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Re-framing Food

Stephen Gurr, Registered Dietician & Sports Nutritionist on Cyno

“…the diet on offer at the end of the industrial food chain (as exists in Canada) is linked precisely to the types of chronic disease most prevalent in industrialized society (e.g. Canada!)” (1)

As this quote from world renowned journalist and author Michael Pollan highlights, much of the “food” (more on this later!) available on grocery store shelves runs counter to that which is recommended to promote health and well-being. Or as one colleague of mine put it, many of the options available at our local supermarket and in the other food environments that we inhabit too often represent the difference between (“fill in the blank”) sandwich and a (“fill in the blank”) salad.

Surprising to many folks is that diet related disease such as diabetes and heart disease is the leading cause of death globally, more than that attributed to tobacco and outdoor air pollution. Given the long-time lag between cause e.g. eating the doughnut and drinking the Pepsi, and effect e.g. the diagnosis of diabetes and high cholesterol, it’s understandable that it garners so little attention on a day to day basis. However, the link between poor diet and health is undeniable and very real. By extension, the food choices we make at the supermarket, at the restaurant and in the home really do matter. The NOVA food classification system has increasingly been shown to make it easier for folks to make choices that align with good health and well-being.

The NOVA food classification encourages us to think less in terms of the nutrients a food provides e.g. amount protein, iron or vitamin C, and more in terms of the degree of processing of the food. Its advocates suggest we should be aim to get most of our calories from un- or minimally processed foods e.g. fresh fruit and vegetables, plain nuts, canned vegetables, while limiting intake of ultra-processed foods, which they define as “..industrial food and drink formulations made of food derived substances and additives, often containing little or no whole foods”(2). These foods typically provide excessive amounts of energy, fat, sugar, and/or sodium, intake of which is associated with an increased risk of diet related disease like type 2 diabetes and cardiovascular disease that Pollan was referring to. As these foods are often cheaper than less processed, healthier foods and perfectly “designed” to be hyper-palatable, when combined with sophisticated and aggressive marketing, it’s not surprising that in many countries intake of ultra-processed foods constitutes over 50% of peoples total energy intake.

The appeal of the NOVA classification is that it makes it harder for food manufacturers to deceive us with questionable nutrient and health claims often made on ultra-processed foods that existing nutrient guidelines can encourage. Examples abound. Sugar-laden granola bars that are “high in protein”, chocolate nut spread that is “low GI”, cereals processed to within an inch of their lives fortified with “essential vitamins and minerals”, and one of my favourites, candy that is “99% fat free”. Manufacturers also manipulate the portion and serving sizes of these foods so as they fit within certain nutrient criteria e.g. less than 5g of added sugar, creating the impression that they are a healthy choice, rather than a wolf dressed up in sheep’s clothing.

The inconvenient truth is that none of us really “need” any of all the ultra-processed foods so ubiquitous in our food environments. However we may rationalize our “need” for that chocolate bar (“it’s a good source of anti-oxidants”) or Rice Krispies (“it’s a good source of iron”) or kale chips (“it’s a good source of folate and Vitamin A), we will always be better off obtaining those same nutrients through un- or minimally processed foods. That is, we will always be better off eating the banana, not the granola bar, the grain, not the white sliced bread, the potato, not the chips, the grilled fish, not the frozen fish bites, the fruit, not the juice. You get the picture! As Pollan so beautifully put it, we should aim to eat mostly food, not “edible food like substances”, which most ultra-processed foods are.

The science is very clear. Excessive intake of foods high in saturated and trans-fat, added sugars and sodium and inadequate intake of fresh fruits and vegetables, whole grains, nuts and seeds does increase risk of diet related disease. Using a “NOVA lens” will make it easier to identify and choose foods and beverages that are consistent with improved health outcomes, and easier for you to leave those that are not on the supermarket shelf.

This post is an edited version of an article that first appeared on my blog

Extra reading and resources

Ultra-processed foods, diet quality, and health using the NOVA classification system. Excellent resource if you want to take a deep dive into the research looking at the impact of ultra-processed foods on health.

INFORMAS(International Network for Food and Obesity / Non-communicable Diseases (NCDs) Research, Monitoring and Action Support). “A global network of public-interest organizations and researchers that aims to monitor, benchmark and support public and private sector actions to increase healthy food environments and reduce obesity and NCDs and their related inequalities”

Stop Marketing to Kids Coalition. One of a number non-profit organizations globally that are advocating for strict regulation of advertising of unhealthy foods and beverages to children.

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