Yes, #repealtheseal, but not just in this case

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Much has been made of the Academy of Nutrition and Dietetics’ (AND) decision to place a “Kids Eat Right” seal on Kraft Singles. In the virtual world of Twitter, the #repealtheseal trend is off and running. Yesterday, a colleague of mine emailed me and asked that I sign a petition that would join me with thousands of other dietitians who object to the AND’s decision. After giving the matter some thought, ultimately I did sign, but I did so with hesitation.

When I was on my cross-country bike trip, food was often a source of debate. On one hand, riding our bicycles was essentially our full-time job, and as such our nutritional needs were so enormous that we needed a daily tsunami of protein, fat, and carbohydrate just to keep heading east. On the other hand, we were a charity group on a tight budget. Balancing these competing needs led to tension, arguments, and some questionable choices, many of which I begrudgingly tolerated. Unrefrigerated clam chowder and yellow tap water in Washington? Umm, okay, fine. Expired energy bars bought in bulk at a negotiated discount and fragments of broken glass in my PB&J in Montana? Definitely not thrilled.

But “pasteurized prepared cheese product” instead of real cheese slices in North Dakota? That ticked me off, as the difference in price was so slim that I felt our balance had tilted too far towards finances at the expense of respect for our needs as athletes. So while I am not a huge fan of Kraft Singles for myself, let’s get one thing straight: My objection to the AND’s use of their seal has nothing to do with this specific food.

My objection is not that the AND is endorsing Kraft Singles; my objection is that the AND is endorsing any foods at all. If I found an AND seal on broccoli, I would still take exception, which probably separates me from some of my colleagues and explains why I initially hesitated to sign the petition and risk lumping myself in with other dietitians with whom I disagree on the following point. Good/bad or healthy/unhealthy food dichotomies create more problems than they solve. They move people further away from balance and internal eating cues and push them towards external food regulation and feelings of guilt and self-depreciation. If you see one food on the shelf that has an AND seal, what does that say about the seal-less food next to it, and how do you feel about yourself and your behavior if you choose to eat the latter?

Kraft Singles might not have been my food of choice during long bicycle rides, but I can understand that we as a group made the decision to purchase them because of monetary constraints. Remember that people in our own neighborhoods struggle to afford food on a daily basis. Food pantries, the Supplemental Nutrition Assistance Program (SNAP), canned-food drives, and similar initiatives do not exist just for the heck of it. For some of our neighbors, affording Kraft Singles is the best they can do.

Joanne and I each have patients for whom getting enough nutrition is a challenge for medical reasons as well. A few months ago, I suggested to a father that he pack Starbursts with his daughter’s lunch and I make no apologies for that advice. While I of course understand that candy for a meal potentially has downsides, in the case of this patient and the struggles she was facing, the upsides won out. We have other patients with eating disorders for whom the highest nutritional priority is just eating – period – so they can continue their recoveries on an outpatient basis rather than ending up in a treatment facility due to medical necessity. If we as dietitians limit food choices for patients like these by making them shy away from foods that lack a seal, then we are not meeting them where they are at; we are failing to help them to the best of our abilities.

Furthermore, remember that virtually all of us make choices in life that do not prioritize health, and for many of us that extends to food. Cheese product may not be my personal cup of tea, but some people genuinely love it, and perhaps those same people might turn their heads at the sight of my favorite foods. Attempts to cut out favorites for reasons other than medical necessity often ultimately backfire by triggering overeating. For example, someone may eat slice after slice of cheddar in an attempt to satisfy a craving that one Kraft Single could have quenched at the outset. When we take all-or-nothing approaches and “nothing” proves to be unsustainable, the only alternative we have at our disposal is “all.” The floodgates open, and what could have just been one slice – if we were eating in response to internal cues – turns into the whole package.

Given all of these reasons, just as my colleagues and I stand up to the AND for inappropriate use of their seal, we have to be careful to avoid making this about the specific product at hand and remember that placing a seal on any food – any food at all – is the real issue.