Paula Deen and the Fallacy of Moderation

photo: People.com , Brian Killian/WireImage

This a guest blog post by Carol Plotkin, MS, RD, CDN

Moderation is a word that has been used quite often when describing healthy eating and drinking patterns. Webster’s Collegiate Dictionary defines moderation as avoidance of extremes or tending toward average. What does this really mean when we are talking about food? Does it mean one cookie a day or one less cookie than we usually eat? Perhaps it means that we don’t eat the whole cookie jar? Does it mean once a day, once a week, once a month or once a year? The problem is that it can mean anything that we want it to mean. This isn’t good enough when we are talking about promoting healthy eating behaviors. To say “all things in moderation” to me seems like an excuse to maintain the status quo, which arguably is average.

Paula Deen announced this week that she has had type 2 diabetes for the past three years. Her announcement mentioned very little about following healthy dietary habits. Rather, she stated that she has always been a advocate for moderation (there’s that word again). Deen’s recipes are not known for being healthy and it must be extremely embarrassing for her to have developed a disease that has a strong tie to dietary factors. Regardless of the cause of diabetes, diet and exercise are integral for its management. They are much too important to be passed off by the use of a non-specific word such as moderation. Deen’s announcement this week motivated me to write this blog post, but this post is not about her.

The food industry loves the term moderation for the very reason that it is non-specific. Hershey’s has created the Moderation Nation to help consumers find balance in their lives. Part of their message is that 100 calories a day of chocolate can fit into your balanced diet. That’s fine, if you do not need to lose weight, but about one third of American adults are obese. George Blackburn, MD, PhD, Chief of the Nutritional/Metabolism Laboratory, and Director of the Center for the Study of Nutrition Medicine, which are affiliated with the Beth Israel Deaconess Medical Center in Boston, Massachusetts, reports that for a vast majority of obese Americans, as little as 200 calories a day prevents them from losing the 20-30 pounds necessary to gain significant health benefits(1). That is less than a small package of M&M’s (240 calories). Often, that 100 calorie treat becomes a 200 or 300 calorie ”nibble” especially when the whole package contains more than 100 calories. The concept of moderation keeps consumers buying products, which is the primary concern of major food manufacturers and restaurants. In the case of Deen’s Savannah, GA restaurant, it keeps the line of patrons circling the block waiting to be seated. Moderation promotes sales and keeps the customers coming through the door.

Last month the marketing research group NPD discovered that Americans are following MyPlate guidelines only 2% of the time. That translates to seven days out of the year! That surely is not moderation and I would argue that the message of moderation is not working. MyPlate promotes such a simple concept and advises Americans to consume half of their plate from fruits and vegetables. It doesn’t get much easier than that!

So what can we do that is better? The National Heart, Lung and Blood Institute in collaboration with the National Institute of Diabetes and Digestive and Kidney Diseases developed the WeCan Program to teach children and families how to choose healthier diets and exercise more. This program uses the Stoplight Approach to teach which foods should be eaten every day (green light), which foods should be eaten in smaller quantities and less often (yellow light) and which foods should rarely be eaten (red light). Another way to define this approach uses the words “Go, Slow, and Whoa.” These three simple words convey more meaning than the word moderation and help to underscore that not all foods can be eaten regularly in moderation if you are trying to lose weight. This approach can be used to teach adults how to better control their food intake too and shows great promise in some area weight management programs.

Stoplight symbols have been added to packaged foods in some European countries to help consumers choose healthier diets. It’s doubtful if food manufacturers would allow such a system in this country because many food products would be labeled yellow or red which could potentially negatively impact sales. You can understand why manufacturers prefer the use of the term “moderation” when it comes to promoting healthier diet habits.

Smart phone users can benefit from using the Fooducate application which independently grades thousands of grocery food items and provides a stoplight color code and letter grade to help consumers make appropriate food choices. The app also discusses the reason for the grade so that you can better understand what makes a food more or less healthy.

Resource:
1. Blackburn, GL and Waltman, GA. Expanding the Limits of Treatment-New Strategic Initiatives. J Am Diet Assoc. 2005;105:S131-S135.

Carol Plotkin, MS, RD, CDN is owner of On Nutrition, a nutrition consulting business.
www.rochesternutrition.com
www.facebook.com/OnNutrition
www.twitter.com/OnNutrition

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  • Ken Leebow

    I finally found the best definition of “Everything in moderation.” – The notion that it’s O.K. to eat everything in moderation is just an excuse to eat whatever you want.

    Source: 101 Incredible Diet, Health, and Lifestyle Tips

  • Lclunie

    Very nice article. Keep up the good work, one by one, we can all change things.

  • Lclunie

    Very nice article. Keep up the good work, one by one, we can all change things.

  • http://482gr8.wordpress.com/ Pambrown48

    Excellent! Thank you. I’m currently down 91 pounds (and counting). There are certain foods I can’t eat in moderation because they set up cravings. I must abstain completely. I’ve accepted that.

  • http://twitter.com/LeahMcGrathRD Leah McGrath, RD

    I understand why you’re writing this article and it does contain some interesting information but while you say that “this is not about her (Paula Deen)” you have plainly used this as an attention grabber & an opportunity to promote an app and also once again publicly chastised Ms Deen  for getting a disease.  It is unfortunate that so many, including dietitians, presume to know so much about Ms. Deen’s medical condition.  If she was your client would you say “you must be embarrassed to have diabetes”?  Moderation is often the first and most important step for many in making changes in their eating/drinking habits.  The “cold turkey” or “do not eat” messages don’t work. Furthermore this is what gives many dietitians the reputation of being “nutrition Nazis” and why many would rather get their nutrition advice from magazines or other types of nutrition advisors.    The stoplight approach has been around for decades – even in the US. We now have a many of other nutritional ranking programs.  All are minimally effective and seem to work best with the people who would be taking the time to read labels anyway.  

    • Anonymous

      It’s about the Puritan/Calvinist mindset, and about magical thinking, and about how they work together.  The Calvinist notion is that anything that’s too much fun, or that pleasurable in itself, is in some sense sinful and must — and WILL — be punished.  Deen, thus, is being punished for her sin of enjoying food too much.

      And then there’s the magical-thinking element:  oh, no, that will never happen to ME.  I will say the magic words.  I will obey the taboos.  I will avoid the forbidden foods and forbidden actions.  I will never eat butter, will not go to the mall on the forbidden days (http://snopes.com/rumors/mallrisk.asp), will never sniff a free sample of perfume (http://www.snopes.com/rumors/perfume.asp), will never harbor a negative thought (http://www.washingtonpost.com/wp-dyn/content/article/2007/04/06/AR2007040601819.html), will take my resveratrol supplements (http://blog.fooducate.com/2012/01/16/resveratrol-health-benefits-rely-on-faked-data/) and thus I will be safe.  Bad things will never happen to ME.  To other people, who didn’t obey the taboos and thus deserve what happens to them, but not to ME.

    • http://twitter.com/OnNutrition Carol Plotkin

      You are absolutely right Leah. I suppose I could have use Winston Churchill as an example as he was known to love food and drink and had health issues that some would say were related to it, but I’m not familiar with him being credited as discussing the moderation of consumption. He is not topical for this issue. It is common practice to use examples to support an argument. That is simply what I have done by using Paula Deen as an example and she is used as a hook to get the reader to read the article. If the article helps the reader examine their own eating philosophy, then I have achieved my goal. This is done all the time in writing and I am surprised to be critized for it.

      As for chastising Ms. Deen, I am not chastising her for having diabetes and I find it odd that you have read this into my article. I am sympathetic to how it must feel for her to have this disease that has a close tie to diet. If there is anything that I chastise her for it is not acknowledging that diet is an important part of the management of diabetes. She decided to make a public statement about her diabetes, but was irresponsible in the message that she was giving to the public.

      I have said nothing about ”cold turkey” in the article. I simply ask the reader to re-examine the use of the term moderation and realize that it is very subjective and it may not be in their best interest to “buy in” to its use. “Go, Slow, Whoa” are subjective too, but less so than moderation. People need to find what works best for them and I view it as my job to challenge current thinking and to provide different options. Paula Deen provides a great example to discuss why moderation may not be a good option for all people.

      The last thing I will address is my discussion of the Fooducate app. I use it a lot in my practice and teach my clients how to use it. I like that it uses the stoplight colors to help people make decisions. I thought about discussing Dr. Katz’s NuVal system, but it is not used in the grocery stores in my region and I have no perspective about its use. I’m sure that it is very useful, but as you say, these things self-select people who are motivated to read ingredients (or who have smart phones). There is a huge segment of people who are being missed. Hopefully those people do not “buy in” to Deen’s conflicting message of moderation.

    • http://twitter.com/OnNutrition Carol Plotkin

      You are absolutely right Leah. I suppose I could have use Winston Churchill as an example as he was known to love food and drink and had health issues that some would say were related to it, but I’m not familiar with him being credited as discussing the moderation of consumption. He is not topical for this issue. It is common practice to use examples to support an argument. That is simply what I have done by using Paula Deen as an example and she is used as a hook to get the reader to read the article. If the article helps the reader examine their own eating philosophy, then I have achieved my goal. This is done all the time in writing and I am surprised to be critized for it.

      As for chastising Ms. Deen, I am not chastising her for having diabetes and I find it odd that you have read this into my article. I am sympathetic to how it must feel for her to have this disease that has a close tie to diet. If there is anything that I chastise her for it is not acknowledging that diet is an important part of the management of diabetes. She decided to make a public statement about her diabetes, but was irresponsible in the message that she was giving to the public.

      I have said nothing about ”cold turkey” in the article. I simply ask the reader to re-examine the use of the term moderation and realize that it is very subjective and it may not be in their best interest to “buy in” to its use. “Go, Slow, Whoa” are subjective too, but less so than moderation. People need to find what works best for them and I view it as my job to challenge current thinking and to provide different options. Paula Deen provides a great example to discuss why moderation may not be a good option for all people.

      The last thing I will address is my discussion of the Fooducate app. I use it a lot in my practice and teach my clients how to use it. I like that it uses the stoplight colors to help people make decisions. I thought about discussing Dr. Katz’s NuVal system, but it is not used in the grocery stores in my region and I have no perspective about its use. I’m sure that it is very useful, but as you say, these things self-select people who are motivated to read ingredients (or who have smart phones). There is a huge segment of people who are being missed. Hopefully those people do not “buy in” to Deen’s conflicting message of moderation.

  • Diane C Nicholson

    Leah, TV personalities are open to having the views that they espouse, analyzed and scrutinized. Deen has encouraged others to eat high-fat, high-sugar “food” and has insisted that it is fine “in moderation”.  The use of the word moderation is as open to interpretation as is the term “common sense”.  Since all signs point to type 2 diabetes being one of the common results of eating in such a manner, one cannot help but wonder how she can avoid feeling responsible for her own disease and at least partially so, for the diseases of many others.  And I have difficulty with caregivers insisting that we are not capable of understanding that such foods are dangerous and therefore should not be ingested.  My husband and I went from a normal diet to vegan; literally overnight.  It’s been 16 years and we have never strayed.  I don’t believe that our abilities are so different from those of other people.

  • Hdjdj

    Call me crazy but isn’t Paula fat? Isn’t the proof in the pudding? Usually fat people do not equal moderation.

  • Dallascovington

    The “cold turkey” or “do not eat” messages DO work.  I quit smoking 30 years ago, Cold Turkey and haven’t had a puff to date.  I lost a lot of weight (34 pounds since Aug 2011) and have kept it down by the Do Not Eat / Moderation (my technique).  I don’t read labels, I have enuff common sense and will power to not dive into a bag of potato chips- or suck up a gallon of ice cream before I say, Gee I need to lose weight. As for ‘cravings’- nah, it is simply YOUR CHOICE & mind over matter.  Know the consequences before that bite.  Have some ice cream, a weekly treat, but remember one must work just a tad harder to keep the weight off, so I say, Bah on all these gimmicks.  The Jennies, and the Watchers…yes they work, but go off their program just once for any length of time and these clients gain their weight back AND THEN SOME! And then they go into depression again.  

    • Anonymous

       You’re exactly echoing my earlier posting.

  • Anonymous

    This shaming of Paula Deen and how “embarrassed” she must be has got to stop! It is not justified. She never told her audience to eat doughnuts every day. Plenty of thin people have diabetes. It used to be called ADULT ONSET DIABETES because it is a disorder associated with AGE. I assume you would not shame her because of her age? It also has a very strong GENETIC component. Are you blaming her for a genetic predisposition? You should be “embarrassed” for taking a holier-than-thou position on someone else’s medical issue about which you know nothing.

    • Michele

      Teenagers and young adults in their 20s are being diagnosed with Type 2 (“adult onset”) diabetes and pre-diabetic conditions in droves, as are pre-teens. For the vast majority who develop Type 2, being overweight is the the straw that breaks the camel’s back. 

    • Michele

      See comment below.  While Type 2 used to be primarily developed by overweight, inactive adults past middle age, it is no longer the case: 
      http://www.health.com/health/condition-video/0,,20192922,00.html

  • Jillshealthylifestyle

    I really feel the whole point is being lost in the blame game.  More disturbing is the fact that she is promoting a drug as the cure instead of backing the prevention method which can stop people from ending up where she is in the first place.

    • carolc

      All I can do is speak from experience.  My husband was diagnosed with Adult Onset Diabetes at age 57.  He was overweight, not a lot, and we didn’t eat junk food.  However, he was so appalled by the illness (it can make men impotent) that he switched to eating more fruits and vegetables, changed some other eating habits, started exercising and lost weight.  Because of his actions, he did not need any medication and his blood sugars returned to normal. 

  • Nancy Ortiz

    The message Ms. Deen is advocating is : Don’t worry about the diet – use drugs instead, with her endorsement. She is NOT alone, many Americans follow this advice but are NOT making money off the concept. Yes, drugs have side effects. That is why many Health Professionals are concerned with her message. Diabetes costs are spiraling out of control. Heart disease is the #1 reason diabetics die.

  • Pingback: Poor Paula Deen « American Fat

  • Cartoonguy_99

    If Paula Deen cooks the way she does for ENTERTAINMENT.  If she ate that way everyday she, or anyone else would be 500 pounds.  Moderation IS key and is COMMON SENSE.  Eat 90 percent healthy and 10 percent indulgence is a pretty simple concept to grasp. And Deen’s Ooey Gooey cake is DEEEELISH!!!!

    Do I eat it every day? No maybe once a month or two months are just around the holidays. I have what you call ‘common sense’ so I know that adding a stick of butter to something probably isn’t a good idea as a daily habit.

    And so what if she a spokesperson?  Even if she ate ‘healthy’ foods (whatever that is) in an over-abundant quantity she would have still gotten overweight and still have been predisposed to developing diabetes. Raising awareness isn’t being hypocritical. 

    And the only reason Anthony Bourdain (who used to be a drug addict by the way) got his shorts in a bunch is because he hates all thing food network (even though it now owns the travel channel that he is on).  Had he not chimed in, it probably wouldn’t have been as big a hoo-ha as it was.

    • carolc

      I keep hearing “food choice”.  If a person is fed junk food from when they are little, is it really a “choice” what they eat when they grow up?  This is the problem.  Food habits are the hardest thing to change.  And, recent research shows food preferences are developed in the womb.

  • L Fan

    Good information, just a little tired of seeing the judgement of what Ms. Deen is doing.  The only ones who should feel embarrassed are those passing such severe judgement on her, I’m inclidned to think it’s judgement when her name is on the title and her picture is in the article.  I hope it’s not too much to think that the majority of people make their own choices on food they eat and don’t just rely on what one T.V. personality has to say, so let’s not hang them for their choices.  They should, I suppose, expect their opinion to be scrutinized because of their profession but it would also be refreshing for the media to back off. Let’s learn to read labels, about good food for us and get in some exercise.  I wish Ms. Deen the best, seems like a lovely lady.  I’m sure even with the medication she’s cut back on the Krispy Cream hamburger :)
       

  • Robert Roy

    I find it most ironic that the solution to diabetes and obesity epidemic is more fruit and grain, less meat and fat, when fruit and grain are responsible for metabolic syndrome and thus obesity and diabetes….

  • http://twitter.com/DyeDiet DyeDiet

    MODERATION. The word is “non-specific” for those who have no idea what it is to listen to your own body. Most of us know very well what is to work or run in moderation, or to sustain a moderate pain. Should I explain this? So everyone has “specific” feeling of moderation in terms of what and when is enough. But what often happens is that people tend to indulge their selves by crossing the well-known border of moderation. They do this NOT because they do not understand what moderation is about. They cross the line forcefully for different reasons. Some indulge, some foolishly think that this is their “freedom” to stuff their bodies with whatever they want. So the solution is not in imposing reflex-like three-color view of food on the nation but in tedious way of educating people and building healthy culture in the nation. This is long way. And, as in most of life situations (including the damn weight loss!), there is NO simple and quick solutions so many of us are still hunting for…