Do we count Calories or Nutrients?

We have often been told to count our calories in order to help us lose weight. Is this the best? Or is there another way to look at it? A new concept is “nutrient counting”. The idea has roots in the fact that there is a rise in overweight and obesity in many nations. It has been seen that overweight or obese people can be undernourished despite their adequate food intake due to the food choices being high in energy and sugar and low in fibre, vitamins and minerals. If one is counting nutrients then the more concentrated or dense the food is in certain nutrients for the same volume, the better the nutrient density is. The Position Paper by the American Dietetic Association, the Dietary Guidelines for America  defines nutrient-dense foods as foods “that provide substantial amounts of vitamins and minerals (micro nutrients) and relatively few calories”. Foods that are low in nutrient density are foods that supply energy but relatively small amounts of micro nutrients.  The Guidelines promote the consumption of nutrient dense foods.

Nutrient counting is not always straight forward and perfectly accurate. Classifying foods as good or bad in such a black and white manner is not preferable as healthy eating is more complex than that. Naturally nutrient dense foods would be fruits, vegetables, and whole-grain products. Fortified foods are certain cereals and fruit juices that have been fortified with extra nutrients that they may not naturally contain. Food fortification can be a cost effective way to increase nutrient density of staple foods, especially in lower socioeconomic populations. Where possible, the goal is to eat wholefoods that are minimally processed and as close to their natural state as possible. But when choosing foods that have been fortified, be mindful of the content of other added nutrients like trans fats or sugars in foods that are more processed. 

How then do we improve our nutrient count?

1. A good place to start is with the obvious. Think about how you could include more whole fruits and vegetables on a daily basis. Eat raw veggies as a snack, load up on soups during winter & add vegetables to mince dishes, curries & stews.
2. Choose more whole-grains and starches that are unprocessed & high in protein and fibre. Add cooked lentils to your brown rice or blend hummus from chickpeas and enjoy with veggie sticks.
3. Learn to understand & read labels to compare nutrient contents, if required. Your Registered Dietitian can help you with this.
4. When out grocery shopping and choosing foods from a certain food groups think about which one would be more nutrient dense. Buy the chicken breast over the cheese sausages or the plain yoghurt over the flavoured one.
5. What we do with the food in the kitchen is also important. Keeping foods raw will maximise vitamin and mineral intake but deep frying vegetable fritters will add fat and destroy some micro nutrients. Prepare food to lock in as much nutrient value as possible.
6. Think about what you are putting into your body and be conscious of nutrient content always. The closer the food is to it’s whole and natural state & the less processing it undergoes, often leads to a more nutrient dense choice.
7. Look out for simple marks or logos on our South African products which can help to know if they are healthy for us or not.

GI Foundation mark for low GI foods. Foods with a low GI can help to improve energy levels and aid in weight management by keeping levels of sugar in the blood more stable	The Heart and Stroke Foundation of South Africa mark on food means that food has meet the criteria for low saturated fat, trans fat, and sodium levels and has no added sugar and may be a source of fibre.
Diabetes South Africa stamp for foods that are suitable for Diabetics and promote good blood sugar control	Certain foods are fortified with Vitamin A, Thiamin, Riboflavin, Niacin, Vitamin B6, Iron, Zinc according to government regulations.

References:

1. World Health Organisation: Obesity and overweight factsheet. Jan 2015. http://www.who.int/mediacentre/factsheets/fs311/en/
2. Practice Paper of the American Dietetic Association: Nutrient Density: Meeting Nutrient Goals within Calorie Needs. Journal of the American Dietetic Association. May 2007:860-869.
3. Nutrient density: principles and evaluation tools. Adam Drewnowski and Victor L Fulgoni III. Am J Clin Nutr 2014;99 (suppl):1223S–8S.
4. The Nutrient Rich Foods Index helps to identify healthy, affordable foods. Adam Drewnowski. Am J Clin Nutr 2010;91(suppl):1095S–101S
5. Concept of a nutritious food: toward a nutrient density score. Adam Drewnowski. Am J Clin Nutr 2005;82:721–32.

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