Public Health England released their latest strategy this week to tackle childhood and adult obesity.
To do this they are challenging the food industry to reduce the calories in products by 20% either by; reformulating the recipe, reducing the portion size, or by encouraging consumers to purchase the lower calorie products. However, the latest strategy is not only targeting the food industry, but the general public as a whole with their ‘One You’ campaign which advises that we follow the 400/600/600 rule of thumb and have 400 calories at breakfast, 600 calories at lunch, and 600 calories at dinner. Snacks and drinks should make up the remaining calories as current recommendations suggest men should consume 2500 calories and women 2000 per day.
This new advice has really split the nation, with some for and some against. I was invited to share my opinion on Channel 5 News but I wanted to come on here and go into a little more detail. So, let’s take a look at both sides of the argument.
The One You Campaign is intended to help people be more calorie aware when they’re eating out and about, and the new PHE guidelines are challenging high street food outlets to reduce calories in their foods in order to help with this. However, they may be “lower calorie” what I think will really make the difference is that these lower calorie options are a) genuinely healthier and b) affordable and comparable in price to the alternative higher calorie versions. It is important to remember that low calorie does not always equal healthy, and the quality of the food is just as important as the quantity of calories. They may be able to make a smaller or even lower calorie BigMac burger but overall it isn’t going to change the nutritional value a whole lot, and although there is nothing wrong with having a burger every now and then, I think we risk sending the wrong message which says low-calorie foods are good, and high-calorie foods are bad. As registered dietician Nichola Ludlam-Raine said on BBC Breakfast this week “calories are not king”, and so we can’t disregard the overall nutritional value of the food.
However, Dr.Ayan Panja makes a valid point with his comment on the new guidelines “you can buy frozen broccoli and carrots or fish fillets on a very tight budget, but that would require boiling up veg and potatoes and slamming fish into an oven. But for those who genuinely can’t cook and have to eat out, I think it is a positive step that high street chains are trying their best to make their products healthier”
It is true that portion sizes have certainly increased over the years, which does make it easy for us to consume excess calories. But even if we do shrink the portion sizes or remove some fat or sugar to make lower-calorie foods, how much will that change the consumers choice or behaviour towards food? Rosie Saunt, a registered dietician and half of the Rooted project, made an important point that whether people will feel satisfied with a small meal or a snack, or simply opt for two instead, is something we don’t know yet. We have had diet and low-calorie foods and drinks on the market for years now, but having them on the shelves doesn’t necessarily mean people will choose them, particularly if they taste different to the real deal. Changing the environment is one thing, but changing behaviour towards food is another.
In my opinion, I do see the value in people having some amount of awareness of the calories in food but I don’t think calorie counting is for everyone, and I don’t think it helps people develop a healthy relationship with food. However, taking a step back and looking at the bigger picture Dr.Zoe Williams offered her opinion from a public health perspective and reminded us that “we can’t forget that PHE are trying to help reduce health inequalities, which means target the majority of people and in particular those with the worst health, lowest incomes, and often the poorest diets. They will never be able to create a guideline to suit everyone – after all, we know personalised nutrition is always best!”.
So although it may not be the best approach towards healthy eating, if it helps people to improve their diet in a simple, achievable way then it could have some value. Speaking with Dr.John Sykes I feel he summarised this view point nicely with “The message of 400/600/600 would better the health of my patients. I wouldn’t say it was an optimal message for health as calories are not the marker of health food. However, this message is simple, easy, and realistic to follow and if applied correctly would mean a better diet than what many are currently consuming”.
So, what is my overall viewpoint on this?
As an NHS doctor I see the implications of obesity on the healthcare system and the NHS spends about £6 billion a year treating obesity-related conditions, so I agree that it is imperative that we do something to address this issue and I commend PHE for wanting to help create an environment that encourages people to make healthier or well informed choices. However, as I said earlier, there is the risk of using calories as an indicator to whether a food is healthy or not. I think we can all agree that there is a pretty big difference consuming 100 calories of steamed brocolli compared to 100 calories of jelly sweets. So a lower calorie diet is not necessarily a healthy one.
Furthermore, although this is not a calorie restriction per se, as it is within the current recommendations, it is essentially a calorie controlled diet which has little evidence for success in the long run. I also worry about the message it sends to people who are at risk of, or recovering from, eating disorders. We need to promote healthy relationships with food and give people more context surrounding healthy food choices. There is no one-size-fits-all, there is no perfect diet, there is no (or there should be) no rules around food.
Moving forward with this my advice would be to use your own judgement and intuition here. If you feel like you have a good relationship with food and follow a healthy, balanced diet then you probably don’t need to pay much heed to these guidelines. Focus on the quality of your diet – a variety of fruits and vegetables, a mixture of whole grains and legumes, some nuts and seeds, plus protein from good quality sources such as fish, lean meats, dairy, or tofu.
For more information on health and nutrition please take time to have a browse around the website and read through my library of blog posts. I also urge you to check out my new book ‘The Food Medic For Life” which will help you fall in love with cooking and improve your relationship with food, so that you approach it not only as a source of nutrients, but also happiness, satisfaction and health.
