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.

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.

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).

As a nutrition communicator I spend much of my time trawling the pages of PubMed, tapping away on the computer, laptop, iPhone or iPad, using social media and other electronic networks to share balanced, evidence-based food and nutrition information.  It was actually quite a relief to rest my thumbs for a few days and use my own voice and ears instead.  So much so that I now sound like a pack-a-day smoker!

Together with Sarah (a colleague from the NZ Nutrition Foundation) we presented a social media workshop for dietitians at the conference, and while we were very successful in convincing New Zealand dietitians to jump onto the blogosphere, I was surprised at how much the experience reminded me that social media is only useful in-between times of face-to-face contact.  In fact when I think about it, the dietitians I interact most with via social media networks are the ones I’ve actually met in person.

Is it a generational thing? Being someone who grew up without the internet, who can even remember what working-life was like prior to email, perhaps I’m biased?  Are you more likely to respond to questions and take part in social media discussions about professional issues when you’ve actually met the person seeking input?  I guess I’ll get my answer from your comments below…

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.

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. 

My recent diagnosis has forced me to learn more about gluten free food and I’m finding it fascinating. There is a huge industry catering for people with either mild or severe intolerances, or allergies. While the most common components of concern are gluten, milk protein, eggs, lactose, seafood, and nuts; the scope is so much wider than this, and the availability and variety of accommodating foods in 2011 is really very impressive.

Last week there was a myriad of gluten free, allergy related articles in light of Allergy Awareness Week and the upcoming show. Allergy New Zealand did a fantastic job of profiling it across all major print publications, though I also noticed themes such as ‘is gluten free healthier?’ and ‘taking the food fad too far’ developing in the media. It seems people who don’t actually have true intolerances or allergies believe cutting out gluten, or other components is fashionable and/or healthier. This fallacy isn’t helped by celebrities endorsing the weight loss benefits of eating gluten or dairy free.

I only have a mild intolerance so it’s not life-threatening if I do cave into a little bread here and there. I do sympathise with people who have coeliac disease, and I’m sure they’d agree with me – cutting out gluten is definitely not a glamorous choice by any means. We are all very grateful that our supermarkets stock our special products as it really does make life, for those of us who need them, so much easier.

Having completed 16 radio interviews and five interactive celebrity cooking demos with audiences of hundreds, and with 600 “likes” on the Food Week Facebook page, Sarah Hanrahan from the Nutrition Foundation is justifiably satisfied with progress so far.

The approach of Just Cook – promoting positive, no stress cooking, with basic, inexpensive pantry essentials and just talking about food in a positive light has been received well by people so far.  “It’s so much more practical and well received than telling people what not to do”, said Sarah when we spoke to her today.

With rising food prices and cost of living increasing, many families struggle to manage on an average New Zealand wage (as shown by Campbell Live reporter Tristram Clayton’s reality check in living on a budget), Just Cook, and its message “Just get in the kitchen and cook!” shows it’s absolutely still possible to make healthy, tasty meals in the home without breaking the budget.

Research shows the biggest barriers to cooking at home are time, money and knowledge. Just Cook provides practical tips on how to address these barriers, such as knowing where to add a tin of beans or a cup of oats or to make meals go further for a fraction of the cost, adding good nutrition without compromising taste. The Food List  – a handy list of pantry, fridge and freezer foods to keep on hand at all times – is a great guide of kitchen essentials that can help those shopping on a budget prioritise what’s needed. And the Just Cook interactive kitchen houses easy, affordable, tried and tested recipes that cater to any combination of ingredients commonly held in NZ pantries.

The programme also has a schools component for year 10 pupils which will be followed and evaluated in the coming weeks. Students are challenged to produce a recipe on a budget to feed a family of five, using items in the pantry list and a few extra dollars.

As I write this, Sarah is just packing up from the final celebrity chef cooking demo in Britomart, where Masterchef finalist Nadia Lim cooked up a storm from the Food List in the fabulous kitchen provided by Fisher & Paykel. 

You can access the celebrity chef recipes here, proof that some of our top foodies have great ideas for inexpensive food!

We welcome any of your favourite recipe ideas or comments for making meals go further on a budget – please post these in the comments section below.

Our food producers are not afforded the same luxury. Our protests here have more vigour and sting.  Take the ongoing issue of the price of milk. There is a target we can see and touch.

A staunch defender of the indigenous food industry, veteran agricultural reporter Jon Morgan wrote in the Dominion Post this week that when it comes to food pricing “some self-styled Kiwi mums, backed by the usual self-promoting suspects of the Green Party, talkback radio hosts and TV presenters have Fonterra in their sights”.

His column, headed: Not letting the facts get in the way of a good story, drew on the evidence of Massey University professor of pastoral farming Jacqueline Rowarth, the theme being food is cheap – when adjusted for inflation, that is.

Unfortunately food is not an intellectual exercise.  Even if we accept the evidence of Professor Rowarth that all Kiwis over 18 years spend $5 a day on impulse buys versus $10 a day on supermarket shopping – and that wage increases have outstripped food price rises – the pain at checkout is undiminished.

While facts – and their constant repetition – may over time have some influence on how we view food prices, no amount of communication is going to change the fact that our spending priorities have been re-ordered.  As important as food is, we now have infinitely more spending options than our parents, or even our older siblings, and we are determined to exercise them.  This is our birthright, so we should not expect our attitudes to food prices to change anytime soon.

Having a basic understanding of the components of food and knowing what to expect when specific foods are prepared in different ways shouldn’t just be the realm of food technologists.  There was a time when most household cooks understood the food they purchased and cooked.  One view is that now we don’t really have household cooks,  we have household shoppers and household “food assemblers”.  According to Richard Dennis of the Australian Institute on Checkpoint, most of us don’t have a meal plan in mind when we visit the supermarket.  He describes convenience as “the enemy of good planning”.

How have we ended up like this?  Food was once plentiful and, in most cases, cheap, we were fit and healthy, there was no such thing as global warming, and we just got busy doing other things.

But the halcyon days are no more.  Food is expensive, it takes a lot of resource to produce in the quantities we need, and our population has an obesity and diabetes problem.  For all these reasons we simply cannot afford to carry on in the same fashion.  Throwing away food is hurting us more than just by leaving us with feelings of guilt.  Fresh fruit and vegetables have risen more than 12% in price over the last year, and are, apparently, the items most often thrown out.  According to Dennis this is partly because we don’t plan our meals well, but also because what we think is fresh often isn’t, so starts to deteriorate sooner than expected.

This lack of connection with food is causing some authorities to question having “best before” dates on labels.  But surely the answer is to just engage a bit more with the foods we choose to buy?

Examples include: knowing that yoghurt or cottage cheese that’s past its best before date is going to be OK as long as it tastes and smells OK; knowing how to cook something to preserve it for a bit longer; and storing foods appropriately to help extend their life (eg, apples in the fridge, potatoes in the dark, etc).

Another key thing is to learn how to plan meals ahead, so that we go to the supermarket prepared and just buy what we need.  It won’t only save money but it will be good for our waistlines and ultimately, the planet.