The most boring advice: Everything is good in moderation

Collaboration with cooks in primary schools

A large part of her work has been collaborating with cooks in the City's primary schools and the kitchen at Vitatorg. Among her projects is a kitchen management system for both departments, which is currently being implemented. Once implementation is complete, anyone will be able to see the nutritional value of meals online and also access information about allergens and intolerances.

She also provided education to after-school program supervisors about what kinds of food would be good to offer, always basing this on the Director of Health's recommendations. This resulted in a visual guide with ideas. "I then created examples of varied after-school menus for several weeks. That gave them a resource to use for complying with the recommendations," says Ellen Alma.

The next project was collaborating with the cooks who prepare food for the city's primary school children. "We organized gatherings with the cooks and held an education day one summer before school started, which went well. There was great interest among them to meet," she says, and since then the education day has been held annually.

This matters because about 70% of primary schools have a cook who prepares food for the children. "They hadn't had a forum to meet, compare notes and share good advice," she says.

The recommendations aren't being revolutionized

The Director of Health recently introduced new dietary recommendations. "The recommendations are always updated regularly. But they're never radically altered. The scientific knowledge isn't being revolutionized, but research is always being added and the evidence becomes stronger regarding certain aspects," says Ellen Alma, noting that part of the current changes involves increasing consumption of fruits and vegetables and vitamin D.

"There are such significant positive health effects from eating lots of vegetables and fruits. At least five servings per day was recommended," she says, adding that a serving is about 100 grams, but "not a whole broccoli. One apple is often 160 grams," she adds. "This isn't an impossible amount being recommended," she says, with the current recommendation being 500-800 grams per day.

"These studies show that this is dose-dependent. The greater the amount, the more positive the health effects," she says, noting that only 2% of Icelanders manage to eat five servings per day according to the latest national dietary survey.

The power of social media is great

Ellen Alma says it's sometimes complicated dealing with those who want to fix problems by selling some product, supplements or vitamins to improve people's health. The power of social media can be great and not always for good. "There's a group that promotes themselves heavily and makes claims that we as nutritionists and health professionals wouldn't be allowed to make. We would lose our operating permit. These are people who don't have such an operating permit and are trying to sell some product or services. The only thing you can do is point out that this isn't something based on science," she says.

She says it should be enough for people to eat food to get nutrition and vitamins, except for vitamin D which all Icelanders should take as a supplement. "We get energy and vitamins from food. Today people have been sold on the idea that you need to buy supplements from a store to get vitamins. People have stopped connecting this to food. It's just not correct at all that you need to buy supplements if you eat a varied diet," she says, explaining that the situation is somehow such that people buy expensive protein powder and supplements but might not bring themselves to spend money on blueberries. The salesmanship is intense. The message is that if you buy protein powder and supplements you'll get more energy and health for your muscles. Understated messages, like telling people that eating more vegetables and fruits will keep them very healthy for a long time, don't hit the mark the same way.

"People want these quick fixes but don't necessarily want to adopt lifelong eating habits like we're trying to encourage. The big picture matters more than exactly what you do today," she says.

Getting nutritious lunch at school is important

She says school meals matter greatly, with lunch at school representing about 30% of the energy children get throughout the day. The goal is for children to get at least one nutritious, high-quality meal each day. "Children get vastly different food at home. It depends on the resources, ability and knowledge in their homes. There needs to be one place where we can ensure they get food that contains all the nutrients they need to function well in school, grow and develop normally. We need to guarantee they get nutritious food there because we don't know what's happening elsewhere. We can't control what people feed their children at home. The sad reality is that children have no say in what they eat at home. They're completely dependent on adults, who have varying resources and abilities to choose the right food for children."

She considers the introduction of free school meals a beneficial move. "When school meals became free, many more children started eating lunch at school," she says.

Schools offer meat or fish dishes along with vegetarian options. "There should ideally also be a salad bar they can choose from," she says, recalling a study from Rimaskóli where mixed salad was separated into individual containers and vegetable consumption increased fifteen-fold as a result. So presentation matters too.

"Our recommendation is to separate the vegetables. Then they're more likely to take a little to taste and there's a better chance their diet will become more varied," she says, recalling an example from a school where barley was added to the salad bar. "The longer it's there, the more likely the kids are to try it," she says.

At one school, two types of fish were regularly on the menu — both white fish and Arctic char. At first the kids didn't want the Arctic char, but now the pink fish is more popular. So persistence is important — if something stays on the menu long enough, kids are more likely to try it. She knows of another similar story about pearl barley. "This is the place where we should get them used to tasting and trying new things," she says.

Don't focus on what's forbidden

Schools offer many opportunities for food education, such as in home economics classes. "A home economics teacher who worked on a project with me at the university experimented with cooking recipes according to dietary recommendations," she says, referring to kids around 10 years old who usually hadn't seen white, raw fish before. "They tasted the fish because they were the ones who cooked it."

Ellen Alma is opposed to a "dos and don'ts" approach. "You shouldn't focus on what's forbidden but rather emphasize what you should eat more of, like fruits and vegetables. If you want to know what food is healthy and best for your body and mind, it's best to follow dietary recommendations from the Director of Health.

People are familiar with media reports claiming coffee is a cure-all one day and something no one should consume the next. That's because they only look at one scientific study at a time. "What's done with the recommendations is that all the research is compiled and the overall effects are examined," she says.

"If you look at your dinner plate, it should be roughly composed like the food wheel. About half should be vegetables and fruits. If you follow the recommendations, you don't need to worry, but you also don't need to worry if you can't follow them perfectly every day," she says.

Wishes she had better nutrition information as a child

She wishes she had had access to better nutrition information when she was a child. I'm passionate about getting this message to children who need it. That's why I find this work so important — what I've been doing in the schools."

Finally, if you could share just one message with everyone, what would it be?

"It would be this annoyingly boring phrase: everything in moderation. It's so boring but so true. You can eat whatever you want without worrying about it, as long as you focus on eating nutritious and varied foods as often as possible. Don't fall into all-or-nothing thinking — it's important to stay flexible."

Close to Katrínartún

She plans to maintain good relationships with her colleagues at the city since it's not far away — the Director of Health's office is located in the tower at Katrínartún, right next to Reykjavík City's building at Borgartún.

"The experience I've gained here has been so valuable because now I understand how things work in a large municipality. It's not enough to just create recommendations and send them out into the ether — you have to follow up," she says, envisioning future educational collaboration. "I've reached so many people through my work with Reykjavík City, but this new position is nationwide. Now I can start planting seeds across a larger area."

• View dietary recommendations