Ready for the reality check?
In all likelihood, you’re overestimating the quality of your diet. Here are a few tips for interrogating your nutritional blind spots.
Nutrition Diva is hosted by Monica Reinagel. A transcript is available at Simplecast.
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Hello and welcome to the Nutrition Diva podcast. I’m your host, Monica Reinagel. And today, I have some sobering news to share about the likely quality of your diet. (Also, some practical ways to improve it, if necessary.) But first, a quick listener Q&A
Christina writes: “It seems every time I go down the oil aisle in the grocery store, there's a new type of oil. I recently saw avocado oil. I know avocados are good, but what about this oil? Is it better than olive oil?”
Avocado oil is actually quite similar to olive oil and can be used the same way. Both are rich in heart-healthy mono-unsaturated fats.
In addition, avocados and avocado oil are particularly rich in carotenoids. Among their many benefits, these nutrients help protect against macular degeneration, which is the leading cause of vision loss in older adults.
Now, of course, you can also get carotenoids from eating red and orange vegetables like carrots, winter squash, and red peppers. Watermelon is another great source.
And adding avocado (or avocado oil) to a salad can help boost your absorption of the carotenoids in your salad veggies.
However, avocado oil tends to be quite a bit more expensive than olive oil, so you may not want to replace good old olive oil as your everyday go-to.
And now, let’s get into today’s main discussion:
How healthy is your diet overall? If you had to give it a grade, what grade would you assign it? A? C? F?
Last year, Jessica Thomson, Alicia Landry, and Tameka Walls published an interesting study in the journal Nutrition. They were trying to establish whether a person’s dietary quality could be reliably assessed simply by asking the individual to self-rate the healthfulness of their diets—the way I just asked you to rate yours. As you can imagine, this could potentially be really useful for doctors, who often don’t have time (or, quite honestly, the skill) to conduct a more detailed dietary assessment.
A thousand adults were asked to rate their overall diets as excellent, very good, good, fair, or poor. Their answers fell along a pretty standard bell curve. The most common rating was the middle one (“good”), which was selected by 41% of the subjects. About a quarter rated their diets as only fair, and 6% thought their diets were poor. This was roughly mirrored on the other end of the spectrum, with 22% saying their diet was very good and 8% rating their diets as excellent.
The researchers also had access to information about what the subjects actually ate and they used this information to calculate a healthy eating index score for each participant. The HEI essentially measures how closely a diet conforms to the Dietary Guidelines.
Ready for the reality check?
According to their Healthy Eating Index scores, fewer than 1% of the respondents had an excellent diet (vs. the 8% who believed their diets to be excellent). Another 11% scored as either very good or good (vs. the 30% who thought they fell into those categories). But by far the largest group, accounting for 70% of the subjects, had diets that scored as poor. Oof.
So, not only are we doing very badly at following the dietary guidelines. But apparently, we are also really bad at estimating the healthfulness of our diets. Only 15% of the subjects rated their diets accurately. And the vast majority of us (75%) think we eat a lot healthier than we actually do. In fact, the group that was most accurate in their self-assessment was those who said their diets were poor—and it turned out that they were right 96% of the time.
Part of this is just human nature. We also tend to overestimate our driving abilities. We all believe that others should not be texting while driving, for example, but more than a quarter of us believes that texting does not affect our own driving performance.
Why are we so delusional about the quality of our diets? Perhaps we overestimate the healthfulness of our diet because we are unclear on what healthy actually is. Although the Dietary Guidelines for Americans (on which the HEI is based) are pretty straightforward, the truth is that—much to the chagrin of those in charge of health policy—the DGA have a limited impact on people’s behavior. Most people don’t actually know (or care) what’s in them.
At the same time, there are a lot of competing narratives in the popular media and around the water cooler about what constitutes a healthy diet. I was struck, for example, by a survey done last year by the International Food Information Council. Slightly over half of those surveyed said that they were following a specific healthy diet or eating pattern. But there were almost two dozen different eating patterns or strategies reported, everything from vegan to paleo, keto, Mediterranean, carb-cycling, intermittent fasting, and the always-mystifying “clean eating.”
So lots of people are trying to eat healthy but very few of them are defining that the same way.
If we don’t have a clear (or shared) notion of what a healthy diet is, that could certainly contribute to our inability to assess the healthfulness of our own diets.
I think self-beliefs also play a role here. If we believe we are someone who takes good care of themselves or is healthy, we may be blind to the ways in which our behaviors don’t actually line up with our self-perception.
For example, I received an email from a listener who was trying very hard to make healthy choices. “I watch everything I eat closely,” she wrote. “I do not drink soft drinks and avoid artificial sweeteners and flavors. I am trying to eat and drink as much organic and natural as possible. I make decaffeinated tea and use 1/2 cup of sugar per pitcher of tea and drink 40 to 80 ounces a day. Am I getting enough water?“
So, my health-conscious listener, despite going to such lengths to avoid artificial sweeteners and flavors, caffeine, and eating organic, was still consuming 100 to 200 grams of added sugars every day.
As I wrote to her privately, I think that reducing her intake of added sugar (which is 4 to 8 times higher than recommended) is probably more important than any of the other things she mentioned. Probably more important than all of them combined.
I share this story only to illustrate how easy it is to get caught up in things that might not matter nearly as much as the really important things we’re overlooking—and this may be part of the reason that most of us over-estimate the quality of our diets.
We all have our nutritional blind spots.
Are you so worried about eating only organic produce that you eat fewer vegetables? Because the benefits of a diet rich in fresh vegetables far outweigh the risks of pesticide exposure.
Do you diligently avoid products made with high fructose corn syrup but fail to limit your intake of “natural” sweeteners? Because the amount of concentrated sweeteners in your diet has a much more profound impact on your health than whether they are natural or not.
Do you always choose whole-grain bread, cereals, and pasta but fail to observe reasonable portion sizes? Because portion size has a bigger impact on blood sugar than whether a grain product is whole or refined.
You might want to give some thought to where your nutritional blind spots might be.
I think another contributing factor is the cognitive bias that leads us to pay more attention to things that are out of the ordinary. So the couple of weeks that we spend on some sort of health kick loom larger in our memory than the months that we may spend not giving our food choices a whole lot of thought. As a result, we overestimate the impact of that little health kick.
As many of you already know, the Nutrition GPA app was one way I attempted to solve this problem—by giving people a simple but objective way to rate the quality of their diets over time. If you haven’t ever checked it out, maybe today’s episode will inspire you to do that. And if you have questions about using the app or the science it’s based on, feel free to send them my way.
You can email your nutrition questions to nutrition@quickanddirtytips.com or call the Nutrition Diva listener line at 443-961-6206. and your question could be featured in a future episode!
I’d also like to invite you to check out my other podcast. It’s called the Change Academy, where we explore the art and science of creating positive behavior change, both in our own lives and in our workplaces and communities. You can find it on all the major podcast platforms. Just search for Change Academy.