A NEW approach to dietary guidelines is hoping to steer people away from diet-related disease by encouraging them to prioritise nutrient-dense foods.

Last month’s Societal Role of Meat conference in Denver was a given a first look at the “nourishment table” – which essentially pushes people to prioritise nutrient-density and limit ultra-processed foods. The final paper is expected to be published in a special addition of the Animal Frontiers journal next year.

The organisers of the conference have long raised concerns about policies and dietary guidelines nudging people towards reducing red meat intake, with concerns about the health impact of taking away one of the most nutrient-dense foods available.

Their second conference in Denver heard about the growing body of evidence linking diets with less meat to malnutrition, chronic disease and severe nutrient deficiencies. While these problems are persisting and worsening across the world, the availability of dietary advice is increasing.

Dr Frederic Leroy launching the nourishment table at the Societal Role of Meat conference in Denver.

Brussels-based Vrije University professor Frederic Leroy, who is leading the development of the nourishment table, told the conference that dietary advice was increasingly limiting and not based in good scientific evidence. Given the prevalence of health issues across the world, he said it was fair to say they are failing policies.

“When we look at the main nutritional discourse today, it is often about processing levels and nutrient density,” Dr Leroy told the Denver conference.

“The outcome we wanted to achieve was not so much about the now-eroded concept of ‘healthy diets’, because nobody really knows what that means anymore. We wanted to put the focus on nourishment and choice.”

Dietary guidelines pushing malnutrition levels of meat

Over the years dietary guidelines have evolved for a range of reasons that were not always about scientific evidence – including economic and religious considerations and, in some cases, industry lobbying.

Recently dietary guidelines have tried to include environmental considerations, with the relevant body in Australia recently coming under fire for its attempts to include environmental sustainability in the guidelines. The United States has also proposed recommending a decrease in meat consumption.

One of the highest profile attempts at putting environmental and dietary issues together was the EAT Lancet planetary health diet, which has been adopted as a policy target by cities across the world. It involves a food plate recommending only small amounts of meat and highlighting red meat as an unhealthy food.

“If you to go to the meat intake proposed by the EAT Lancet diet, you will be in the zone of countries that have high growth stunting rates among young children,” Dr Leroy said.

“We need to be careful with our interpretation of that. But it is a warning sign that if you start that experiment it could have consequences.”

The rise of ultra-processed foods

Dr Leroy ran the conference through a brief history of diets, explaining how the introduction of high nutrient dense animal sourced foods had been a vital part of the evolution of humans since pre-history.

He said the next big change in diets came in the neolithic era where diets high in cereal staples were adopted, which had initially led to malnutrition.

“It was only after agriculture became more sophisticated, introduced more crop varieties, improved technologies, introduced secondary animal sourced proteins (like dairy and eggs) and improved access to traditional animal proteins that we finally managed to get back in the green zone,” he said.

Dr Leroy said the rise of ultra-processed foods was the next challenge putting populations into malnourishment and undernourishment.

His presentation was preceded by University of California professor Ty Beal, who highlighted how ultra-processed foods were displacing nutrient-dense foods where countries had gained wealth. He also highlighted that lower income countries were following higher-income countries into more ultra-processed diets.

Dr Leroy said research into the impact of ultra-processed diets had its limitations and the studies are still evolving. However, he said some clear trends of associations between ultra-processed diets and cardiometabolic disease, obesity, mental health disorders and mortality were starting to emerge.

“We know from intervention trials that if you expose people to ultra-processed foods it will lead to overeating, it will result in weight gain and that will result in other health issues,” he said.

“Lots of things are going on that are documented. To which degree all these mechanisms play a role is still open for debate and there is a need for more research.

“But if you take all the evidence that is available, it is a prudent decision to steer away from those foods.”

Dr Leroy said it was also important to mention that the nourishment table was not calling for all ultra-processed foods to be avoided – just for diets to be dominated by whole foods and only ultra-processed foods on occasion.

He said processing was a useful intervention in some cases.

“It is especially useful if you are going for a diet that is heavily based on plants, because digestibility needs to be increased,” he said.

“We also know that it becomes more difficult for vegan diets to hit the protein targets in the western diet settings when they are consuming less ultra-processed foods. Hitting nutritional targets with vegan diets can be done, but it is not an easy task.”

Including dietary freedom

One of the main issues the nourishment table is trying to address is the limiting nature of dietary guidelines, food pyramids and plates.

“There is a huge diversity of traditional diets that all do a very good job of nourishing populations with a lot of flexibility,” Dr Leroy said.

“A friend recently sent me this quote from Steven Bratmann’s book Health Food Junkies, which I think is very pertinent to this discussion: ‘after a point of reasonable dietary improvement, neither happiness nor health comes from including strictness’.

“Nourishment is about much more than the nutrients and the calories. Enjoy your meals because it is worth it.”

• To read and watch more about the nourishment table head to this link from Dr Leroy’s ALEPH website.

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