Where Americans and Nutritionists Disagree?

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1. Is Sushi ‘Healthy’? What About Granola? Where...

   www.nytimes.com/interactive/2016/07/05/upshot/is-sushi

   Jul 04, 2016 · Is Sushi ‘Healthy’? What About Granola? Where Americans and Nutritionists Disagree. ... Is _____ healthy?...

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   Is Sushi ‘Healthy’? What About Granola? Where Americans and Nutritionists Disagree

   By KEVIN QUEALY and MARGOT SANGER-KATZ JULY 5, 2016

   We surveyed Americans and a panel of nutrition experts about which foods they thought were good or bad for you.

   

   Olive oil

   Orange

   Almonds

   Kale

   Percent of nutritionists

   saying a food is healthy

   Spinach

   Eggs

   100%

   Apple

   Hummus

   Quinoa

   Oatmeal

   Carrots

   Avocados

   Cashews

   90%

   Cottage

   cheese

   Turkey

   Chicken

   Quinoa, lauded as a "superfood," was rated healthy by about 90 percent of nutritionists. Ordinary Americans were uncertain.

   Shrimp

   Whole

   wheat

   bread

   Tofu

   Canned

   tuna

   80%

   Sushi

   Skim

   milk

   Peanut butter

   Corn

   Wine

   70%

   Whole

   milk

   Baked

   potatoes

   Popcorn

   Both nutritionists and the public were split about the healthiness of many common items, including butter, red meat, whole milk and cheddar cheese.

   Steak

   Orange juice

   60%

   Pork chops

   Cheddar cheese

   Granola

   50%

   Foods along this line were rated equally by nutritionists and the public.

   Coconut oil

   40%

   Frozen yogurt

   Butter

   Hamburgers

   Kind bar

   30%

   Pizza

   Beer

   Crackers

   No food elicited a greater difference of opinion between experts and the public than granola bars. About 70 percent of Americans called it healthy, but less than 30 percent of nutritionists did.

   Granola bars

   20%

   Beef jerky

   Diet

   soda

   White bread

   American cheese

   SlimFast shake

   Chocolate

   chip cookies

   10%

   Bacon

   Ice cream

   Percent of all Americans

   saying a food is healthy

   French fries

   Regular soda

   20%

   30%

   40%

   50%

   60%

   70%

   80%

   90%

   100%

   Is popcorn good for you? What about pizza, orange juice or sushi? Or frozen yogurt, pork chops or quinoa?

   Which foods are healthy? In principle, it’s a simple enough question, and a person who wishes to eat more healthily should reasonably expect to know which foods to choose at the supermarket and which to avoid.

   Unfortunately, the answer is anything but simple.

   The Food and Drug Administration recently agreed to review its standards for what foods can be called “healthy,” a move that highlights how much of our nutritional knowledge has changed in recent years – and how much remains unknown.

   With the Morning Consult, a media and polling firm, we surveyed hundreds of nutritionists – members of the American Society for Nutrition – asking them whether they thought certain food items (about 50) were healthy. The Morning Consult also surveyed a representative sample of the American electorate, asking the same thing.

   The results suggest a surprising diversity of opinion, even among experts. Yes, some foods, like kale, apples and oatmeal, are considered “healthy” by nearly everyone. And some, like soda, french fries and chocolate chip cookies, are not. But in between, some foods appear to benefit from a positive public perception, while others befuddle the public and experts alike. (We’re looking at you, butter.)

   “Twenty years ago, I think we knew about 10 percent of what we need to know” about nutrition, said Dariush Mozaffarian, the dean of the Tufts Friedman School of Nutrition Science and Policy. “And now we know about 40 or 50 percent.”

   Here’s what we found.

   Foods considered healthier by the public than by experts

   Percent describing a food as “healthy”	Nutritionists	Public	Difference
   Granola bar	28%	71%	43
   Coconut oil	37%	72%	35
   Frozen yogurt	32%	66%	34
   Granola	47%	80%	33
   SlimFast shake	21%	47%	26
   Orange juice	62%	78%	16
   American cheese	24%	39%	15

   Of the 52 common foods that we asked experts and the public to rate, none had a wider gap than granola bars. More than 70 percent of ordinary Americans we surveyed described it as healthy, but less than a third of nutritional experts did. A similar gap existed for granola, which less than half of nutritionists we surveyed described as healthy.

   Several of the foods considered more healthful by everyday Americans than by experts, including frozen yogurt, a SlimFast shake and granola bars, have something in common: They can contain a lot of added sugar. In May, the Food and Drug Administration announced a new template for nutrition labels, and one priority was to clearly distinguish between sugars that naturally occur in food and sugars that are added later to heighten flavors. (You’d be surprised how many foods contain added sugar.) It’s possible nutritionists know this, but the public still does not.

   Foods considered healthier by experts than by the public

   Percent describing a food as “healthy”	Nutritionists	Public	Difference
   Quinoa	89%	58%	31
   Tofu	85%	57%	28
   Sushi	75%	49%	26
   Hummus	90%	66%	24
   Wine	70%	52%	18
   Shrimp	85%	69%	16

   On the other end of the spectrum, several foods received a seal of approval from our expert panel but left nonexperts uncertain. Most surprising to us was the reaction to quinoa, a “superfood” grain so often praised as healthful that it has become the subject of satire. (At the moment, The New York Times cooking site offers 167 recipes for quinoa, roughly a third of which are explicitly tagged “healthy.”)

   In addition, tofu, sushi, hummus, wine and shrimp were all rated as significantly more healthful by nutritionists than by the public. Why?

   One reason may be that many of them are new foods in the mainstream American diet. Our colleague Neil Irwin measured mentions of trendy foods in Times coverage over the years, and found that quinoa had only recently picked up steam. Others may reflect mixed messages in press coverage of the healthfulness of foods. Shrimp was long maligned for its high rate of dietary cholesterol, though recent guidelines have changed. And public messages about the healthfulness of alcohol are conflicting: While moderate drinking appears to have some health benefits, more consumption can obviously have real health costs.

   We weren’t surprised to find areas in which both ordinary Americans and experts disagreed.

   We expect researchers to be better informed about current research, and everyday consumers to be more susceptible to the health claims of food marketers, even if the claims are somewhat dubious.

   But some of the foods in our survey split both the public and our panel of experts.

   Foods that both experts and the public have mixed feelings about

   Percent describing a food as “healthy”	Nutritionists	Public	Difference
   Popcorn	61%	52%	9
   Pork chops	59%	52%	7
   Whole milk	63%	59%	4
   Steak	60%	63%	3
   Cheddar cheese	57%	56%	1

   Four of the foods listed above – steak, cheddar cheese, whole milk and pork chops – tend to have a lot of fat. And fat is a topic few experts can agree on. Years ago, the nutritional consensus was that fat, and particularly the saturated fat found in dairy and red meat, was bad for your heart. Newer studies are less clear, and many of the fights among nutritionists tend to be about the right amount of protein and fat in a healthy diet.

   The uncertainty about these foods, as expressed both by experts and ordinary Americans, reflects the haziness of the nutritional evidence about them. (If you’re a steak lover and you find this news discouraging, our colleague Aaron Carroll has written that red meat is probably fine in moderation.)

   It’s clear that many shoppers do want to eat healthful foods but are unsure what to choose. To gain some perspective on this, we asked Google which foods were most commonly part of a simple search: “Is [blank] healthy?” We used these results to generate some of our survey questions. The food people were likeliest to ask about was also one nutritionists generally approve of: sushi.

   Is _________ healthy? What American internet users searched for most often

   1. sushi

   2. hummus

   3. popcorn

   4. peanut butter

   5. couscous

   6. oatmeal

   7. tofu

   8. Nutella

   9. pho

   10. quinoa

   11. brown rice

   12. granola

   13. shrimp

   14. tuna

   15. cottage cheese

   16. rice

   17. honey

   18. rye bread

   19. pizza

   20. tilapia

   21. watermelon

   22. guacamole

   23. white rice

   24. cheese

   25. stevia

   26. dark chocolate

   27. coconut milk

   28. pork

   29. canned tuna

   30. feta cheese

   31. polenta

   32. frozen yogurt

   33. beef jerky

   34. coffee

   35. falafel

   36. chinese food

   37. juicing

   38. greek yogurt

   39. brown sugar

   40. chicken

   41. sparkling water

   42. turkey bacon

   43. yogurt

   44. salmon

   45. sourdough bread

   46. smoked salmon

   47. dried fruit

   48. miso soup

   49. Indian food

   50. Basmati rice

   There are some areas of nutritional consensus. Nearly everyone agreed that oranges, apples, oatmeal and chicken could safely be described as healthy, and also agreed that chocolate chip cookies, bacon, white bread and soda could not.

   Foods that both groups think are unhealthy

   Percent describing a food as “healthy”	Nutritionists	Public	Difference
   Hamburgers	28%	29%	1
   Beef jerky	23%	27%	4
   Diet soda	18%	16%	2
   White bread	15%	18%	3
   Chocolate chip cookies	6%	10%	4

   Foods that both groups think are healthy

   Percent describing a food as “healthy”	Nutritionists	Public	Difference
   Apples	99%	96%	3
   Oranges	99%	96%	3
   Oatmeal	97%	92%	5
   Chicken	91%	91%	0
   Turkey	91%	90%	1
   Peanut butter	81%	79%	2
   Baked potatoes	72%	71%	1

   Where does this leave a well-meaning but occasionally confused shopper? Reassured, perhaps: Nutrition science is sometimes murky even to experts.

   Your overall diet probably matters a lot more than whether you follow rigid rules or eat just one “good” or “bad” food. Our colleague Aaron Carroll has published a list of common-sense rules for healthful eating, which represents a good start.

   We also asked our experts whether they considered their own diet healthful, and how they described it. Ninety-nine percent of nutritionists said their diet was very or somewhat healthy. The most popular special diet type was “Mediteranean”; 25 percent of our nutritionists picked it. But the most common answer, even for experts, was “no special rules or restrictions.”

   About this project

   We developed our list of foods in consultation with nutrition experts and Google search trends. Our public poll was conducted online by the Morning Consult and included 2,000 registered voters. You can read the full results here, with crosstabs here. Our survey of nutritionists was sent to the membership of the American Society for Nutrition, a professional group for nutritionists. Not every member completed the survey, but 672 nutritionists did. We view our expert survey not as a scientific measure of all nutritionists, but as a useful if imperfect measure of what foods professionals consider to be healthful.