What makes that movie popcorn so bad for you?

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

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

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?

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"

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

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

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

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

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

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?

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

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

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"

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.org).

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

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

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.