Almost by chance I learned that a few weeks ago the Ministry of Health published a series of content on your website related to healthy eating, offering information and recommendations in this regard. They are hanging on this linkon the ministry’s own website, in a quite prominent and visible way:
As you can see, the content is organized into four sections, two of which refer to existing knowledge about food and health, «Food, what do we know» and «False myths.» A third talks about «Shopping and cooking skills», with information and advice regarding menus and portions. And in the fourth, «Social aspects of food», some content related to what the title itself indicates is included.
As you can imagine, as soon as I had some time I started reading everything. And I have to say that I was greatly disappointed, because what I found was of little rigor and poor quality.
Regarding the contents that relate food and health, which are those of special interest in this blog and those most directly associated with the Ministry of Health, the information is scarce, poor and quite outdated. Much of it is based on decades-old ideas and theories and includes very debatable statements and recommendations that are not based on evidence. And where there are no major errors, little value is added.
It certainly does not have the rigor or quality that I believe something that represents a ministry should offer, on a topic as complex and related to health as food.
Below he compiled some of the fragments that he considers less accurate, copied literally from the website itself. For each of them he included a brief critical explanation, as well as links to related articles and studies.
This phrase is supposed to be especially important, since it is the first of the five key guidelines given for following a healthy diet:
To begin with, the recommendation to «eat varied» is included, but today, in a world with miles and miles of food products at our disposal, there is no minimally solid scientific evidence to confirm that, in general and in developed societies, the variety is beneficial to prevent chronic diseases or obesity. That is why she is a director who has practically disappeared from dietary guides (although she was present years ago), as explained in this post.
If we review the studies on the subject, we will see that variety is not especially useful with respect to health and, at best, there is some (although scant) evidence that it could be beneficial if applied only to foods considered healthy. . (article,
study).
On the other hand, the same guideline also recommends «adapting foods to the activity you perform», without further explanation added. What exactly does that mean? And how is it done?
This is another of the five key guidelines, written in a very generic way and without explanations. It is true that there is some evidence that may lead to discouraging large dinners (article, study), but what evidence is there that prolonged fasts are negative? In fact, there are more and more studies that show just the opposite, that intermittent fasting can even be beneficial (articles,
study). Also, what is considered «prolonged»? Some hours? Several days?
In this case we are dealing with a fairly concrete and quantified statement. But in this case the evidence fails again. There is no evidence that it is beneficial to always include cereals in main meals, so it is quite surprising that it is the only case in which the incorporation of a type of food in the meals and the recommended quantities is clearly specified.
It is true that there is a lot of evidence on the relationship between the consumption of whole grains and better health (article,
study). Therefore, when recommending, it should be done explicitly, making it clear that we are referring to whole grains. However, in the text this «nuance» remains in the background: «
You should try to consume them in their integral variety.«. The verb «seek» is not consistent with what the evidence says.
On the other hand, no complementary explanation is included, something that would be very good, since nowadays it is really difficult to distinguish cereals that are truly whole grains from those that are not (article,
study).
This statement appears in the section that talks about macronutrients, specifically carbohydrates. And to be rigorous, it is not correct. There are trials from decades ago in which it was proven that there are no significant differences in the glycemic response between sugar (simple) and starch (complex) (
study,
study). What there is evidence of is the need to select unprocessed and whole foods, which are usually rich in fiber and other nutrients, which usually slows down digestion.
These warnings in the section on proteins informing us of the possible dangers of eating them «in excess» (without detailing what is considered excessive) are also old acquaintances. They are based on simplistic and incorrect approaches (article, article,
study). Currently, most dietary guidelines do not establish a maximum protein intake in healthy people, since there is no evidence of adverse effects when ingesting them above the recommended amounts.
We can find this paragraph in the section dedicated to «False myths», which aims to «dismantle» the supposed myth that bread is unhealthy (by the way, wouldn’t it be more correct to talk about «myths», since dry?). However, there is no evidence to support the comments and recommendations included, which are clearly favorable to the consumption of bread and which seem to be taken from the press releases that its manufacturers usually send to the media. Quite the contrary, according to the latest studies, bread is the food that provides the most calories to Spaniards (study, study) and one of those that provides the most salt (
study).
Furthermore, bread made with refined flour, which is what the vast majority of people consume, is nutritionally quite poor and is associated with more overweight and other possible negative effects (article with studies).
On the other hand, as with other cereals, until very recently it was practically impossible to find «real» whole wheat bread in Spain, as I tell in this post.
Well no, there is no evidence that «ideally» we should eat five meals a day. Studies have not found a clear relationship between the number of meals and better health. And what little evidence there is suggests that it may be better to eat fewer meals a day (article, article,
study,
study).
More explanations, more absences.
As already mentioned, in addition to these debatable statements and recommendations, the rest of the text does not provide much value either. In fact, there are other sections that, in my opinion, offer content that, rather than informing, could even mislead potential readers. Starting with the five key recommendations, I do not believe that any country has prioritized a similar selection among its main dietary recommendations. Furthermore, the second of them says «
Always take into account the size of the portions, since it is another of the keys to nutrition.«, is something as little concrete as saying «always take into account the type of food, since it is another of the keys», without going into more details. Are you trying to tell us that we should try to reduce the portions? And why What is not said more clearly? There is no further explanation, but if it really is that important, how do you know what the ideal serving size is for each food or meal?
Another example: In
this section, it talks about the different food pyramids and «healthy dishes» that have existed in the US and three current pyramids of Spanish origin are mentioned. But, despite presenting visible differences, they are not analyzed, commented on or evaluated, so the reader will not know what to do with them or which one to choose.
In another section titled «
Adapt recipes to make them healthier«There are tips for cooking in a healthier way. And almost all of them are related to reducing the amount of fat used. However, according to the most recent studies, the consumption of total fat is not associated with worse health, quite the opposite, its consumption is related to a lower risk of mortality (article,
study). Therefore, it does not seem that the amount of fat used when cooking is the key priority factor that we should take into account to improve our health.
On the other hand, it should be noted that at no time or in any section is it clearly and as a priority to limit ultra-processed food. A recommendation that is included in more and more dietary guides, since the evidence that links its consumption with worse health accumulates incessantly (article,
study,
study).
Ultimately, the intention was good, since, inexplicably, in Spain we do not have an official guide with dietary recommendations to optimize health, updated based on scientific evidence. But there is a lot to improve.
A Ministry of Health should offer content of another level.
