“The only uncontroversial fact we can agree upon in nutrition,” Sigma Nutrition Radio Ep. #397: Dietary Nitrates & Nitrites

This week’s Sigma Nutrition Radio is an excellent conversation about the current nutritional science around dietary nitrates and nitrites, their potential impacts on the prevalence of positive and negative health outcomes, and recommendations for a healthy diet. As I’ve said elsewhere, I don’t feel qualified to opine on the science–Danny and Alan are the experts, and my skillset is finding reliable sources of information and digesting and applying information from them, not evaluating the nitty-gritty details of where those recommendations come from. So, instead, I’m going to go on a bit of tangent as we discuss this episode.

One of the things I love about the episodes where Danny and Alan dig into a nutrition topic is the deep level of nuance they bring to their conversations. They are scrupulously cautious about not making overbroad statements and they always provide context to their recommendations. The same cannot be said for many other sources of nutrition information.

I want to use this episode as a springboard to talk about nutritionism,(1) and how I see it as carrying with it some of the same potential pitfalls of diet culture. By “nutritionism” I mean reducing foods to their component macronutrients and micronutrients and the implication that by knowing each of these constituent parts, we have what we need to know in order to define a healthy diet. Nutritionism is a natural consequence of nutrition science, but it can carry with it some unintended risks.

Nutrition science is an area of research that has bloomed over the last century, and it informs so much of the health guidelines we all consume. However, it also carries with it the risk of reducing the importance of foods to a few of their nutritional components rather than understanding them within the wider context. An orange becomes a good source of vitamin C. Eggs are protein and fat. The flour used to make bread for toast is fortified to provides essential nutrients. Each component of the breakfast is seen only by what we can justify as “good” or “bad” for us, rather than in the larger context of being a component of a well-balanced meal together, or in the context of someone’s overall diet and health, or even within the context and importance of family time and a shared morning meal. Nutrition science carries with it both the power to inform us as to how we can improve our health while simultaneously becoming a tool of moralizing or justifying individual food choices. Like a lot of tools, it has limits and carries with it potential risks that I think we need to pay attention to. Moralizing food is only one example of a potential pitfall of nutritionism, splitting food into the false-dichotomy of being “good” or “bad.” And I’m opposed to most applications of dichotomous thinking. Our choices are almost always more nuanced than that. And healthy behaviors fall on a spectrum, so our advice must necessarily fall on a spectrum, too.

Grocery store shelves are filled with the results of nutritionism. You can find yogurt fortified with the fiber inulin on the assumption that “fiber is good,” but ignores that types of fiber matter, and the context in which that fiber is consumed impacts its benefits. Orange pop is sold as a “good source of vitamin C,” health-washing what is otherwise a quick source of sugar with very little other health benefits. We find packaged food products of all kinds that are some variation of the same handful of ingredients promoted as with or without whatever the superfood or boogeyman of the moment. These products are low on the priority list for attaining nutritional health. They encourage us to focus on minor details without considering the larger context of how they fit into an overall healthy diet.

In the context of this conversation about nitrates and nitrites, a natural consequence of nutritionism would be for someone to decide they need to avoid all sources of dietary nitrites. This conclusion misses the potential for harm from the rule-making itself and the resulting behaviors that may stem from it. I’m interested in the “downstream” consequences of these sorts of decisions. Maybe for some folks this rule-making results in nothing problematic, in which case the decision is fine. But it’s worth paying attention to, especially when we’re inclined to all-or-nothing approaches in general. Does the complete avoidance of this food or category of foods have other consequences–physical, psychological, to relationships, etc.–in which case the pros and cons of the rule needs to be assessed. If cutting out all nitrites means you never let your kid eat a hotdog, which limits your choices when you eat out in restaurants, picnics and at kids parties and changes how you talk about food in front of your kids thereby teaching them to walk around with lists in their heads of “good” foods and “bad” foods, and increases the likelihood that they will have disordered relationships with food, then I would suggest it might not be a great option for you and your family. The relative risk of the occasional hotdog may be lower than the relative risk of teaching to moralize foods to your kids.(2)

Having a more nuanced level of understanding of the pros and cons of a particular nutrient helps to inoculate us from catastrophic thinking, fear-mongering, health-washing and extreme mindsets about food. The advice that Danny and Alan land upon is nuanced, giving recommendations for increasing healthier sources of dietary nitrates and nitrites and limiting, but not entirely avoiding, potentially riskier sources of them. These recommendations avoid the pitfalls of nutritionism while giving individuals a roadmap to making the best decisions for themselves and their families.

Podcasts – Sigma Nutrition

(1) I believe I first encountered this term in a Michael Pollen book, so I want to give credit to him for it. A quick search tells me he popularized it in In Defense of Food.

(2) This is an over-simplification in order to illustrate a point, of course, and I recognize that the relative risk of limiting any one single food in a child’s life is relatively low. However, folks who are inclined to cutting out one food often carry with them a longer list of “bad” foods, and it is the larger tendency to moralize and put excessive importance on certain food choices that I suspect is the real risk factor.

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