One of the well-worn adages that I hear most frequently from people who are resisting making health-promoting changes to their eating habits is “It’s OK to eat anything, as long as it’s in moderation”.
People who are struggling with their weight insist that they only eat chocolate or chips “in moderation”, so that can’t possibly be the reason they can’t lose weight.
Many of my vegan clients express frustration at family members and friends who insist that they only eat a “moderate amount” of meat, so that makes them almost vegetarian (which is akin to being almost pregnant).
I’ve heard many dietitians insist that there are no bad foods, only bad diets, and that even the most nutritionally bankrupt foods are perfectly OK to eat regularly, as long as you do so “in moderation”.
The problem is that the concept of moderation is so ill-defined, so slippery and elastic, and so subjective that it provides no meaningful guide to making health-supporting dietary choices whatsoever. A series of fascinating studies on how people define “moderation”, published in 2016, graphically illustrates this point.
A team of researchers from Duke University and the University of Georgia in the US designed three experiments to explore people’s concepts of dietary “moderation”.
Their conclusion, after analysing the results of their experiments, is sobering, and should be taken to heart by all health professionals who are engaged in helping people attain or maintain a healthy weight, as well as by individuals who are personally struggling with this issue:
“Moderation messages are unlikely to be effective messages for helping people maintain or lose weight.”
(I would argue that anyone who needs to make radical changes to their diet to overcome a chronic disease should also heed the advice to ditch ‘moderation’, regardless of their weight status).
What did the researchers find, that made them so dubious of the value of preaching “moderation”?
In their first experiment, they tested the hypothesis that “participants will define moderation as greater quantities of food than the amount of that food they believe they should eat.”
To do this, they recruited 89 young women and sat them down in front of a table piled high with chocolate chip cookies. They then asked the women to answer three questions, in random order:
- How many cookies should one eat?
- How many cookies would you consider to be moderate consumption?
- How many cookies would you consider indulgent?
What they found was that over two thirds of participants defined “moderation” as more cookies than one “should” consume, while only 9% defined moderation as less than what one should consume, with the remaining 24% defined moderation as the same as what one should consume.
Unsurprisingly, all participants defined “indulgent” as a higher number of cookies than both moderate consumption, and what one should consume. However, the gap between the number of cookies they thought they “should” consume and the number they considered “indulgent”, was greater than the gap between “should” and “moderate” – that is, “they perceived moderate consumption of cookies as greater than what they should eat.”
In the second experiment, the researchers continued to explore how individuals conceptualise moderation, but this time they added a new hypothesis to test: that people’s definition of “moderation” is affected by how much they actually like a food, and how often they eat it.
294 adults were shown a photo of 24 gummy candies. First, they were asked one of three questions:
- How many gummy candies is a reasonable amount to eat in one sitting?
- How many gummy candies in one sitting constitutes “eating in moderation”?
- How many gummy candies should you eat in one sitting?
Next, participants were asked how much they like gummy candies, and how often they eat them.
Once again, the number of gummy candies that participants defined as “eating in moderation” was higher than the number they believed they “should” consume. They also perceived a “reasonable amount” of gummy candies to be more than a “moderate” amount, as well as more than they “should” consume.
In addition, the more that participants liked gummy candies, and the more often they ate them, the higher the number of candies they defined as “moderate”, “reasonable”, or the amount that one “should” eat in one sitting.
In other words, people define “moderate” amounts of unhealthy foods as the amounts they personally like to eat!
In the final study, 51 participants were asked how frequently they consumed each of 12 food and beverage categories, including soft drinks, alcoholic beverages, ice cream and fast food, and how many servings they consumed.
Surprise, surprise, across the board, participants reported their own consumption of all the items as “moderate” or “better than moderate”… no matter how much they actually ate.
“The more participants indicated consuming a particular item, the larger the number of servings they considered to be moderate… [and] the more participants consumed of a particular food or beverage category, the greater the consumption of that product they defined as moderate; to the extent that participants consumed relatively little of an item, they also suggested that moderate consumption would be indicated by relatively little consumption of that item.”
Perhaps the most concerning aspect of the findings of this series of studies was how utterly unaware participants were of the influence that their personal preferences and consumption habits exerted on their definitions of moderation.
On the whole, participants had essentially no insight whatsoever into the fact that they almost universally defined “moderation” as greater than their own level of consumption of each food and beverage, and that the amount that they defined as “moderate” was directly proportional to how much they liked the item in question.
There were three main conclusions from the study, which are worth unpacking one by one.
Firstly, “messages conveying eating in moderation may be misguided and are unlikely to reduce consumption.”
Scientific etiquette requires researchers to understate the implications of their research, but based on my clinical experience with both overweight and ill people, I would put it somewhat more strongly than that: messages conveying eating in moderation do more harm than good and rob many people of their right to live in healthy, well-functioning bodies.
Secondly, “perceptions of moderation are highly idiosyncratic and… improving moderation messages may require providing specific
information about what moderate consumption means… Other messages related to moderation such as eat a ‘reasonable quantity’ may be equally inefficient at producing healthy consumption.”
In a world where consumption (not just of food, but of ‘things’ more generally) is falsely promoted as the path to happiness, the whole idea of imposing limits on oneself is frowned upon. But it’s my personal experience that imposing self-defined limits on my consumption is actually liberating. Once I have set a limit on a particular behaviour, I have no further decisions to make about it, which frees up my energy – as well as my material resources – to engage in more of the activities that genuinely promote happiness.
For example, in the process of moving house recently, I realised that I have rather more clothes and shoes than I actually need (believe me, that tends to happen when you have to pack up all of that ‘stuff’!). Consequently, I committed to only buying new clothes or shoes when the ones I have wear out.
If I see a dress I like, or a pair of jeans on the sale rack, or an email promoting cool vegan shoes or comfy bamboo clothes, and I’m tempted to whip out my credit card, I just ask myself whether the items I already have are worn out. If not, I don’t buy. I’ve never been much of a shopper anyway (at least, not since my early 20s), but having this simple rule has still freed up a lot of time and prevented me from buying anything new to clutter my wardrobe with, for the past 4 months. And that means I have more money to donate to charities, which gives me a much deeper and longer-lasting sense of satisfaction than blowing cash on clothes!
And finally, “personally constructed definitions of moderate consumption appear to justify overconsumption. That is, people may implicitly endorse their reported consumption as appropriate because the typical amount they eat is less than what they define as moderate.”
In other words, people kid themselves when it comes to how much unhealthy food they eat, because they don’t want to face up to the reality that they’re eating too much of the foods that make them overweight, sick and miserable.
Doctors, dietitians and other health professionals who perpetuate the ‘everything in moderation’ dogma are not doing their patients or clients any favours; in fact, they’re enabling their self-destruction.
Now, if you’re one of those rare people who is naturally abstemious and rigorously honest with yourself about your consumption habits, and you’re completely well and enjoying life, then good luck to you – this message is not for you. I’ll leave you to your own devices, because you clearly have an accurate sense of “moderation” and no trouble with sticking to it.
But for everyone else… If you’re struggling with your weight, plagued with chronic health problems or suffering from low vitality, then here’s a big heads-up for you: “Everything in moderation” is not working out for you! And it never will.
The only sensible solution is to abandon the notion that there is a “moderate” amount of any unhealthy activity that you can safely engage in, and only ever apply the concept of moderation to activities that support health and life.
For example, sleep is crucial to good health, but few of us have any problem recognising that sleeping for 14 hours a day is excessive. And we all know that water is essential for life, but no sane person would believe that drinking 10 litres of water per day is good for them. The fact is, we’re far better at defining “moderate” or “reasonable” levels of health-promoting behaviours than health-compromising behaviours.
I’ll leave the final words to the authors of this enlightening and thought-provoking paper:
“Successfully exerting self-control in eating involves both recognizing that a self-control conflict exists (e.g., to refrain from another portion of food) and overriding the desire to eat more… Our results suggest that moderation messages may increase the likelihood of failing to identify a self-control conflict with regards to either a type or amount of food. If indulging in a tempting food can easily be viewed as moderate consumption, then no self-control conflict arises, and people can continue with unhealthy behaviors. Because awareness of a conflict is an important trigger for self-control action to take place… researchers [and health practitioners – my editorial comment] must reconsider how people prepare themselves to recognize such conflicts. People need to be honest with themselves about the amount of food they need to consume to reach their weight-loss or weight-maintenance goals.”
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