Change the Way We Eat

Items of interest with a personal connection....

2011-11-22T09:27:00.001-05:00

There's so much to report this week!

A very good friend and respected colleague of mine is on Dr. Oz today....again! This time she talks about the link between obesity and cancer. Here's a clip of what's to come: Dr. Kathleen Wolin talks about Obesity and Cancer on Dr. Oz.

The website for ChildObesity 180 has launched as well. Currently focused on three main initiatives (healthy out of school time snacks, healthier school breakfasts, and physical activity during school hours), this new Tufts project is very exciting! Check it out: ChildObesity 180: Reverse the Trend

And finally, my alma mater, Hotchkiss, gets mention in the NYT for their program that connects students to the land via farming on school property. I didn't think it was possible to love Hotchkiss more, but I absolutely do. Read more about the efforts at Hotchkiss and other New England schools:

Prep Schools Encourage Students to Learn to Farm

Perhaps Hotchkiss and the rest will start a nationwide trend!

Finally Fall!

2011-09-15T08:48:00.000-04:00

Happy Back to School! I love fall- for me, it's the time of year for new beginnings, new challenges, and, honestly, my birthday! It's the time of year where I feel like I get a fresh start. Which is why I'm so excited to follow my advisor, Dr. Miriam Nelson, as she tours the country visiting the Change Clubs!

What are they? US Today has a great article that talks about the Change Clubs and what tasks specific communities are tackling: Change Clubs get Americans Moving.

Want to follow Mim, Eleanor and Rebecca on their nine-week, cross-country trek? Check out the StrongWomen Tour site! I'll be peeking in every day!

Dietary Guidelines 2010

2011-01-31T11:14:00.001-05:00

Every five years, the USDA and HHS release updated Dietary Guidelines for Americans....and today is that day.

Four Key Recommendations:
1. Balancing Calories to Manage Weight
2. Foods and Food Components to Reduce
3. Foods and Nutrients to Increase
4. Building Healthy Eating Patterns

What I liked:
- The word LIMIT is back, and specifically refers to sodium, solid fats (read saturated fats, like those found in meat products), added sugars and refined grains.
- Specific foods are emphasized (as opposed to nutrients)(and they are done so in this order): Vegetables, Fruit, Whole Grains, Fat-Free or Low-Fat Milk products, Seafood, LEAN meats, Eggs, Beans and Peas, Nuts and Seeds
- In the specific messages for consumers: Make half your plate fruits and vegetables. This particular message is very strong, easily understandable to consumers and cannot be beat. I hope this particular message gets driven home the hardest.
- Also included in the consumer handout is the message to Drink Water instead of Sugary Drinks. See comments above.

What was disappointing:
- What happened to the strong recommendation about eating a plant-based diet?
- The message on sodium is very important, but it's asking a lot. It will require industry buy in, and I'd prefer to see an equally strong message about salt (what people consume) and salty snacks and convenience foods in particular.
- The Calorie Message: Do consumers get this? I think they don't and that it's a waste of space. Consumers don't count calories. The DGs would be better served talking about specific foods and food groups, not calories and nutrients (see comments on sodium vs. salt).
- The Building Healthy Eating Patterns is similarly weak. It also references calorie intake. Not very clear for consumers.
- The further reduction in Saturated Fat intake was not adopted. I think this was a trade-off in terms of emphasis...a greater emphasis was on sodium. It makes sense, but still.
- In the executive summary and key messages for consumers, the Physical Activity Guidelines were not specifically referenced. Getting more physical activity and reducing sedentary behavior is a good message- and it was highlighted- but the specific recommendations are more clear. How much and what kind of physical activity one does matters- and this needs to be communicated, repeatedly, to consumers.

So, I look forward to seeing what happens to the MyPyramid and other consumer messages. We'll see what happens...and how other leaders in nutrition and food policy respond!

Find further information, the Executive Summary and Consumer-Specific messages here.

A Bone to Pick with the USDA

2010-11-06T15:16:00.001-04:00

Yesterday, I was lucky enough to hear Kathleen Merrigan, Deputy Secretary of the USDA, give the keynote speech at Friedman's Annual Symposium. You *might* recognize her as one of Time Magazine's "100 Most Important People in the World". Well, I wholeheartedly agree. (I might be biased as she was one of my favorite professors during the master's program.)

One of the questions she fielded from the audience was about what the USDA was going to do to address the issue of SOFAs in the American Diet. (SOFAs stand for solid fats and added sugars. Not to be confused with the other "sofa" issue here in the States, mainly that people won't get off them.)

What Dr. Merrigan didn't mention was the checkoff programs currently in existence here in the United States. These are quasi-governmental bodies aimed at increasing consumption of certain key commodities produced in the US. I say they are quasi-governmental because, although they are really a part of AMS (the agricultural marketing service), they are paid for by taxes on industry and the boards of the committees include private sector players.

These programs are responsible for campaigns such as the milk mustache, "Beef. It's what's for dinner." and "Pork: The Other White Meat". All of these programs encourage consumption of products high in saturated (solid) fats. (Saturated fats are those fats that are solid at room temperature and are almost exclusively found in animal products.) This is in direct opposition to government health messages, such as the Dietary Guidelines, which call for Americans to "limit" (you should read that as "avoid") saturated fat. In fact, the current recommendations to the USDA by the Dietary Guidelines Advisory Committee actually calls for even lower recommended intakes for saturated fat (from 10% of daily caloric intake down to 7%).

This makes this report from the NYT especially disturbing. At a time when Americans are eating way too much saturated fat from cheese products, the USDA is teaming up with industry (Dominos, Wendy's, BK) to fund ad campaigns to encourage consumption?

It's enough to make you sick.

Maybe even give you a heart attack, and I do mean that quite literally.

Shape Up Somerville: Eat Smart, Play Hard

2010-11-04T16:03:00.000-04:00

Shape Up Somerville is an innovative, comprehensive lifestyle intervention designed to improve dietary habits and increase physical activity. It's a program run out of the research center that I am working for, and PBS just did an excellent report on it.

Check it out! (Reshaping Somerville)

I actually took general nutrition as an undergrad from Dr. Economos...I absolutely credit her with planting the seed that eventually led me back to Tufts for a Master's in Food Policy and Applied Nutrition!

Preventing Fractures

2010-10-25T09:04:00.000-04:00

Mim Nelson is quoted today in the WSJ: Building Better Bones.

Why Banning Soda Purchases for Food Stamp Users is Misguided

2010-10-07T07:06:00.000-04:00

I woke up (early) this morning to the following story: A Push to Ban Soda Purchases with Food Stamps. I just about fell out of my chair, not because of the story itself, but because I had just had a practice exam session with a colleague and we had discussed something very similar.

Essentially, Mayor Bloomberg has requested that the USDA allow NYC to ban the purchase of sodas and other sugary beverages (referred to from here on as SSBs, or sugar-sweetened beverages) using Food Stamps. First, I applaud the stance that Mayor Bloomberg has taken on health and the obesity epidemic. And I agree with him that we need to get the American public to drink less SSBs (but not just those who are using Food Stamps, a program which is now actually called SNAP, which is going to be relevant to my argument). I just don't agree that restricting Food Stamp purchases this way is either the right way to do it (in terms of stigmatization) or the correct way to do it (in terms of behavior change). And here's why...

First, how does Food Stamps, formally known now as the Supplemental Nutrition Assistance Program work? Food Stamps is a nutrition program that is a means-test targeted program, meaning your eligibility to receive benefits is based on your means (your income plus other assets). It's actually got another layer of targeting built in, in that you have to be interested enough in receiving the benefits (need them enough) that taking the time to apply and submit proof of income and assets is worth it. Once you qualify to receive benefits (the main test is having a gross income at 130% of the poverty line or less), then your benefit is calculated.

Here's where the "Supplemental" aspect of SNAP/Food Stamps comes in. Food Stamps are designed to be supplemental to your food budget. The underlying assumption is that, assuming you have income, you are putting some of that income towards food purchases. The benefit formula is as follows:

Benefit= Maximum Benefit- (0.3 times your income level)

Therefore, as your income goes down, your benefits will go up, and at a level of zero income, you will receive the maximum benefit. The current maximum benefit for a family of four is $668 per month. At levels of income above zero, it is assumed that 1/3 of your income will be spent on food.

This is a crucial point, as there are really two main buckets of people who receive Food Stamps benefits in terms of how the program affects their spending: Constrained and Unconstrained. Unconstrained individuals, because they are spending some of their income on food in addition to the benefits of SNAP, are not changing their spending habits- meaning that they are not spending more than they would like on food, and that Food Stamps is not increasing their purchasing of food to a level greater than they would prefer. In this case, Food Stamps acts as an income transfer: the cash that they would have already preferred to spend on food can now be freed up in their budgets to be spent on other needs. It is like giving these recipients a raise- their budget is increased, and there are no restrictions on their spending (aside from the fact that some things are banned under food stamps: non-food like liquor, and some prepared foods). The key point here is that they are spending more on food than their Food Stamp benefit alone.

Constrained individuals on the other hand are forced to buy food that they wouldn't otherwise buy. This indicates that they have needs greater than food (medical care, housing) but the government has essentially chosen for them that they will spend this benefit on food. It's not an income transfer in this case. Even at the same level of income as someone else, this group has different preferences (higher priorities than food spending) but are forced to spend Food Stamp dollars on food. This group would rather have cash that could be spent on their higher priority items.

The point I am trying to make here is that, for unconstrained individuals, banning the purchases of SSBs using Food Stamp dollars will not have the intended effect. If a given recipient prefers to purchase SSBs, it's simply a matter of shifting their food budget so that their own dollars are spent on SSBs and Food Stamp dollars are spent on something else. This group can still buy Sugar-Sweetened Beverages at the same rate previously, given how cheap SSBs are relative to other foods, particularly nutritious foods, in the diet. Only those very constrained individuals would have their purchases changed by this policy.

This is my first problem with this policy: it won't meaningfully change behavior among the targeted population.

My second issue is that it stigmatizes Food Stamp recipients. It restricts their choices, and in so doing, feels punitive. Food Stamp recipients are not the only Americans who are drinking far too many SSBs. I feel this policy is a lot of noise and attention for one that won't work in the way intended, and that time, money and effort could be better spent on policies that have a more effective design.

If we REALLY want to change the food choices that Americans generally, and Food Stamp recipients specifically, make, then I propose that we make fruits and vegetables cheaper. It's non-punitive. It's got potential to change behavior. One of the complaints that is often heard from Food Stamp recipients is that they would like to buy healthier choices, but that fruits and vegetables (and other non-processed foods) are so much more expensive. I could devote a hundred pages to how this happened (Thank you, Earl Butz), but the bottom line is that people's purchasing decisions are based on the relative costs of different foods, and if we make fruits and vegetables competitive with the reconstituted soy/corn blend junk that it competes with (re: pretty much all processed foods, including SSBs), we just might have the START to a solution. (By no means do I think this will be enough to fix the obesity epidemic in this country.)

Food Stamps, like all policy interventions, is not a perfect solution, but it is a rather elegant one. Like all policies, it's a compromise. It's designed to not distort the markets (by increasing food demand or imposing different consumption choices on the recipients), but at the same time allow the government to put a priority on food spending for low income families. From a free-market perspective, giving cash benefits would be the ideal market solution, but for obvious reasons, this is not politically very popular. Food Stamps tried to bridge this gap, and while it has its flaws, it does the best it can.

Birthday Post

2010-09-28T09:13:00.000-04:00

I can't come up with an adequate introduction to this video from the TED conference. Just go watch and see for yourself!

A lot of talk about food in the NYT today

2010-09-22T08:57:00.000-04:00

Check it out....

An editorial on antibiotic use in livestock.

The first paragraph of Thomas Friedman's op-ed highlights the way we're viewed by other countries.

More updates on the egg recall.

And more on the debate between sugar and HFCS (bottom line: no evidence they're significantly different...sugar is sugar and we need to eat A LOT less of it).

It's nice to see food politics taking center stage.

If PopTarts didn't exist.....

2010-09-19T18:57:00.000-04:00

what would you eat instead? That's the question that a brand manager for PopTarts claims that most consumers struggle to answer.

Let me help you out with this one: fruit and granola. Or some oatmeal with fruit? Or how about whole wheat toast with some delicious jam even?

Check out the report on CNN.

I'm off to go bemoan the state of the American diet.

My report on the recs for the 2010 DGs is coming. There are some interesting updates....

New Dietary Guidelines Advisory Report Released

2010-06-16T12:23:00.000-04:00

The US Dietary Guidelines Advisory Report has been released!

....and everyone has something to say about it:
The LA Times
US Food Policy (Parke Wilde's Blog)
Food Politics (Marion Nestle'sBlog)

Even Gawker has a post.

I'm still digging through it and will post my take on it shortly.

Compelling Arguement for Nationwide Salt Reduction Plan

2010-05-01T19:42:00.000-04:00

Salt has been in the news an awful lot lately, and many companies are moving to reduce levels in processed foods. Here's why this makes sense from a public health standpoint, as written by Dr. Katleen Wolin at the Siteman Cancer Center at Washington University's School of Medicine:

Why is reducing Salt in Our Food Important?

Not THAT again

2010-05-01T19:24:00.000-04:00

Food companies love, and I mean LOVE, to trot out the old "It's not us, it's you" argument about obesity. It's not our delicious, salty, high fat, high sugar, tasty snacks and sodas that are making you fat...it's that you are not exercising enough! Pepsico's Indra Nooyi is just the latest in a long line of companies making some version of this claim. The Wall Street Journal's health blog has a great piece on exactly why the math on this doesn't work.

Food companies don't want to admit that the hard sell they are giving us every day to buy their snack foods are part of the problem.

I recently made a similar point in one of my take-home finals (the books I referenced are listed below):

§ All that time we’re saving by eating more convenient processed foods? We’re not using it to exercise. The modern world has done an amazing job of making our lives easier. In fact, maybe it has made it too easy. A lot of these books make a strong case for unprocessed, home cooked whole foods- all foods that, by nature, don’t carry health claims. I strongly support this stance. And yet, we haven’t found the right balance between convenience and health. As big box supermarkets open in parts of the world primarily dependent on open air markets, there is a strong desire to press pause and prevent this occurrence. However, as Dr. Popkin implies, denying these folks the ability to shop in a convenient, climate controlled environment is denying them an improvement in standard of living, as well as ensuring population weight gain. The advent of processed foods, prepared foods and takeaway meals was both a reaction to more women in the workforce and a necessary factor for it. This, coupled with great strides forward in technology, has greatly increased our standard of living in the United States. However, as technology enriches our lives, our backsides widen. We’ve been fortunate to live in a world where technology has made our lives easier, but we’ve neglected the other side of the energy equation: expenditure. A number of the books I read pointed out the need for a greater emphasis on physical activity and exercise in our daily lives. Now that we don’t have to work so hard to survive, we will have to find ways to build meaningful energy expenditure back into our routines. It’s worth nothing this point because big food often takes the stance of supporting physical activity initiatives and promotes physical activity as the way to dig the country out of the obesity crisis (Brownell, Nestle and Popkin all note this big food tactic). In this way, physical activity has become another health claim by big food: it’s not us, it’s you. You just need to exercise!

Books referenced: Barry Popkin's "The World is Fat", David Kessler's "The End of Overeating", Michael Pollan's "The Omnivore's Dilemma", Kelly Brownell's "Food Fight" and Marion Nestle's "Food Politics"

Interesting quote in the most recent New Yorker

2010-05-01T19:07:00.000-04:00

In "The Talk of the Town" section of this week's New Yorker, there was a bit about different groups of Europeans stranded in the States due to the volcano eruption in Iceland. One such group was composed of Belgian college students. One of them, Jolien Demanet, said they were all missing vegetables, having subsisted on "burgers and paninis". She said, "If you want to eat a normal meal with vegetables here, you have to spend money".

Well, that just about sums it up. Junky food-like substances? Cheap. Actual vegetables? Not so much.

Introducing Sick Delicious

2010-04-22T12:42:00.000-04:00

I have two people whom I call regularly on to mitigate kitchen disasters, often as they are occurring. These people are Kate and Rachel Hull (have to distinguish her from my other best friend from high school, Rachel Phillips...yep, a pair of Rachels and they're awesome). This does mean I am often borderline hyperventilating and covered in flour at the time of the call, like the time Rachel helped me get the consistency for my gnocchi dough right by walking me through it, long-distance. Despite the fact that she could only hear my best-guess description of what was going on, the husband and I ate gnocchi that night. And now, this culinary goddess (well, she's a goddess of all things to me!) has her own blog:

Sick Delicious

She's an amazing cook. I love eating at her house. In fact, here are the beautiful desserts she made me for my bachelorette party. Yep, she REALLY loves me.

If you want to seriously improve your life by eating the best food ever, I suggest you get on over to Sick Delicious.

Dr. Miriam Nelson talks about women's fitness in USAToday

2010-04-20T14:58:00.000-04:00

I'm a big (read: HUGE) fan of Mim Nelson and this article from USAToday discusses the importance of physical activity and counting calories (have to do both to lose weight, and both are important in weight gain prevention).

Read it here: Women: Walk your way to life-long fitness

Ready to take control of your health?

2010-03-31T09:22:00.000-04:00

Want to take a proactive approach to your health? Check out yourdiseaserisk.com- an excellent online assessment tools with steps you can take to reduce your risk for various cancers, osteoporosis, heart disease, and stroke.

This was developed in part by a good friend of mine, Dr. Kathleen Wolin. She's a rock star!

Shut the front door!

2010-03-16T16:17:00.001-04:00

Take a look at this!

Saving the world....one lentil at a time

2010-03-16T15:22:00.000-04:00

Sometimes, I feel like all anyone does is point out all the things that are wrong in the world but no one wants to take the time to figure out what can be done...and even if they did, how would that apply to you, the individual? What can you do?

Here's an elegant summary of the global food market and its issues, as well as a step you can take to turn the tide:

How to feed the world?

I especially like how there is no implied good vs. evil in this clip. The message allows you to be the hero, and if we're going to fix the issue of how to feed the world (and feed them WELL), it will take all of us!

(What an excellent piece of social marketing.)

The only thing that the video neglects is that if you choose lentils over beef, the benefit is twofold: the planet AND your waistline. It's a win-win! (And lentils can be delicious. Scroll down past the enticing cookies and milk photo to get to the lentil soup at Pane e Pomodoro.)

School Lunch and Weight

2010-03-15T13:43:00.001-04:00

A new study indicates a link between school food and overweight/obesity, as discussed by Ed Bruske in today's Cafeteria Confidential article. (Ed Bruske also wrote an excellent series on cafeteria meals, Tales from a D.C. School Kitchen.)

I pulled this quote as I felt it said so much about this issue:

But this latest study points to something even more ominous that should occupy the attention of federal lawmakers: a growing bifurcation of the food system wherein poor kids are routinely subjected to cheap processed food that damages their health, while kids from wealthier families get access to the best our local farms have to offer. That is the underlying message of the growing Farm to School movement: that all kids deserve fresh, wholesome food, not just the ones whose parents shop at Whole Foods or the farmers market.

More studies like this one will undoubtedly show that school food quality is a social justice issue that demands immediate attention. And while some politicians might be loathe to pay for improving it -- that is, if they think about it at all -- it is also a health issue with potentially devastating consequences for the national budget.

Caring about the Why

2010-03-15T11:33:00.000-04:00

This morning, I was reading the article about the host of issues confronting the nation's sewer and water supplies (Toxic Waters- Saving the U.S. Water and Sewer Systems Would Be Costly) and it got me thinking. There are a lot of services that people want- and rightly believe- the government should provide (clean water, an education, public transportation, etc). But people balk at any increase in paying more than they already are. I worry that we're pushing off paying for needed repairs and maintenance onto the next generation. In the States, you get to have a say, but you also have to pay. You can't have better services without paying for them. When one of the residents, as quoted in the NYT article linked above, said that he didn't care WHY the water wasn't working, it fills me with a sense of defeat.

We should care why. We should care about the why of everything. Better solutions, a better tomorrow, all of this is built on the answers to the who/what/when/why/how of now.

(And yes. It's probably going to cost something.)

Food for Thought

2010-03-09T10:21:00.000-05:00

Great graphic on why a salad costs more than a big mac.....here.

Olympians and their McDonald's Meals

2010-02-25T11:55:00.000-05:00

The commercial where McDonald's seems to claim that you can "eat like an Olympian" by eating Chicken McNuggets makes me just about jump off the couch every time it comes on. I just highly doubt that athletes who take their sports this seriously and have worked this hard to get to the VERY top of the game eat very much food that is high in saturated fats, sodium, carbs, sugar, etc.

NPR addressed this corporate sponsorship just this morning, and Dr. Gary Bennett from Duke University spoke about it. I've worked for Dr. Bennett and have the highest respect for him.

Have a listen here:

Nestle and Ludwig call for ban on all Front-of-Pack Labeling

2010-02-25T11:24:00.000-05:00

There's been a lot of talk about the editorial written by Dr. Nestle and Dr. Ludwig in the latest issue of JAMA. Copies and commentaries can be found on the blogs foodpolitics and fooducate.

In an ideal world, I would love to see that. I think the labels create confusion and are more about marketing than health. A healthy diet is more than this or that single nutrient, but you'd never know it to look at the front of most products...low in this, high in that...compared to what and says who? I don't think these labels help consumers and I have grave concerns that they mislead many.

So what's to stop the government from stepping in? Well, big food for one. They have watched sales of products rise with certain health claims and ridden each wave of the "nutrient du jour" for years. (Remember when all of the sudden "whole grains" and "x grams of fiber" were on every package?) I suspect they will want to protect this valuable form of advertising that appears to be helping consumers to make the "better" choices they desire.

Another issue lies with the FDA. Consumers are confused as to what these claims mean and often assume that the government regulates them. Therefore, they think they are somehow sanctioned. On the flip side, many experts and the media claim these labels are unregulated. The truth is that there are regulations, but not only do some nutrition experts argue that they are not strict enough, they are also mostly unenforced. The FDA is under-funded and under-staffed. Playing label police is one of their many functions. Until they have enough funds and folks to enforce the rules, the rules don't really count. A plus side to banning all F-O-P health claims is that it would be a lot more straightforward to enforce.

While I think we're going to see some changes in health claim regulation in the next year, I expect a more incremental approach than an outright ban. We'll see how the interests of all the different stakeholders play out. But I can't help but hope that such a measure would go through.

Here's a good example of some of the confusion created by the status quo: A girl in my Health Claims class the other day said she bought "Whole Grain Cheezits" the other day (I see part of the problem as just buying Cheezits in the first place, but that's a post for another day). She said the front of the label claimed "5 grams of Whole Grains per serving" or some such. But she said when she flipped the package and looked at the Nutrition Facts Panel, there appeared to be ONE gram of fiber per serving. Now, most people don't often look at the NFP for reasons too varied to go into here. But here's what gets me: Whole Grains is not a synonym for Fiber. Fiber is what counts, and whole grain products should have more fiber. (Fiber added to products normally not containing much often means fiber from sources that are not digested the same, so things like "Splenda with Fiber" should be taken with a grain of salt. Not literally. Eat an apple if you want fiber and use the regular splenda would be my advice.) But there is confusion about whole grains and fiber, and due to current regulations and lack of enforcement, these claims for "whole grains" are at best confusing and, at worst, actively misleading.

Serving Size Chaos

2010-02-18T11:28:00.000-05:00

As we head into what will likely (read: hopefully) be a new era of labeling regulations, William Neuman's video for the NYT, "Serving Size Sleight of Hand" is an excellent look at the disconnect between stated serving sizes on packages and what we actually eat.

Check it out here: "Serving Size Sleight of Hand".

What makes that movie popcorn so bad for you?

2009-11-19T11:30:00.000-05:00

Often, it's coconut oil. 90% saturated fat. I feel like coconut oil is all over the place lately, such as in a big display at the checkout counter at Whole Foods in Cambridge the other day. Coconut oil is not a healthy alternative to anything. Despite the fact that it sounds healthy.

I want to reiterate that label reading is important.

More talk about movie popcorn at Well. Also, CSPI is a great source for level-headed, evidence based advice on nutrition.

Evidence

2009-11-19T10:40:00.001-05:00

The internet is a beautiful and dangerous thing. When a friend said she knew someone who had been diagnosed with hypoglycemia and asked me what that meant, I went looking for some resources I could link her to. The internet provided me with a wealth of reputable websites I could link her to that demonstrated, quite nicely, that hypoglycemia is a state, resulting from altered blood sugar levels, and not a disease or condition, like diabetes, which can cause hypoglycemia. (Check out this great site from the NIH if you are interested) Unfortunately, I also came across all kinds of quackery.

As a medical researcher, I spent years of my training focused on how to evaluate the evidence base. We do this often through systematic reviews and meta-analyses. We also learn how to generate reliable and valid original data, as through randomized controlled trials or observational studies. These might suggest that exercise reduces your risk of colon cancer (seen in a wealth of studies and confirmed through meta-analysis) or that, contrary to what the folks marketing SnackWells might want you to believe, all fats aren’t bad for you – just saturated and trans fats.

What alarms me is that the freedom of the internet allows anyone to make health claims without substantiating them in any form. So what can the average consumer do when faced with the assertion that, say, shark cartilage cures cancer? As with everything, consider the source.

Does the website provide the source of the information?

Does it cite a research study or set of research studies?

Did it come from a research study, done by an individual at an accredited school of medicine, nutrition, or public health? And was it published in a peer reviewed journal? If yes, that’s a good sign. If no, start to be skeptical.

Who is hosting or sponsoring the website? Is it someone you’ve heard of – a national organization – like the American Cancer Society, American Dietetic Association, or American Medical Association? Anyone can come up with the name of an organization so a fancy-sounding name doesn’t mean much.

There is LOTS of good science out there. And there is a LOT you can do to prevent disease (for some personalized tips, try Your Disease Risk). But there is also a lot of junk science.

BPA

2009-11-18T16:55:00.000-05:00

All this talk about BPA got me thinking it's time to toss (read: recycle) the old reusable plastic bottles we'd been using for the gym and at work/school.

But what about those expensive Sigg bottles I just purchased last summer before school? Were they lined in BPA? I'd heard that Sigg had BPA-free bottles, but had no idea if mine made the cut. Thankfully, TIME magazine has the answer: peer inside. If you have a shiny, coppery lining, it's not BPA free. If it's a pale, matte yellow, it's a keeper. Sigg claims that their old liners, with BPA, didn't leach the way plastic bottles did.

Read more about the controversy here.

As for us, we're switching to BPA-free stainless steel. In fact, I purchased ours through a charity started by my wonderful dentist and his family called One4Three. 100% of the proceeds go to providing clean water (through buiding wells and filtration systems) in Anitgua, Guatelmala and Gitwe, Rwanda. It takes the sting out of replacing those expensive Sigg bottles to do a little good in the world!

(If you would like to purchase a bottle, click here.)

Nutrition Myth of the Day: Does Saturated Fat fight Inflammation?

2009-11-18T14:00:00.000-05:00

The answer is no. Not surprising. Healthy fats are still unsaturated fats, like those found in vegetable oils (but NOT palm or coconut oil, which are loaded with saturated fat), and fish oils.

Read more here.

And cook with more heart healthy vegetable oils (0live, canola, etc) when you can. They are known to raise HDL levels in blood- the healthy fats that are protective against heart disease.

Wise Words from "The Economist"

2009-11-08T16:23:00.000-05:00

Regarding health claims and current attempts at reguation:

"A few helpings of vegetables will do more good than any probiotic yogurt."

Hear, Hear.

Juice Cleanses

2009-11-03T12:53:00.001-05:00

I often get questions about "cleanses" or juice fasts. Other than starving yourself to drop a few pounds in a few days, there's not much to it. I've heard all kinds of justifications for them, such as it gives your digestive system time to "rest" (as if it needs a break) and that it detoxifies your body (yes, one of the functions of the digestive tract is waste removal). Then, I read the following in the Dean's Letter for Tufts Nutrition, and think faculty member Dr. Edward Saltzman sums it up best:

In an Associated Press article about the popularity of fresh-squeezed fruit and vegetable juices, Associate Professor Edward Saltzman, M.D., debunked some of the more extravagant claims that such juices detoxify organs and cleanse the digestive tract. "I honestly don’t understand the concept of intestinal cleansing. It’s not like you’d find old tin cans or spare tires in the colon," he said. "Anything that results in increased motility or movement in the intestines, such as intake of fiber and fluid, would result in the evacuation of bowel contents."

Finally, these juice cleanse regimes are expensive. Spend those hard earned pennies on something else!

RIP Smart Choices

2009-10-30T14:26:00.001-04:00

Reports today that all eight food companies have opted out of the Smart Choices program...from Marion Nestle's Food Politics....

Well, you know I won't miss it.

Bad News for Smart Choices, Good News for Consumers

2009-10-15T11:49:00.000-04:00

Looks like Connecticut's Attorney General's office is taking a closer look at the so-called Smart Choices "It's better than a doughnut" label. Am keeping an ear out for any response from Tufts and other affiliated academic institution.

Strong words from the AG here.

More of the Same

2009-10-13T16:58:00.000-04:00

While I hate to be pessimistic, this latest partnership to combat obesity leaves me wary. The Healthy Weight Commitment Foundation, composed of a mix of food companies, supermarkets and NGOs, wants to reduce obesity through energy balance.

The focus seems to be increasing physical activity and "creating healthier options". My concern is twofold. First, what food companies consider "healthier options" often seems to be jamming a so-so (or plain awful) product with extra fiber or spraying it with vitamins. Putting fiber in pop-tarts or froot loops may increase your fiber intake, but it doesn't make that product an excellent source for whole grains, and it's still not a fruit or vegetable. The second issue is that increasing physical activity is only half the battle. Exercise alone is not enough. Food companies want you to exercise more, but still buy their products. Don't be fooled. They want you to EAT MORE. They aren't going to undermine their own profitability to promote good health. Their might be a way to align the two (food company profitability and good health), but, so far, these industry-sponsored initiatives haven't worked that way (see earlier posts on Smart Choices).

There IS good news, though. The RWJF's involvement as an independent evaluator means there will be more accountability than we've seen previously. Fingers crossed.

Nutrition Myth of the Day: Canola vs Coconut Oil

2009-09-29T16:48:00.000-04:00

In the brouhaha regarding all things corn, canola oil sometimes gets confused with it's lookalike, corn oil. Canola- it's not a fancy name for corn oil, it's an acronym standing for "Canadian Oil, Low Acid". And it's made from rapeseed. Rapeseed just wasn't the best name for marketing purposes, as you can imagine.

I have recently heard that there is some movement towards using coconut oil as a cooking oil substitute because it is a) not from corn and b) good for digestion.

Here's something that's not good for your digestion OR your heart....Coconut oil has approximately 11.8 grams of saturated fat per tablespoon, compared to approximately 1g per tablespoon for canola oil or 1.9g per tablespoon for olive oil. Saturated fat is the "bad" fat- it's the fat found predominately in animal fats. The Daily Reference Value for saturated fat is between 20-36g per day. Three tablespoons of coconut oil and you're pretty much done for the day!

Bottom Line: You're better off using actual lard, in terms of saturated fat content (which is arguably the most important consideration when choosing a cooking fat). It only has 5g of sat fat per tablespoon (source for all nutrient data: USDA National Nutrient Database). Horrifying, no?

I leave you with a quote about palm oil, another high sat fat vegetable oil, from Greg Crister's Fatland: How Americans Became the Fattest People in the World:

"There was one other thing: Palm Oil was such a highly saturated fat that its proponents secretly touted it as 'cow fat disguised as vegetable oil'".

Reader Question: Raisins-smart choice or concentrated blobs of sugar for my toddler?

2009-09-24T14:36:00.000-04:00

I have a reader! With questions! Here goes....

To find out how much sugar raisins have, I consulted the USDA's National Nutrient Database, which is a great source for finding out nutrition facts, especially for unlabeled goods like fresh produce. They also have nutrient facts for packaged goods.

Raisins wind up being approximately 60% sugar by weight. As a comparison, apples are 10.39% sugar by weight, bananas are 12.23%, and oranges are roughly 9.14%. So, they do look like concentrated blobs of sugar.

They also have less fiber than the fruits listed above (listed here in typical serving sizes):

small box raisins: 1.6g dietary fiber
medium apple w/ skin: 4.4g dietary fiber
medium peeled banana: 3.1g dietary fiber
medium peeled orange: 3.4g dietary fiber

However, I'm torn about telling anyone that feeding their child a whole food is a bad idea. Are there far worse things out there? Yes, of course. Do little kids love raisins because they are so sweet? Probably. Am I going to food police raisin eating? HECK, NO. I'll beat the moderation drum. Raisins as a snack or treat, and as part of a well balanced diet, are great. Personally, I believe that a child who thinks of fruit as a snack (and not chips, cakes or other highly processed snack foods) is being set on a path that encourages healthy eating for life.

Basically, I am Team Raisin. And Team Apple and Team Banana and Team Orange. Anytime your child eats a fruit or a vegetable, I am cheering for you.

Finally, I am happy to answer questions to the best of my knowledge, so please feel free to email me (changethewayweeat@gmail.com).

More on Smart Choices

2009-09-08T15:38:00.000-04:00

Seems like I am not the only one with Froot Loops on the brain....Mark Bittman chimes in on his blog, Bitten.

The Great Froot Loop Debate

2009-09-07T16:38:00.001-04:00

Lately, all I can think about is FROOT LOOPS. I've mentioned the Smart Choices Labeling Program before, but it's gotten under my skin again after an article in the NYT (For your health, Froot Loops). In it, Eileen Kennedy, the Dean of the Friedman School of Nutrition Science and Policy at Tufts University and the President of the "Smart Choices" board, defends the inclusion of Froot Loops in this way:

“You’re rushing around, you’re trying to think about healthy eating for your kids and you have a choice between a doughnut and a cereal,” Dr. Kennedy said, evoking a hypothetical parent in the supermarket. “So Froot Loops is a better choice.”

I am deeply concerned by this line of reasoning. What really confuses me is that the Smart Choice program itself states the intention of the program in the first paragraph on its own website as follows:

"No matter where you shop or what brands you buy - the Smart Choices Program, a new front-of-pack nutrition labeling program, helps shoppers make smarter food and beverage choices within product categories in every supermarket aisle."

There it is: WITHIN product categories. While you can always argue that Froot Loops has a place in a healthy diet under the umbrella of "moderation" and "as part of a healthy diet", the "Smart Choices" program was designed to help you choose a "smarter" (presumably, healthier) option within whatever category you are considering. If you are a mother standing in the cereal aisle, you have already decided to buy cereal, and doughnuts aren't part of the equation. And the "Smart Choices" program is designed to help you identify a "smarter" choice among the cereals you are faced with when you stand in front of that great wall of cereal. Cereals: That is the product category. That the defense of this program has to include a hypothetical situation involving doughnuts (from a different supermarket aisle entirely) is a red flag. It's not called the "It's Better than a Doughnut" program. I agree with the comment made by Walter Willet, chairman of the nutrition department of the Harvard School of Public Health, in the NYT article...these ARE horrible choices.

Equally unnerving are Dean Kennedy's comments that consumers "don’t want to be told ‘You must do this". Yes, I am sure that is the case, and no doubt why the program is called "Smart Choices" and not "You must eat this". My issue is that, while of course no one wants to be told what to do or eat, people DO seem to want some guidance in the grocery store, or these food companies wouldn't be lining up to pay up to $100,000 a year to be included in such a program. Obviously, food companies want you to eat what they are selling. But why is such an esteemed nutritionist backing this program?

Is telling people what they want to hear, instead of the truth, what we stand for at Friedman? I surely hope not.

Book Review: Kelly Brownell's "Food Fight"

2009-08-30T10:29:00.000-04:00

So, I have finally finished Kelly Brownell and Katherine Battle Horgen's "Food Fight: The Inside Story of the Food Industry, America's Obesity Crisis & What We Can Do About It". In all fairness, this book is about five years old, so it should come as no surprise that I felt like it was nothing I hadn't heard before. Still, I wanted to read it because Brownell is the director of the Rudd Center for Food Policy and Obesity at Yale (http://www.yaleruddcenter.or g).

While the book touched on many relevant topics, my chief complaint is that it felt too choppy, and sometimes repetitive. Almost every page had a bold heading, sometimes two or three. It doesn't seem to have a flow, and that makes it very easy to put down for long periods of time. Say, for months. Which is what I wound up doing, as I kept getting distracted by school work or a gripping novel. The upside is that it is easy to breeze through and find something you liked to reference again.

I am also not convinced that there is much hope for drawing parallels between tobacco and big food. I see the similarities, of course, but I think it's an awfully large leap to get people to vilify big food in the way that was possible with big tobacco. Big tobacco had one product. It was a known killer. It was addictive. Do I wish we could convince people to believe that fast food, soft drinks, and salty, high fat snack foods are as detrimental to your health, that eating this way will make you sick in myriad ways and potentially ruin your health? Sure. I just think trying to get people to look at Big Food as the same as (or even similar to) Big Tobacco is not the way to do it and relegates the whole food movement to a position that is untenable and un-winnable. Obviously, big food's primary interest is profit, not health. I know they can't be trusted to put the nation's health first (see Marion Nestle's discussion of the "Smart Choices" front of pack labeling program-disappointing and, sadly, unsurprising: www.foodpolitics.com/2009/08/smart-choices-44-sugar-calories/). Personally, I just don't think we can get critical mass on this point. It's hard to unravel the tangled web of Big Food and decide WHO, precisely, is the bad guy when the same company feeding you oatmeal is also selling you sugary sodas (that'd be Pepsi serving you up Quaker Oats). There's a way forward, but I don't think this is it. However, I plan to read Brownell's article "The Perils of Ignoring History: Big Tobacco Played Dirty and Millions Died. How Similar Is Big Food?" and let you know if I feel differently afterwards.

Overall though, the book had tons of great nuggets and succinctly described numerous studies and various successful or deceitful health programs (guess who sponsored those?). The section on the economics of eating and the discussion on taxing foods were both excellent and I will go back to them over and over again.

A similar book that I found more readable was Greg Critser's "Fat Land: How Americans Became the Fattest People in the World". This book came out about the same time as "Food Fight" and reads more easily. It is a brief and entertaining introduction to and history of American food policy, an explanation of the cultural changes that have occurred in the past thirty years, and it discusses many landmark studies in a way that is both easy to digest and keeps the story moving. It's a book that even those NOT obsessed with food and food policy can enjoy.

Next Up: "The End of Overeating" by David Kessler, MD

Hoopla over the new "FIVE" Ice Cream from Haagen Dazs

2009-08-27T17:45:00.000-04:00

Haagen Dazs, purveyor of amazing ice cream, has launched the campaign for its new ice cream line, "Five". Playing into the idea, popularized by Michael Pollan, that you should only eat those processed foods for which you are able to recognize all the ingredients listed (and the shorter that list the better), this new line has a total of five ingredients for each flavor. Each flavor consists of milk, cream, eggs, sugar and one of the following: vanilla, chocolate, coffee, mint, ginger, passion fruit, or brown sugar. Hence, Haagen Dazs Five.

Well, I couldn't help but wonder what changing the ingredients did to the fat content and calorie count of each. Dubious, I assumed that all of the above would rise, and while we're at it, sugar, too!

And I was WRONG. Granted, I only looked at three flavors (I do have an internship to do complete here, people): Vanilla, Chocolate and Coffee. In each of these, the calorie count, the fat content, the saturated fat content, and the sugar content were lower than in the original version, with only one exception (coffe's sugar content was the same for both five and original).

Per 1/2 cup serving

VANILLA FIVE	VANILLA ORIGINAL
220 calories	290 calories
11g - total fat	18g- total fat
7g- saturated fat	11g- saturated fat
22g sugar	26g sugar

COFFEE FIVE	COFFEE FIVE
220 calories	270 calories
12g- total fat	18g- total fat
7g- saturated fat	11g- saturated fat
21g sugar	21g sugar

CHOCOLATE FIVE	CHOCOLATE ORIGINAL	CHOCOLATE SORBET
220 calories	270 calories	130 calories
12g- total fat	18g- total fat	0.5g- total fat
7g- saturated fat	11g- saturated fat	0g- saturated fat
20g sugar	21g sugar	20g sugar

So, that's a piece of good news....although, your best bet, as always, is the sorbet.

It's making us sick, in the immediate sense, too

2009-04-13T08:32:00.000-04:00

Food Safety has become a hot button issue recently, as we reel from and react to tainted spinach, tomatoes and, now, peanut butter. A report from the NYT today runs with the headline that we're backsliding in terms of food safety (U.S. Food Safety No Longer Improving). (NB: The article states that for a variety of food borne illnesses, the evidence is not statistically significant.) Even the Associate Commissioner for Foods at the FDA, David Acheson, clearly states that the "FDA needs to do more inspections". I think they've known this is true for quite a while, and my question is HOW? And when?

One issue is that the amount of people who are made sick from food borne illnesses are really just a "best guestimate", which is derived from the amount of people who become ill enough to see a doctor and for whom the doctor then decides to request further testing. It's a little bit shaky, but shouldn't the point be preventing the illnesses altogether? I understand the value of determining a way to monitor and measure the amount of people made sick from food (in the immediate, not chronic/long term, sense), and the necessity of tracing the food back to the origin, but from a food safety perpspective, and a health perspective, shouldn't we focus more on stopping contamination at its source and having stringent enough regulations to make that a priority for food companies? Haven't we heard this story now three times?

(A more preventive-focused health care system would also be step in the right direction, but that's a blog for another day.)

It seems like most can agree the current system isn't working, but whether we can fix the system we have or need to draft a new "Department of Food" is up for debate (NYT's Room for Debate: Do we need a Department of Food?). The NYT article focuses primarily on issues of food safety, but if we're dreaming (and, at this point, I think we really are), why couldn't we have a department of food that coordinates with both the FDA and USDA, focuses on food safety, nutrition and public health, and food production's relationship with the environment (the health of the earth) and our own health? For too long, I think, there has been a tug of war between the USDA and the FDA, between nutrition and the enviroment, between cheap food and good food. There are a lot of problems, and I would ideally like to see a fresh start. One in which everyone involved, from consumers, doctors and public health advocates, the USDA, the FDA, DHHS, and environmental groups, work together to find a way forward.

While something like this may be possible in the long term, the folks in the Room for Debate article bring up that there are some immediate issues that need to be addressed before worrying over creating a new governmental agency. Solutions such as removing officials who advocate for agribusiness, creating tax breaks for companies that implement and follow food safety measures and hefty fines for those that contaminate the food supply are all excellent ones, and seem doable. I highly recommend the article.