By Bernie Mertens, Nutrition and Behaviour MSc. Registered Nurse BSc (Hons)
Pretty much all the food (and drink) we consume are catalogued in some way. Whether it’s based on product type or ingredients included, it’s all a way of categorising food for the ease of consumer recognition. Some given labels are broad and more scientific than others, including “macro-nutrients” or “micro-nutrients”[1]. Others, although maintaining a scientific standpoint, may be more easily identifiable, such as carbohydrates, protein, fibre, vitamins and minerals; whilst some have more of a socio-cultural significance. Language such as “healthy”, “clean”, “good” or “unhealthy” and “bad” are frequently paired with specific food types through rationalisation of social constructs [2] that are used to help people maintain a healthy lifestyle. However, these words are often accompanied by individual bias, not to mention emotive significance. But to the general public, what does all this food labelling actually mean? One thing’s for sure, it can actually be pretty confusing, not to mention a lot to digest (sorry-had to).
Foods that are lower in nutritional value and energy dense (ie. ultra-processed snacks or fast-food) are consistently described as a “treat” or “reward” [2]. For example:
- biscuits
- ice-cream
- breakfast cereals
- packet ham
- packet sliced bread
- crisps
- fruit flavoured yoghurt
- some ‘ready meals
- frozen pizza
- fizzy drinks eg cola
This is generally because of the high amounts of sugar, saturated fats and salt making it a flavoursome experience; but these words, although meant to imply occasional consumption, also infer positive connotations towards foods that have lower nutritional value making them feel more enjoyable. Additionally, undertones surrounding the word “healthy” can be negative, often translating to “lacking” or “unexciting” because they are used to endorse the limitation of ultra-processed foods [3] as a way of to promoting the consumption of whole, nutritious foods and promote good health.
However, a great deal of emerging research suggests that eating behaviours are highly linked to emotion.[4] What we eat effects how we feel and often how we feel and perceptions of food can dictate what we decide to eat, which is different for everyone [5]. Marking certain foods with a big red UNHEALTHY sticker that are also “treats” or “rewards,” can be echoed by a wave of guilt and shame after consumption; and because of these underlying connotations, some labels can be harmful to people who have tricky relationships with food [6]. Equally, labelling food with high nutritional content as categorically “healthy”, “clean” or “good”, can not only reinforce this notion of shame for eating “unhealthy” or “bad” foods, but by doing so, reinforce harmful eating behaviours in vulnerable people [7].
This can be a mind field for anyone trying to understand nutrition, especially those people with no prior knowledge, or who are impressionable to public opinion-such as children. So, whilst being mindful about how stigmatisation of food labelling can affect choice, and specific labels are affected by social attitudes, let’s see if we can filter through the noise and work out how to fuel our bodies in the best way.
Firstly, the main takeaway here is that nutrition is personalised. Why? Because we’re all different. Our genders, ages, health status, ethnicity, income, taste preferences, attitudes, lifestyle-to name a few, all have an impact on individual requirements for nutritional consumption, availability [8] and what our bodies need to function at their best[9]. For example, nuts are a good source of protein and fats (and micronutrients), and if consumed in moderation, are considered “healthy”. In some studies they have even been shown to reduce disease risk![10] However, for someone that has a deathly allergy to nuts, they would be considered pretty “unhealthy”, to say the least. Another example of this can be outlined by thinking about the amount that someone who is training for a marathon, or someone else who spends hours muscle building in the gym may need to consume compared to someone who is living a generally sedentary lifestyle. Therefore, different dietary practices from one person to another are bound to be vast, and are important to consider when exploring any nutritional guidance.
Nonetheless, it is impossible for governmental bodies to establish a national individualised eating plan for everyone across their lifespan, and so general guidance has been published to help people establish habits to promote good health.
There have been guidelines, formulated by health professionals, adapted to different cultures and accessibility to foods in different areas of the world. By proxy, this is considered “healthy” as they aim to support good health and well-being through targeting a variety of macro and micro nutrients for daily consumption by observing the whole diet instead of individual foods which is considered “balanaced”. According to current nutritional guidance a typical balanced diet should consist of carbohydrates (which are made up of the majority of foods), but encouraged are those with large amounts of fibre (such as fruit and veg) that also contain a variety of vitamins and minerals and regulate digestive health[1]. A balanced diet should also incorporate smaller amounts of fats, and protein. These contain micronutrients which are essential for bodily growth and repair and good brain health[11][12] . Of course, hydration is also key here, but research, although ever-changing, indicates that these are the benchmarks for dietary standards to maintain long-term well-being.[10]
For further information and personalised guidance, book an appointment with a registered nutritionist:
There are number of established whole-diets have boasted health benefits, and have become increasingly popular in nutrition research starting with is the Mediterranean diet [13]. This diet consists of a high intake of a variety of fruit and veg, fish, lean meat, olive oil, nuts and legumes as well as a reduction in dairy and red meat, ultra-processed foods and as a consequence, reduced saturated fat, sugar and salt [14] which is often associated with poor long-term health. Current evidence suggests whole-body benefits, including cognitive function, digestive system and a reduction of chronic disease [14] due to the regular, high consumption of a variety of nutrients. There are multiple variations of this particular diet (DASH, MIND etc.) that aim to target specific health objectives. The DASH (Dietary Approaches to Stop Hypertension) or MIND (Mediterranean-Dash Intervention for Neurodegenerative Delay) diets are focused specifically on improving aspects of health such as heart disease risk and cognitive function [15], and both claim positive results [16][17].
There are also a number of diets that use restriction to limit intake of certain food groups that can also affect health including vegetarian and vegan diets. Both of these diets focus on a reduction of animal products, with vegetarians excluding meat (and fish) but continue to consume dairy products (and sometimes eggs) and the vegan diet requires an elimination of animal products altogether [17] . There is an abundance of literature scrutinizing the pros and cons of these diets, the benefits including the increased consumption of whole fruits and veg and decrease consumption of saturated fat which has been associated with health benefits such as reduced risk of some long-term diseases such as depression and cardio-vascular disease [18][19] , and the cons disputing the lack of essential nutrients found in animal products such as protein, omega-3 and B12 that prevents recommendation without the inclusion of supplements [20]. Most people opt for these diet choices out of moral association to the environmental impact of food production, the highest cause being meat and dairy products [21], but in some cases as a commitment to animal welfare which reaffirms the association that emotional load carries with diet choice.
- Omega-3‘s are a family of essential fatty acids that are important for brain development and function. There is evidence to suggest that omega-3 fatty acids may play a role in the prevention and treatment of ASD, as well as other neurodevelopmental disorders. Learn more about Omega-3 fatty acids in our blog article: Dietary Omega-3’s and Autism: Can children benefit from consuming more dietary EPA and DHA
Perhaps more modern adaptations of the vegan/vegetarian diets are the pescatarian or flexitarian diets, which embrace the health benefits of higher fruit and vegetable intake alongside a decreased consumption of meat, rather than strict exclusion. Pescatarian diets are more commonly defined by their inclusion of fish (but not other meat)[1], and flexitarian diets veto animal products the majority of the time, but occasionally eat meat and dairy [22]. These types of diets allow for the freedom of flexibility in which they maintain a variety of nutritional sources, with moderate limitations for more of balanced take on otherwise fairly restrictive diets.
Other exclusive diets used to promote health are ketogenic (low carb, high protein and fats) and gluten-free, which are all based on restricting specific food groups but can be harmful to some population groups who require certain nutrients[23].
Learn more about gluten free diets in our blog article, written by the world renowned researcher Dr Alex Richardson: Gluten-Free, Casein-Free Diets and the Autistic Spectrum – What’s the Evidence?
What’s worth noting is that regardless of the specifics, in none of the aforementioned diets advocate ultra-processed snacks or fast-foods. To really drive this point home, in all the research we have on ultra-processed foods, it has only ever shown negative health outcomes in both physical and mental health [24][13][25]. The long and short of it is that these foods contain little to no nutritional value, and therefore the nutrients that our bodies require to function correctly isn’t being metabolised and instead we are left with a lot of excess energy and nowhere to put it. This causes problems such as obesity which can have a detrimental effect to long-term health [26].
In light of this, there is guidance out there which advises food swaps which can be utilised as “healthier” alternatives for otherwise under-nourishing foods [27]. Suggestions include switching:
- white bread to wholemeal
- sugary snacks to fruit
- processed/red meats to lean meats such as chicken or fish
- home-made food instead of ready meal
- ice cream to frozen yoghurt etc
This can be tricky with neurodivergent individuals but there are also helpful suggestions for practical swaps that could alleviate the pressure [28].
Our bodies are basically a mixture of complex networks that rely on constant coordination for optimal functionally. This is achieved through the metabolism of the nutrients we digest through the food we eat. So, if we aim to consume a balanced with a variety of nutrients, there’s a high chance that we will aid the successful and consistent performance of our internal network.
The emotive relationship we have with food can cause stigmatisation to affect the way we eat. The way we perceive food plays an important role in food choice[29] and labelling foods as “healthy”/ “good” and “unhealthy”/“bad” isn’t always helpful for definition and can be damaging. By paying attention to current food guidance but also considering what you want to achieve (whether that be better mental or physical health, or a better relationship with food and eating in general), we can understand if these foods are right for us.
However, everyone is different and therefore, perhaps a more attainable way of approaching diet choice is first establishing what it is you want to achieve through the nutrients you are consuming, and adapting this to your own individual goals and lifestyle restrictions. You will then be able to establish how you can achieve personalised goals based on the nutritional content of food rather than the labels it’s attached to. This way we can attempt to destroy the negative stigma that is associated with food classification and create an environment where we can enjoy food through an understanding on how it can positively impact our health. And this, my friends, is what we call a healthy diet.
If you require additional support with making changes to your diet, please book an appointment with one of our registered nutritionists:
Alternatively, if you are deficient in any nutrient, view our list of supplements that may benefit your mental wellbeing:
References
[1] https://www.healthline.com/health/food-nutrition/micros-vs-macros
[2] Johannes Brug, Determinants of healthy eating: motivation, abilities and environmental opportunities, Family Practice, Volume 25, Issue suppl_1, December 2008, Pages i50–i55, https://doi.org/10.1093/fampra/cmn063
[3] Buckton, C.H., Lean, M.E.J. & Combet, E. ‘Language is the source of misunderstandings’–impact of terminology on public perceptions of health promotion messages. BMC Public Health 15, 579 (2015). https://doi.org/10.1186/s12889-015-1884-1
[4] Alexandra Malia Jackson, Anaderi Iniguez, Hyun Jeong Min, Megan Strickland, Jane Lanigan, Appetite, Volume 191, 2023, 107071, ISSN 0195-6663, https://doi.org/10.1016/j.appet.2023.107071.
[5] Jeffery Sobal, Carole A. Bisogni, Constructing Food Choice Decisions, Annals of Behavioral Medicine, Volume 38, Issue suppl_1, December 2009, Pages s37–s46, https://doi.org/10.1007/s12160-009-9124-5
[6] Vartanian LR, Herman CP, Polivy J. Consumption stereotypes and impression management: how you are what you eat. Appetite. 2007 May;48(3):265-77. doi: 10.1016/j.appet.2006.10.008. Epub 2006 Dec 8. PMID: 17157957.
[7] Furst, T., Connors, M., Sobal, J., Bisogni, C., & Winter Falk, L., 2000. Food classifications: Levels and categories, Ecology of Food and Nutrition, 39:5, 331-355, DOI: 10.1080/03670244.2000.9991623
[8] Pechey, R., Monsivais, P., 2016. Socioeconomic inequalities in the healthiness of food choices: Exploring the contributions of food expenditures. Prev Med. 88:203-9. doi: 10.1016/j.ypmed.2016.04.012.
[9] Cena, H., Calder, PC. 2020. Defining a Healthy Diet: Evidence for The Role of Contemporary Dietary Patterns in Health and Disease. Nutrients. 27;12(2):334. doi: 10.3390/nu12020334.
[10] Lockyer, S., de la Hunty, A., Steenson, S., Spiro, A., Stanner, SA., 2023. Walnut consumption and health outcomes with public health relevance—a systematic review of cohort studies and randomized controlled trials published from 2017 to present, Nutrition Reviews, 81:1, 26–54, https://doi.org/10.1093/nutrit/nuac040.
[11]https://www.betterhealth.vic.gov.au/health/healthyliving/protein
[12]Flaskerud, J., 2015. Mood and Food, Issues in Mental Health Nursing, 36:4, 307-310, DOI: 10.3109/01612840.2014.962677
[13] Zielińska M, Łuszczki E, Michońska I, Dereń K. The Mediterranean Diet and the Western Diet in Adolescent Depression-Current Reports. Nutrients. 2022 Oct 19;14(20):4390. doi: 10.3390/nu14204390. PMID: 36297074; PMCID: PMC9610762.
[14] Fresán, U., Bes-Rastrollo, M., Segovia-Siapco, G., et al., 2019. Does the MIND diet decrease depression risk? A comparison with Mediterranean diet in the SUN cohort. European Journal of Nutrition. 58(3):1271-1282. DOI: 10.1007/s00394-018-1653-x.
[15] Khayyatzadeh, S., Mehramiz, M., Mirmousavi, S., Mazidi, M., Ziaee, A., Kazemi-Bajestani, S., Ferns, G., Moharreri, F., Ghayour-mobarhan,M., 2018. Adherence to a Dash-style diet in relation to depression and aggression in adolescent girls, Psychiatry Research, 259: 0165-1781, 104-109, https://doi.org/10.1016/j.psychres.2017.09.075.
[16] Arjmand G, Abbas-Zadeh M, Eftekhari MH. Effect of MIND diet intervention on cognitive performance and brain structure in healthy obese women: a randomized controlled trial. Sci Rep. 2022 Feb 21;12(1):2871. doi: 10.1038/s41598-021-04258-9. PMID: 35190536; PMCID: PMC8861002.
[18] Ocean, N., Howley, P., Ensor, J., 2019. Lettuce be happy: A longitudinal UK study on the relationship between fruit and vegetable consumption and well-being. Soc Sci Med. 222:335-345. doi: 10.1016/j.socscimed.2018.12.017.
[19] Dinu, M., Abbate, R., Gensin,i GF., Casini, A., Sofi, F., 2017. Vegetarian, vegan diets and multiple health outcomes: A systematic review with meta-analysis of observational studies. Crit Rev Food Sci Nutr. 22;57(17):3640-3649. doi: 10.1080/10408398.2016.1138447.
[20] Craig, WJ. 2009. Health effects of vegan diets. Am J Clin Nutr. 89(5):1627S-1633S. doi: 10.3945/ajcn.2009.26736N.
[21] Sandström, V., Valin, H., Krisztin, T., Havlík, P., Herrero, M., Kastner, T., 2018. The role of trade in the greenhouse gas footprints of EU diets, Global Food Security, 19: 2211-9124, P- 48-55, ISSN https://doi.org/10.1016/j.gfs.2018.08.007.
[23] Masood, W., Annamaraju, P., Khan Suheb, MZ., et al. Ketogenic Diet. [Updated 2023 Jun 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK499830/
[24] Sánchez-Villegas, A., Toledo, E., de Irala, J., Ruiz-Canela, M., Pla-Vidal, J., Martínez-González, MA., 2012. Fast-food and commercial baked goods consumption and the risk of depression. Public Health Nutrition. 15(3):424-432. doi:10.1017/S1368980011001856.
[25] Godos, J., Bonaccio, M., Al-Qahtani, WH., Marx, W., Lane, MM., Leggio, GM., Grosso, G., 2023. Ultra-Processed Food Consumption and Depressive Symptoms in a Mediterranean Cohort. Nutrients. 18;15(3):504. doi: 10.3390/nu15030504.
[26] Visscher, TL., Seidell, JC., 2001. The public health impact of obesity. Annu Rev Public Health. 22:355-75. doi: 10.1146/annurev.publhealth.22.1.355.
[27] https://www.nhs.uk/healthier-families/food-facts/healthier-food-swaps/
[28] https://www.healthychildren.org/English/healthy-living/nutrition/Pages/Food-Substitutions.aspx
[29] Sobal, J., Bisogni, CA., 2009. Constructing Food Choice Decisions, Annals of Behavioral Medicine, 38:1, P- s37–s46, https://doi.org/10.1007/s12160-009-9124-5.
Disclaimer: The views and opinions expressed in this blog post are those of the author and do not necessarily reflect the official policy or position of any professional organization or guidelines. The information provided is for educational and informational purposes only and is not intended as a substitute for professional advice, diagnosis, or treatment. Always seek the advice of your therapist or other qualified health provider with any questions you may have regarding a medical or mental health condition.