September 2007

Making Sense of the Most Misunderstood Foods
By Sharon Palmer, RD
Today’s Dietitian
Vol. 9 No. 9 P. 56

When it comes to food and nutrition, people are on information overload. But instead of providing clarity, this information glut often bogs people down in confusion. Today’s Dietitian weighs in on 10 oft-misunderstood foods.

Even with, and possibly because of, an abundance of information on food and nutrition in magazines and newspapers and on television and the Internet, people are still confused about what to eat. All you have to do is announce that you are a dietitian at a social event and watch people line up with nutrition questions. Just what kind of fat should I be consuming now? Do raw foods have more enzymes? Should I take flavonoid supplements to prevent cancer? What about Beyoncé’s Master Cleanser Diet? The questions can go on forever.

According to the American Dietetic Association (ADA), as consumers increasingly take responsibility for their own health, people want all the information they can get their hands on to make healthful food choices. This desire can leave people vulnerable to food and nutrition misinformation. While there is an increasing amount of reliable information at the public’s fingertips, people must often wade through a swamp of fallacy to find the pearls of truth. The ADA’s position is that the most common types of food and nutrition misinformation, including food fads, health fraud, and misdirected claims, can lead consumers to make incorrect inferences or generalizations about the health benefits of certain foods. Avoiding food and nutrition misinformation was a key message of this year’s National Nutrition Month.

To make matters worse, we live in an era that finds nearly every nutrition study published in mainstream media outlets. At times, study results are conflicting, and the average person may have a hard time understanding how to apply these research findings to their own lifestyle. “There is widespread confusion about nutrients in general, and that is particularly because there are so many different opinions regarding the subject. Our reliance on medical studies makes things confusing because results are always conflicting and medical studies on nutrition are hard to perform and prove,” says Lynn Goldstein, MS, RD, CDN, HHC, a dietitian and holistic health counselor in New York.

Nutrition misinformation can lead to a fear of particular foods or food groups—from potato aversion by the low carb folk to cheese guilt among low-fat fanatics. Sometimes, when nutrition issues get so muddled that people can no longer find their way, they may throw up their hands and think it doesn’t really matter what they eat. That’s where dietitians can step in and answer the difficult questions, helping people put perspective back into their diets.

“I think the overarching problem is that people do not understand how to put foods together in a healthful way. Dietitians tend to play into this when we focus on one nutrient issue in food. But it’s all about balance and moderation. The key is to help people make healthy choices and reduce their risk of disease,” says Dayle Hayes, MS, RD, president of Nutrition for Future, Inc., in Billings, Mont.

Today’s Dietitian explores 10 of the most misunderstood foods that people get tripped up on and offers a fresh, balanced look at sifting through the misperceptions.

1. Fats. If you’re looking for one of the biggest crowd confusers, look no further than fats. Thanks to a history of crucifying the bad fat of the year, offering health halos for good fats, and food marketing campaigns that put fat-free into everyone’s face, the public is at a loss for what to do about them. While some people pour olive oil on their foods like a health tonic, others avoid fat on food labels like the plague. And while many got the anti-trans fats message, they zoned out on saturated fats.

“Fats are completely terrifying to many people. The fat-free revolution that came about in the ‘80s did nothing but make people fatter. A healthy diet needs good, healthy fats in it, but you have to keep everything in moderation. Fats do have a lot of calories, so if you are trying to cut back, you need to look at your diet as a whole and see where you are overeating. Good, healthy fats include mostly healthy oils like olive oil, canola oil, grapeseed oil, sesame oil, and the tropical oils such as coconut and palm oil,” says Goldstein. It’s important for people to understand that you can get too much of a good thing—even healthy oils, which are dense in calories. And beware of fat-free or low-fat food products, which can often be just as high—or even higher—in calories than regular products.

2. Cheese. Cheese has all the forces of yin and yang. On one end of the spectrum, it conjures up images of a great food dating back to 6000 BC that developed a rich, ethnic identity in countries around the globe—from France’s camembert to Greece’s feta. Cheeses are at the core of many food cultures and can contribute high-quality protein, calcium, phosphorus, zinc, vitamin A, riboflavin, and vitamin B12 to the diet.

On the other end of the spectrum is our penchant for cheese nibbling that has flourished in recent years, and we’re not talking about a slice of cheese on a lunch sandwich. Today, Americans have cheese in their omelets, salads, casseroles, and appetizers. U.S. cheese consumption has tripled during the past 30 years, now averaging 31 pounds of cheese per person per year. Whole milk cheeses generally contain from 80 to 120 calories, 6 to 10 grams of fat, and 4 to 6 grams of saturated fat per ounce. Crumbling an ounce of whole milk cheese over a salad is the nutritional equivalent of crumbling an ounce of microwaved bacon over it.

The bottom line is that cheese is all about moderation. An ounce of cheese is about the size of a pair of dice. Most people get far more than that when they’re grazing on a cheese and cracker platter as a predinner gnosh. But that doesn’t mean that people have to scratch cheese off their shopping list.

“I doubt that most consumers could accurately list the fat and saturated fat content in different varieties of cheese. However, even if consumers did get this idea, it doesn’t mean that they can never have cheese. There is real confusion about foods being labeled as good or bad. The real issue is that you don’t need four slices on your cheeseburger. We need to talk about it in a balanced way. Several nutrients in dairy foods are shortfall nutrients, as described in the 2005 Dietary Guidelines for Americans. We should not be scaring people away from enjoying nutrient-rich foods like cheese,” says Hayes.

3. Fish. There’s so much for people to get a handle on when they come face-to-face with the seafood sneeze guard at their favorite supermarket. Mercury levels, omega-3 fatty acids, endangered species anyone?

“People are totally confused about fish. They have got a clue that maybe fish has omega-3 fatty acids, but they don’t understand the gradation and what fish has more or less. I don’t think consumers understand that omega-3 fatty acids vary depending on the species; the range is quite large. And then there’s the problem of how to balance the whole mercury issue,” says Hayes, who notes that even RDs have a hard time keeping up with the environmental issues surrounding fish. Hayes recommends the American Heart Association (AHA) Web site reference “Fish, Levels of Mercury and Omega-3 Fatty Acids” as a helpful resource for selecting fish (www.americanheart.org/presenter.jhtml?identifier=3013797). Also, the Endangered Fish Alliance (www.endangeredfishalliance.org) offers information on threatened fish species such as Chilean sea bass, orange roughy, and swordfish.

4. Potatoes. Thanks to the low-carb movement and the glycemic index, the poor old spud is frequently maligned. Rather than a wholesome comfort food, many people see a potato as a guilty delight. But potatoes have been an important cornerstone of the Western diet for centuries. At the height of Ireland’s potato famine in 1845, an estimated 1 million people died of starvation.

“Potatoes probably are a misunderstood food. I have people tell me, ‘I’m so happy I’m getting rid of my carbs.’ But potatoes are listed as a white vegetable. And there are all kinds of potatoes—purple skin potatoes, red skin potatoes, and Yukon gold potatoes—that provide different phytonutrient benefits from the pigment that comes in their peels and skins. Although not technically a potato, there’s also the sweet potato, rich in vitamin A. Potatoes are a reasonable source of vitamin C, potassium, and fiber, especially in the skin,” says Roberta Larson Duyff, MS, RD, FADA, CFCS, food and nutrition consultant and author of the American Dietetic Association Complete Food and Nutrition Guide.

A medium potato can deliver 45% of the daily vitamin C, 620 milligrams of potassium, 3 grams of protein, 2 grams of fiber, and trace amounts of thiamin, riboflavin, folate, magnesium, phosphorous, iron, and zinc—all in a no-fat, no-sodium, 110-calorie bundle. But that doesn’t mean people shouldn’t beware of gargantuan baked potatoes, mashed potatoes with ladles of gravy and butter (over the top and mixed into the recipe), and indulgent potato toppings.

5. Tropical oils. Just like fashion, in the world of fats, it seems that everything old is new again. Artificial trans fats were born when health organizations painted saturated fats, including tropical oils, as the “bad” fats. Now that trans fats have been duly vilified, tropical oils are returning to food labels. Tropical oils solve many functionality problems in trans fat-free food processing that many liquid vegetable oils cannot address. But does that mean that tropical oils, including palm, palm kernel, and coconut oils, are still considered unhealthful fats?

According to the AHA, saturated fat intake should still be limited to 7% to 10% of daily caloric intake, which includes tropical oils containing high levels of saturated fatty acids. Coconut oil contains 92%, palm kernel oil 82%, and palm oil 50% saturated fatty acids. But some studies have shown that palm oil has beneficial effects on blood cholesterol.

Adding to the tropical oil mayhem, the Center for Science in the Public Interest urges companies not to switch to palm oil, as this oil is generally produced in Indonesia and Malaysia, where oil palm plantations have replaced rainforests filled with endangered species, in addition to the fact that it promotes heart disease, even if not to the same extent as partially hydrogenated oils.

“This is a huge question and so controversial,” says Goldstein of the healthiness of tropical oils. “Unrefined organic coconut oil is actually a great oil to use in cooking. It has a very high smoke point, so it can be used in high-heat cooking, unlike olive oil. Coconut oil was originally put on the ‘do not eat’ list because it was considered a saturated fat. This oil actually has predominantly medium-chain fatty acids, which are metabolized rapidly by the liver for energy and do not participate in the raising of cholesterol levels. Coconut oils have been used in the tropical regions for centuries, and these cultures do not exhibit higher cholesterol or increased heart disease risk than cultures that use olive oil.

“Palm oil was also given a lot of flack for being a saturated fat. Palm oil is another very good oil to use and cook with. Palm oil is rich in beta-carotene, vitamin E, and other antioxidants. Also, its fat acts more like monounsaturated fat in the body than saturated fat,” says Goldstein, who adds that palm kernel oil, which is not a healthy oil to use, should not be confused with palm oil.

6. Eggs. A common urban legend circulating is that cholesterol watchers no longer have to limit eggs. In fact, the AHA Web site includes eggs on its “Common Misperceptions About Cholesterol” page. The AHA notes that since an egg yolk has 213 milligrams of dietary cholesterol, one egg can fit into the dietary recommendation of 300 milligrams of dietary cholesterol per day. But that means people need to watch their dietary cholesterol intake from other sources during the day to fit within recommended levels.

“The conversation has been about saturated fats and trans fats in foods, but cholesterol in foods is an issue, too. To keep within the 300 milligrams per day cholesterol guideline, one egg yolk is enough. Eggs are an inexpensive protein source that can fit into a healthful diet, but people need to be aware of other foods that they are consuming, not just their morning eggs,” says Duyff, who notes that many egg dishes can have more than one egg per serving.

Duyff reports that of further confusion to the egg conundrum is omega-3 fatty acid-enriched eggs, which have unique benefits, noting, “Organic, free-range eggs have other health halos that may be taking people’s first attention.”

7. Dried fruit. Most people have probably gotten the message that fruit equals healthy, thanks to the 5-A-Day The Color Way campaign. The fact that a variety of colorful fruits offer a rainbow of phytonutrients and health benefits has been easy for consumers to digest. But dried fruits have gotten mired down in a few negative issues, such as nutrient density. For example, a miniature box (0.5 ounces) of raisins has 42 calories, while 10 fresh grapes (1.7 ounces) have 34 calories. While packages of mixed, dried fruits boast their “antioxidant” appeal—and indeed they are usually packed with a superstar nutrient lineup—they can net hundreds of calories per fistful if one were to feast on an open bag. And many dried fruit mixes contain extra, unwanted ingredients, unbeknownst to consumers.

“I think dried fruit is a great addition to a healthy diet. But you need to be sure you are getting 100% fruit. Many packaged dried fruits will add additional sugar, preservatives, and colorings that are unneeded. Dried fruit is no more fattening than fresh fruit if it is all-natural and eaten in small amounts,” says Goldstein.

8. Sports/Energy drinks. How do you hint that you’re hip and fit these days? Carry a neon-colored sports drink bottle around. Sales of sports and energy drinks are soaring, with close to $3 billion in sales in the United States. If only fitness were as easy as sipping a beverage.

“Sports drinks were originally created and are still appropriate for athletes or for anyone doing moderate to heavy exercise for more than 90 minutes at a time. When you sweat that excessively during exercise, like someone training for a marathon or other event, you lose electrolytes, as well as deplete your carbohydrate stores. These drinks are appropriate to replenish these losses. If you are exercising for less than 90 minutes or not at all, just looking for a drink to quench your thirst, water is appropriate. These sports drinks do have sugar and other sources of calories and will contribute to weight gain if you drink too much. Often, sugar-filled drinks are a major contributor to obesity because we do not recognize fullness from liquid calories the same way we do from food calories,” says Goldstein, who also notes that many doctors and dietitians suggest these drinks for diarrhea when they can actually aggravate the condition.

9. Nuts. Nuts have always been burdened with a negative reputation for containing high levels of fat and calories, which can scare off skittish weight watchers scanning nutrition fact labels. But in recent years, it seems like every nut on the block is promoting its healthiness and basking under a health halo. Indeed, nuts offer an excellent source of plant protein, fiber, and a variety of nutrients, depending on the profile of the individual nut. Many nuts have also been found to lower cholesterol levels, thanks to their healthy oils. Nuts have also become newsworthy thanks to their food allergy status, as they are one of the most common. So the public has a lot to ponder when it comes to nuts.

“I think things have shifted the other way with nuts because of on-package health claims. People now think that nuts are a ‘good food.’ However, as with any nutrient-rich food, it’s a question of serving size with nuts. Whether they have healthful fats or not, it doesn’t mean you should have as much as you want. They have very positive nutritional attributes; for example, they are also sources of shortfall nutrients for American adults and children. It is all about enjoying a reasonable portion size,” says Hayes.

10. Wine. Wine is enjoying a new healthy buzz these days, thanks in part to evidence that polyphenols in red wine, especially resveratrol, proanthocyanidins, and quercetin, offer cardioprotective benefits. Wine’s popularity has grown by leaps and bounds. In 2006, total U.S. wine sales rose to $27.8 million, the 13th year in a row that saw a steady sales increase. It seems like everyone is sharing the love for wine. Even the 2005 Dietary Guidelines for Americans suggest that moderate alcohol consumption may have health benefits.

But the AHA suggests that if people drink alcohol, they should do so in moderation (one to two drinks per day for men and one drink per day for women), adding that even though wine may have some potential benefits for cardiovascular risk, people shouldn’t drink wine to gain potential benefits. The American Institute for Cancer Research maintains the position that even though there may be cancer-fighting potential for resveratrol, alcohol consumption has a convincing link with cancers of the mouth, pharynx, larynx, esophagus, and liver; a probable link with colorectal and breast cancer; and a possible link with lung cancer.

Then, there’s the often-neglected fact that alcohol calories count, too. An average bottle of table wine contains 562 calories. “I don’t think many people stop to think about calories when they share a bottle of wine. The calories really add up, especially if wine is a regular part of meals,” says Duyff.

It seems that dietetics professionals have a big chore on their hands to help clear up the urban legends and misperceptions about food and nutrition that plague our society. According to Hayes, “As a profession, dietitians should not be in the business of scaring people into avoiding certain foods. Our food police mindsets haven’t kept people from eating things. We need to help people recognize that there is very little in the American food supply—restaurants, supermarkets, vending, or snack foods—that is served in appropriate portion sizes. The fundamental issue is that we need to help people with portions. We need to find ways to help consumers enjoy balance and moderation in eating. This will be more effective and enjoyable for both consumers and dietitians.”

— Sharon Palmer, RD, is a contributing editor at Today’s Dietitian and a freelance food and nutrition writer in southern California.