Evaluating Sweden's Food Guidelines

Julia Belluz’s article “The US food guidelines are way too complicated. There's a better way” contrasts the US and Swedish dietary guidelines. She makes a good case that the US dietary guidelines are likely to be almost incomprehensible to the supposedly intended audience. That is too bad, because speaking a bit metaphorically, the Standard American Diet can be thought of as close to a global minimum among relevant diets. See: “How to Summarize a Big Chunk of Nutrition Research: Almost Anything You Are Likely to Think Of Is Better Than the Standard American Diet.”

The Swedish dietary guidelines, on the other hand, are clear enough to evaluate. Let me give my views; I think the Swedish dietary guidelines are partly right and partly wrong. (This post is thus analogous to my post “The Keto Food Pyramid,” which evaluates similarly clear “Keto” recommendation.)

Here are the points I wholeheartedly agree with, followed by links to relevant posts:

  1. less sugar

  2. less alcohol

  3. more non-starchy vegetables

  4. more nuts

  5. more exercise

Some of the other recommendations are dicier:

6. Some kinds of fish and shellfish stimulate a lot of insulin which takes a toll; other kinds are low on the insulin index.

7. Fruit combines much that is nutritionally valuable with a lot of sugar. Fruit juice, by subtracting the fiber is a considerably worse deal. Unfortunately, most of the fruit available in the modern supermarket has been bred to have a higher sugar content. Fruit is a better deal nutritionally when you choose either commercial varieties or “heirloom” varieties that have lower sugar content. See:

8. Wholegrain is generally quite high on the insulin index. In my view, it has a much healthier reputation than it deserves. Among common foods, oatmeal is the biggest exception. (The less processed the oatmeal is, the more I trust it.) See:

9. On healthy fats, there is broad agreement that transfats are bad and a fair amount of agreement that monounsaturated fats—as found in olive oil, avocados, and nuts—are good. I see a lot of disagreement about whether saturated fats are good or bad and about whether polyunsaturated fats are good or bad. On balance, I treat all fats other than transfats as good. Moreover, given the importance of reducing easily digestible carbohydrates (sugar and many starches) that are very common in processed food, and the dangers of too much protein, getting enough calories will usually require increasing the consumption of dietary fats, which in my view are quite healthy by comparison. See:

10. I totally disagree with the claimed virtues of lowfat dairy products. Although there may be reason to avoid dairy entirely, if you are going to have dairy, full fat is better in my view. It is even more important to avoid milk with the A1 protein. Because most tests of the health effects of milk involve A1 milk, it is difficult to know how much of the observed problems with milk consumption would still be there if A2 milk were used. See:

11. I worry about too much meat. But contrary to the conventional view, I seem it as problematic because of its protein, not because of its fat. Certain types of meat are also high on the insulin index. Overall, the story for meat is complex. My advice is to eat meat sparingly, and to lean toward fattier cuts in order to avoid eating too much protein when you do eat meat. (This applies to fish, too.) See:

12. I am quite skeptical of the idea that too much dietary salt is a big problem. For those with high blood pressure, salt deprivation to get to an abnormally low level of salt in one’s system may be an appropriate treatment—though it seems likely to have a relatively small effect in reducing blood pressure and could have a side effect of leaving one feeling weak (judging from how sodium deficiency feels for me when I forget to take spoonfuls of salt while fasting as detailed in “Fasting Tips”). On the high side of salt intake, I suspect that healthy individuals will naturally excrete salt to keep it from going above the normal level. See:

Note however, that avoiding salt may get people to avoid highly processed foods, which would a very big boon to health. Of course avoiding sugar would do even more in this direction. (In my view, sugar is both very bad in itself and a good marker for highly processed food, which is often bad not only because of its sugar content, but for other reasons as well.) The bottom-line for most people: worry about avoiding sugar, not about avoiding salt. If avoiding sugar leads to less salt intake, great. See:

Conclusion:

Overall, the Swedish food guidelines are a big step up from the US dietary guidelines. But they should be considered far from the last word on what foods are healthy and what foods are not so healthy. In addition to my disagreements about healthy and unhealthy foods, I also have to complain that the Swedish food guidelines are only about exercise and what to eat, and don’t address the hugely important issue of when to eat. See:

All of these links and more can be found organized in “Miles Kimball on Diet and Health: A Reader's Guide.”