As a Health Professional, Here Are Some of the Most Controversial Topics on Food That Your Clients May Ask You About
Food can be a universal unifying experience, just as much as our convictions about food and nutrition can be dividing and sometimes polarizing. Discussions about numerous controversial nutrition topics take place in the classroom, in the coach’s office or clinic, and online. As a certified nutrition coach or practicing health and wellness coach, it can feel natural to feel like you have to “choose a side” in these debates, especially when coaches ask you for your opinion. At the same time, it is always useful to understand the logic behind both sides of the debate to respectfully and knowledgeably engage in discussions with your clients.
In this article, we give you a general overview of some of the most controversial nutrition topics you are likely to encounter as a coach or nutrition professional. The article doesn’t argue for one side or another but rather provides information about the following:
What it is
Why it is controversial
What those who are for it say
What those who are against it say
Make note that in the sections that discuss why people are for or against a certain topic, we do not make claims as to the scientific validity of the arguments, though we may link to another article where you can learn more about the subject. Instead, we summarize some of the most popular arguments on each side.
To engage in the debate and learn more about the topic, aim to stay up-to-date with your wellness and nutrition knowledge with these tips.
Anti-Diet Culture
What Is Anti-Diet Culture
To understand the anti-diet culture, it is vital to understand diet culture.
According to dietitians at the University of California San Diego, “diet culture is a set of beliefs that values thinness, appearance, and shape above health and wellbeing.” It does so with a restrictive approach to eating—restricting calories, nutrients, or certain food groups and labeling foods as “good” and “bad.”
What Those Who Are For It Say
Anti-diet culture, or an anti-diet approach, believes that diets and diet culture prioritize profits over peoples’ health. It demonstrates that many professionals who promote diet culture also benefit from the dependency that individuals develop on their services to maintain a certain weight or body shape, pointing out that this approach is inherently unsustainable.
Anti-diet culture aims to decouple food restriction from health and points at the gaps in the research around the connection between restrictive diets and health. It is also closely tied to the fat liberation movement, which is a social movement that aims to change anti-fat biases and the stigma of obesity in society by raising awareness about the experiences, and especially the obstacles and inequities, that fat people face.
While promoters of anti-diet culture don’t prescribe to another dietary philosophy, many dietitians feel that it pairs naturally with intuitive eating, which holds the same principles and allows people to reject diet culture while providing the tools to adopt a mindset that does improve health. It is also often linked to a Health at Every Size (HAES). Both intuitive eating and HAES are discussed below.
What Those Who Are Against It Say
The medical, nutrition and fitness professionals who are against anti-diet culture (or still favor the adoption of diets after being aware of the anti-diet approach) may be so for multiple reasons:
They may believe that people’s minds and bodies must be trained to learn what to eat to meet their body’s needs and that diets are an effective way to do so.
They may point to research and data that supports the effectiveness of specific diets on health.
They believe that being overweight or obese is inherently bad for a person’s health.
They note that achieving certain body shapes or compositions is a science, and protocols, including diets, are the best way to achieve these desired body shapes.
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Intuitive Eating
What Is Intuitive Eating
Intuitive eating is an anti-diet approach that was made popular by registered dietitian nutritionists Evelyn Tribole and Elyse Resch in the book Intuitive Eating: A Revolutionary Anti-Diet Approach. It is an approach that stems from the belief that humans do not need to restrict our food intake with diets, go hungry, or see foods as inherently “bad” for us. Instead, it champions the idea that learning about our nutritional needs and tuning into what our body is telling us is the best indicator of what to eat, when to eat, and how much to eat. It is centered on the belief that to feel our best, we need to heal our relationship with food.
Unlike most other dietary approaches, intuitive eating doesn’t have a “formula.” It is based on ten core principles that do not discuss specific foods or food groups but instead aim to help us connect with our bodies and heal our relationship with food.
The intuitive eating approach often goes hand-in-hand with rejecting diet culture and with believing health can be achieved at every size when we don’t assign value to weight.
What Those Who Are For It Say
Intuitive eating has only recently been on many nutritionists’ radars. Those who are champions of the lifestyle approach, however, argue that intuitive eating has been the natural go-to eating approach throughout much of human history and that restrictive diets are an invention of the diet industry and arbitrary and idealized body types.
Those who are champions of intuitive eating believe that restrictive eating leads to hunger, body dysregulation, and a greater desire to eat foods perceived as “bad.”
By implementing the principles of intuitive eating, mental health and physical health are reestablished. Not only do intuitive eaters have greater confidence, but they also trust in their hunger cues and honor their nutrition.
Intuitive eating nutritionists believe that intuitive eating can be adopted by and beneficial to all people, regardless of health status.
What Those Who Are Against It Say
For many, intuitive eating is a radical approach to satisfying our nutritional needs. Even after understanding the principles of intuitive eating, some people do not think that trusting our intuition leads to healthy eating habits. Some people may be against intuitive eating if it means that they might gain weight if they believe that weight is an indicator of health.
Additionally, others may be against the intuitive eating approach if they believe that people must train their bodies to eat through food restriction. This may include knowledge related to the influencing power of the food industry on our minds.
Others might accept that intuitive eating could be a useful approach for generally healthy people, but they may feel that it is not relevant or applicable to people who are living with metabolic diseases, like type 2 diabetes or thyroid disease, since hormonal and hunger signaling pathways are impaired.
Health at Every Size (HAES) Movement
What Is the Health at Every Size (HAES) Movement?
The HAES movement is an approach that states that all people, regardless of size or weight, can be healthy. It highlights that body ideals, including shape, size, and weight, are cultural, and, in the West, they are made persistent by diet culture and those who benefit from people spending money to achieve a specific body ideal. The HAES movement is closely tied to the Fat Liberation Movement.
What Those Who Are For It Say
People and professionals who are supporters and proponents of the movement are firm believers in the HAES principles to close gaps in access to healthcare, build an inclusive and respectful community, and support people of all sizes in finding ways to take care of themselves in a way that makes sense to them.
Those who promote the HAES movement believe in the HAES principles. These include:
Respecting body diversity and honoring differences in size, age, ethnicity, gender, disability, sexual orientation, religion, class, and other human attributes.
Being critically aware of scientific and cultural assumptions that connect weight and size to health status.
Promoting compassionate self-care, including finding joy in a variety of movement types and supporting flexible eating that values pleasure and honors appetite, satiety, and hunger, while also respecting the social conditions that frame what is available to eat.
HAES promoters point out that many of the measures of health connected to body weight and body size in adulthood are not relevant or based on principles of causality. This applies to BMI and waist circumference, which HAES promoters believe are poor and arbitrary measures of health status.
In other words, it points out that there is limited to no evidence to point out that body weight is a cause of common health problems. In this sense, one cannot assume that a person in a larger body is unhealthy or that a person in a smaller body is healthy.
Proponents of HAES also demonstrate how damaging it can be for individuals in larger bodies seeking care when health professionals assume that weight is causing the health problem without looking at labs that actually indicate health status (gaslighting).
What Those Who Are Against It Say
Many of those who are against the HAES principles or movement are not convinced that a person’s health cannot be determined by their size or body shape. They may also be against HAES for many of the same reasons they may be against intuitive eating and anti-diet culture approaches, including:
Believing that people’s bodies and minds need to be trained to eat in a certain way through prescribed restrictions.
Pointing to research where weight loss did result in improvements in indicators of health, like blood pressure, triglyceride, insulin, and even subjective measures of health and wellbeing.
People feel inspired or motivated by external changes they see as a result of dietary changes they make.
Intermittent Fasting
What Is Intermittent Fasting?
Intermittent Fasting (IF) is a dietary protocol that focuses on the timing of meals. People who fast intermittently cycle between periods where they abstain from eating and others where they eat. Popular IF protocols include:
The 16/8 method, where people fast for 16 hours and have an 8-hour eating window
Eat-Stop-Eat, where people fast for 24 hours once or twice a week, then eat regular meals the rest of the week
The 5:2 method, which restricts calorie intake to about 500 calories two days of the week, but the other five days, people can eat normally
It differs from fasting for religious or cultural reasons and instead boasts the health reasons why people should fast intermittently.
What Those Who Are For It Say
Proponents of intermittent fasting highlight the health benefits of abstaining from eating for at least 12 hours, but up to 20 hours a day. The fasting benefits they point to include:
Improvements in workout results
Weight loss
Staving off emotional eating
Reduced inflammation
Extended lifespan and healthspan
Simpler eating plans, thus a greater likeliness of sticking to them for longer
What Those Who Are Against It Say
People who are against intermittent fasting often argue that:
There is limited evidence to show its benefit for most of the health claims, or most health claims are based on animal trials.
It is unsustainable.
It could be dangerous for people with metabolic disorders.
It leads to disordered eating.
It ignores hunger cues.
It can lead to bingeing during “eating windows.”
Intermittent fasting is restrictive, and it may present a significant change from the way people are accustomed to eating. Many experts believe that intermittent fasting is not sustainable in the long term for most people.
BMI/Body Mass Index
What Is BMI (Body Mass Index)?
BMI, or Body Mass Index, is a widely used metric for assessing an individual’s body size. It is calculated by dividing a person’s weight in kilograms by the square of their height in meters. BMI is often used as a simple and quick method to categorize individuals into different weight categories, such as underweight, normal weight, overweight, and obese.
What Those Who Are in Favor of It Say
Proponents of BMI as a health metric argue that it is a useful tool for identifying potential health risks associated with body weight. For instance, a study on US Army recruits found that recruits from certain states with higher BMI were less fit and more prone to injuries, suggesting a link between BMI and physical readiness. Similarly, during the COVID-19 pandemic, a study in Israel observed significant changes in BMI among children and adolescents, indicating the pandemic’s impact on body weight and potentially long-term health.
Supporters also highlight the importance of BMI in public health policies. For example, BMI surveillance and screening programs in schools, despite ethical debates, are seen as vital for promoting healthy lifestyles and preventing obesity, as discussed in a comprehensive review.
What Those Who Are Against It Say
Critics of BMI point out its limitations and oversimplifications. They argue that BMI does not distinguish between muscle and fat mass, nor does it account for the distribution of fat in the body. This can lead to misleading categorizations, especially in athletes or individuals with high muscle mass.
Skeptics also question the effectiveness of BMI as a standalone health indicator. A study on U.S. military veterans explored the relationship between personality and BMI, suggesting that health assessments might need to consider psychological factors alongside physical measurements.
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In summary, while BMI is a widely accepted tool for assessing body weight, its use and interpretation remain the subjects of ongoing debate, with arguments for and against its effectiveness in accurately reflecting an individual’s health status.
Meal Timing, Nutritional Timing, and Chrono-Nutrition
What Is Meal Timing and Nutritional Timing?
To grasp the concept of meal timing and nutritional timing, it’s essential to understand the roles they play in our daily lives. Meal timing refers to the scheduling of food intake throughout the day, while nutritional timing involves the strategic consumption of different nutrients at specific times. These practices are not just about what we eat, but when and how we eat, significantly impacting our health and well-being.
What Those Who Are in Favor of It Say
Proponents of strategic meal and nutritional timing emphasize its importance in synchronizing our body’s internal clock with our eating patterns. Studies, such as the 2021 research on hospital nurses with shift work highlight how meal timing can influence body mass index (BMI) and metabolism. Similarly, the 2022 narrative review on renal patients underscores the critical interactions between food, drug absorption, and overall nutritional status.
Advocates also point to the concept of “chrono-nutrition,” as discussed in a 2022 study, which explores the relationship between meal timing and health outcomes like diabetes and cardiovascular diseases. Furthermore, the 2021 review on meal timing during pregnancy suggests that proper meal scheduling can improve glycemic control, indicating its potential as a lifestyle intervention.
What Those Who Are Against It Say
Critics of meal timing and nutritional timing argue that the human body is adaptable and can handle a variety of eating patterns without significant health consequences. They question the practicality of strict meal schedules, especially in modern lifestyles with varying work hours and social commitments. Some also point out that the focus should be more on the quality and quantity of food consumed rather than the timing.
Additionally, skeptics may highlight the need for more extensive research to conclusively determine the long-term effects of meal timing on overall health, considering that many studies in this field are still in their early stages or have small sample sizes.
The Ketogenic Diet
What Is the Ketogenic Diet
The ketogenic diet, or keto diet for short, is a dietary regimen that is high in fat, moderate in protein, and very low in carbohydrates. It is based on the physiological principle that restricting the intake of energy from carbohydrates will push the body to enter ketosis, a state where it breaks down fat and uses ketones for energy instead of using the readily available and easily accessed carbohydrates.
In general, it promotes the consumption of foods high in fat, including oils and animal foods, and it may or may not limit the source of fats (saturated versus unsaturated fats). It does, however, severely limit the consumption of foods that provide significant carbohydrates to the body, namely most fruits and grain-based foods.
The keto diet is boasted for claims to benefits to metabolic health and weight, among others.
What Those Who Are For It Say
Those who promote or follow the keto diet do so to achieve a certain body shape or size, to lose weight, to improve energy levels during training, to improve brain function, and to help people fight sugar cravings.
Many people may follow the keto diet to help treat or manage chronic health conditions, such as epilepsy, type 2 diabetes, cancer, Alzheimer’s and Parkinson’s disease, and nonalcoholic fatty liver disease.
What Those Who Are Against It Say
People who are against the adoption of the keto diet argue that it promotes an unnatural or unhealthy eating pattern and goes against our biological need for carbohydrates. They argue that the “keto flu” deemed normal is the body’s way of crying for help and that there are few studies in healthy populations that demonstrate its benefit and safety in the long term.
Some people accept that keto diets be beneficial as part of a disease management protocol in people with specific diseases. However, they do not believe that it is a sustainable or healthy way to access the other benefits, like blood glucose management and weight loss, that it claims.
Organic vs. Non-Organic
What Is Organic Food?
Generally speaking, organic food is grown or raised without most commercial pesticides (for plants) or hormones (for animal products) and isn’t genetically modified or doesn’t use genetically modified organisms (GMOs) in the production process. Many organic food certifications also require production or manufacturing companies to adhere to a series of ethical guidelines with workers to promote a healthy working environment and to conditions that promote humane environments for animals.
Different countries have varying definitions and guidelines, but most countries require food producers and manufacturers to adhere to strict regulations and pay certification agencies in order to market their products as organic.
What Those Who Are For It Say
People who choose to eat organic food may do so for numerous reasons, including:
The belief that organic foods are inherently healthier or more nutritious
Aiming to avoid the consumption of antinutrients and pesticide residues
Promoting sustainable food production practices
Not knowing enough about the long-term effects of eating foods with pesticides on health
What Those Who Are Against It Say
People who are against or indifferent to the consumption of organic food may believe that:
There isn’t convincing evidence that organic food is healthier or more nutritious.
There isn’t evidence to show that conventionally grown food is detrimental to health.
Organic food is often more expensive and thus out of reach for most people and inherently classist.
It is possible to make environmentally responsible food choices without necessarily eating organic.
Organic label can mislead people to think they are making healthy choices; non-nutrient-dense foods can also be labeled organic.
Superfoods
What Are Superfoods?
Superfoods are those that have one or more nutritional or health benefit that is perceived as “better than the average food.” It may be due to elevated nutrient density, the presence of a particular nutrient that has a role in preventing or managing disease, or due to its role in a functional nutrition approach.
Those For Them Say…
Promoters of superfoods may argue that the label is an easy way to help people make healthier food choices. Highlighting specific foods and their nutritional benefits help people learn about the roles of nutrients in their body while also learning about nutrient density.
The argument is simple but consistent and far-reaching. Highlighting superfoods raises awareness about them, and, when given a choice between the superfood and a similar option, people will be more likely to choose the superfood.
Those Against Them Say…
People against the term “superfoods” usually are not claiming that they aren’t healthy or nutrient-dense. Instead, they may argue that the use of the term superfoods is arbitrary. Superfood claims follow trends based on market trends rather than on studies of nutrient density.
They may also argue that consuming one or two specific foods, without regard to frequency or portion, doesn’t ensure improvements in health. Instead, it is more beneficial to focus on food groups or types and eating patterns as a whole rather than on certain foods.
Often, superfoods are those that are not locally grown but instead have a new and “exotic” feel in the market. In this sense, especially in the West, it often results from co-opting cultural foods and elevating them not for their cultural significance but rather for their nutritional value. This can be problematic when market trends push people to desire the superfood, making them more expensive and less accessible to the populations and communities for whom they are both nutritionally and culturally important. This was the case with quinoa and chia, for example.
Plant-Based Diets
What Is a Plant-Based Diet?
A plant-based diet is one where most of a person’s nutrition comes from plant-based foods, like fruits, vegetables, and grains.
What Those Who Are For It Say
The biggest promoters of plant-based diets often claim that it is the best way to ensure a sustainable future for our environment and a healthier future for people.
Many individuals and professionals choose to eat a plant-based diet for the health benefits it can offer, including:
Helps to prevent and manage diabetes
Helps manage hypertension and lower cholesterol levels
Increases fiber and phytonutrient intake
Anti-inflammatory benefits
Since one of the primary arguments against a plant-based diet is that it cannot meet protein needs, supporters point to numerous studies that demonstrate that it is possible to meet most nutrient needs on a plant-based diet.
Plant-Based Meat and Meat Substitutes
What Are Plant-Based Meat and Meat Substitutes?
Plant-based meat and meat substitutes are products designed to mimic the taste, texture, and nutritional value of animal meat, using plant-derived ingredients. These products have gained popularity as sustainable and health-conscious alternatives to traditional meat.
What Those Who Are in Favor of It Say
Advocates for plant-based meat substitutes emphasize their environmental and health benefits. A narrative review by J. Szenderák and colleagues highlights consumer acceptance of these products, noting their potential to reduce the environmental impact of animal product consumption. Proponents also point to the nutritional advantages of plant-based meats. For instance, a study on the Swedish market found significant variations in the nutritional composition of meat substitutes, with some products being good sources of nutrients like zinc.
Furthermore, supporters argue that plant-based meats can play a role in addressing public health concerns associated with farmed meat consumption. A 2020 review explores the broader implications of meat alternatives, suggesting they may have smaller environmental impacts and potentially offer health benefits compared to farmed meats.
What Those Who Are Against It Say
Critics of plant-based meat substitutes raise concerns about their nutritional adequacy and processing methods. The same Swedish study mentioned earlier notes that not all meat substitutes contribute significantly to absorbed iron, highlighting the need for careful consideration of their nutritional content.
Skeptics also question the ability of these products to fully replicate the sensory experience and nutritional profile of animal meat. A 2022 study on the texturization of plant-based meats points out the challenges in creating meat-like fibrous structures and textures, indicating that there is still room for improvement in the processing techniques.
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In summary, while plant-based meat substitutes offer promising environmental and health benefits, their nutritional composition, processing methods, and sensory qualities continue to be areas of debate and development.
What Those Who Are Against It Say
Some of the arguments against a plant-based diet point out some of the nutrient shortcomings it may have, including protein and vitamin B12.
They may also argue that well-balanced plant-based diets tend to be expensive for individuals to follow when compared to conventional diets. Some people may also feel that eating a plant-based diet means that they will have to cut out cultural foods.
Others also argue that a plant-based diet isn’t synonymous with a healthy or well-balanced diet; for example, plant-based diets do not necessarily rule out ultra-processed foods.
Grass Fed Meat vs Grain Fed Meat
What Are Grass-Fed and Grain-Fed Meats?
Grass-fed meat comes from animals that have grazed on pasture, while grain-fed meat comes from animals typically raised on feedlots and fed primarily grains. The debate between grass-fed and grain-fed meats centers around their nutritional content, environmental impact, and overall health implications.
What Those Who Are in Favor of it Say
Proponents of grass-fed meat emphasize its environmental and nutritional benefits. A study titled “Reconciling Reduced Red Meat Consumption in Canada with Regenerative Grazing” by J. Dyer and R. Desjardins suggests that grass-fed beef, integrated with reduced red meat consumption, can reduce greenhouse gas emissions while providing sufficient protein supply.
Additionally, grass-fed meats are often touted for their higher concentrations of health-promoting phytonutrients. A 2021 study by S. van Vliet, F. Provenza, and S. Kronberg found that grass-fed meat and milk contain higher levels of phytonutrients, which are linked to anti-inflammatory, anti-carcinogenic, and cardioprotective effects.
What Those Who Are Against It Say
Supporters of grain-fed meat often highlight its affordability and consistency in taste and quality. Grain-fed meat is generally more marbled, leading to a tender and flavorful product preferred by many consumers.
Moreover, a 2022 study comparing different beef systems, including grain-fed, found that grass- and grain-finishing resulted in nutritional trade-offs rather than absolutes. This study suggests that grain-fed meat can also have favorable fatty acid profiles, challenging the notion that grass-fed is always nutritionally superior.
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The choice between grass-fed and grain-fed meats involves a complex interplay of nutritional, environmental, and economic factors. While grass-fed meat is often lauded for its environmental sustainability and potential health benefits, grain-fed meat remains a popular choice for its flavor and affordability. The decision ultimately depends on individual preferences, values, and dietary needs.
What Are Soy and Soy Products?
Soy and soy products, derived from soybeans, are a staple in many diets worldwide. They are known for their high protein content and are often used as meat substitutes. Soy products include tofu, tempeh, soy milk, and edamame, among others. The health implications of soy consumption have been a topic of debate among nutritionists and health professionals.
What Those Who Are in Favor of it Say
Advocates for soy consumption emphasize its numerous health benefits. A comprehensive assessment of the literature on soy, as discussed in the article “Soy foods and supplementation: a review of commonly perceived health benefits and risks” by C. D’Adamo and A. Şahin, suggests that soy foods and isoflavones may provide relief from menopausal symptoms and protect against breast cancer and heart disease.
Another article, “Soy Products as Healthy and Functional Foods”, by H. Jooyandeh, highlights the health benefits of soy protein, particularly in reducing the risks of developing age-related chronic diseases. Epidemiological data suggest that populations regularly consuming soy products have reduced incidence and prevalence of conditions like cancer, heart disease, and osteoporosis compared to those who consume little soy.
What Those Who Are Against It Say
On the other hand, some studies raise concerns about the potential adverse effects of soy consumption. The article “Soy and Breast Cancer, have we Analyzed all the Risks?” by J. Koo and L. Schramm points out that the results from studies on soy and breast cancer prevention have been contradictory, with some suggesting potential risks, especially with unfermented soy products.
Furthermore, the paper “Not all soy products are created equal: caution needed in interpretation of research results” by J. Erdman et al. emphasizes the need for caution in interpreting research on soy and its components. It suggests that not all soy products have the same health effects, and there is a need for standardized approaches in reporting and interpreting data related to soy consumption.
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The debate over soy and soy products as health-promoting or disease-promoting is complex. While there is evidence supporting the health benefits of soy, particularly in traditional, minimally processed forms, there are also concerns about potential risks, especially with certain types of soy products and in specific health contexts. Consumers should consider the variety and processing of soy products they consume and stay informed about ongoing research in this area.
Main Takeaways
This article provides general information about these topics and provides an overview of the debate on these topics as they stand in 2021. Keep in mind that the information was presented in a polarized manner (against and for) for simplicity’s sake. However, not all nutrition and wellness professionals sit entirely on one side of the fence in each of these debates. Many professionals may take on a much more nuanced approach and recognize that both sides have their merit.
We encourage nutrition professionals to continue to keep their knowledge up-to-date and engage in conversations with other professionals with different opinions with the aim of providing the best and most relevant information to their clients.
References
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Fad or Evidence-Based Diet? Paleo, Keto, Mediterranean, and More
Learn about the different classifications of diets, where some of the most popular diets rank in terms of evidence, and the qualities and characteristics of diets that support overall health in this AFPA 6.0 unit CEC course.
100% Online | Self-Paced | Complete in 6 Months or Less
