It’s easy to feel overwhelmed by the various, confusing and often contradictory diet guidelines that exist to help us make better food choices. Here, food journalist, Joanna Blythman, reviews The Nourishment Table, a new dietary framework from Brussels which has been designed to help us make healthier food choices based on two key considerations: nutrient density and degrees of processing.
It seems sometimes that endless discussions of what, exactly, constitutes healthy eating is getting us absolutely nowhere. Never in living memory has so much attention been devoted to this subject, yet ironically, obesity and diet-related ill-health are rampant.
However, happily, a fresh approach is moving us on from this stale and unproductive impasse.
An international collaboration of scientists with expertise in nutrition, food science, epidemiology, evidence-based medicine and cultural food studies, led by Professor Frédéric Leroy at Vrije Universiteit in Brussels, launches this March. The ‘Nourishment Table’ is a much-needed new way to think about how we eat. One glance, and it will instantly resonate with those of us who have felt for some time that current ‘healthy eating’ advice has proven to be both unhelpful and futile.
Until now, public health bodies have almost exclusively focused on a one-size-fits-all dietary prescription. The Eat-Lancet Planetary Health diet, launched in 2019, was one such initiative. It promoted a, supposedly, universally applicable diet that was overwhelmingly plant-based, and encouraged us to reduce our consumption of animal-sourced foods. This diet has been scientifically challenged on the grounds that anyone who follows it risks developing deficiencies in vital nutrients, in some cases, malnutrition and stunting.
Rather than focusing on foods to restrict, the Nourishment Table centres on the overall nutritional quality of the foods we consume, by focusing on two key questions.
Nutrient density is the first consideration – that is, how rich a food is in the macro- and micro-nutrients that are essential for good health. The Nourishment Table encourages us to seek out appetite-sating, nutrient-dense foods, such as meat, eggs, dairy, oily fish and leafy greens, to help us get the essential nutrients we need, without eating excessive calories.
The level of processing is the second factor. Has a particular food product been only minimally or moderately processed – cooked, fermented, dried, soaked, frozen, perhaps, or ultra-processed? The answer matters.
While minimal processing can boost nutrient availability, digestibility and improved shelf-life, ultra-processing subverts the natural structure or ‘matrix’ of a food, stripping out and reducing its nutrients. At the same time, it adds excessive levels of sweeteners, salt, hi-tech industrialised ingredients and synthetic additives.
Ultra-processed foods are engineered to be hyper-palatable, so they drive overconsumption, even addiction, while delivering fewer essential nutrients. A body of scientific research now shows that eating a diet heavy in ultra-processed food leads to overeating and poor health outcomes.
Through the lens of nutrient density and degrees of processing, the Nourishment Table shows us what we would be best advised to eat. In essence, that’s a diet made up of medium- to high nutrient-dense foods that are either unprocessed or have undergone only low or moderate processing.
In this way, the Nourishment Table represents a sharp u-turn in thinking. Around the world, with the exception of Brazil, which published a paradigm-shifting set of dietary guidelines in 2014 that for the first time factored in the level of processing, diet guidelines have barely changed.
The post-World War 2 demonisation of any food that contains saturated fat or cholesterol has held sway. Alongside that, the elevation of grain-based, starchy foods and the worship of fruits and vegetables, have been handed down as the definitive recipe for healthy eating.
Simplistic visual guides, such as the UK ‘Eat Well’ plate and the US ‘Healthy Eating’ pyramid which categorises food into ‘healthy’ and ‘unhealthy’ groupings, along with familiar mantras, such as ‘Five-A-Day’, have become embedded in public health messaging, despite a shortage of scientific evidence to support them.
We have been nudged into thinking that plant-based foods are always good, while livestock-sourced foods are probably bad. Public health guidance recommends broad food groups, such as ‘starchy foods’ and ‘fruit and vegetables’, and lays down macronutrient ratios, such as ‘low fat’. But it overlooks the importance of getting enough vitamins, minerals and bioactive compounds. Along with the associated focus on calorie counting, it looks as if some people may be missing out on essential micronutrients because they have restricted their intake of nutrient-rich foods in an effort to lose weight or be healthier.
Consequently, our diets in recent years have typically included fewer animal-derived foods than those that sustained our hunter-gatherer ancestors for millennia. Human physiology, however, is adapted to nutrient-rich diets that include substantial amounts of animal foods. Low intake of these valuable foods, as seen in the plant-heavy diets that are widely evangelised, easily leads to deficiencies in key micronutrients.
In this respect, the Nourishment Table breaks with the plant-based paradigm that has dominated food policy in recent years, by recommending that 25-30% of total calories, or at least half of protein intake, should come from animal sources. The reasoning here is that animal-sourced foods, such as dairy, eggs and meat, are amongst the most nourishing options available. They bring to the table essential nutrients that are often limited in many diets globally – nutrients which are much less bio-available from plant sources.
“We have been nudged into thinking that plant-based foods are always good, while livestock-sourced foods are probably bad. Public health guidance recommends broad food groups, such as ‘starchy foods’ and ‘fruit and vegetables’, and lays down macronutrient ratios, such as ‘low fat’. But it overlooks the importance of getting enough vitamins, minerals and bioactive compounds.”
Animal-sourced foods provide key nutrients, such as haem iron, fatty acids, and certain vitamins and amino acids, in highly bio-available forms. These are much harder to obtain in sufficient quantities from plant-based diets.
A body of research, encompassing global cohort studies and evolutionary data, supports the observation that diets with 25-30% of calories from animal-sourced foods are optimal for health. This proportion of animal-sourced foods helps us get enough vital nutrients while still leaving room for plant-based staples, fruits and vegetables.
The scientists who have come up with the new Nourishment Table point out that anyone eating less than 25-30% of animal foods in their overall diet will need to take food supplements or eat products fortified with synthetic vitamins and minerals, to ensure that they do not develop micronutrient deficiencies. But if a plant-based diet meets essential nutrient requirements, possibly through careful planning or fortification, and emphasises minimally processed foods, it can nevertheless align with Nourishment Table principles.
By highlighting foods that are naturally dense in key vitamins, minerals and proteins, along with moderate processing to enhance nutrient absorption, the Nourishment Table is more adaptable than a one-size-fits-all approach to groups with elevated dietary requirements. Children, for instance, need highly bioavailable nutrients for growth and brain development, while pregnant women require extra micronutrients like iron, zinc and folate. Older adults benefit from protein-rich foods to maintain muscle mass and overall vitality.
Another welcome aspect of the Nourishment Table is that because it applies the two core principles of nutrient density and processing level, rather than advocating a universal blueprint, it is not embedded in a narrow Western-centric mindset. This makes it relevant and practical for different populations worldwide. Our current dietary guidelines read as though they assume uniform global conditions, whereas the reality is that people’s eating habits are influenced by the foods that are available locally and traditional eating patterns.
A person who lives in Senegal, Seoul or Sicily will eat very differently to one in Stavanger, Singapore or Salford, but all of them can use the Nourishment Table to ensure they make nourishing choices. This valuable new food framework helps us see that there isn’t a single ‘correct’ diet. Rather, our dietary dilemmas can best be resolved by adopting diverse approaches that are culturally authentic, as long as they align with the core principles of maximising nutrient density and minimising ultra-processed foods.
