Food plates: UK versus USA
March has been a busy month for a number of institutions revising their ‘food plates’ – “eat well” guides that recommend the proportions of various foods that should be consumed in a routine nutrition to achieve a healthy and balanced diet.
The two examples we review in competition today are from respectively:
Public Health England on behalf of the UK Government
Tufts University in Boston.
(There are links to both at the bottom of the page for further information & graphics)
UK Eatwell Guide
Let’s start with the positives.
There is a decent emphasis on fruit and vegetables, with the importance of variety emphasised. A gold star is rewarded for encouraging wholegrain and high fibre carbohydrates. The stance on protein is acceptable, including plant-based protein. The recommendation to reduce consumption of processed and sugary foods, eating less often and in smaller amounts, is to be commended, as is the stance on including oily fish once a week and reducing consumption of processed meat. However…
I must admit to being disappointed that the government did not see fit to increase the recommendation for the daily consumption of fruit and vegetables from ‘Five-a-Day’ to at least Seven-a-Day’. I also think a trick has been missed by not actively discouraging the inclusion of refined starchy carbohydrates. I appreciate the recommendation is to ‘choose wholegrain’ – but to my mind this is not strong enough. Excessive consumption of refined starchy carbohydrates can lead to weight gain and increased body fat, as refined carbohydrates are absorbed rapidly into the blood stream causing blood sugar and insulin level spikes. Further, when wholewheat is refined the outer bran layers and germ are removed and as most nutrients are found in the bran and germ they are lost, as well as loss of fibre. Wholewheat also contain many different antioxidants important in the prevention of cancer, heart disease and type 2 diabetes.
With regard to oils and spreads, the advice is far too limited. No information about butter, lard, coconut oil or olive oil for cooking or anything about other unsaturated fats for eating, such as avocados, nuts and seeds. Instead it seems to actively promote just vegetable oils and margarine, which is ridiculous.
Altogether the advice is also too focused on low fat, not highlighting the dangers of hidden sugars in low-fat dairy products. Most shocking in the written detail accompanying the graphic was the assertion that fruit juice or a fruit smoothie can be 1 of your 5 a day! Perhaps it’s worth quoting Canada’s Senate Committee on Obesity, which declared on March 1, “Canada’s dated food guide is no longer effective in providing nutritional guidance to Canadians. Fruit juice, for instance, is presented as a healthy item when it is little more than a soft drink without the bubbles.”
There was no encouragement to swap salt for herbs and spices in cooking, while the overall space allocated on the plate for starchy refined carbs seems too large, especially in comparison to vegetables and fruit. Finally, legumes should have a separate section and dairy be included in fats.
The Tufts guide
This is more specifically described as ‘My plate for Older Adults’, but in my view it is actually a very good starting point for all over the age of 21.
This plate is much more generous with fruit and veg in comparison to the UK Eatwell Guide. Further, there are fewer refined carbohydrates, while recommended grains are specified as wholegrains. A great-to-see inclusion of herbs and spices, so extra kudos on the very important issue of recommending variety and how to achieve it, while also lowering salt intake. Finally, good to see fruit juice side-lined.
Once again vegetable oils and margarine are encouraged, as well as rather too much emphasis on low-fat and fat-free. Where is the information for olive oil, butter, lard and coconut oil for cooking? Legumes need to be separated from protein, while specific fat and dairy sections could be added, with nuts and seeds included in fats. A lack of explanation regarding fats, particularly the health necessities of fats, is also a disappointing omission, but even more surprising is there being no mention of consuming oily fish once a week.
Both plates, if adopted, will provide decent sources of nutrition, with the general advice being sound. It is surprising that neither mentions probiotics, but most disappointing, particularly in the case of the UK, is that an opportunity has been missed for more radical recommendations. In light of the decision by the UK government to adopt a sugar levy on soft drinks from 2018, this is particularly relevant to juice and fruit smoothies.
Followers of Dr. Robert Lustig (including No Targets) have campaigned for this sugar levy, so it’s no surprise we are also opponents of juices and fruit smoothies being recommended as 1 of your 5 a day.
Dr. Lustig’s research established that fructose, the sugar found in fruit, is metabolised only in the liver and into fat when ingested in large quantities. Of course when the liver produces fat people can become insulin resistant, increasing the risk of both cardiovascular disease and type 2 diabetes. Juice and fruit smoothies provide a concentrated dose of fructose (hence the revelation highlighted by the Canadian Senate committee) but eating fruit with its carefully balanced fibre content (the most important part) mitigates the effect, effectively giving the liver enough time to deal with it. Of course eating fruit, as opposed to drinking a liquid, also makes you feel fuller with fewer units consumed, so less fructose needs to be absorbed, so reducing risk. Public Health England should know this and have been bolder. Unfortunately advertisers of smoothies and fruit juice will continue to capitalise on their products being recommended by Public Health England as 1 of your 5 a day to sell more cartons, exploiting the public, putting children at risk and most likely helping to exacerbate the obesity crisis. This is a loophole that needs to be closed – and quickly.
The winner is Tufts principally because of it’s balance and variety of nutrition and in particular its encouragement of the consumption of plant based foods. It’s overall advice is decent, being practical and achievable. There is of course still room for improvement as I have highlighted, but if all adults followed the Tufts recommendations the general population would be moving in the right direction.
Public Health England
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