Search results: a life in food

The amazing New York City Health Department, almost unique in its interest in public health and willingness to do what it can to improve the health of New Yorkers, adds another campaign to its collection of hard hitters.  This one is on the need to reduce portion sizes.

The subway campaign posters in Spanish and English.  Here’s an example in Spanish.

I especially like this campaign because much of the work on increasing portion sizes in the food supply was launched by my former doctoral student, now Dr. Lisa Young.  See:

• Young LR, Nestle M, The contribution of expanding portion sizes to the US obesity epidemic. American Journal of Public Health, 2002. 92(2): p. 246-9.
• Young LR, Nestle M, Expanding portion sizes in the US marketplace: implications for nutrition counseling. Journal of the American Dietetic Association, 2003. 103(2): p. 231-4.

Larger portions do three things:

• They have more calories, obviously.
• They induce people to eat more calories
• They induce people to underestimate the number of calories they are eating

All of these induce people to eat more than they need or should.

The expansion of portion sizes alone is sufficient to explain rising rates of obesity.

The Health Department’s campaign makes sense.  Let’s hope it helps.

Update, January 10: The American Beverage Association doesn’t like the ads much, according to Crain’s:

Portion control is indeed an important piece of the solution to obesity,” said said Stefan Friedman, New York spokesman for the American Beverage Association, in a statement. “But instead of utilizing scare tactics, the beverage industry is offering real solutions like smaller portioned containers and calorie labels that show the number of calories in the full container, right up front, to help people chose products and sizes that are right for them and their families.

And if you think the New York City ads are tough and hard-hitting, try these “Strong4Life ads from the state of Georgia.  Shocking people out of complacency?  Or just shocking?

Update, January 25: The New York Times reports that the shocking photograph of an overweight man with a leg amputation was “photoshopped” from a stock photo.

This is unfortunate, as it opens the Health Department up to unnecessary criticism:

The American Beverage Association, which opposes the city’s efforts against sodas and fast food, called the advertisement overwrought. “This is another example of the ‘What can we get away with?’ approach that shapes these taxpayer-funded ad campaigns,” Chris Gindlesperger, the association’s director of communications, said in a statement.

I got a call yesterday from Sam Kass, the senior policy adviser on Michelle Obama’s Let’s Move staff, objecting strongly (an understatement) to my post about her new physical activity initiatives.

I interpreted her speech as a pullback from healthy eating initiatives.  “Eating better” is demonstrably bad for business.  The food industry much prefers “move more.”

Mr. Kass says no pullback was intended.  Instead, he said, this is an expansion of Let’s Move into another one of the program’s five essential “pillars.”

Pillars?

I did not recall anything about pillars.  I went to the Let’s Move website. Sure enough, there they are:

At the launch of the initiative, President Barack Obama signed a Presidential Memorandum creating the first-ever Task Force on Childhood Obesity….[Its] recommendations focus on the five pillars of the First Lady’s Let’s Move! initiative.

1. Creating a healthy start for children
2. Empowering parents and caregivers
3. Providing healthy food in schools
4. Improving access to healthy, affordable foods
5. Increasing physical activity

In February 2010, Mrs. Obama discussed these elements in her speech launching Let’s Move, although without using the word “pillars.”  The word also did not pop up in her speech discussing the new activity initiatives.

When I need help with this sort of thing, I consult Obama Foodorama,  a treasure trove of information about food at the White House.  Here’s what Let’s Move has done and is doing about the pillars:

1. Creating a healthy start for children: encouraging breastfeeding, Let’s Move Child Care, and other such programs
2. Empowering parents and caregivers: MyPlate and MiPlato, front-of-package labeling
3. Providing healthy food in schools: child nutrition legislation, Healthier US Challenge , salad bars in schools
4. Improving access to healthy, affordable foods: combating food deserts, reducing the price of fruits and vegetables, encouraging gardening, and green markets
5. Increasing physical activity: Presidential Active Lifestyle Award challenge (PALA) and the new initiatives

In the broader context of the Let’s Move pillars, a focus on physical activity makes sense.  It is an addition, not a substitution.

But Mrs. Obama’s speech did not frame it like that.  Instead, her speech implied that she had given up on healthy eating because it is too difficult (kids have to be forced to eat vegetables), leaving open the possibility that “eating better” is too hard to promote in an election year.

I wish her speech had placed the initiative in context.   Had it done so, it would not have been open to this kind of interpretation.

I’m not much of a TV watcher so I missed the episode of The Good Wife in which CBS offered a new version of the food guide icon.

Fortunately, the Minneapolis Star Tribune got permission to reprint it.

According to the Tribune’s account of the episode, “Whiskey Tango Foxtrot,”  a character representing the cheese industry proposes a more dairy-prominent alternative to the USDA’s MyPlate:

As for me, I still miss the 1992 Pyramid, maybe because it did not lend itself to such easy satire (see previous post).

The word is out.  Congress caved in under pressure from lobbyists on the school nutrition standards (see yesterday’s post).

Pizza is now officially a vegetable!

Here’s what the press is saying:

• NPR
• Washington Post
• NY Daily News
• New York Times

Cartoonists: get to work.

Additions, November 17

• The Daily on the Frozen Food Association’s mistaken lobbying efforts
• Eat, Drink, Better on the background legislation
• San Francisco Chronicle on choice comments (mine is first)
• Michele Simon’s thoughtful summary
• Obama Foodorama’s deep background:

School meals are a high-profit market for major food corporations….Thus in the last year, powerful food companies, agriculture lobbies, and various coalitions of lawmakers have allied in battles over each food area that USDA sought to restrict. This has included the creation of slick PR campaigns.

For instance, ConAgra and the giant, privately held Schwans, which sell millions of processed school meals, including pizza, have funded the “Coalition for Sustainable School Meal Programs,” which includes a website with a campaign called “Fix the Reg,” asking parents and other “interested parties” to contact USDA and lawmakers to demand changes to the school nutrition rule.  This group was especially interested in keeping USDA’s current designation of tomato paste as a “vegetable” intact, something many nutritionists have argued makes poor sense.

Addition, November 18:  For even deeper background, see what Marian Burros has to say in Obamafoodorama.

Addition, November 22:  President Obama signed the Consolidated and Further Continuing Appropriations Act into law.

SEC. 743. None of the funds made available by this Act may be used to implement an interim final or final rule regarding nutrition programs under the Richard B. Russell National School Lunch Act (42 U.S.C. 1751 et seq.) and the Child Nutrition Act of 1966 (42 U.S.C. 1771 et seq.) that—

(1) requires crediting of tomato paste and puree based on volume;

(2) implements a sodium reduction target beyond Target I, the 2-year target, specified in Notice of Proposed Rulemaking, ‘‘Nutrition Standards in the National School Lunch and School Breakfast Programs’’ (FNS–2007–0038, RIN 0584–AD59) until the Secretary certifies that the Department has reviewed and evaluated relevant scientific studies and data relevant to the relationship of sodium reductions to human health; and

(3) establishes any whole grain requirement without defining ‘‘whole grain.’’

 

Order from your local independent bookstore or University of California Press or Barnes and Noble or Amazon.com.

Reviews, interviews, and commentary on Why Calories Count

2014

July 26   Review in Science Magazine

2013

September  Review in Health Affairs 2012;31 (9):2150-2151.

September 7 Radio interview with Dr. Don

August 15  Review in Frankfurter Allgemeine Zeitung by Thomas Weber (in German)

August 1  Review in the American Journal of Clinical Nutrition by Barbara Rolls

July 26  Interview with Tami O’Neill for EcoCentric blog

July 13  Interview with Donna Feldman on MyNetDiaryBlog

July 19   Interview about Why Calories Count with Nina Kahori Fallenbaum for Hyphen magazine: “Rice is Nice.”

June 6  KQED’s Forum (radio) Host: Spencer Michels

May 25 Video interview with Linda Watson on HuffPo.

May 21  Radio New Zealand

May 15 Radio interview with Susan Moran

May 14 TV Interview with Linda Watson on Cook for Good

May 9  Jenny Hutt radio

May 9  Candy Sagon on the AARP blog

May 4  Fort Worth Star-Telegram

May 2  Oprah.com

April 26 Review in Eat.Drink.Better

April 26  Susan Albers in the Huffington Post

April 24 Review on StarChildScience

April 20 Review in the Wall Street Journal

April 19  Interview with LifeScript

April 18 Review on The Black Sheep Dances.

April 17  The Page 99 Test and Campaign for the American Reader’s Page 99 of Why Calories Count.

April 16  A review in Serious Eats by Leah Douglas.

March 29: Times Higher Education (U.K.)

People should read this book. They should read it if they are obsessive weight-watchers or serial dieters, or just concerned about what their children eat. They should read it if they work in public health, the food industry, catering or education. And they should certainly read it if, like my colleague who reacted with horror to the title and the idea, they work to counter the “myth of obesity” and are supporters of the “health at any size” movement.

March 29: a blog from Finland (in Finnish)

March 28: Healthy Eating blog

March 26: Lisa Young’s portion teller blog

March 25: Miriam Morgan’s review in the San Francisco Chronicle

March 22: Eleanor West’s interview on Civil Eats.

March 21: Mark Bittman in the New York Times

March 20: Jane Brody in the New York Times

March 15: Nature magazine

Obesity has gone global — as has misinformation about nutrition and food. Nutrition scientists Marion Nestle and Malden Nesheim unscramble the confusion with a serving of science. They reveal how calories — those potent but ill-understood measures of heat energy — are really counted, why we need them, how we use them, how many we actually need and why it all sometimes goes so wrong. From ‘secret’ calories to food politics, malnourishment and calorie restriction for health, this is a feast for the mind.

February 1: The Scientist

Nutritional science guru Marion Nestle’s new book, Why Calories Count, seeks to crack open the inscrutable nature of the calorie. Think of the book, cowritten with Cornell University nutritionist and biochemist Malden Nesheim, as a diner’s elemental guide to eating. Nestle and Nesheim deconstruct the calorie—the bane of many a belly in the developed and developing worlds—to its barest components as a humble unit of work or heat before reassembling it and discussing its implications for disease, obesity, politics, and modern marketing.

From the strict chemical definition of a calorie to the 25-year quest by the Center for Science in the Public Interest to require nutritional labels, including calories, on alcoholic beverages, Why Calories Count weaves scientific and social tales into a rich portrait of the American diet and the laws that have shaped it.

By thoroughly burrowing into the meaning and impacts of calories, the authors intend to bestow a more relaxed yet active state of mind upon the reader. “Get organized. Eat less. Move more. Get political,” they suggest. Sounds like the most succinct diet book ever written.

Excerpts from other reviews

From Kirkus Reviews: A strong, rigorous overview of the calorie, its regulation and the politics behind food labeling and marketing.

From Library Journal (see the Barnes and Noble website): Neither a diet nor a weight-loss book, this scholarly, seriously researched work assists readers in evaluating diet claims, formulating strategies to lose, gain, or maintain weight, and learning how to make healthy food choices….and—what will probably be of most interest to the general reader—the role of big business in creating calorie-laden food and why it’s less politically controversial to recommend exercising than cutting back on calories.  

Summary

Calories—too few or too many—are the source of health problems affecting billions of people in today’s globalized world. Although calories are essential to human health and survival, they cannot be seen, smelled, or tasted. They are also hard to understand.

This book explains in clear and accessible language what calories are and how they work, both biologically and politically.   It takes readers through issues fundamental to understanding diet and food, weight gain, loss, and obesity, and sorts through the misinformation put forth by food manufacturers and diet program promoters.

Nestle and Nesheim explain the political stakes and show how federal and corporate policies have come together to create an “eat more” environment and give readers the information needed to interpret food labels, evaluate diet claims, and understand evidence as presented in popular media.

Their concluding advice: Get organized. Eat less. Eat better. Move more. Get political.

Blurbs for Why Calories Count:

“We need to understand what ‘empty calories’ are, so that we can feed our children food that is truly nourishing. On this topic, there is no better teacher than Marion Nestle, who writes with meticulousness, clarity and grace.”  —Alice Waters, author of The Art of Simple Food

“If you want to understand what’s wrong with our eating habits, you must understand the central role that calories play.  Nestle and Nesheim are two of the America’s finest nutritionists–and this book explains, clearly and succinctly, why calories count.  It is essential reading not only for people interested in food policy, but for everyone who wants to eat well and be well.” —Eric Schlosser, author of Fast Food Nation

“This superbly well-researched and scientifically sound book makes it clear how today’s food environment often overrides physiological regulatory controls of body weight. Why Calories Count is essential reading for anyone who wants to understand why so much about food choice lies in the hands of food marketers whose goal is to sell more products, not necessarily in the interests of public health.”  —Dr. David Kessler, author of The End of Overeating

“Thank god authorities like Nestle and Nesheim have teamed up to give us an epic view of a calorie: what it is, where it came from, what it means, how and why we count them. Thank god they’ve managed to decode nutritional science into a commonsense language we can all understand.  And thank god they’ve put calories in their place in a wider cultural and political context to help us think meaningfully about the food our lives depend upon.  I’m grateful.”  —Betty Fussell, author of Raising Steaks

“Calories. We all talk about them—many are even obsessed with them—but what do we really know about them? Not much. Marion Nestle and Malden Nesheim’s latest book changes all that, pulling back the curtain on calories and helping us understand them in a whole new light. You’ll never look at a 100-calorie pack of corporate cookies the same way again.” —Anna Lappé, author of Diet for a Hot Planet

 

U.S. News has just released its rankings of 20 popular diet plans—the “Best Diets for Healthy Eating.”

The top five:

• DASH (Dietary Approaches to Stop Hypertension)
• TLC (Therapeutic Lifestyle Changes)
• Mediterranean
• Mayo Clinic
• Volumetrics

These may be healthy, but from the standpoint of survey respondents, they don’t work very well.  To the question “Did this diet work for you?” the “no’s” hugely outnumber the “yes’s” for a whopping 16 of the 20 diets.

The four exceptions:

• Weight Watchers (#6)
• Vegetarian Diet (#9)
• Eco-Atkins (#15)
• Vegan (#16)

Diets are about maintaining or losing weight.  This means balancing food energy against the amount of energy used in metabolism and activity.   To lose weight, you have to eat less or move more or do both.  It also helps to eat better and make healthier food choices.

All of the diets on the US News list are based on healthy food choices.  But these are the only four diets on the list that seem to help a majority of people to eat better and eat less.

 

 

I have a commentary in the October 23 issue of New Scientist (UK):

World’s first fat tax: what will it achieve?

Enviably healthy Denmark is leading the way in taxing unhealthy food. Why are they doing it, and will it work

Two studies released this week provide additional evidence that vitamin supplements are potentially harmful and, at the very least, do no good.

This depressing news comes from the Iowa Women’s Health Study.  Older women in the study who took supplements ranging from multivitamins to high doses of single nutrients had a greater risk of dying than those who did not.

Equally depressing are the results of a trial of high-dose vitamin E and selenium versus prostate cancer.  It found higher rates of the cancer among men taking vitamin E (selenium was somewhat protective).   In this trial, it was so obvious that the supplements did not protect against prostate cancer that the investigators ended it before its scheduled date of completion.

USA Today interviewed me and Dr. Jeffrey Blumberg (Tufts University) about our interpretations of these trials.

I think that the main conclusion to be drawn from this research is that supplements do not make healthy people healthier.   They may not cause harm at high doses, but they appear not to do good.

I don’t take them and I don’t recommend them—except to people who have diagnosed nutrient deficiencies or other problems handling nutrients.

Dr. Blumberg, in contrast, thinks multivitamins constitute a useful nutrition insurance policy and everybody should be taking them.

Supplements are a good example of how scientists can interpret research in different ways, depending on point of view.  I illustrate this point in Food Politics in a table in which I compare what I call “belief-based” (for lack of a better term) and “science-based” approaches to deciding whether supplements are needed, effective, or safe (see table 29, page 232).

For example, on the need for supplements, a belief-based approach rests on:

• Diets do not always follow dietary recommendations.
• Foods grown on depleted soils lack essential nutrients.
• Pollution and stressful living conditions increase nutrient requirements.
• Cooking destroys essential nutrients.
• Nutrient-related physiological functions decline with age.

A science-based approach considers:

• Food is sufficient to meet nutrient needs.
• Foods provide nutrients and other valuable substances not present in supplements.
• People who take supplements are better educated and wealthier: they are healthier whether or not they take supplements.

The statements in both approaches are true.

This is why point of view is such an important consideration in interpretation of nutrition research.