For years, we’ve been told that a ‘healthy diet’ is one that excludes ‘unhealthy’ foods. But given all we know about nutrition, is that really the most helpful way to think about food?
We all want to eat a healthy diet, but actually getting to the nub of what that means can be tricky. In one ear, you’ve got diet culture telling you that keto is the only way to avoid getting type 2 diabetes, and in the other, we’re told to eat ‘intuitively’ and sack off all the rules.
Healthy eating isn’t easy to understand, and that’s because of the wide array of information out there. So, we thought we’d separate fact from fiction to confirm, once and for all, what it is to have a healthy diet.
The World Health Organisation describes a healthy diet as being one that ‘protects against malnutrition in all its forms, as well as noncommunicable diseases’ including diabetes, heart disease, stroke and cancer. An unhealthy diet, on the other hand, is one that increases the risks of developing poor health.
As well as claiming that the earlier you adopt healthy dietary practices in life, the better your life outcomes, the WHO also warns against consuming too much fat or free sugars to ‘avoid unhealthy weight gain’.
Maybe that’s something you’d expect from a health organisation; perhaps that kind of thing sounds jarring at a time when weight is such a loaded topic, there’s confusion about how bad fat really is and whether or not we should count our macros all up for debate as we try to move away from diet culture. Can we even chat about healthy diets without addressing the very fractious subject of weight loss/gain? So what does eating a ‘healthy diet’ look and feel like for women in 2021?
What is a ‘healthy diet’, according to the experts?
Getting down to brass tacks, a ‘healthy diet’, according to registered dietitian Harpreet Sohal, is one that goes heavy on variety. “A healthy diet includes wholegrain carbohydrates, plenty of fruit and vegetables, high-quality protein (both animal and plant-based) and dairy (or fortified dairy-alternatives),” she tells Stylist.
While it’s also one that’s lower in saturated fat, salt and free sugars (added sugar), she’s keen to stress that a healthy diet includes foods that we enjoy and which are part of our culture. That’s important, she says, because “nutrition isn’t ‘all or nothing’ and food doesn’t have a moral value.”
The difficulty starts when we cut food groups out for whatever reason. Some of us go vegan because we want to stop animal suffering; others go keto or paleo in the hope of rebalancing hormones or getting back to a more ‘natural’ way of eating.
While those of us who adopt these lifestyles may think that we’re eating in the healthiest way possible for us, we do have to work harder to ensure that key vitamins, minerals and fibre aren’t cut along the way. “Just because a food is labelled ‘keto’, ‘paleo’, or ‘plant-based’, that doesn’t automatically mean it is healthy,” Sohal stresses. She goes on to warn that without careful substitution and alternatives, our health could indeed be in danger from adopting niche diets.
“If you want to follow a certain diet, I definitely recommend seeking advice from a registered dietitian for tailored, holistic and expert guidance about what may work best for you and your health.”
Does a healthy diet really protect us from illnesses?
So far, so obvious. But remember that the WHO says that a healthy diet is one that offers some kind of protection against non-infectious diseases – so how exactly can it do that? “The evidence shows that healthy eating and lower intakes of saturated fat, salt and free sugar can help to reduce your risk of heart disease, high cholesterol, high blood pressure, type 2 diabetes and certain cancers,” says Sohal.
A study of 21,000 people in China conducted between 2014 and 2015 found that by switching to a low-sodium salt substitute, stroke risk was cut by 14% and premature death from other causes by 12%.
Back in 2019, a pretty shocking study found that low fruit consumption may have contributed to more than 1 million deaths from stroke worldwide, and more than 500,000 deaths from heart disease every year. Low vegetable intake accounts for 200,000 stroke deaths and over 800,000 heart disease fatalities.
Other long-held health beliefs, however, are coming under increasing scrutiny. Diabetes UK says, for example, that type 2 diabetics can enjoy sugary foods as part of a healthy, balanced diet while a systematic review of nearly 60,000 people found that reducing the intake of saturated fat had no statistically significant effects when it came to heart attacks, strokes or all-cause deaths.
Perhaps the conversation we need to be having is more about what we’re not eating enough of, rather than what we consume too much of.
Weight and diet – a necessary partnership?
Salty diets may result in high blood pressure and, if you’re genetically vulnerable, an unchecked sweet tooth could end in a type 2 diabetes diagnosis, but we rarely talk about health and food from a place of gain – what food can protect us from, rather than what too much of it might cause.
Not all weight gain is ‘unhealthy’ either; sometimes, gaining more body fat can be lifesaving (physically and mentally). It’s for that reason that Sohal says having a healthy relationship with food is one of the most important markers for determining what is or isn’t a healthy way of eating. “Worrying or being preoccupied about food or macro intake 24/7, following strict diets or food rules with little flexibility for day to day life, or being constantly hungry on a diet are all red flags that indicate you might need some expert support with your nutrition,” she says.
Fellow nutritionist Kimberley Neve agrees: “Not obsessing about what you’re eating or being worried about it” is a sign of a healthy diet. “Not following a strict meal plan, but being able to eat comfortably in a way that feels good, which includes foods that are less nutritious! Mindful eating practices are healthy too, ie honouring your hunger and not ignoring it, and being able to stop eating when you’re full.”
How then can we work with the WHO’s definition of a healthy diet? Neve is adamant that it’s totally possible to talk about healthy and nutrition without touching on weight and weight loss. “Health and nutrition are definitely not just about weight loss. Eating a healthy, balanced diet will improve your mental health, energy levels, digestion, strength and much more that can’t be measured on the scales,” she stresses.
“Genes play a huge role in our body size, so it’s important to understand that weight is not the only measure of overall health.” That said, she is careful to suggest that there is a point where excess weight can be a risk factor for issues such as cardiovascular disease and type 2 diabetes, but the fact is that a healthy weight range differs from person to person.
“The other factor is food history: if a person has struggled with an eating disorder, then being ‘healthy’ means not suffering with that anymore – the weight is not as important as mental health, although it’s all linked.”
Unpacking the diet industry’s role in our understanding of nutrition
Sohal’s biggest bugbear when it comes to nutrition is detox diets. “They come in many forms to promote weight loss, remove ‘toxins’ and make you ‘feel shiny and new’,” Sohal says, going on to give examples of fasting, juicing, going dairy or gluten-free, and using detox supplements.
“Fads like these sound fabulous but most claims aren’t backed by science. They’re just marketing ploys to convince you to part ways with your cash and can be potentially harmful. Your body is fully equipped to detox itself via your liver, kidneys, gut and skin.”
Neve also stresses that no kind of detox can be healthy – despite the fact that often the foods that get juiced are nutritious. When it comes to defining what ‘healthy’ means in terms of diet, Neve defines it as involving “plenty of vitamins and minerals and a combination of carbohydrates, fats and proteins.”
The carbohydrates, she says, should be full of fibre, “which means including whole grains, lentils, beans and vegetables to ensure good gut health. Fruit and vegetable intake should be as high as possible – they’re full of micronutrients like vitamins, minerals and antioxidants.”
Food is only one part of the health puzzle
Fundamentally, diet is only one part of a healthy lifestyle. Yes, food can be powerful (fail to get enough calcium and you could develop rickets; scurvy and stroke result from lack of fruit; too little iron causes anaemia), but food alone can’t keep us alive and well. We need daily movement, social connections, mental stimulation.
As Sohal said, part of a healthy diet is about being at peace with what we’re eating. Perhaps the greatest thing we could do to stay healthy is reframe how we see food: as something that protects and adds value to our lives.