Healthy Foods, Healthy Diets, and Healthy Eating: Beyond Ethics and Political Philosophy

Healthy Eating Policy and Political Philosophy: A Public Reason Approach by Barnhill and Bonotti is a terrific effort to provide a systematic method for appraising the ethical aspects, broadly understood, of regulations and policies connected to food, diet, and eating. In this commentary I purport to highlight the originality and the merits of the volume by considering what it doesn’t accomplish in three of its parts. I first call attention to the specific construction of the subject matter, namely on the question whether to be at stake are eating behaviors, dietary patterns, or certain food items; while Barnhill and Bonotti do not problematize it, this question is arguably pivotal to design effective policies and to adequately assess them. Second, I discuss the technical concept of “constitutive evaluative standards,” used by Barnhill and Bonotti to lay out their view, as this part of their work calls for an alignment with research on the philosophy of nutritional science and, more generally, philosophy of science. Finally, I take up the technical concept of “accessible reason,” which plays a central role in ascribing the public status to reasons, advocating for a more thorough determination of this concept based on recent work in epistemology.


Healthy Eating Policy and Political Philosophy: A Public Reason Approach
) is a terrific effort to provide a systematic method for appraising the ethical aspects, broadly understood, of regulations and policies connected to food, diet, and eating.In this commentary I purport to highlight the originality and the merits of the volume by considering what it doesn't accomplish in three of its parts.The choice to proceed this way is no doubt dictated by the complementary nature of my philosophical expertise; but, more importantly, I hope that my approach clarifies the pivotal role that the volume has in suggesting the urgency of certain of research topics for philosophers of food.
Given the occasion and the short space, my intention is not to provide a full-fledged answer to the questions I raise.Rather, it is to point out deserving issues that the book leaves unaddressed.These connect to the following three fields: ontology and metaphysics; 14 Page 2 of 8 philosophy of science; and epistemology.Hence, in the sequel, I first call attention to the specific construction of the subject matter, namely on the question whether to be at stake are eating behaviors, dietary patterns, or certain food items; while Barnhill and Bonotti do not problematize it, this question is arguably pivotal to design effective policies and to adequately assess them.Second, I discuss the technical concept of "constitutive evaluative standards," used by Barnhill and Bonotti to lay out their view, as this part of their work calls for an alignment with research on the philosophy of nutritional science and, more generally, philosophy of science.Finally, I take up the technical concept of "accessible reason," which plays a central role in ascribing the public status to reasons, advocating for a more thorough determination of this concept based on recent work in epistemology.

The Subject Domain
My first set of comments regards the exact subject domain of Healthy Eating Policy and Political Philosophy.Barnhill and Bonotti do not explicitly discuss the scope of their topic; rather, their analysis often shifts from eating behaviours, to dietary guidelines, to individual foods or meals.Clearly, these are not the same, as they pertain to different domains of discourse, namely, different entities, processes, and properties (initial reads on this topic include Borghini and Engisch 2021;Borghini et al. 2021;Borghini 2015 and2012).So, to put it bluntly, is the book after policy and political philosophy issues related to healthy eating, a healthy diet, or certain healthy food items?
The tone of this question is obviously theoretical.As such, it may appear to some reader as unrelated or not germane to the more empirical character of Barnhill and Bonotti's investigation, which seeks to inform policies that promote positive relationships between food and health.Yet, it is arguably desirable that we master the terms we use in policy discourses.So, for instance, if a policy argues for equitable access to a certain good, or for a democratic decisional process, it is desirable to characterize what equality and democracy stand for in these contexts.Similar considerations apply to the domain of discourse: depending on how we characterize it, many other aspects of the policy will have to be adjusted, too, including: the scope and scale of the phenomena under study; the stakeholders that are involved; the objectives of the policy; and the scientific and epistemological expertise needed to design and assess the policy.
In other words, as the domain of discourse shifts from eating to diets or to specific foods, we cannot assume that the framework needed to design and evaluate policies regarding such domain stays the same.Of course, certain ethical and political principles are valid across all sorts of fields of intervention-say, for instance, social justice, substance abuse, sexual education, etc.; but, Healthy Eating Policy and Political Philosophy promises to deliver something more specific than a generic framework and, what I am getting at, is that the overall perspective put forward by Barnhill and Bonotti should be complexified to accommodate for different domains of discourse.
For example, the concepts "healthy food" and "healthy diet" do not always align.In fact, a diet strictly made of healthy foods can sometimes be unhealthy: the paradox of orthorexia, to cite just a case in point, consists precisely in a diet of healthy foods that are consumed under an unhealthy psychological perspective and, probably, in unhealthy dietary patterns.Or, to offer a different example, "healthy eating" may sometimes be compatible with consuming generally "unhealthy foods," if it provides specific psychological or social benefits, or if it provides nutritional support for specific occasions (e.g., to recover from an eating disorder or from an intense physical training).
As a role of scholarship on food and health is to orient and systematize the jungle of actions undertaken by multiple regulators and actors, I take it pivotal to clarify which processes are under scrutiny.In what ways can we revise the framework to design policies that are sensitive to the specificities of the different domains of discourse?Clearly, this is a task that calls for a thorough study: as the domain shifts, the questions that the policy asks should be adjusted to reflect aspects such as: a specific food domain at the core of the policy; a temporal scale; an intended audience; any epistemic competence required to assess the policy; etc. Over-simplifying for the sake of exemplification: a conversation on healthy foods and food products will be highly focused on nutrients, production processes, and food systems; it will involve actors such as food producers, distributors, and market regulators; and it will require an expertise in producing food, rather than consuming it.Instead, a conversation on healthy eating will focus on modes and practices of consumption; it will involve psychologists, marketers, and assorted activist groups (e.g.linked to fat activism, eating disorders, etc.); and it will call not only for experts from the scientific community but also for the perspectives of actors that can represent communities and groups affected by healthy eating.The analysis offered by Barnhill and Bonotti is not sensitive to the different issues that arise in these two domains; a policy tool would arguably deliver more trustworthy, accurate, and precise suggestions for revisions if it were built to be more sensitive.
A part of the manuscript where the need of a theoretical refinement is most apparent is the discussion, in Chap.6, of evaluative standards.Within those, Barnhill and Bonotti include descriptive metaphysical standards, which they characterize as "metaphysical beliefs such as religious beliefs or beliefs related to supernatural or folk worldviews, the truth of which cannot be established via scientific enquiry" (Barnhill and Bonotti 2022: 157-158); in Table 6.1, they exemplify descriptive metaphysical standards also by referring to "commonsense metaphysical beliefs" (153).Yet, the above comments circa the ambiguity of the scope of the volume-is it about eating, dieting, or food items?-suggests precisely that there is much more to descriptive metaphysical standards than religious, supernatural, or folk beliefs.These fall short of capturing the complexity of the issues at stake.
Scientific inquiry cannot establish in and of itself ontological categories in the food domain; and those cannot be swiftly derived from commonsense reasoning.The business of doing metaphysics and ontology rests precisely on the fact that we need a concerted theoretical effort to deliver systematic and consistent representations of a domain of discourse; healthy eating is no exception.If we shift the domain from healthy eating to healthy diet or to healthy foods we are actually changing the terms of the debate; and, while certain of its overarching ethical dimensions may remain unvaried, we cannot assume that the rest of the framework will not be affected.
My suggestion is, hence, not only to complement the policy discussion with some indicator that takes stock of the domain of discourse, but that all steps of the policy design take stock the specificities of such domain.To insist on the parallel: if a policy aims to be democratic, each and all of its steps should comply with this aim; equally, if a policy aims to be for a healthy eating, all its steps should take into account the specific temporal scales, stakeholders, and complexities of diets-that differ substantially from those of healthy foods and food products.
In sum, as I see it, the theoretical effort by Barnhill and Bonotti advocates-albeit implicitly-for new avenues of research on the metaphysics and ontology of food, pointing out the need to provide a framework for addressing disputes regarding healthy eating 14 Page 4 of 8 efforts.Similar instruments have recently been provided with respect to other areas of dispute, including local food (Borghini et al. 2022), geographical indications (Borghini et al. 2023), and eating spaces (Bonotti et al. 2023).The call is for experts in food metaphysics and ontology, to lay out a framework that can accompany specific policy effort, e.g., efforts about healthy food production, about healthy dietary habits, about healthy meals, about healthy food products, or about healthy eating.Theoretical tools should be aligned to match policies, or else we would run the risk of crisscrossing and conflating-say-a bunch of healthy food for what constitutes a healthy diet or being served a healthy dish with what makes for an occasion of healthy eating.

Evaluative Standards
The case of descriptive metaphysical standards, brought up in the previous section, can also be regarded as the symptom of a more general issue with Barnhill and Bonotti's theoretical perspective on evaluative standards in Chaps.5 and 6.Their treatment is thorough and extensive; yet, as I shall try to motivate, it rests on the representation of a scientific debate which does not do justice to its complexity.
First of all, Barnhill and Bonotti build their view based on an infelicitous characterization of health.At the outset of their discussion, in section 5.2, they write: It might seem, therefore, that there is a shared, though narrow, conception of health: health as the absence of illness (excluding disabilities).We might therefore be hopeful that the aim of reducing rates of disease is a public health aim consistent with all reasonable conceptions of health.
Then again, in 5.3.3,Barnhill and Bonotti write: Even those who believe that health involves more than just the absence of illness are likely to agree that at the very least being healthy means not being ill.Now, this minimal conception of health, which would supposedly form the backdrop for a public debate on healthy eating efforts,1 is not only narrow.In fact, it is first of all ambiguous, as the first passage operates a shift from "illness" to "disease" that is somewhat puzzling: the two concepts arguably have different meanings even in everyday discourse; also, their theoretical kinship has been the subject of subtle studies since at least the classic Boorse (1975), and in the context of a discussion on public heath should be tied to broad empirical-ethical considerations (Seidlein and Salloch 2019).Thus, even assuming that health is related to the absence of some conditions, we should problematize more subtly between what such conditions are; while this is a task that does not strictly pertain to the ethical terrain where Barnhill and Bonotti dwell, it is troublesome that they assume an ambiguous definition.
In addition, and perhaps more importantly, the cited minimal conception sidesteps a longstanding debate that has shown the intricacy of the relationship between "disease" and "health," including the importance of seeing the multiple value-laden dimensions of "health" that are not connected to "disease."In fact, the very Constitution of the World Page 5 of 8 14 Health Organization states that "health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."(WHO 1992) While this conception of health may be regarded as inadequate by some, it strikes as implausible that Barnhill and Bonotti ground their view on a minimal conception of health that runs counter even to the WHO standards.
As it stands, then, the minimal conception cannot be endorsed.It would obviously violate the spirit of a public reason framework to ground the framework itself on an obsolete conception of healthy eating, which would constitutively leave out of the conversation important value-laden aspects.Hence, implicitly, Barnhill and Bonotti's work calls for the theoretical task of ascertaining a more palatable conception of health that can underly public discussions of policy efforts.It is here that the complexity of the contemporary scene in nutrition science becomes relevant.
Even assuming that "health," "disease," and "illness" are somehow related, which nutritional responses can be considered diseases or illnesses?A well-known example, here, are food allergies (Glabau 2022): when is it that a patient is allergic and when is it that an allergy can be regarded as an illness or a disease?In addition, which aspects of human nutrition contribute to form diseases or illnesses?There are many approaches to nutritional science today and a varied constellation of actors and stakeholders: in what ways can we account for this complex picture in a public debate on healthy eating, healthy diet, or healthy food?Suppose that, upon scrutiny, we cannot find the common minimal standard that Barnhill and Bonotti invoke: what are the consequences for their view?
In short: rather than assuming the existence of a minimal conception, Barnhill and Bonotti's perspective ought to be linked to the multifaceted debate on the scientific status of nutrition science (see, for a short sample, Scrinis and Monteiro 2022, Jukola 2019, Landecker 2015).This is a delicate task, which requires careful study.Only once we cast a better light on the different uncertainties and issues there are with constructing even a minimal shared view of nutrition and, from there, of healthy nutrition, a healthy diet, and healthy foods, we can establish a credible link with a political philosophy on this topic.

Accessible Reasons
The third and final topic I wish to discuss is related to evaluative standards, but it focuses on the epistemic underpinnings of the accessibility account for public reasons provided by Barnhill and Bonotti.In a framework that sees a policy as ethically viable only if it is justifiable in terms of public reasons, it becomes crucial to define what constitutes a public reason.Drawing from the literature on public justification, especially Vallier 2014, Barnhill and Bonotti go through three options, which should be quickly and cursorily summarized.According to the first, a reason becomes public when it is intelligible to some members of the public, according to their evaluative standards; this view is deemed as too permissive, as it leaves room for quirky evaluative standards and forms of reasoning to be endorsed.According to the second option, a reason is public when shared across the members of the community targeted by the policy, i.e. if all members regard it as justified; this proposal, instead, is considered as too optimistic, as no policy could ever reach such a consensus.According to the third option, a healthy eating policy is publicly justifiable if the reasons for the policy being endorsed are accessible to the relevant stakeholders.This is the one adopted by Barnhill and Bonotti; as they put it: 14 Page 6 of 8 While it [the accessibility conception of public reason] does not demand that a reason be shared amongst all citizens in order for it to be suitable for public justification, it does require that any reasons put forward in public justification should be grounded in evaluative standards that are widely shared (rather than in evaluative standards that are endorsed by only one or a few specific person(s))" (130).Now, under which conditions a healthy eating policy can be seen as accessible by some actor?At the beginning of 5.3, citing Vallier, Barnhill and Bonotti state: according to the accessibility conception of public reason, a reason R A can offer a suitable public justification for a law or policy if it is accessible to all citizens at the right level of idealization, i.e. if they 'regard R A as epistemically justified for A according to common evaluative standards' (130).
A few pages later, in section 5.3.3,they add: Under the accessibility conception, healthy eating efforts could be publicly justified by reasons that appeal to shared evaluative standards.These may include, e.g., the methods and standards of the natural sciences (139).
The latter part of this passage leaves much room for speculation.What are the methods and standards of the natural sciences that Barnhill and Bonotti refer to?While the accessibility account can be traced back to Rawls, the structure of scientific research has evolved quite dramatically since Rawls.In this sense, Barnhill and Bonotti's work showcases the need to design a conception of accessibility that is in keeping with the messy structure of contemporary scientific research on nutrition and that can thus keep into account processes and methods such as citizen science, privately funded research, and multiple contrasting approaches.Are there really core methods that are shared?If not, how can we envisage a plausible conception of accessibility?
A second aspect of the accessibility relation that seems in need of improvement or, at the very least, of further discussion concerns its sensitivity to different actors.The homogeneity of science and scientific knowledge envisaged by Rawls seems inadequate to capture the current scenarios where healthy eating policies are debated.Towards the end of Chap.5, Barnhill and Bonotti suggest adopting an indirect model, where only certain actors (e.g.scientists and regulators) would join the public debate on behalf of all other actors too.Yet, this solution risks not only of being seen as elitist: it again undermines the complexity of scientific discourse.What sorts of reasons are at stake in a discussion regarding healthy eating policies?It may be opportune to tell apart between different varieties, including: reasons for (different forms of) experts; reasons for stakeholders; reasons for an educational or dissemination or policy setting; and reasons for lay people.What we need, then, are criteria to tell apart different sorts of reasons and, depending on the issue at stake, we can compose an adequate panel of people to represent societal actors.
These topics are widely discussed today, but what is needed is a clear link with the political philosophy perspective put forward by Barhnill and Bonotti.So, here it is an additional task that deserves a separate discussion and future research.

Conclusions
One can conjecture that Barnhill and Bonotti do not address the issues I surveyed in my short commentary because they do not pertain to ethics or political philosophy.As they make clear since the first page of the Introduction, their attention is on the "ethical assessment of healthy eating efforts, namely issues related to respecting diverse conceptions of the good and diverse perspectives and practices vis-à-vis eating and health."My remarks have shown the need to develop parallel tools to those delivered by Healthy Eating Policy and Political Philosophy: tools that would push philosophical reflection on healthy eating policy beyond ethics and political philosophy, informed by scholarship in metaphysics and ontology, philosophy of science, and epistemology.