When discussing the best approaches to promoting health through food, a recurring criticism arises regarding the public intervention model. Critics of this model argue that prohibitionism is ineffective, taxes imposed by states on products of poor nutritional quality have never worked, and trying to regulate food marketing aimed at children is practically impossible in this digital world. As a solution to "prohibitionism," the option emerges to educate citizens about responsible consumption and promote "so-called healthy" food products. In other words, instead of a "witch hunt"—because there are no bad foods, only foods that should be consumed occasionally—we should instead promote more foods that are suitable for a healthy life.
The issue is complex and certainly deserves a more detailed analysis with the supporting scientific evidence. Regarding this antagonism between prohibiting and promoting, I venture a brief reflection.
Yes, we need to promote healthy consumption patterns. We need to empower our citizens. And we need to promote certain foods of great nutritional value more frequently. This is because these foods lack dedicated promoters. Most of the time they are unprocessed or minimally processed foods, whose producers, lacking their own brands, need support. The different varieties of lettuce or potatoes, lemons, plain water, bread, eggs, tomatoes, beans, and oranges need to be promoted more and better. They are the basis of a healthy diet that protects our planet. The Ministry of Health and the DGS (Directorate-General of Health) have already done so recently in a national communication campaign , but we all need to do more. And, as healthcare professionals, we have an obligation to write about and disseminate the nutritional benefits of these foods. Up to this point, we all agree.
But however much we may invest in these foods, the budgets for promoting food (much of it) of poor nutritional quality are and always will be infinitely higher and will have the capacity to pay the best nutritionists, psychologists, influencers, and marketers. Because, among other aspects, it has the capacity to generate higher profit margins and because it is concentrated in the hands of a few "players," as they say now. That's the economy at work.
Where I disagree is with the proposed solution. In my understanding, competing with this industry to consume more (even if they are so-called healthy products) as a preferential strategy is a disservice to the planet. And to our fragile resources now that the world population continues to grow. There is a word that nutritionists need to start using more and that most economists don't appreciate so much: Frugality. It's a word that first appeared in some Greek writings more than 2000 years ago, among the Epicurean and Stoic philosophers. In the Epicurean school, simplicity and moderation in food were sought as a way to achieve a certain ethical and even political stance in life. Later, in the 1950s, the term was taken up again by Ancel Keyes in the initial definitions of the Mediterranean Diet . And when the Commission responsible for the nomination of the Mediterranean Diet as Intangible Cultural Heritage of Humanity/UNESCO, with the support of the DGS (Directorate-General of Health), publishes the 10 principles of the Mediterranean Diet in Portugal, frugality is the first principle of this healthy food consumption model.
Returning to the present day, it is estimated that by 2035 , in just a few years, half of the human population will be overweight, and food production and consumption will be a major contributor to climate change and the extinction of humans, which may be underway. In Portugal, the latest National Food Survey (IAN-AF) , considering the total amount of food and beverages consumed, identified that 30% of the food consumed is perfectly dispensable for achieving a healthy diet. It is precisely in these foods and beverages with high amounts of sugar, fat, and salt that the largest promotional investments are concentrated, many of them aimed at children and young people.
Reducing this consumption, which is perfectly dispensable from the point of view of human needs, polluting, and a major contributor to disease, should be central to the strategy of public policies related to health and the environment.
The topic is difficult. The experience with Covid-19, where many of our freedoms were reduced, makes it difficult to currently make any speech about reducing food consumption. The right of the most disadvantaged to consumption patterns similar to those with greater economic capacity is a right. The citizens' distrust of political power and its governing ethics is even less so. And the populist language currently in use makes any intervention in this regard even worse.
But this social and political environment should not prevent health professionals, and nutritionists in particular, from continuing to fight for healthier choices to be easier or at least possible (especially for the most disadvantaged), and for the consumption of foods and drinks that are unnecessary for our bodies to be reduced or eliminated. Again, frugality. This means being uncompromising with those who promote foods and drinks of poor nutritional quality, with those who sell products of poor nutritional quality in public spaces or in educational institutions and health facilities, or with those who continue to advertise nutritionally unnecessary foods to children and young people despite the law prohibiting this activity .
Civil society cannot be left out of this fight. This is truly the fight of the century, from an environmental and public health perspective. And nutritionists who have no conflict of interest in these areas have something to say.
PS – A final note on the myth that there are no bad or good foods, only foods that can be consumed occasionally and others more frequently. Regardless of our mental health and the pleasure associated with the sporadic consumption of certain foods, I must say that there are foods that add no nutritional value to our diet and others that do. In other words, there are indeed foods that are bad from a nutritional point of view and others that are good. Just as there are good quality hotels and bad quality hotels. And the quality of those hotels is not related to the number of hours we spend there.
Written by
Pedro Graça, Director of the Faculty of Nutrition and Food Sciences at the University of Porto