all research, nutrition science continued to forge ahead and a better understanding of fats began to emerge. The low fat kiss of death criteria however remained cast in regulatory concrete.

Then in September 2016, the FDA announced its intention to review the rules for healthy. The process is going to take years, but in the meantime, we have this interim statement:

Foods that use the term “healthy” on their labels that are not low in total fat should have a fat profile makeup of predominantly mono and polyunsaturated fats (i.e., sum of monounsaturated fats and polyunsaturated fats are greater than the total saturated fat content of food).

Since most folks don’t even know that these rules exist, it’s worth asking what difference does it makes. Most of my foodies friends for example are not paying much attention and could care less what the FDA decides to do.

Being an RDN however I really do care and here’s why.

Dietary rules and guidelines impact public policy. They are written into federally mandated programs like school nutrition. They regulate nutrition labels on packaged food. And effective next year, the rules will be extended to restaurant menu labels.

But getting back to my roast chicken, the FDA interim statement has a significant impact on whether or not it’s healthy to eat the skin.

The fats in my roasted chicken are primarily in the skin with the rest marbled into the leg muscle. That’s why the skinless breast was lauded in the first place. Dry and tasteless but no fat.

Now let’s take a closer look at the fat profile for a roasted chicken. Total fat is composed of saturated fats and unsaturated fats. Mono-unsaturated fats and poly-unsaturated added together equal total unsaturated fats. When we compare the two values, we can determine which type of fat predominates. Are there more saturated fats? Or more unsaturated fats?

Some folks find it easier to think in terms of a ratio. My roasted chicken has a good ratio. For every gram of saturated fats, we have over 2 grams of unsaturated fats. Clearly the unsaturated fats predominate. And that ratio looks pretty good to my eye.

The FDA doesn’t directly regulate recipe tags, but folks like me who develop recipe tags need to keep a watchful eye on the rules. Personally I have mixed feelings. On one hand, I would prefer that the FDA did less micro-managing. On the other hand food manufacturers need to be held accountable and a few good rules helps keep them honest.

But I’m thrilled the FDA has decided to review and revising the rules. It will probably take a couple of years before they decide what those revisions will be, but in the meantime it looks like my roasted chicken most certainly did get a little healthier.

BUY GOOD STUFF.    The breed of the chicken determines the flavor. My preference is a chicken that grows slowly. Heritage breeds are grown here in the states but most are descended from a French breed called cou nu or naked neck. This “slow grow” bird takes almost twice the time to reach market weight. The birds are not cheap because they require more feed, fuel, water, and land per pound of meat to sustain their growth. But for folks like me who appreciate a really flavorful bird, the extra dollars are well spent.

COUNT WHAT MATTERS.  Nutrition Facts per 5.5 ounce serving roast chicken: 350 calories, 21 grams fat, 0g carbohydrates, 38 grams protein. That serving size reflects 1/8 of a whole chicken that weighed  about 4 pounds as purchased raw.

Fat breakdown for those 21 grams total fat is 6 grams saturated and 13 grams unsaturated (5 grams poly and 8 grams mono). In other words, unsaturated fats predominate in a ratio of 2.2 to 1.

 

 

 

 

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Thanksgiving 2010

THE MEAL

Everyone loves Thanksgiving.  It is our national family social get together and our yearly communal sit down.  Probably the only American meal where we actually sit down and eat the same basic set of items.  Roast turkey and gravy.  Cranberries.  Stuffing.  Mashed potatoes.  Squash or pumpkin.  Checking my facsimile edition of The Original Boston School Cooking Book published in 1896, the menu items are pretty much the same.  The notable exception is oyster soup.  Does anyone serve that anymore?  Certainly not me.  I have made many Thanksgiving dinners for family and friends over the years because the tradition deserves to be honored.  But turkey is not my favorite.  A little too bland.  And sometimes a little too dry.   Do I love the day any less?  Absolutely not!  It just means I put aside my taste for a really gamey bird and cook to please the less adventurous who come to my table to indulge.

Looking at a whole meal has always fascinated me.  Eating is holistic.  People eat meals as opposed to individual items and since Americans eat pretty much the same set of items, Thanksgiving is a perfect meal to look at.  Using recipes from my software data base, prices from various local markets, and some off the shelf preparations, here is the menu board for a traditional Thanksgiving meal.

Onion Soup, ¾ cup (180ml)

Roast Turkey with Skin, 6 ounces (170g)

Turkey Gravy, ¼ cup (60ml)

Bread Stuffing, ½ cup (100g)

Cranberry Sauce, 2 Tablespoons (35g)

Mashed Potato, ½ cup (105g)

Green Beans with Almonds, ½ cup (120g)

Sparkling Apple Cider, 8 fl oz (230ml)

Pumpkin Pie, 1 piece (155g)

THE METRICS

total cost  $7.40   ●   total calories 1240 per serving

Let’s talk dollars first.   Any foodie worth his salt can drive the cost up by sourcing specialty items.  Free range grain fed turkeys.  Even better heirloom wild turkeys (my personal choice).  Maybe a bottle of vintage wine…  But Thanksgiving is not complex and perhaps it is more in keeping with tradition to keep the meal simple.  Besides, many people prefer the taste of turkey, not the more gamey flavor of a heirloom bird.  My first surprise was how reasonably priced a traditional Thanksgiving could be.

My second surprise was how much time the analysis took.  What I thought would be a straightforward exercise ended up getting complex.  Some items have incomplete data and due diligence is required every step of the way to determine a reasonably accurate calorie count.  That may be one of the reasons why so few meals seem to get analyzed.

Besides the time commitment, however, there may be another reason meals, especially great meals, do not get analyzed.  Companionship, cooking, setting, sharing, savoring – the magic of a great meal is what my fellow foodies love and cherish.  The risk of analysis is that it can break the magic of the moment.  And that is a valid observation.

But let’s just try a bit of analysis by putting the calories into the context of who may be sitting at table.  Aunt Sally is over 50, never exercises, sometimes indulges in sweets but otherwise eats like a bird – miniscule portions, no skin, no dark meat, no gravy, and a whole piece of pumpkin pie.  Makes sense because her daily requirement is about 1600 calories.  She will also get full benefit of the only deep orange vegetable on the table.  Then there is cousin Jeremy.   On the move, physically active, into sports, early twenties, always hungry.  He eats double portions of everything in sight.  Makes sense because his daily requirement is about 3000 calories.  And then there is everyone else in between, but that is enough for now.  A little bit of analysis goes a long way and I need to get cooking …

Happy Thanksgiving.  Enjoy the meal!