Every aspect of our diet has become inexorably linked to the quality of our individual human health and the wellbeing of the planet. From drought-inducing avocados in Chile, through to the role of mental health in binge eating, the ability to live healthily in the future is defined by our relationship with food today. Learning how to eat a healthy diet is a fundamentally empowering education which opens the door to a happier and longer life. Yet, when obesity and diabetes rates in the UK have almost doubled in the last 25 years, it suggests we have still much to learn about eating healthily at a national level.
Government holds responsibility for encouraging us into healthier lives, expecting to corral the entire population into better ways of eating through specific guidelines of what we should or should not eat. UK efforts have long relied on the EatWell Guide (formerly ‘plate’), an unsophisticated infographic which charts various food groups, prescribing both loose and rigid terms for the food we should eat for a healthy diet. According to the Guide, approximately 33% of our diet should come from starchy carbs – be it bread, rice or potatoes – but what percentage of a Big Mac meal is the fries and bun? No idea? That’s not surprising. While 150 ml of fruit juice or smoothie is noted as a specific limit not to be crossed, juices are often sold in 250 ml bottles, putting us all at risk of immediately failing on this particular piece of advice.
This is the crux of the problem: everyone lives in different ways, eating different diets, served in different portion sizes, for different reasons. Failure is inevitable under the auspices of the EatWell Guide, because offering a singular national dietary guide will always fail to adequately account for individual variations in body weight, level of physical activity, taste preferences, geographical location, income level, cultural context and more. It’s the dietary equivalent of suggesting that we all wear size eight shoes.
In Brazil, they’ve chosen to do things differently. In 2016, led by Carlos Monteiro, the famous professor of nutrition and public health at the University of Sao Paolo, the government released ground-breaking dietary guidelines which give 10 simple pieces of advice for a healthier life. Gems include “Eat regularly and carefully in appropriate environments and, whenever possible, in company” and “Be wary of food advertising and marketing”, while processed food are given a solid thumbs-down at several points. Getting rid of specific amounts of one food or another makes the guidelines easy to understand and best of all, not something you can ‘fail’ at.
Whilst Monteiro and colleagues were ahead of the curve in the advice they dished out, it appears that the UK is also on the cusp of a sea-change in how our health is managed. In the Government white paper ‘Advancing our Health: Prevention in the 2020s’, released in July 2019, it is clear that the management of our health will become increasingly digitised and personalised, with data being used to create custom-fitted health interventions. Personalised nutrition is also a huge growth area in the private sector.
If next-generation dietary advice is shaped to the nuances of our individual lives, where does it leave the Eatwell Guide with its 150 ml of fruit juice? In the bin – which opens up the space for something completely different.
It only takes a little ‘nudge’
In Alcoholics Anonymous, nobody tells you not to drink alcohol. This may appear contradictory to the aims of the organisation; it would seem more logical to tell newcomers what the basic requirement of sobriety is – don’t touch any booze. However, alcoholics need to find the desire within themselves to stop their addictive patterns, because simply telling them to stop is a futile strategy. Friends and family will have undoubtedly told them to stop drinking, maybe doctors or colleagues as well. Hence, AA members are not required to be sober; the AA website says, “The only requirement for membership is a desire to stop drinking.” Asking people what they want, rather than telling them what to do, is where wisdom lies. If AA asked its members to drink no more than 5 units of alcohol a day, the programme would be littered with failures, rather than being recognised as one of the most successful interventions for addicts.
Gently guiding people into decisions, rather than being prescriptive, has gained a lot of traction over the last decade. ‘Nudge’ is a theory for influencing citizen’s behaviour which has become incredibly popular within government and business. Brainchild of Nobel prize-winning economist Richard Thaler and Cass Sunstein, their 2008 book of the same name gave rise to the theory that people can be easily influenced by small changes in the context of their experience. Nudges don’t use bans or prescriptive options, they are modifications to the architecture of choice that surrounds us, which changes behaviour without using economic incentives.
Let people make their own decisions
The next generation of dietary guidelines needs to throw away models like the Eatwell Guide, with hard-to-measure carb limits and restrictive quantities of juice. We need to introduce ideas that nudge people towards better choices for themselves, society and the planet, once they’ve found the desire to do so. How would dietary guidelines look if they considered how our food choices impacted food waste or offered advice for encouraging positive change in industry or government? What advice can you give to help people whose mental health and eating habits are forging an unhealthy relationship? If we took all these points into consideration, we’d end up with something like this.
Influencing our diets with positive messages allows citizens to be nudged into discovering and making better choices for themselves, based on the context of their own lives. From social inclusion to growing vegetables, eating animal products to food advertising with positive messages, guidelines like this would present ideas which individuals can interpret for themselves.
Nobody likes being told what to do, as we all learned when our parents first told us to tidy our bedroom or do the washing up as a child. If the Government removes the restrictive guidelines that exist, they open the path for a new approach – positive dietary advice, which empowers personal choice, considers physical and mental health, respects the environment, and acknowledges the diversity found in society and culture, whilst supporting those who desire a healthier life.
(N.B. These guidelines have also been submitted to the National Food Strategy by Gavin Wren for consideration)
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