Nutrition and Health

Where has all the common sense gone?
Published on Tuesday, May 7th, 2013

Fad diets. They’ve always been a bugbear to dietitians and nutritionists. Generally they’re written by people with no formal nutrition expertise or understanding of scientific evidence, but rather astute business people who know that silver bullet promises can earn them serious money from book sales. Fads provide great news bites, and therefore often pop up in media articles. Sigh.

The current fad is no exception. I took this photo in my local book shop this week, and you’ll see that the recurring silver bullet today is cutting out sugar. It seems we’re lining up in droves to buy these books, judging by the amounts stocked in bookshops.

As a dietitian who works with food industry clients, including a sugar company*, I know quite a bit about the role of sugars in our diet, our intake of sugars in New Zealand, and the evolving scientific consensus involving sugars and health. So this diet fad is keeping me pretty busy as I try to inject some New Zealand context and scientific evidence into the space.

Let’s be clear, I’m not advocating for unrestricted sugar consumption, or arguing that sugar is particularly good for you. Advice relating to sugars is, and always has been, relevant to strategies to reduce the high risk of overweight and obesity in many countries. However, a singular focus on sugars is unwarranted and would be ineffective for the wider population, when there is nothing metabolically special about sugars (over any other energy source) to cause weight gain. This singular focus also distracts from the importance of a person’s whole diet, and may unintentionally reduce diet quality by reducing intake of nutritious foods such as fruit, vegetables and milk, and increasing intake of saturated fats.

In 2010 an Australian nutritionist, Dr Chris Forbes-Ewan, provided this useful and balanced feedback on one of the books pictured above. The points he made are still just as relevant today, and I could not put them better myself.

My own personal advice on sugars is pretty simple – ideally items high in sugars should either; also contain a lot of other essential nutrients (vitamins, minerals, fibre, phytonutrients) to justify their regular consumption; or be enjoyed in small amounts.

I used the word enjoyed deliberately. Food is more than a collection of nutrients. We are social beings who interact, share, love and dream over food. Without the ability to enjoy food (responsibly) life just isn’t much fun.

To justify their investment, some of those on these fad diets claim all sorts of short term health gains. I’ve even been approached by “believers” suggesting that all dietitians should provide this advice to their clients, because a number of general practitioners are promoting it. With all due respect to general practitioners, nutritional science isn’t generally their area of expertise.

While I applaud the “believers” for changing their lives, there is no evidence that the responsible consumption of sugar caused their initial health problems. Frankly, cutting any common source of dietary energy from your diet altogether will drastically reduce overall energy intake. Simply being conscious of (and thereby restricting) what you’re putting into your mouth is known to result in weight loss to start with.

Unfortunately the long term results on weight and micronutrient status are unknown – generally because people can’t stomach fad diets for very long. That’s what makes them fad diets. But not to worry – the astute authors will have dreamed up another fad diet to make their money from by then, and so the rollercoaster devoid of common sense continues…

*this blog represents my own personal views, not those of my clients.
Who’s to blame? Time to try something different
Published on Monday, March 4th, 2013

We all know about the world’s obesity epidemic and the serious health consequences ahead of us. But we seem to be stuck in a blame game, rather than really committing to effective, collaborative solutions.

Week after week books are published and media reports are issued focussing on finger pointing. For the past six months in particular all fingers have been pointed at the food industry – in particular the “food giants” – for manipulating and addicting consumers to their products. Prior to that – at least in New Zealand – experts have pointed to Government, for their lack of investment in preventative health and unwillingness to introduce regulatory taxes, bans and restrictions for certain foods and food marketing. And any health-related association or sports group is now being criticised for working collaboratively with food companies because of the fear that food companies only associate with health-related associations as a fluffy PR exercise. It is not known what foundation there is for such fear, but it’s enough to make food companies throw in the towel on their numerous attempts to introduce healthier options and reformulate existing products, and just start doing exactly what they’re being accused of (if people are determined to think that anyway).

In the meantime is the population any better off? When the average person spends less than a second deliberating over their supermarket choices and juggles food provision for their families with all of the other priorities in our busy lives, what is all this finger pointing achieving for them?

I would venture to say it’s doing more harm than good. It’s causing even more confusion. The bottom line is people have to eat and drink something to stay alive. Dietary experts and food and nutrition guidelines largely make recommendations based on the four food groups, which actually don’t relate well to what the average person has to choose from when they’re in the supermarket or eating out these days. People also don’t have the lifestyles or incomes that enable them to grow their own foods or shop at farmers markets (wonderful as they are). They simply buy and eat what they like/can afford/are familiar with – in that order. So achieving the shift that motivates them to also vitally include in the purchasing mix “know is healthy for them” requires the following:

- Unity and clarity in scientific advice from Government and academics which relates to the current food supply, not the foods which Nana had to choose from when she shopped for her family back in the 1960s.

- No more contradictory, confusing, subjective and unsubstantiated messages or blanket statements which only result in people giving up and going back to what they know and like.

- Support and endorsement from the scientific/health community when food companies make positive nutritional changes, so that there is actually a demand for healthier products from the population.

- Dropping the blame game. Truly collaborative implementation of solutions is the only way forward to deliver real benefits to the population. This will involve significant compromise for all parties, who must commit to concrete actions and be held accountable to those in the long term.

Can’t we just get on with it?
Food Addiction
Published on Friday, September 21st, 2012

Are we using the term “addiction” too freely these days? Headlines portray a range of human weaknesses from social media “addiction” to shoe shopping “addiction”. We’ve long known about the serious nature of alcohol, nicotine and narcotic addictions, and the severe consequences they have on our society. But a relative newcomer is the term “food addiction”, discussed yesterday at an Australasian psychiatry conference in Wellington, and promoting this
rather odd Stuff poll. (Last time I looked at the poll results the category “something else” was in the lead. Not really surprising since chocolate does not have its own category – clearly the poll was written by a man!)

Is food addiction the ever-elusive single cause of the obesity epidemic? As a slightly pedantic sceptic, I must admit to finding this term somewhat illogical.

The official definition of addiction is: a persistent, compulsive dependence on a behaviour or substance. To some degree aren’t we all persistently, compulsively dependent on food? After all, unlike nicotine, gambling, alcohol and narcotics, we cannot live without it. Preferably we need it at least three times a day, every day, for our whole lives. Yet only a third of the population are supposedly at risk of having “food addiction”. If broccoli was your preference, would that be labelled an addiction?

Don’t get me wrong – I’m not trying to belittle the justifiably valid concerns of those who feel completely out of control around food, and who legitimately see this as a reason for their own weight problems – I just don’t see these people being in the majority. I was intrigued when I recently saw a notice on a bus advertising an Overeaters Anonymous meeting. Perhaps this is something we will see more of, and hopefully, as with AA, it will be a very helpful framework for individuals in order to work though common issues towards recovery.

But does this loss of control around food (or more correctly, specific types of food) occur in isolation? I’m no psychiatrist, but it would seem to me that underlying reasons for this type of behaviour would be multifactorial and complex. Overeating is therefore a symptom, which sadly results in symptoms of its own, exacerbating a cycle of health problems.

I don’t think the complete loss of control around food, with a continuous drive to eat more and more around the clock is solely responsible for the obesity epidemic we face. Most of us eat a little too much on a regular basis and are too inactive to balance
this intake of calories. Over time this leads to a gradual increase in the waistline, until we are in a situation where more people are overweight than are normal weight within the population, and nearly the same proportion are obese.

If it helps people to examine what they’re eating and how active their lifestyle is to label themselves as a “food addict”, then so be it. The only outcome I’m interested in is people getting healthier. This involves solutions that enable all of us to take more ownership of our health and make wiser choices about what foods and drinks we choose to buy and consume, in what amounts, and how much we sit being inactive. What do you think?
Canned foods get a thumbs-up for sound nutrition and affordability
Published on Wednesday, June 13th, 2012
Image thanks to FreeDigitalPhotos.net

The universal call to increase the consumption of fruits, vegetables, higher fibre foods and seafood, coupled with tightening family budgets, means that a study published recently in the Journal for Nutrition and Food Sciences is highly relevant.

The study looked at the nutritional qualities and relative cost of canned foods, and reassuringly found that canned foods provide sound nutrition at an affordable price, in a convenient format. Specifically much-needed key nutrients, such as fibre, protein, folate, vitamin C, and vitamin A were shown to be significantly preserved in a range of canned foods.

The nutritional findings are in line with research undertaken here in New Zealand about 10 years ago, but the latest study went an extra step by evaluating affordability on a price-per-serve basis against fresh, frozen and dried counterparts. The affordability measures took into account preparing and cooking time, and also energy usage.

The study looked specifically at canned beans, corn, mushrooms, peas, pumpkin, spinach, tomatoes, peaches, pears and tuna; comparing then with their fresh counterparts.

Two examples of the findings were:
- Tomatoes – It is nearly 60 percent more expensive to obtain dietary fibre from fresh tomatoes as from the same portion of canned tomatoes.
- Corn – When looking at purchase price alone, fresh corn is less expensive than canned or frozen. However, when the cost of waste (most notably the cob) is factored in, as well as time to prepare, canned corn offers the same amount of dietary fibre with a 25 percent cost saving compared to fresh and the same amount of folate with a 75 percent cost saving compared to fresh.
The NZ Nutrition Foundation (NZNF) commented on the relevance of the findings, as they come at a time when many families are struggling to put healthy food on the table because of limited budgets. It also makes the point that canned foods ensure essential nutrients are more accessible to consumers, particularly those with limited storage, preparation facilities, limited time, skill or interest in preparing fresh foods.

I find this heartening, at a time when so many of our current foodie programmes put great emphasis on the use of fresh fruit and vegetables. I fear this may be setting the bar too high for many kiwi families who are struggling to make ends meet. We now know that canned foods do deliver the goods nutritionally and needn’t shy away from the limelight, in the informed kitchen.
Sugar – since when did the facts get in the way of a good story?
Published on Monday, June 11th, 2012

Last night’s Sunday programme on sugary soft drinks (TVNZ 10 June, 7pm) promised yet another “expose” of the type our current affairs love to hype up to get our eyeballs and ears on their screens at the right time. Previous shows from the US and Australia clearly paved the way for our own home-grown version of another chapter in the great obesity debate.

It was a great opportunity to show what is happening in NZ and how we as a nation are faring in these tricky times and what the food industry and health sector are doing to address a global issue.

Not surprisingly, but no less disappointingly the piece was fairly one dimensional and single-mindedly focused on sugar and soft drinks. What it did highlight, once again, was the limited lens through which so many people choose to examine the link between food and health, or rather food and disease as appears to be the main focus.

While I commend Sunday for attempting to help New Zealanders think about what they choose to eat (or in this case drink), the facts do not warrant the dramatic way in which this, and many other stories are presented.

It certainly makes for good TV to show a wheelbarrow full of sugar to represent how much we each consume annually, but this is somewhat misleading. Likewise we each consume several Olympic-sized swimming pools of water annually, which also looks frightening. In fact on a daily basis our median intake of sucrose when last measured in 2008/09 was just 48g. And it’s on the decline (it was 53g in 1997).

Also, only 5% of our energy (as measured in 2008/09) came from non-alcoholic beverages. And just 1.4% of energy was contributed by the sucrose in all non-alcoholic beverages (only part of which is sugary soft drink). The rest, presumably, is contributed by fat, lactose, fructose, glucose and protein (remembering this group includes all non-alcoholic beverages other than plain milk). So are the other foods and drinks which contribute 98-99% of our energy intake unimportant? I think not.

In New Zealand, our intake of sugar (and particularly sugary soft drinks) differs significantly from countries like the United States, where much of the concern about sugar intakes stems from.

I don’t wish to trivialise the issue, as clearly the above figures are population medians, and some New Zealanders do over-consume. I would like to propose however, that these individuals are unlikely to be over-consuming on sugary soft drinks alone, and are more likely to be part of the growing number of food-illiterate people who don’t understand what over-consumption is.

To Professor Rush’s point, there is some evidence that we feel less satiated when we drink kilojoules, compared with when we eat them (because our stomachs empty more quickly), but I think the issue of satiation is far broader than just blaming drinks for our obesity problem. More and more New Zealanders seem to have become so accustomed to constant grazing on food and drink, to the point that many do not recognise the feeling of satiation, let alone the feeling of hunger.

What drives us to this? Economic, cultural and social issues that shape the environment we live in and the choices we make. Recently I read some research which found that most people no longer know what a calorie/kilojoule is. Yes, sugar and sugary drinks provide kilojoules, but so does everything we eat. In order to improve our health as a nation, individuals need a basic understanding of their own diet and how it relates to their own health; they need tools to help them make the best choices for them individually and they need to accept some individual responsibility for what they feed themselves and their families on a daily basis.

Yes, I do provide independent nutrition advice to a range of food companies, including NZ Sugar and Coca-Cola Oceania, so you may think my opinion is biased. As a result though, I’ve been following this issue closely and am aware of the evidence, plus lack of evidence, surrounding it. In my experience, it’s hard to get those without a vested interest in this issue to speak up – at least in New Zealand. My personal view is to stick to the facts, and to address all of the issues with practical solutions, rather than pinpoint one possible contributor alone. If there was a single silver bullet to address obesity, we would have found it my now, and we’d all be an ideal BMI.
Blind men and an elephant
Published on Thursday, March 15th, 2012

There’s an old Indian tale about giving a group of blind men an elephant to describe through feel. As each of them is feeling different parts of the elephant, they end up squabbling as none can agree on how to describe it as a whole. Each sticks fervently to their version of the truth, without communicating effectively and realising that all of their “truths” in harmony describe the total picture.

Lessons from this ancient fable are just as relevant today when we evaluate how various scientific experts approach the totality of scientific evidence. Recently we had a good example of this when one prominent scientist published his professional (and somewhat extreme) opinion on sugar in Nature, resulting in a media storm and “expert” slanging match across the globe. Personally I thought Dr Arya Sharma’s commentary on this was one of the better ones.

The very essence of scientific endeavour is to prove or disprove hypotheses, and since research often raises more questions than it answers, further research is usually justified. So individual researchers passionately chase logic down the path where their research leads them. It’s hardly surprising that when they come up for air and see what other “descriptions of the elephant” exist, debates can get heated. People who “describe the animal in the same way” comfortably reference each other’s material, while desparately trying to disprove the findings of others who might describe the animal differently. Hence many highly esteemed experts fight it out in the media and the general public become more confused and disenchanted than ever.

In the world of nutrition science nothing is black and white, as everything is highly dependent on a complex web of lifestyle variables and genetic make-up. It is therefore difficult to make clear and meaningful recommendations on a population basis, and no wonder really that we usually wind up back at use-your-common-sense messages, such as “eat a variety of foods” and “a balanced diet” which can be waffly and confusing for people.

White hat scientists (and there are a lot of them), tend to take the approach that it won’t do anyone any harm , rather than the evidence-based approach. There is an increasing school of thought that goes; since it takes so long to prove or disprove scientific theories on nutrition, we should just make recommendations which may not be effective but can’t do any harm. The American Heart Association clearly states in its position paper on sugar that “research tools thus far have been insufficient to confirm a direct link” [between added sugar intake and weight gain]. Then they go ahead and make prudent recommendations anyway.

Sadly this well-intended advice often serves to confuse and alienate the public further, as they reach for another chocolate bar and vow never to listen to another expert. Judging by the comments on TVNZ’s Breakfast facebook page (Feb 24th) this is certainly what happened when the NZMJ published a viewpoint article listing 49 foods for obese people to avoid, and the media made a complete meal of it. Yet again, the dietitians among us come out of it looking like the food police.

So, can we win? Is practical, meaningful and evidence-based dietary advice the ever-elusive holy grail? I’d love your views on this.
Motivating the imperfect, irrational human being
Published on Monday, October 3rd, 2011
At the Dietitians NZ Conference in Nelson this year I attended a memorable workshop by Melbourne-based Psycoholgist John Boyle, on making changes and breaking habits.

Lightbulbs went on in my head throughout the workshop, appropriately titled A conversation around compliance, motivation and the imperfect, irrational human being. Often health professionals wonder why people come to them for help, only to fail to follow the advice or treatment plan that’s provided.

This nonsensicality begins to make sense when the complexity of our brain, emotions and thought-patterns are accessed (and when you bear in mind that to some extent, we are in fact all imperfect, irrational human beings).

As many of us know breaking an old habit, is remarkably difficult. Of course there are cases where people have turned their lives around in an instant, but these are far outweighed by those of us who have tried every way to leave behind a habit, and still struggle to achieve lasting results. In fact often we can end up worse off than when we started.

But don’t despair – some helpful tips, gleaned from John’s workshop on this topic, included:
- When encouraging change, we must first ensure that in doing so, we don’t increase resistance to change. If we are confronted, a natural instinct is to resist, demonstrate reluctance or react. Often, objective, logical evidence is dismissed and any attempt to use logic and scientific argument can have the opposite effect that’s intended.
- We as humans are wired to loss aversion – meaning if you told me I need to give up chocolate biscuits, I may work to avoid this. Instead it is important to focus on what I would gain from giving up that box of chocolate biscuits each day.
- We have a commitment to our beliefs which is often difficult to terminate, even when things aren’t working. Evidence in support of a belief (such as, “no I don’t believe I need to exercise in order to lose weight”) may be lacking, but this belief has the power to create an immoveable force, leading us back to our old habits.
- Motivational interviewing is a common and effective technique used in all forms of counselling, including dietary counseling. Instead of confronting or persuading someone to change, this technique focuses on helping a person to mobilise their values and goals so that change becomes the bi-product of this. This is done using tactics such as practicing reflective listening, open-ended questioning, and summarising – then being able to identify and act on ‘change statements’ – i.e. acting when a person is actually ready to change. Changes statements include those which; recognise a problem, show concern, show an intent to change, or show optimism about changing.
While motivational interviewing is widely used by health professionals, I believe it can be applied to many areas of our day to day lives, and the way we communicate with each other. Without knowing it, I was constantly using this technique quite successfully when employed as a nanny. When the children resisted eating their vegetables, I would focus on what they’d immediately gain from eating them – which was having the freedom to leave the table and go and play on the trampoline again. And to a 12 year old this prospect was irresistible.

I’d be interested in hearing your thoughts on where you think this could be applied, whether it be with your children or partner, or even with colleagues or business associates.
The expansion of New Zealand waistlines
Published on Friday, September 23rd, 2011

With the release of the 2008/09 nutrition survey summary report last week, I was heartened to read that diet-wise, New Zealand adults seem to be starting to make the right choices. According to the survey, since 1997 we’ve reduced our overall energy fat, saturated fat and sugar intakes. We’re eating more healthy fats and protein, fruit and selenium. We also have lower total cholesterol levels with a better total:HDL-cholesterol ratio, potentially due to these dietary changes, but more likely due to higher rates of statin use. A couple of interesting findings were the drop in our intakes of vitamin A, iron and zinc; possibly resulting from cutting down on full cream dairy products and red meat.

But the real kicker is what’s happened to our waistlines, despite all this apparent healthy change. There’s no doubt about it – we’re all getting fatter. Sadly, as is often the case, this trend disproportionately affects certain groups in the population, with obesity rates amongst Maori and Pacific peoples in particular, starting to scale to dizzying proportions.

While everyone agrees the reasons are multifaceted, a number of experts have provided commentary in the past week as to why this dichotomy is being seen, including (and I’m paraphrasing for the sake of brevity):

1. “It’s because people under-report what they eat in surveys” (Rod Jackson)

Yes, this has been documented in the literature, but in comparing like methodology with like methodology are we really likely to be recording our food intake any less accurately now than we were in 1997? Even with an interviewer in our homes and going through our cupboards? I’m not sure this is the only explanation.

2. It’s partly because we’re less active than ever before and the survey did not assess activity levels.

Certainly the basic energy in: energy out equation loop isn’t completed without an assessment of physical activity levels. There is no question that sedentary behaviour is the elephant in the room with respect to obesity. No matter how much we idolise our sporting heroes as a nation, the majority of us are more likely to sit on our backsides for most of the day. Every day. But, are we likely to be even more sedentary now than we were in 1997? The 2006/07 NZ Health Survey found no change in regular physical activity between 2002/03 and 2006/07. However, according to Professor Grant Schofield, our levels of sedentary behaviour are likely to be on the increase, with more hours of TV viewing, more sedentary jobs and greater car ownership/distance travelled by car in the last 15 years. I don’t think we’ve heard the last on just how dangerous sitting can be for our health.

3. “It’s because our environment is too jammed with easily available high fat, salt and sugar foods” Robyn Toomath.

This is where we start to go around in circles, because the dietary intake data on the whole indicate we’re actually eating less fat and sugar. In fact the only source of sugar which is growing in our diets seems to be fruit. And in our fear of fat we seem to be switching to low fat dairy at the expense of retinol intakes and cutting out red meat to the expense of our zinc and iron intakes. So are we reporting our intakes correctly? (… and the circular nature of this dicussion goes on).

I would love to know what you make of all of this. It would be great to get a discussion going. Just insert a comment below (if there are no comments yet you need to click on the no comments box in order to make one).
Do tales of expensive tomatoes really protect the public interest?
Published on Thursday, August 4th, 2011

Media are required to walk a fine line between generating interest from their publics while ensuring they are not misrepresenting facts to do this. They also tend to target one aspect of an issue to illustrate a point with the effect that a singular aspect of a complicated issue can become the focus of everyone’s attention. The use of tomatoes as an indicator of soaring food prices is a case in point.

Food costs are rising and hunger is a heart-breaking reality for some people. But selecting an out of season fruit to highlight the issue of food prices won’t change that. Nor does it actually help people. Where has the age-old advice to buy in season and also to use nutritionally-similar frozen and canned as an alternative gone?

Is the price of milk yet another example of consumer expectations being formed by media to generate interest in a story that is now considered a major issue? Is the way this issue is being played out also telling people that milk should be cheaper than soft drinks?

Because so few people actually understand the food manufacturing process, it is not well understood that milk – a high nutritional value fresh protein food – costs far more to produce (think livestock management, cool chain processing, packaging, handling and storage). And because shelf stable soft drinks are simpler and cheaper to produce, their makers are frequently chastised by suggestions they are enticing people to put soft drinks in their trolley in place of milk.

The commentators who see a good story idea with some opportunity to link it to an issue of public good, often don’t present the full picture, and as a result the public’s interest isn’t served because attention to one aspect ignores potentially bigger issues. Perhaps they think people are too simple to understand a more complicated analysis of society?

Now a new dimension has emerged, with media commentators offering their own personal opinion on subjects others have had to spend years studying at university. A weekly food product analysis in a certain weekend paper is a case in point. While it offers some interesting observations on what’s in foods, and clearly scrutiny of food composition is important, the naivety of some of the comments would embarrass a new food technology graduate. And certainly frustrate most nutritionists.

Surely for this and other examples, there should be some level of accuracy and expert input to ensure a better degree of accuracy and perspective? That, to my mind would serve the public good a whole lot better.

Even Shortland Street has medical experts advising them on accuracy and we all know this is fictitious in the extreme. Credibility and impact of the media can only be eroded over time if these sorts of issues are not addressed. Then they really will be unable to protect and defend the interest of the public they represent.
When is a healthy recipe not a healthy recipe?
Published on Tuesday, June 14th, 2011

It has become the fashion for most, if not all, of our lifestyle magazines to present what they call “healthy recipes”. This is a development that concerns me, not for the fact they are promoting healthy food, but because such recipes are generally devoid of any nutritional reference points.

Perhaps there is an increasing demand by some for healthy, affordable meal ideas. The unparalleled success of the Healthy Food Guide magazine would certainly indicate this.

As a result, everyone seems to have jumped on the bandwagon with ideas for “healthy” snacks, “healthy” pantry items and “healthy” meal ideas. The problem is that most of these recipes do not stack up when put against real nutrition criteria, such as energy (kilojoule) content, fat content, sugar content, fibre content and salt content. Healthy Food Guide pride themselves (rightly) on their rigorous nutritional criteria for recipes and as such, when they say “healthy”, they really do mean healthy.

Some recent examples of other so-called “healthy” meals include anything vegetarian or gluten free, or anything our nana might have made. While the use of a range of vegetables in vegetarian recipes is to be applauded, sadly when they are swimming in cream, oil or high fat cheeses their health benefits are somewhat offset. One particular recent example of “healthy” has been a vegetable stack on a mashed potato base with parmesan wafers. When analysed it was found to provide more than 75% of the daily energy requirement and more than 100% of the daily requirements of fat, saturated fat and sodium in just one serve. The recommended serve size was also very large.

While there are regulations around using claims such as “low fat” on food labels, there are no such regulations covering the promotional headlines often seen on the covers of magazines. Usually analysis of the supposedly “low fat” recipes reveals the promotional headline is outrageously misleading.

Just as frustrating can be the use of terms such as “diet foods” – inferring healthy – but actually meaning for people (rightly or wrongly) trying to avoid particular food components such as gluten and lactose. The recipes might be devoid of lactose or gluten, but they can make up for it with lashings of fat and sugar.

I suspect that some of references to “healthy foods” are intended to mimick Healthy Food Guide magazine. However I suspect the success of that magazine is due not just to its strict nutrition criteria for recipes. It’s also due to its “best friend” approach to its readership, in providing helpful, supportive ideas, while ensuring the information it provides is factually correct. Contrast this with the claims of a recent article in a popular magazine, headlined “why sugar is making you old”. It quotes a “celebrity dermatologist’s” theory about how sugar consumption affects the elasticity of the skin. Any objective analysis of the published research in this field would find the evidence for such claims to be shaky, at best.

I have discussed this “healthy recipe” trend with other dietitians. They agree there’s a role for Dietitians NZ to provide some guidance on this, so watch this space for more information.