On 16 March 2017, the results of a survey on Swiss eating habits were released. The survey, dubbed MenuCH, quizzed 2,000 Swiss residents between the ages of 18 and 75 on what they eat.
The report shows that Swiss meat consumption is at unhealthy levels. Average weekly consumption of 780g far exceeds the recommended level of 240g, says the report. In addition, the report points out that Swiss consumption of sugary and salty snacks and fats is four times the recommended level, and that most Swiss do not eat enough fruit or vegetables. Only 12.4% follow the WHO recommendation of at least 5 portions of fruits and vegetables per day.
At the same time the press release says: “In Switzerland we eat more than the recommended amount of meat but too little dairy.” This recommendation to consume more dairy is odd given the high fat and low fruit and vegetable consumption observed in the report. It also flies in the face of World Health Organisation (WHO) dietary advice1. The WHO recommends limiting consumption of foods containing high amounts of fat, especially the saturated fats found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee and lard.
So who is behind the survey?
The survey was mandated by the Swiss Federal Office of Public Health and the Swiss Federal Food Safety and Veterinary Office, which supports the Swiss Federal Office for Agriculture, a government department which plays an active role in formulating agricultural policy.
In addition, the MenuCH report refers to the Swiss nutrition triangle. This colourful piece of geometric nutritional guidance is the work of the Swiss Society for Nutrition (SSN), an association funded by companies such as Coca Cola, Swiss Meat, Danone, and Emmi – the last two sell dairy products2.
In Switzerland, there appears to be quite a bit of overlap between those producing and selling food and those offering nutritional advice. This conflict of interest is not confined to Switzerland. Nutritional guidelines in the US are provided by the US Department of Agriculture. The clue is in the name.
Food triangles attempt to make nutrition simple. Eat less of the things at the top and more of those at the bottom. The problem is in their detail. The Swiss food triangle recommends one portion (100g to 120g) of high-protein food every day on top of three portions of dairy.
The problem is it leaves out many major sources of protein, listing only meat, eggs, fish, tofu, Quorn, seitan, cheese and quark. Nearly all of these are either high in saturated fats or highly processed, foods the WHO recommends limiting. On the other hand no low-saturated-fat-high-protein whole-plant foods are listed, foods that the WHO suggests eating with abandon1.
The WHO recommends between 33 and 66 grams of protein per day4, depending on healthy body weight. In addition, WHO research suggests ensuring the nine indispensable amino acids are all included in the protein consumed, as the body cannot make these. The quantities of these essential amino acids in various foods have been compiled by the Food and Agriculture Organization of the United Nations (FAO). Plant foods such as barley, lentils and oats contain all of them5. For example lentils have all nine, and more of six of them than cheese, and more than seven of them than beef5.
Oddly, the grains and cereal section of the SSN’s food triangle, gives little information on plant protein content. While plant protein is mentioned in the text, unlike the meat and dairy products in the trapezoid above, no protein percentages are given in the chart. The section on meat, fish, eggs and tofu goes further saying that plants cannot supply enough protein. This doesn’t agree with the science. The list of high-protein plants is long and vegetarians find it easy to get enough of it.
The widely believed idea that meat dairy, and sometimes soya beans and quinoa, are the only complete forms of protein is a myth. The FAO, a department of the United Nations, has an online database of the amino acid content of common foods. Click here to see FAO database. Here is a table comparing the amino acids contained in several foods.
FAO database – Food amino acid content
Protein and amino acid requirements in human nutrition – (WHO/FAO/UNU) page 135
USDA database – Calories and saturated fat
The SSN’s food triangle has a dairy section that recommends three portions of dairy every day because of its high protein and calcium content – three portions is described as 450g to 600g of yogurt. Again high-protein high-calcium whole-plant foods are missing. According to their chart, 180g of plain yogurt contains 7.2g of protein, only 4% of its weight. Hardly high protein. Dry spaghetti has around 12%3.
The 252mg of calcium in 180g of yogurt is significant, but no higher than some vegetables. Other calcium rich foods such as spinach, almonds, soy beans, white beans, figs and chia seeds are not even mentioned. 100g of spinach, 100g of white beans and 2 teaspoons of chia seeds together will deliver roughly the same amount of calcium as the yogurt. Sure it is bulkier and requires a bit more chewing, but on the positive side it has close to half the calories, hardly any saturated fat and a lot more fibre.
The SSN claim that meat and eggs contain iron, while true, misses the point. Gram for gram, some plants, such as spinach, contain more iron than beef, one of the most iron rich meats. 100g of spinach, has roughly 10% of the calories of 100g of beef but contains 10% more iron – a 100g steak has 3.2mg of iron and 100g of Spinach has 3.6g of iron. Other foods rich in iron include oats, almonds, lentils, white beans and hazel nuts and chia seeds. These foods typically contain more iron than beef and eggs and a lot less saturated fat and calories.
100g of spinach (3.6mg), lentils (3.3mg), oats (4.7mg), white beans (3.7mg), and whole wheat dried pasta (3.6mg), all have more iron than 100g of beef (3.2mg).
Some research suggests that less of the iron and calcium from plants is absorbed by the body, something known as bioavailability. A 2009 study concluded that iron absorption from plants was lower than from meat. and said this could be a problem in developing nations where people are more likely to suffer from micronutrient deficiencies.
Some recommend those not eating meat should consume 33mg of iron per day, more than the 18mg per day recommended for meat eaters. But given that 100g of Spinach has 23 Kcal compared to the 221 Kcal in 100g of steak, loading up on Spinach is unlikely to lead to an excessive waistline. Menstruating and lactating women should consume more iron than others. There is some evidence suggesting simultaneous consumption of Vitamin C helps with plant iron absorption.
On the positive side, there is evidence suggesting that phytate, the substance in plants that reduces micronutrient absorption, may help to ward off some cancers.
The Swiss food triangle mentions vitamin B12. It was once thought that some plants naturally contained vitamin B12. It turns out they contain B12 analogs, which look like vitamin B12 but aren’t. Vitamin B12 is in the river water we used to drink. Now the chlorine in water removes it. Some meat eaters get enough indirectly via the animals they eat, which get it from their environment like we used to. The best way to get more of this very important vitamin is from supplements and fortified foods.
Illnesses such as obesity, type 2 diabetes, cardiovascular disease, high blood pressure, stroke, and some types of cancer are now considered largely avoidable lifestyle or non-communicable diseases, brought about by tobacco, alcohol, not running round as much as we used to and poor diet.
Nutrition will become a more pressing issue as poor diet sends more to the doctor and hospital. Rising Swiss health insurance premiums are already becoming hard to swallow, harder than foods high in saturated fats it seems.
1 World Health Organisation – Healthy diet fact sheet (in English)
2 Swiss Society for Nutrition donors – (in French) – Take a 5 minute French test now
3 Barilla spaghetti has 7g of protein per 57g (2oz), or 12.2% – (in English)
4 UN report on protein and amino acid requirements in human nutrition – page 243 – (in English)
5 FAO database of food amino acid content (in English)