Vexing Vocab: Examining Healthy

Pittsburgh Dietitian Blog Posts
August 29, 2014

This series (“Vexing Vocabulary”) is written with the intention to clarify or correct common misconceptions in the health industry, specifically the confusion caused by buzzwords. In most industries, information is spread using commonly accepted terms to raise awareness or drive trends. While this allows us to communicate and receive information at an increased rate, it is also responsible for the rampant spread of partial and even complete misinformation. Personally, I think it is because most buzzwords have multiple meanings, which creates an overlap of information that is not compatible. Being able to understand and identify that most commonly used terms have multiple meanings is the first step towards becoming an informed consumer. As you read this blog, if you think of some commonly used buzzwords that you would like to see a post on, let us know!

When I decided to do this series, the first word that came to mind was “Healthy”. I cannot count how many clients have been misled by the word healthy, especially those interested in weight loss. From advertising driven by the supplement and food industries, to local chefs trying to frame their restaurant as unique and modern, there are so many origins of this word that alter perception and encourage consumption. To help frame the best way to navigate this term, it is helpful to start with it’s marketing origin, then explore the other areas of common use.

The Food and Drug Administration (FDA) uses its slightly intimidating Code of Federal Regulation (CFR) to outline the regulation of products in the food industry. Within this often-vague reference material, among the claims language, lies a chart which outlines the conditions for use of the word “Healthy”. The table includes specific restrictions to total fat, saturated fat, sodium, cholesterol, and requirements for 10% DV of two vitamins or minerals, as well as a fortification procedure when applicable. Initially the guidance seems very logical, but upon further assessment, it becomes clear the information used to outline the use of this claim is very outdated. This regulation was created during the low-fat craze that spanned a vast majority of the second half of the 20thcentury. This information was established before we realized refined sugar can be a problem, before the astonishing surge of processed products that now use this claim to their advantage, and long before we understood all fat is not created equal (yes, even saturated fats).

This outdated information becomes problematic for two main reasons. First, and most obviously, it instantly eliminates foods that we know are good for the body. Foods like nuts, seeds, and other plant-based fats are immediately eliminated from this claim (avocados, walnuts, etc), while any sugary cereal with reasonable sodium and a couple vitamins is eligible. The second, and less obvious reason is the psychology the word healthy inspires in consumers. Healthy has an obvious opposite, unhealthy. This claim has instilled a black and white classification of food in many people, which creates a very limited relationship with food. The fact is food is not that polarized. Instead of classifying foods into two categories, it is much more powerful to recognize the potential of all foods as options among a balanced diet rich in variety.

Ultimately, the current FDA definition does not highlight healthy foods for people looking for wholesome or nutritionally dense foods. Heavily processed foods that have no business in the forefront of our choices (Special K bar anyone?) overshadow foods like nuts and seeds, which are an unprocessed nutrition powerhouse when portioned appropriately. The goal of this claim was to help consumers make decisions, but instead it has effectively skewed the consumer’s perception of healthy, and simultaneously created a polarized medium for categorizing foods.

While the FDA’s attempt at consumer enlightenment is an obvious failure, the chef inspired local food movement’s definition is far from perfect. Before I start, I need to say that I am a huge supporter of sustainability and local foods. The process of routing locally grown, minimally processed ingredients from the ground to the table is one of my favorite movements. I will never dispute that this is much healthier for the environment, and even nutrition density (I‘ll get to this shortly). Regardless of the benefits, it still fails to help consumers understand what it means to be healthy as a big picture goal. Unlike the FDA, this movement does recognize all fats are not created equal. Instead of an extreme restriction of fat as a nutrient class, there is clear recognition that the fatty acid profile (types of fats) is worth identifying and even highlighting. More importantly, it promotes a reduction in processing foods with pesticides and other chemicals. The major lapse in this definition is the ignorance to long-term health in terms of calorie needs and total consumption. While locally sourced vegetables cooked in extra virgin olive oil as a side to grilled salmon has a fatty acid profile and antioxidant count that puts a tear in my ear (so pretty), it is also extremely high in fat (for one meal), and as a result total calories. It is the chef’s job to create dishes that excite the eyes and tantalize the tongue. Often times this means the dishes will have no regard for total calories, total fat, and sodium. If the consumer is accounting for this, and has created a deficit early in the day to prepare, great!, but that would be an exception to the norm. Regardless of the quality of the ingredients, caloric intake is very important when we are discussing health. To the chefs of the world, I challenge you to incorporate portion control and moderation of calories into your definition of healthy.

There are many other definitions of healthy, but in my experience these are the two that have the largest impact. So many weight loss clients come to me under the impression a granola bar or bowl of special k is the snack they are restricted to. Just as many citing a dinner at the new, trendy local restaurant in town without regard to portion size will still allow for weight loss because the ingredients are sourced in a sustainable manner and they only use “Healthy Fats”. In truth, healthy is not something you can use to label one meal. Healthy is not a predetermined set of macronutrients brought to you by Kelloggs. Healthy is a lifestyle. This lifestyle requires a focus on the undeniable triad: balance, moderation and variety. Food selection should be nutritionally dense and attentive to caloric needs simultaneously. Nutritionally dense refers mainly to foods while large quantities of micronutrients (vitamins, minerals), phytonutrients (antioxidants) in comparison to the calories provided. Heavily processed low calorie foods are often stripped of valuable nutrients. Alternatively many foods need to be eaten in moderation to maintain a calorie intake that meets daily needs.

So where do we stand? As an individual, healthy is a personalized definition. From that image of yourself, a diet and lifestyle is sculpted. All foods can make it into this image, but the ones that should attend most frequently are those with limited processing and ingredients, a powerful nutrition profile, and maximum taste. This can include snacking, eating at restaurants, and many other habits and behaviors typically deemed unhealthy, if done in moderation. My advice to all consumers is to read the ingredient list on food labels for actual quality, and remember a healthy restaurant does not guarantee a three-course meal will fit into your weight loss or maintenance plan. Happy eating!

Andrew Wade, RDN, LDN

Registered Dietitian/Nutritionist

A.M. Wade Nutrition Group LLC

Case Specific Nutrition

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