How To Compile an Affordable Diet that Includes Recommended Vitamins and Minerals

Washington Post carries a thought-provoking and slightly depressing article: Even a Dietitian Can Find It Hard to Craft a Diet That Covers All the Bases. Essentially, even a very experienced Registered Dietitian found it difficult to design a diet that met all the dietary guidelines within 1800 calories (day’s menu for a hypothetical 35-year-old, 5-foot-4-inch woman who weighs 130 pounds and exercises three times a week) and that isn’t taking issues such as affordability into account. The dietitian couldn’t succeed because the only way to meet the RDA for iron meant that she had to include a fortified, processed food product that contributed to the too-high level of sodium intake.

Although I’m slightly down-hearted, I’m not daunted because we are expected to be able to do this for ourselves and anyone else we cook for on a regular basis. There is much to be said for looking at a diet over a period of a few days or a week rather than a one-day hypothetical. We store iron, so as long as that balances out over the week, it’s acceptable if the intake varies. Likewise, the Omega 3 intake from a piece of mackerel lasts for 3-4 days. According to Catherine Collins, principal dietitan at St George’s Hospital:

Diets…are all about context: ‘There is no such thing as a good food or a bad food, only a good diet or a bad diet.’ Surely Tunnock’s caramel wafers are a bad food? I love them more than anything in the world, but that doesn’t mean I don’t feel guilty about hiding them at the bottom of my bread bin. Collins is unfazed. ‘A woman’s calorie intake should be around 2,000 a day, of which 10 per cent can be naughties like chocolate.’

One of the more pressing immediate problems is which free, online, diet/recipe analyser to use. There are several US/Canadian analysers that use the USDA Recommended Daily Allowances (RDAs) to calculate nutritional profiles: eg, Recipe Zaar, Nutrition Data (with some idiosyncratic information such as ‘inflammatory index’), Dietitians of Canada Recipe Analyzer and Fitday. There are some small differences between UK (more detail at the Food Standards Agency) and US RDAs, such as vitamin C intake which is 40mg for adults in the UK but 75-90 mg for adults (without any special dietary needs) in the US.

My Google-Fu has not discovered a comparable UK analyser. If anybody knows of a UK tool, please don’t keep it to yourself but leave a comment about it. If there isn’t one then it looks as if the diet will have to comply with USDA RDAs. Because there isn’t an RDA for Omega 3 as yet, I’ll take a look at the various Recommended Daily Intakes (RDIs) and choose one. There are various recommendations that 5 A Day is only a stepping stone to the ideal goal of around 9 A Day so I’m going to aim for 7-9 A Day.

I’m curious to discover whether it is feasible to put together all of the dietary guidelines and recommendations and come up with something that people want to eat, is sustainable/practical and affordable within a budget of £40 per week for 4 people. I’m beginning to think that there should be a moratorium on dietary advice or guidelines unless somebody has assessed whether or not it meets these criteria.

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16 Comments

Filed under dietitian, nutrition, supplements, vitamins

16 responses to “How To Compile an Affordable Diet that Includes Recommended Vitamins and Minerals

  1. Rita

    Is it me, or does anyone else find this infantilism in food preferences (“10% in “naughties” “) weird? Constant references to the impossiblity of giving up sweets, time-outs for puddings etc just produce a feeling of nausea.
    Instead of thanking our lucky stars that we have enough to eat, and the simplest guidelines imaginable for a healthy lifestyle, the rich world seems to be obsessed with (literally) having its cake and eating it. Shouldn’t people grow out of this stuff?
    Take the sugar out of the food budget and things look a bit different.
    Perhaps taking the subsidies away from the useless, destructive production of animal protein and investing it in fruits and vegetables might make a truly healthy diet more accessible to more people – including those who don’t have the luxury of looking up vitamin tables on the internet?

    • In this specific case, no – not that weird given the demographic of the reporter and the people who were most likely to read that piece. Like it or not, ‘naughties’ is the term used by women’s magazines and food magazines to describe cakes, pastries and confectionery items so it is readily understandable by many people who are the target. If people could readily give up sweets, puddings and various snacks then it wouldn’t be something that RDs need to address on a regular basis.

      Yes, most of us are unimaginably privileged in our food access and security, taking a cultural and historical perspective. Nonetheless, we are constantly told that, from a public health perspective, the general standard of dietary intake is sub-optimal.

      If you were to remove sugar from a family’s food budget then – depending on the usual purchases, the food bill might go up substantially unless the people did not substitute those foods with fruit etc.

      You may well be correct about agricultural subsidies, however the economic policies involved are so tangled that it is even more difficult for the average person to disentangle than, say, looking up vitamin and mineral charts. Plus, if the dietary recommendations are now so complex that it is difficult for even an RD to come up with a ‘balanced day’ within the guidelines then it is an interesting project to look at whether these are readily achievable – if not, then government and various others might drop the hectoring tone. I think Carrie’s suggestion that guidelines and recommendations should not be released unless they have been sanity -checked is a good one.

      It is difficult to see how removing subsidies overnight or even in the short to medium term would bring about a state of education/general knowledge/sufficient family time whereby most people would know what to cook or have the time to prepare it.

      ETA: I should also say that on this blog we are very much behind Michael Pollan’s maxim: Eat food. Not too much. Mostly Plants.

  2. Rita

    Yes, I didn’t suggest that swapping around subsidies would instruct people, just that it might make healthier choices easier. Nor was I imagining that sugary products would be replaced in the shopping basket by healthier produce, simply that if these “naughties” were subtracted from the shopping bill, it would be lower – since they are unnecessary, they do not need to be replaced with anything. I do realise that we all find giving up unnecessary and unhealthy food products extremely difficult – it seems to be one of the penalties inherent in not having to struggle to fill mouths – but perhaps treating these appetites in a less precious way, as “naughties”, “indulgences”etc, but rather as infantile tastes over-extended into adulthood might make people feel differently about them. Appetites are cultural, after all.

    • In the piece in question, the ‘naughties’ were 10% of the daily calorie count. Now, perhaps too many people eat more than 10% or eat too many calories a day relative to their calorie expenditure and they could delete these calories. Others would have to replace any necessary calories with other sources that might be more expensive or not – depending on their choices. It would cost less than 2p to eat 200 calories worth of some own-brand biscuits – it would cost considerably more to replace that with 2 apples, it might cost not much more to replace those calories with a bowl of lentil soup. I can think of some underweight elderly people who need a low residue diet and have no appetite for whom making up calories with 2 chocolate biscuits might be just what they fancy and meet their calorie needs.

      ‘Naughties’ are as expensive as people’s budgets allow. Where the expression might be unhelpful is when considering foods such as chocolate. A lot of the chocolate in the UK might be viewed as empty calories – unless you are a mountain climber who is in need of an energy boost or similar. However, 3 squares of 70% chocolate is recommended as part of a heart-healthy diet because of the antioxidants. Some hot chocolate drinks seem revolting (depending on personal preferences) but for some people that is the only way that they will drink a milk product and obtain calcium – which may be a mineral that they lack from other sources. Cocoa made with proper cocoa powder or 70% chocolate and milk might be a useful foodstuff. As the RD in the piece said, diets have to be seen in context.

      I couldn’t agree more than appetites are cultural and situational. However, the public has now been subjected to several decades of dietary advice and it seems that matters are not improving. See, e.g., recent NYT piece: Bad Habits Asserting Themselves – Five fruits and vegetables a day. Exercise, several times a week. Millions of middle-age Americans are having none of it.

      Anyone who hasn’t heard the healthy lifestyle message has to be living under a rock. But whether it’s the vegetable-hating inner child or the primal urge to conserve physical energy asserting itself, millions of middle-age Americans are having none of it. Over the last 20 years, the share of Americans 40 to 74 who eat five fruits and vegetables a day has dropped to 26 percent from 42 percent, according to the latest analysis of an authoritative national survey on health and nutrition.

      Most people are familiar with healthy-eating messages but they don’t implement them. There are arguments as to whether it is appropriate for medicine to rescue people from the consequences of some lifestyle choices. There are arguments as to whether the present guidelines are compatible with most people’s needs. There are several relevant issues: i) are people are confused about dietary advice; ii) are the dietary guidelines practical and affordable for the majority; iii) are the dietary guidelines out of kilter with the way that most people live their lives in wealthy nations (sedentary jobs, lack of time, crime-ridden neighbourhoods and thin flat walls that make exercising difficult)? There are many more.

  3. robaker

    Is it possible to balance RDAs of ‘other stuff’ against calories? I’m thinking along the lines of a pre-processed food line built around, say, 250 and 500 calorie packs. As an overweight male I could go for 1750 a day, then up it to 2500 once target achieved (contrived example, not to scale, see doctor first, etc). Assuming the ‘other stuff’ is balanced to 2500 calories per day across the range, would I have a shortfall during my dieting period (1750 calories a day)? Could some of the range be ‘double-dosed’ in ‘other stuff’, in which case I could get 750 calories from the double-dosed range and end up with 100% RDA ‘other stuff’ but still only 1750 calories?

    • It depends on what you are trying to do. There are food lines such as you describe, they tend to be the very low calorie diets such as Lighter Life, Cambridge etc. Those and some of the meal replacement plans.

      I know what you mean – the difficulty is that these plans acclimate people to the plans rather than healthful eating most of the time.

      Doubling up the dose in a particular range might be quite unwise for quality control reasons – so, practical more than anything else.

      The original example was from a dietitian who was trying to balance a 1 day menu for 1800 calories and she found that it allowed no wiggle room – she did it, but not without breaching sodium amounts. Over a week, I think the RD would have provided a balanced menu rather than the problems caused by this snapshot.

      There is some concern that restricted calorie diets can end up as a little deficient without a lot of planning and additional information. That wouldn’t necessarily matter for short periods but it might if the diet is sustained or it becomes a way of life.

      • robaker

        Hi dvnutrix

        Thanks for the response.

        I think where I was going was: if it’s hard to come up with a good diet from non-processed foods, and given that I don’t mind a bit of processing, is it possible to generate a line of processed foods that tick all the ‘food science’ boxes?

        I’ve tried calorie counting – for less-processed foods this means a lot of weighing and measuring. For more-processed foods there’s still a bunch of that because the buggers go out of their way to make it hard, and you’re still probably eating way too much salt or whatever.

        It just seems like this could all be sorted.

  4. This is ridiculous. If we have a sub-optimal intake of a particular nutrient our bodies would tell us jolly quickly.

    No one, least of all the celebrity nutritionists, know what an optimum diet. I think UK dietitian who came on here last year to say that when the first RDAs were devised by researchers in the USA they had in mind the needs of the elderly, the young and the ill. Therefore the RDAs are, if anything, higher than most of us actually need.

    Life is full of enough problems without inventing new ones.

    • I’d like to add something re this part of LeeT’s comment: “…when the first RDAs were devised by researchers in the USA they had in mind the needs of the elderly, the young and the ill. Therefore the RDAs are, if anything, higher than most of us actually need.”

      Here’s a quote from Derek Shrimpton on RDAs:
      “The term [RDA] recognises that particular groups of individuals (E.g. infants and those over 60) have different needs and for each group, the intention was to be sufficiently generous to encompass the presumed (but unmeasured) variability in requirement among people. This meant that the value was usually set deliberately high” [My italics.]

      I also remember reading that:
      “the National Diet and Nutrition Survey found that the average child consumed levels of vitamins and most minerals that met recommendations, and in many cases, comfortably exceeded them. These conclusions were based on records from 7-day weighed food diaries and were confirmed by biochemical measurements of blood samples” (Link to article on survey.) Which is interesting to me because it seems to be at odds with nutritionista claims that your children may be deficient in x, y, or z. (Although it is a little off-topic for this discussion.)

      [Nothing I’ve referred to here helps much with regards the rather complex situation faced by Danielle Omar, who had to take into account for things like sodium intake.]

      • Yes, the basic RDA looks quite straightforward. It is the other bits and bobs that look slightly messier – such as the B12, not exceeding 6g of salt a day, the recommended fat/sat fat ratio, enough fibre, iron.

        Agreed that nutritionistas are constantly claiming that we are ‘vertically ill’ and play host to multiple sub-clinical deficiencies.

    • This is going to be one of the rare-ish times that I slightly disagree with you. When people eat a varied diet then they meet most of the basic nutritional requirements. There are demonstrably problems with women of child-bearing age who do not meet their special requirement for folic acid/B12 – it’s not that they have a sub-optimal intake for themselves, but may well do if they were to conceive. (I shall dig up a link from somewhere.) Ditto, there are some women of child-bearing age who do not meet their iron needs.

      I doubt that I could back this up, so *anecdote alert*. It is my impression that lots of women are on a restrictive diet, and they follow the sort of diet that they pull together from what they read on magazine, on the net, or even based on diet advice they glean from gurus or personalised diet services. When Catherine Collins looked at some of this advice, it was lacking in appropriate nutrients.

      Our investigations found that some of these sites fail to spot basic nutritional deficiencies and advise potentially harmful eating plans. Some give advice that could lead to anaemia and weakened bones.

      Posing as a working mum with low energy, I went to five sites and presented the same case history.

      I said my diet was based on a breakfast of cereal and a banana, for lunch a sandwich or cheese, tomato and crackers, a biscuit in the afternoon, and fish with a salad for dinner. I said I had red meat and eggs once a week and didn’t take supplements.

      This would give me 25 per cent of the 14.8mg of iron a premenopausal woman needs per day.

      Iron deficiency is a common problem among premenopausal women and can cause tiredness, shortness of breath and heart palpitations.

      Low energy can lead to reduced activity, and consequently high blood pressure and raised cholesterol levels. My diet was otherwise well-balanced.

      Aside from the issue of meeting the basic RDA (which it seems can be done relatively easily) there is the standard health advice for 5 A Day that is really 7-9 A Day. Is it possible to eat 7-9 A Day, meet all of the other guidelines etc. and do this affordably? I’m not sure that someone has looked at that and I’m looking forward to what Carrie finds.

      ETA: folic acid as I was horribly unclear.

      • Claire

        “Iron deficiency is a common problem among premenopausal women ”

        Indeed. I wasn’t aware that I was iron-deficient until I first went to donate blood & “failed”the test. I don’t recall feeling unusually tired or lethargic at the time. Was advised by blood donation service to see GP, found to be anaemic. I was prescribed some iron tablets & given advice about increasing my dietary intake. No longer take the tablets but continue to follow dietary advice & now, some years later, have not once been rejected at donation sessions.

      • Actually, I think you’re right to disagree with me dvnutrix – I failed to give any examples of the several exceptions to my general point re meeting basic nutritional requirements, and the RDA values being set deliberately high cannot guarantee that everyone will be able to meet them simply by eating a varied diet.

        Re women of child-bearing age: of course there is the specific advice that Folic Acid is recommended from the time you stop using contraception until the 12th week of pregnancy, but I was unaware of the issues surrounding B12 status. One study found that of, 1424 pregnant women in Newfoundland during their first prenatal visit, “Serum vitamin B12 levels of 621 (43.6%) women were classified as deficient or marginal”.

        Re iron needs: I have my own anecdote. My vegetarian sister was diagnosed with iron-deficiency anaemia in her late teens/earl-twenties. Struggling to find anything that backs up your impression re restrictive diets but it certainly wouldn’t surprise me (although I’m guessing that diet is not the only factor in iron-deficiency anaemia among premenopausal women). A Danish study (PMID: 8867722) found that “In general, Danish men and postmenopausal women had a satisfactory iron status. Adolescent Danish girls and premenopausal women had a high prevalence of iron deficiency, which should be taken into consideration when establishing guidelines and recommendations for nutritional iron intake in this section of the population”; a study in Bangladesh (European Journal of Clinical Nutrition (2001) 55, 598–604) found that “In all sub-groups, the intake of iron was much higher than the RDA level and mainly based on non-haem iron” and that “Prevalence of anaemia ranged from 63 to 70% in group L and 27 to 66% in group H, respectively” [I note that the iron intake was above the RDA and that it was mainly in the non-haem form].

        “Is it possible to eat 7-9 A Day, meet all of the other guidelines etc. and do this affordably?” If it is possible (and I’m not sure it is) then it will certainly be very difficult judging by what I’ve read so far. The requirements to have enough of each nutrient, but not too much, and in the correct ratio seem to be incredibly difficult to attain. It all looks like an incredibly complicated juggling act to me. And that’s without considering the available budget!

        • I obviously mis-typed something as I was more disagreeing with Lee than you (curse the email reply method as I obviously got confused). :blush:

          I’m about to be blunter than I like about the folic acid/B12 issue but more than half of pregnancies are unplanned so I would argue that a much larger number of women need to increase their folic acid/B12 intake than might otherwise appear.

          By restrictive diets, I meant calorie restricted but also people who are experimenting with deleting gluten, cereals, dairy etc. with no end in view and without having checked that their restricted diet either meets all of their nutritional needs or is sustainable. Plus, there is the issue of vegetarians who eat dairy etc. but don’t explore other sources of iron and protein and may end up as deficient. Other anecdote here – I’m more talking about lifestyle vegetarians using it as a cover for dieting (in the manner of some teenage girls) than people who adopt it as an ethical stance.

          Yes – doing all this, within guidelines and within budget will be the real trick.

  5. Ah. One problem with threaded comments is that it can sometimes be a little difficult to tell which previous comment is being addressed. (Well I find it a little difficult, anyway.)

    Still, this has been a discussion I have found very interesting – and useful (apart from anything else, I’m now in the process of editing an old blog post on vitamins, minerals and RDAs to add elements of this discussion).

  6. Pingback: FSA’s Low Income Diet and Nutrition Survey: Some Snippets « Holford Watch: Patrick Holford, nutritionism and bad science

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