I found myself getting annoyed by this article as I was reading it. While I agree that “moderation” is not the best term to use when referring to eating habits, I don’t agree with the way that this article characterized it.
According to the article, “moderation” should be done away with because there are some foods that we should eat lots of and other foods that we should avoid. I’m more inclined to think that we should do away with “moderation” because it’s not clearly defined in terms of a balanced diet. I see nothing wrong with the sentiment that all foods can be a part of a healthy diet. However, instead of “moderation” we should probably be talking about “every day” foods and “sometimes” foods.
As the article states, we should be eating plenty of vegetables and fruits. Few would dispute that. Where the article and I disagree is about the inclusion of “sugary treats” in a healthy diet. The article states that “none” is better than “moderate” amounts. Well, sure if you’re treating all foods equally in terms of “moderation”. Of course you shouldn’t consume equal quantities of doughnuts and brussels sprouts. I don’t think that doughnuts (or whatever sweet treat it is that you enjoy) have to be entirely eliminated from your diet in order to be healthy. What good is a healthy diet if you’re miserable and hate it? If you’re happy never eating doughnuts, that’s cool. I’m happy for you. Most of us aren’t.
The main study cited to support Ludwig’s argument against moderation is not as cut and dry as he’d have us believe. Ludwig wants us to think that the study was stopped short because those in the control diet (who were advised to eat a low-fat diet) were at greater risk of death than those in the experimental groups (i.e. one assigned to a Mediterranean diet high in extra-virgin olive oil and one assigned to a Mediterranean diet high in nuts). The study was actually concluded early because the researchers had sufficient data to draw conclusions. Continuing it would be unnecessary for their purposes but it wasn’t putting participants lives at risk. Indeed, there was no significant difference in mortality between the groups. Although there was slightly greater risk of stroke among the control group.
This study has been highly criticized for a number of reasons. One reason being that the diets followed by each group weren’t actually all that different from each other; the low-fat control group didn’t actually consume a low-fat diet. However, the Mediterranean groups were given regular counselling sessions while the control group was not. It’s possible that this counselling alone could have accounted for the slightly lower stroke risk in the experimental groups in comparison to the control group. The study allegedly only included participants at high-risk of cardiovascular disease. As no difference in mortality was seen between the groups what are the chances that following any of these diet conditions would improve health outcomes for the general population?
Besides the study mentioned by Ludwig, the article mentions a few other studies which I don’t feel it’s quite as worthwhile to examine closely. Primarily because they’re like “duh Captain Obvious”. Although it’s quite possible that their designs were also not great, as we so often see with nutrition research. Anyway… They tells us of a study that found that people who eat a high variety of sweets and condiments but a low variety of vegetables “made people fatter”. Another study found that eating “plenty” of vegetables lowered the risk of developing Type 2 Diabetes.
The conclusion of the article:
The takeaway? The quality of the foods you’re eating matters more than the relative quantity. In other words, what you eat matters – not just its amount.
It’s probably time to stop saying, “everything is OK in moderation.” Some things just aren’t.
My conclusion: eat plenty of vegetables, whole grains, nuts, seeds, legumes, and fruit. These foods should be the foundation of any healthy diet. However, there are other foods that we eat for pleasure like pastries, chocolates, and potato chips. You don’t have to eliminate these foods from your diet to be healthy. Treat them as treats. The occasional cookie won’t kill you.