The Eatwell Guide continues to court controversy two years after it was revised, not just over its composition but also on cost, writes Jane Renton
Dietary and nutritional advice is never straightforward. No sooner does one supposedly ground-braking piece of research hit the headlines then another scientific paper appears to contradict it. How do we live the ‘good life’ nutritionally speaking, when all around us is a morass of confusion and contradiction?
The UK’s official nutrition guidelines, The Eatwell Guide, revised in 2016, were designed to overcome such confusion. Based on comprehensive evidence from the independent Scientific Advisory Committee on Nutrition (SACN), it was designed to provide practical guidance to schools and other public institutions, homes and families about the nutrients and correct diet needed for health.
The trouble with food is that everyone has views, and is invariably shouty and forthright about expressing them. Everyone is an expert and not everyone agrees with what is in the Eatwell Guide, especially over its alleged health benefits. There is also concern about its very affordability, something that may be due to depressed wages of many people on lower incomes – the working poor than the intrinsic cost of the diet itself. Nevertheless, conforming to the dietary requirements of the Eatwell Guide would put it beyond the pockets of many, claims the Food Foundation.
In fact, the Foundation maintains some four million children live in households that would struggle to afford enough fruit, vegetables, fish and other healthy proteins required to meet the official guidelines. The poorest fifth of families would be compelled to set aside more than 40% of their total weekly income after housing costs to follow Eatwell’s dietary recommendations, the study claims.
“In fact, the Food Foundation says that if you are in the bottom 10% of income, the Eatwell Guide would absorb 70% if your household income, making it utterly unaffordable for the poor to eat well,” asserted Baroness Rosie Boycott, director and trustee of the Food Foundation and chair of Veg Power, at a recent Westminster Food and Nutrition Forum on childhood obesity. It is a topic she has spoken loudly about on a number of occasions.
Public Health England (PHE) claims that a healthy balanced diet in line with the Eatwell Guide should cost around £6 per day for an adult. However, given rising poverty levels among low-income families, many families are struggling to eat either healthily or unhealthily. As a result, the Food Foundation is calling on government to increase welfare benefit payments. They also want the government to create a national food security policy that ensures that healthier foods are made more widely available and affordable to such households through maternity food vouchers and universal free school meals. “The government’s measurement of household income highlights the fact that millions of families in the UK cannot afford to eat in line with the government’s own dietary guidance,” says Anna Taylor, the executive director of the Food Foundation.“It’s crucial that a coordinated cross-government effort develops policy that accounts for the cost of its recommended diet and creates a food system that does not consign those on lower incomes to the risk of diet-related illness.”
According to the Foundation, the official cost of meeting the Eatwell Guide is £41.93 a week. A family with two adults and three children, aged two, five and eight, would need a weekly food budget of £111.35. It estimates that 47% of all UK households do not spend enough to meet the Eatwell cost threshold, a percentage that rises to 60% in single parent families, it calculates.
But it’s not just the cost of following the Eatwell Guide that attracted criticism. Opponents, including manufacturers and food producers, don’t all agree on its nutritional balance. There are three main points: its re-emphasis on carbohydrates, which many maintain is one of the main culprits behind rising British obesity levels and diabetes type 2; the near halving of dairy in the current guidelines, something again which the critics say is alarming given its importance for supplying calcium and iodine, nutrients of critical importance in children’s development; and its near-demonisation of all saturated fats, despite recent studies exonerating their complicity in causing cholesterol to rise.
“We would recommend a maximum quarter of a plate is starchy carbs at each meal, less for people who are overweight,” says Clare Daley, a nutritional therapist and clinical education manager at nutritional supplement company Cytoplan. “Many of the images in the Guide are of different types of wheat. Reduced emphasis on this food would be desirable – suggesting that people try sweet potatoes, for example.”
Earlier this year, cardiologist Dr Aseem Malhotra, the Queen’s former doctor Sir Richard Thompson, and nutritionist Sarah-Ann Macklin called for the overhaul of the Eatwell Guide at a public health debate at the European Parliament in Brussels. Instead, they want to see a low carbohydrate diet based upon the Mediterranean diet to help curb type 2 diabetes.“It’s more important to cut down on the calories in carbohydrates rather than the calories in fat, because it has caused a tsunami in diabetes. And we are all obsessed by sugar. We need to address this right now,” said Sir Richard, a former president of the Royal College of Physicians. Who is right? As food scientists have pointed out, saturated fat is not just one food component but rather a category with acids that can be both good and bad for health. Stearic acid found in dark chocolate offers nutritional benefits, whereas palmitic and myristic acids are likely to contribute significantly to inflammation and even atherosclerosis. The Eatwell Guide was revised in 2016 following recommendations by SACN the previous year to reduce the mean level of free sugars in the national diet. They have in fact been more than halved from 11% to 5% along with recommendations that sugar-sweetened drinks be minimised. It was also recommended that the intake of fibre should be increased for the mean adult population from 23-24g to 30g a day.
Those recommendations for a more balanced diet, and one that included wholegrain carbohydrates, was aligned with a number of large scale studies from around the health, asserts PHE, which formulated the current dietary guidelines.
“Cutting out carbohydrates such as potatoes, rice and pasta goes against a healthy balanced diet, which can help minimise the risk of serious illnesses such as type 2 diabetes, heart disease and some cancers in the long term,” states Alison Tedstone, PHE’s chief nutritionist.
Those new Eatwell guidelines have informed the current school food standards that legally apply to all schools except for academy schools created between 2010 and 2014. However, given that less than 20% of all meals are consumed in schools, both the cost of conforming to the nationally-recommended diet and any suggestion that it may not lead to good, let alone optimal health, is a worry.
This is a debate that will inevitably continue to rage between the low carb aficionados, who also tend to maintain that saturated fats are being unfairly demonised, and the government, which does not want to exclude foods such as wholegrains and rice.
So who is right and who is wrong? Perhaps there is more than a grain of truth in either position. One thing is clear, unless you’ve been living under a rock for the past few decades you cannot fail to note that the nation is getting larger. Obesity used to be rare but is now an epidemic afflicting people from all social classes, but the poor disproportionately badly. It is a tragedy of unprecedented proportions. Alison Tedstone is right to condemn unhealthy fast food, but perhaps there will never be one diet that fits everyone, regardless of genotype.
Eatwell Guide discrepancies
Clare Daley from Cytoplan, shares her views on the Eatwell Guide.
Fruit and vegetables
These are shown in the same area of the plate. Fruit is high in sugar so is not equal to vegetables. Plus, the plate does not emphasise the importance of eating dark, green leafy vegetables every day, vegetables are all treated equally. If aiming for five portions a day, then three or four of these need to be vegetables, with one or two fruit (one max if trying to lose weight). However, a higher number of portions is ideal – we would recommend half the plate is vegetables at both lunch and supper, so aiming for seven portions of vegetables and fruit per day, or even better 10. There is a linear relationship between vegetables and fruit consumption and health.
Fats and oils
The fats/oils shown on the Eatwell Guide are high in omega-6 fatty acids. We eat too many of these in the Western diet and not enough omega-3 fatty acids. Omega-6 fatty acids increase inflammation in the body whereas omega-3 are anti-inflammatory. Therefore, we would recommend avoiding vegetable oil and margarine which are shown on the plate (i.e. sunflower, corn oil etc) in favour of olive oil and small amounts of butter (olive oil is high in monounsaturated fatty acids – not high in the essential fatty acid omega-3 but nevertheless there is lots of research on its benefits). Other sources of healthy fats we would recommend are nuts / seeds, avocado (although very controversial at the moment), and oily fish.
There is no mention of artificial sweeteners. Since the introduction of the sugar tax, some foods are replacing sugar with sweeteners and these have been linked to a number of health concerns.