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A health professional recently wrote of explaining to her father-in-law about eating competence: emphasis is on the how, not the what, eating food you enjoy. "So, am I wasting time reading food labels?"  he asked. Since his major myocardial infarction many years ago, he eats only low-fat, low cholesterol, and no trans fats. I put the question out to my ESI colleagues, and here is what they (we) said.

Ines Anchondo: After eating competence has been established and a Satter DOR is being followed (this may take many visits or just one, depending on the case) if the person is interested in discussing food selection I would discuss it. I do not give directives or guidelines regarding good or bad foods or even better foods for that matter. I mainly talk about offering a variety of fats, more fresh fruits and vegetables (or frozen). I suppose that if people are specifically interested in finding out if there is too much of one thing or another (e.g. trans fats) in the diets we could talk about it upon reviewing their food intake. I don't focus on this. In the population I work with there is too much food insecurity to even begin to be so specific about nutrients. So, in a nut shell I don't use food labels.

Pam Estes: I have worked with several referrals lately who have experienced muddling between  How to Eat’s “pay attention to internals”¹ and the conventional approach’s “choose ‘healthy’ foods” messages. They can't truly honor their appetite when "healthy" is a part of the mix because it is too fraught with anxiety and guilt. Food labels just intensify those feelings, and are not something I talk about at all. Once they graduate from How to Eat, if they want to explore the differences presented by food labels, we can have a more interesting discussion, but by then, they know the decision is theirs as to which they purchase and honoring their own thoughts on the matter is just as important (or more important) as anything I might have to add.

Yours truly’s $.02 worth: Your relative's comment was based on the common assumption that EC tells you to throw the baby out with the bathwater. That is, you throw away all controls and eat willy-nilly. The context management part of EC is all about being knowledgeable about food selection, food composition, etc. NOT ENSLAVED, but knowledgeable so you know what you are getting and you can avoid what you don't want.

More about food selection: I wrote about nutrition facts labels in Secrets in chapter 13, Choosing Food, (a fine chapter if I say so myself). Like Ines and Pam, I am cautious about giving nutrition information: “If I were working with you clinically, I would wait to introduce this information until I was sure you were ready. You would be ready when you could do most of the behaviors on the checklist in Epilogue I, “How to Eat” [page 51 - about attitude, internal regulation, and food acceptance].² You would have developed the meal habit and built up patterns of food selection that worked for you. At that point, nutrition and food selection information would reinforce what you were doing and answer questions that have occurred to you, rather than loading you up with shoulds and oughts.”³

Within that context, starting on page 218, I talk about nutrition labels with the goal of helping readers “make use of the detail without getting caught in the rules.”

Just as nutrition facts can enslave you, they can also set you free [page 201]: “Knowing more about nutrition and food composition will reassure you that you can eat what you enjoy, including foods such as red meat, eggs, starchy and salty foods, and fats and sweets. Essentially, I spend this chapter blessing the food.”³ “Foods you enjoy” could include some of the fat your relative is avoiding. Like a lot of people, he could be way more rigid about food selection than he needs to be. He could benefit from reading Secrets Appendix N: A Primer on Dietary Fat. If he can tolerate that, he might be able to stand Appendix L: Diet and Degenerative Disease.

Some other day, we will talk about the futility of trying to tell relatives anything. :)

1.    Satter EM. Chapter 4, Eat as Much as You Want. Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook. Madison, WI: Kelcy Press; 2008:27-43.
2.    E.M. S. Part 1 Epilogue. Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook. Madison, WI: Kelcy Press; 2008.
3.    E.M. S. Chapter 13, Choosing food. Secrets of Feeding a Healthy Family: How to Eat, How to Raise Good Eaters, How to Cook. Madison, WI: Kelcy Press; 2008:202-220.