Search results: a life in food

Earlier this week I received a 3-page, single-spaced letter—plus 4 pages of charts and figures–from Andrew Briscoe III, the President and CEO of the Sugar Association.

I opened it with some trepidation because the last letter I got from the Sugar Association threatened to sue me (to read it, click here and scroll down to the Controversies section).

Whew.  This one merely expresses general concerns about:

the misinformation reported on added sugars consumption and the overstatement of added sugars contribution to increased caloric intakes.  Americans do not consume 25 percent of their calories from added sugars. We write to provide you with accurate data….

I don’t think I ever said that the average American consumes 25% of calories from sugars (although some surely do) but I have complained that the Institute of Medicine’s “safe” level of intake of sugars is 25% of calories.  This is higher than public health recommendations to restrict sugars to 10% of calories or less.  It is meant as an upper limit, but is often interpreted as a license to eat this much.

One quarter of daily calories from sugars is too high for something that provides no additional nutritional value.

The letter concludes:

The Sugar Association is committed to ensuring that all advice consumers receive regarding sugar intake is based on the best available scientific evidence and related data.  The American consumer will be better served by dietary advice that is science-based, practical and accurate, no matter the issue.

Can’t argue with that.  But as with all matters concerning nutrition, the issue is which science you choose to cite and how you interpret it.

Mr. Briscoe uses the term sugars, plural, because sucrose, HFCS, syrups, honey, and other such things are all sugars.

How much do Americans actually consume?  Mr. Briscoe was kind enough to provide USDA tables that address this question.  These describe the availability of sugars in the food supply, not necessarily what people are actually eating.

My interpretation of the tables is that they say:

• Sugars comprise 17% of total calorie availability.
• Adjusted for waste, the availability of sugars is about 27.5 teaspoons per day per capita (meaning everyone:  men, women, and tiny babies).
• Translating this into calories: 27.5 teaspoons x 4 grams per teaspoon x 4 calories per gram = 440 calories per day per capita.
• On a 2000 calorie diet, that’s 22% of total energy intake, although it will be lower for people who take in more calories.

The CDC has just released a summary of intake of added sugars among children and adolescents, in calories per day.

At 4 calories a gram, 400 calories is 100 grams or 3.5 ounces.  Can these calories contribute to weight gain or other health problems?

You bet.

As Mark Bittman put it in his New York Times column this week,

Let me state the obvious: there is no nutritional need for foods with added sugar.

All of this is part of the bigger question: How do we regulate the consumption of dangerous foods? As a nation, we’ve accepted the need to limit the marketing and availability of tobacco and alcohol. The first is dangerous in any quantity, and the second becomes dangerous when overconsumed.

And added sweeteners, experts increasingly argue, have more in common with these substances than with fruit.

No wonder the Sugar Association uses its own interpretation of the science to suggest that current levels of intake are benign and that no level of intake poses a risk.  Mr. Briscoe’s letter says:

No authoritative scientific body that has conducted a major systematic review of the scientific literature has a found a public health need to set an Upper Level (UL) for total or added sugars intake.  Every comprehensive review of the scientific literature concludes that, with the exception of dental caries, no causal link can be established between the intake of sugars and lifestyle diseases, including obesity.

I’m glad he mentioned dental caries.  Karen Sokal, a physician in California, has been tracking the onset of tooth decay among children in Latin America who are now consuming sodas and candy on a daily basis.  She writes:

Mark Bittman’s excellent editorial, “Regulating our Sugar Habit,” (Feb 27) concludes that eating too much sugar has become “the biggest public health challenge facing the developed world.”  Indeed, it poses a big health challenge for the entire world, especially developing countries.

In my 30 years of global health work, I have seen an explosion in the marketing and consumption of non-nutritious foods and beverages followed by a dramatic rise in childhood tooth decay and obesity. Quarterly business reports praise the food and beverage industry’s increased profits based on increased sales in “emerging markets.” The NY Times article on Kellogg’s purchase of Pringles (Feb 12) stated, “The snack business is growing faster and has greater appeal internationally,” which analysts noted “appears somewhat out of sync with the trends toward better-for-you snacking.”

Governmental regulations to ensure the production and marketing of healthful food and beverages must be applied worldwide and protect the health of the world’s most vulnerable populations.

Indeed, they must.  The Sugar Association has much to answer for in its opposition to public health recommendations to eat less sugar.

My weekly Q and A for NYU’s student newspaper, Washington Square News

Nutritionist’s Notebook: Snacks on a schedule

by Marion Nestle

Published February 28, 2012

Marion Nestle is the Paulette Goddard professor of Nutrition, Food Studies and Public Health at NYU Steinhardt School of Culture, Education, and Human Development. She is the author of “Food Politics” and, most recently, “Why Calories Count: From Science to Politics.” Each week, she will answer student questions about nutrition, health, and food. 

Question: Do you have quick food recommendations for busy students who tend to skip breakfast/lunch or who don’t have time due to busy scheduling? Are there any grab-and-go options that you would recommend?

Answer: From the perspective of nutrition, two principles apply to on-the-go food. Look for fruits and vegetables whenever you can get them, and choose foods that are as unprocessed as possible. The closer you can get to eating basic foods, the more nutrients they contain for their calories — in nutrispeak, they are of high nutrient density.

To see what options might be available, I went to the dining hall at the Kimmel Student Center. Alas, chips are at every counter and cash register. You can do better.

Some healthy choices are obvious: bananas, pears and five kinds of apples. Others are carrot packs, yogurt, hard-cooked eggs, and hummus with pretzels.

You have to search hard for the other interesting options. A helpful manager pointed to snack packs of organic dried banana chips, mangos and goldenberries. Goldenberries look like raisins, which would be another good choice, but I didn’t see any. I also didn’t find any packages of nuts. These are great as long as you don’t eat too many. If you want your dorm cafeteria to carry items like this, ask!

Sandwiches work if they are not too big and unwieldy. The Pret a Manger on Astor Place offers half sandwiches in a stiff, thin cardboard. These are easy to eat on the run.

I avoid power bars. They violate my “no more than five ingredients” rule and I don’t particularly like the way they taste. If I want something sweet, I’ll go for the dark chocolate Brazil nuts I found at Kimmel. If you just eat a couple at a time, they are worth the price.

A version of this article appeared in the Tuesday, Feb. 28 print edition. Marion Nestle is a contributing columnist. Email her at dining@nyunews.com.

In an op-ed in the New York Times this week, Blake Hurst takes on the Chipotle video that got national attention when played during the Grammy Awards. 

If you have not seen this advertisement for Chipotle Mexican Grill, it is well worth a look. 

Coldplay’s haunting classic “The Scientist” is performed by country music legend Willie Nelson for the soundtrack of the short film entitled “Back to the Start.” The film, by film-maker Johnny Kelly, depicts the life of a farmer as he slowly turns his family farm into an industrial animal factory before seeing the errors of his ways and opting for a more sustainable future. Both the film and the soundtrack were commissioned by Chipotle to emphasize the importance of developing a sustainable food system.

The video has had immediate effects.  Hurst, a former hog farmer who is now president of the Missouri Farm Bureau, notes that “The day after it ran, McDonald’s announced that it would require its pork suppliers to end the use of gestation crates.”  Unfortunately,  as Grist points out, this announcement could just be “porkwashing” since the company neglected to say by when. 

And then Bon Appétit  Management Company announced a comprehensive animal welfare policy that phases out gestation crates by 2015.

Hurst defends the use of sow gestation crates. 

These crates do restrict pigs’ movements, but farmers use them to control the amount of feed pregnant sows consume. When hogs are grouped in pens together, aggressive sows eat too much and submissive sows too little, and they also get in violent fights at feeding time. The only other ways to prevent these problems are complicated, expensive or dangerous to the pigs.

Really?  I was a member of the Pew Commission on Industrial Farm Animal Production.  Our report, Putting Meat on the Table: Industrial Farm Animal Production in America, came out in 2008.

During the course of the investigations that led to this report, we visited an industrial hog farm in Kansas where I got a first-hand look at sow gestation crates in (in)action. 

I knew about sow crates, of course, but even so was completely unprepared for the sight of a pregnant sow confined between bars that allowed her only to stand up, lie down, and eat—during the entire 115 days of her pregnancy. 

When we asked why this was necessary, we got this answer: it is easier for the managers. 

• Workers do not have to be trained in animal husbandry.
• Cleaning chores are easier. 
• Feed can be measured.
• The sows cannot fight.
• The sows cannot kill their babies.

Seeing my evident distress, Bill Niman, who was also on the Commission, offered an antidote.  The next day, we drove 100 miles or so and visited Paul Willis’s hog farm.  This is featured in another Chipotle video. 

Willis claims that his relatively free-range sows (confined in fields by electric fences) are nearly as productive.  His animals get to roll in the mud.  They do not fight and do not kill their piglets.

Yes, their meat ends up on the plate no matter how the animals are raised.  But means matter as much as ends. 

Kindness to animals is a  mark of humanity. 

Getting rid of sow crates is a good idea, and the sooner the better.       

USA Today has picked up the various Internet petitions—SignOn, FoodDemocracyNow, CredoAction, etc— to fire Mike Taylor, the head food safety person at the FDA. 

When the FDA hired Mike Taylor nearly three years ago, I wrote a long post reviewing his complicated employment history: Monsanto, FDA, USDA, Monsanto, private sector, university, FDA—a classic example of the “revolving door.”.    

He was at FDA, although recused, when the agency approved GM foods and denied labeling. 

But at USDA, he was a public health hero to food safety advocates.  He was responsible for installing food safety oversight systems that have greatly reduced contamination outbreaks from meat and poultry.

 He was hired at FDA to do the same thing, which is why I thought his appointment made sense at the time.  I thought he ought to be given a chance.

 He has now become the flashpoint for public anger at FDA over issues that include GM foods but go well beyond them:

• Failure to require labeling of GM foods
• Failure to recognize the scaled-down safety needs of small farmers
• Failure to enforce and punish food safety violations by large producers
• Unfair enforcement of food safety procedures against small producers
• Clamping down on raw milk producers

As I explained to USA Today, I’m a big fan of MoveOn and grass-roots political action, and I’ve been advocating for GM labeling since I was on the FDA Food Advisory Committee in 1994 (if only they had listened to me).

But I don’t exactly get where the “fire Monsanto Mike” movement is coming from nearly three years after he was hired.   Why make the political so personal?

As I told USA Today,

What would firing Mike Taylor do? It would show the muscle of the anti-corporate food movement, says Nestle, “and there’s much to be said for that.” However, she questions whether Taylor leaving would do anything to advance the goals of this loose coalition of activists. “Will it make the FDA listen more carefully to demands that it keep its priorities where the most serious food safety problems are? I don’t know.”

All of the issues mentioned in the petitions are important.  All are complicated.  All deserve serious thought and attention to political goals.  Will firing Mike Taylor advance those goals? 

I don’t see how.

What am I missing here?

 

So many comments came in to my blog post on Paula Deen’s diabetes announcement, “weighing in on Paula Deen,” that I thought it was worth revisiting in my monthly (first Sunday) column in the San Francisco Chronicle.  The question (edited) came from a blog reader:

Q: I have been diagnosed with type 2 diabetes and am very confused about insulin resistance, and what carbohydrates I can and cannot eat. So much of what I read is contradictory.

A: The first line of defense against type 2 diabetes is weight loss, but you would never know it from listening to Paula Deen, the celebrity Southern cook who recently announced that she has this disease, or even to the American Diabetes Association.

Having diabetes is no joke. It is a leading cause of blindness, kidney failure, leg and foot amputations, and premature death.

The disease comes in two forms – type 1 and type 2 – but type 2 accounts for 95 percent of cases. In both, levels of blood sugar are too high as a result of problems with insulin, a hormone that enables the body to use blood sugar for energy. But the reasons differ.

Type 1 is an autoimmune disease. It causes the pancreas to stop making insulin or not make enough. Type 1 is not yet preventable and requires insulin treatment.

In type 2, insulin may be available, but body tissues resist its use.

Being overweight is the key factor in type 2. Most people can prevent it by not gaining weight. And most people with the type 2 disease can eliminate symptoms by losing some weight.

Genetics is certainly a factor – many overweight people never develop the disease – but 85 percent or more of people diagnosed with type 2 diabetes are overweight or obese.

In genetically predisposed people, being overweight causes insulin resistance. Metabolism does not handle excess calories very well, and this means calories from any source, not just carbohydrates.

Fast food, soft drinks

Children and adults who habitually consume fast food as well as soft drinks tend to take in more calories and weigh more and are more likely to develop symptoms than people who eat healthier diets and are more active.

This makes healthy eating and physical activity the most important approaches. The vast majority of overweight people at risk of type 2 diabetes can prevent symptoms by losing a few percent of their body weight and doing a couple of hours a week of moderate – not necessarily vigorous – physical activity. The same works for treatment. Some people will still need medications, but the drugs work better with diet and physical activity.

As the Centers for Disease Control puts it, “all diabetes-care programs should make healthy weight a priority.”

Dietary advice for type 2 diabetes is the same as advice for everyone else: Eat a wide variety of relatively unprocessed foods, especially vegetables, fruits and whole grains, and don’t consume too much junk food or too many sugary beverages.

Scientists may argue endlessly about the relative importance of calories, sugars and refined carbohydrates in the diets of people with type 2 diabetes, but everyone agrees that eating less of all three would help resolve symptoms.

Why isn’t weight loss better recognized as a treatment strategy? Paula Deen’s announcement said nothing about losing weight.

The ADA does talk about weight loss on its website ( www.diabetes.org), but you must search hard through several complicated screens before you find, “Losing just a few pounds through exercise and eating well can help with your diabetes control and can reduce your risk for other health problems.”

Pharmaceuticals

I can’t help wondering if the lack of prominence given to weight loss might have something to do with the influence of pharmaceutical companies.

A few years ago, I gave a talk on the importance of weight loss in control of type 2 diabetes at an ADA annual meeting. Although many conference talks dealt with drug treatment, mine was the only one on diet – except for a session on sugars sponsored by Coca-Cola.

The exhibit hall was packed with drug company representatives dispensing free pens, writing pads, books, lab coats and stethoscopes – all with corporate logos.

The influence of drug companies on diabetes advice is worth attention. Deen represents a drug that costs hundreds of dollars a month. Drug companies give the ADA millions every year.

Eating less and being active make no money for anyone (unless people can be induced to join commercial weight-loss programs).

Losing weight is a losing battle for many people. It’s hard to lose weight in today’s “eat more” food marketing environment.

Teachable moment

But a diagnosis of type 2 diabetes should be a teachable moment. Shouldn’t the ADA more strongly urge people with the disease to eat less, eat better and move more, and help everyone find ways to cope with “eat more” messages?

The health and economic costs of type 2 diabetes, and its preventability, are reason enough to demand changes in the food environment. The ADA should be working hard to make it easier for everyone to eat more healthfully, be more active and avoid the need for a lifetime of diabetes medications.

Marion Nestle is the author of “Food Politics” and “What to Eat,” among other books, and is a professor in the nutrition, food studies and public health department at New York University. She blogs at www.foodpolitics.com. E-mail comments to food@sfchronicle.com.

This article appeared on page G – 4 of the San Francisco Chronicle

The latest obesity statistics from the Centers for Disease Control and Prevention show no change over the last several years in either adults or children.  No change is good news.

For adults in 2009-2010 the prevalence of obesity was 35.5% among men and 35.8% among women.  Obesity, in these surveys is defined as a Body Mass Index (BMI) at or greater than 30.

This represents no significant overall change compared to rates in 2003-2008.  

Going back to 1999, however, obesity rates increased significantly among men in general, and among black (non-Hispanic) and Mexican-American women in particular.  In more recent years, the rates among these groups leveled off.

 For children and adolescents in 2009-2010 the prevalence of obesity was 16.9%.  For this group, obesity is defined as a BMI at or greater than the 95th percentile of weight for height.

This represents no significant change compared to rates in 2007-2008, but with one exception: the rate of obesity among adolescent males aged 12 through 19 increased.

For decades, rates of overweight and obesity in the United States stayed about the same. But in the early 1980s, rates increased sharply and continued to increase through the 1990s.

The increases correlated closely with deregulatory policies that encouraged greater farm production and loosened restrictions on food marketing.  These led to an increase in the number of calories available in the food supply, pressures on food companies to sell those calories, a proliferation of fast food places, and marketing strategies that made it normal to drink sodas all day long, and to eat everywhere, at all times of day, and in larger portions.

Why are obesity rates leveling off now except among boys?  Nobody seems to know.

I can make up several reasons, all speculative (and I have my doubts about most of them).

• People have gained all the weight they can and are in equilibrium
• People are more careful about what they are eating
• The poor economy is encouraging people to eat less
• Junk food marketing is targeted more to boys
• Girls are more careful about their weight
• Boys are particularly susceptible to “eat more” marketing pressures
• Boys are under greater psychological tension and eat to relieve it

Anyone have any better ideas?  It would be good to figure out the reason(s) as a basis for more sensible public policy.

The huge fuss over Paula Deen’s type 2 diabetes is understandable.   She is, after all, the queen of high-calorie Southern cooking.  And diabetes rates are especially high in the South.

Perhaps less understandable is the reaction of the American Diabetes Association.  As reported in the New York Times,

Heredity, according to the American Diabetes Association, always plays some part. “You can’t just eat your way to Type 2 diabetes,” said Geralyn Spollett, the group’s director of education.

Wrong.  You most definitely can eat your way to type 2 diabetes.

Type 2 diabetes is closely linked to overweight and obesity.  No, not everyone who is overweight develops type 2 diabetes.  But most people who have type 2 diabetes are overweight.

The first line of defense?  Lose a few pounds.  Even a relatively small reversal of calorie balance can make symptoms of type 2 diabetes disappear and reduce or eliminate the need for drugs.

Mrs. Deen does not mention weight as a factor in her disease, or losing weight as an effective treatment.

Instead, she is now a spokesperson for the drug Victoza.

According to the Times’ account, Mrs. Dean says that it is elitist to criticize her food:

You know, not everybody can afford to pay $58 for prime rib or $650 for a bottle of wine. My friends and I cook for regular families who worry about feeding their kids and paying the bills.

Really?  Does Mrs. Deen think those families can afford to pay the $500 a month drug companies charge for Victoza?

Victoza costs in other ways too.  It has to be injected and is not exactly benign.

Victoza^® is not recommended as the first medication to treat diabetes. Victoza^® is not insulin and has not been studied in combination with insulin…It is not known if Victoza^® is safe and effective in children. Victoza^® is not recommended for use in children

In animal studies, Victoza^® caused thyroid tumors—including thyroid cancer—in some rats and mice.  It is not known whether Victoza^® causes thyroid tumors or a type of thyroid cancer called medullary thyroid cancer (MTC) in people which may be fatal if not detected and treated early…Inflammation of the pancreas (pancreatitis) may be severe and lead to death.

The company also advises:

Victoza^® is an injectable prescription medicine that may improve blood sugar (glucose) in adults with type 2 diabetes when used along with diet and exercise.

Diet and exercise?  Why not just do that in the first place?

As for the American Diabetes Association: its disinterest in promoting diet and exercise is easily explained.  It is funded by drug companies.

I gave a talk at an annual meeting of the Association a few years ago and was astounded by the number of drug companies giving things—writing pads, pens, and tape holders, but also lab coats and stethoscopes—at the trade exhibit.  Much of the scientific meeting was devoted to drug studies.  I spoke at the only session that year on dietary issues.  And Coca-Cola sponsored a session on sugars in diabetes.

Mrs. Deen’s food is best eaten in moderation.  She would do more for her own health and that of her fans if she used her television presence to promote healthier lifestyles.

Update, January 30: Brad Jacobson interviews drug reps on AlterNet (I’m quoted).