A framework for adequate nourishment: balancing nutrient density and food processing levels within the context of culturally and regionally appropriate diets

There are many dietary patterns and habits for the human omnivore to achieve adequate nourishment, often beyond what conventional nutritional recommendations and models suggest. Yet, there are also limits to this dietary flexibility, contingent on nutrient density and food processing levels. The nutrient density of a diet is usually improved by incorporating animal-source foods beyond a threshold, suggested to be at one-fourth to one-third of the caloric intake. Below this threshold, nutrient deficiency risks become a concern and require careful consideration. In contrast, consuming a high share of animal-source foods comes with contentious debates related to the risk of chronic diseases. Minimally processed foods are recommended as the preferred dietary option, but this should not compromise nourishment potential. Especially when plant-based foods dominate dietary intake, processing steps are needed to remove phytotoxins and improve nutrient bioavailability. However, excessive processing levels result in loss of food quality, whereas dietary patterns dominated by ultra-processed foods are likely harmful. This article focuses on the health aspects of human diets, without addressing concerns related to environmental impact or animal welfare. Such concerns can nonetheless be met, to some degree, if dietary guidance sufficiently embraces flexibility. This can be done by encouraging culturally appropriate diets while allowing for the self-selection of a variety of nutrient-dense, satiating foods of a mainly minimally processed nature, based on personal and cultural needs, values, and preferences. The concept of adequate nourishment is particularly important for populations with unique nutritional requirements, such as young children, pregnant and lactating women, and older adults. This article constitutes an interdisciplinary effort combining expertise on such topics as nutritional epidemiology, nutrient security, clinical nutrition, evidence-based medicine, cultural food studies, food history, archaeobotany, and food technology. It aims to synthesize a part of the timeliest conversations on human diets and adequate nourishment, in particular, the roles of nutrient density (and its relation to the dietary animal–plant ratio) and food processing levels (including the much-debated issue of ultra-processed foods). By balancing these dimensions, optimal dietary domains will be proposed with a freedom to operate in manners that are respectful of food sovereignty, while upholding the potential for diverse dietary recommendations. Such flexibility should allow individuals to align their nutritional status with their idiosyncratic perspectives and values based on regional, culinary, and cultural appropriateness, ethics, and sustainability, and within practical and budgetary constraints. We wish to stress that the focus of the article is on nourishment and that we do not venture into other aspects of ultra-processed foods and animal production that are also critical to address, including impact on food politics, biodiversity, climate, and animal welfare, but that are beyond the scope of the current paper. Ongoing nutritional debates in Western high-income countries frequently revolve around two food categories, namely processed foods, in particular, the “ultra-processed” variants (Astrup and Monteiro, 2022), and animal-source foods, especially red meat, processed meat, and animal fat (Barnard and Leroy, 2020). These debates are not new; they were already part of the conversation led by diet reform movements prior to and during the Progressive Era in the United States (1890s to 1920s). The latter period was characterized by an interest in scientific management, fueled by both progressive ideals and wartime food rationing (in 1917), with the aim to increase efficiency and output and to improve public hygiene and health (Biltekoff, 2013; Veit, 2013). This implied the enforcement of standards and rules based on new scientific insights about calories and vitamins, since it was assumed that citizens were unable to govern their own bodies, leading to suboptimal societal performance (Biltekoff, 2013). Reformists advocated for governmental interference in American diets to steer public health toward an optimum, preferring a bland but “rational” New England diet over food choices driven by tradition or taste. Part of the movement, whether out of secular or religious motives, disapproved of red meat and some commonly purchased processed ingredients and foods (sugar and white bread), which were seen as harmful luxuries, while eulogizing whole grains, nuts, and fruits (Shprintzen, 2003). The First World War introduced additional reasons to restrict red meat, butter, sugar, and refined wheat at home, but this time from an economic, geopolitical, and logistical perspective (shipping food aid to Europe in a stable and efficient manner), which resulted in governmental calls for responsible citizenship, by stimulating meatless days and the consumption of wholegrains, while also praising “modern” processed foods like margarine, peanut butter, etc. (Veit, 2013). Reformist views were propagated by the discipline of domestic science, or home economics, institutionalized in the first dietetic associations, and taken up by the American progressive middle class (Leroy and Hite, 2020). In practice, this implied that dietary advice could now be used to delineate social norms and impose middle-class values through what appeared to be the neutral language of science (Biltekoff, 2013). After decades of shifting priorities and lobbying by opposing interests to either restrain or promote the role of specific food groups, dietary guidelines have attempted to limit the full human omnivore spectrum to what is deemed a healthy eating pattern. Such advice cannot be separated from its historical conditions of possibility, i.e., the ways in which it emerged as knowledge at the intersection of institutions, industry, discourse, and social practices, thereby gaining acceptance within society. The constructed notion of “eating healthy,” therefore, overlaps with that of “eating right” (Biltekoff, 2013; Veit, 2013). This prelude is not merely of historical interest; it illustrates how dietary opinions and beliefs are formed and reshaped over time, often under the influence of factors and processes outside of nutritional science itself. This may also help to explain the origins and nature of the healthy user bias in populations that are commonly the focus of observational studies in the nutritional epidemiology of chronic disease (Leroy and Hite, 2020). Healthy user bias occurs when individuals who engage in a particular health behavior also engage in other healthy behaviors that independently contribute to better health outcomes, distorting the apparent effects of the health behavior studied. 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