Eating advice in the United States has taken leave of its senses. It is no wonder that Americans are perpetually on diets.
It is only in the last 20 years that eating, a task we do quite naturally, has become so complex that you apparently need professional spin from nutritionists and dietitians, or worse, from doctors, on how to do it.
Spend a little time on the web (and especially social media) and your head will spin from all the contradictory healthy eating advice: eat organic…no, wait, don’t waste your money; eat less salt…wait, too little salt might be worse for you than too much salt; don’t eat fat…oh, sorry, eating too little fat will actually make you fat because you’ll eat too many poor quality carbs; eat foods that have a low glycemic index…wait, we meant a low glycemic load, er, well maybe eat foods that are both; eat breakfast every day because it will help you control your body weight except when it doesn’t.
With the exception of rare and particularly bleak days, I don’t tend to think of myself as a moron — nor, as far as I can tell, do those who know me well and love me. I will hazard a guess that neither you nor those who love you think of you as a moron, either.
So let’s be bold, proffer one another the mutual benefit of any disparate doubts, and declare: We are not morons!
I propose, then, that this be the year we stop ingesting as if we were. Still with me? Let’s find out.
On the matter of morons, I think they are very much the exception rather than the rule. I have met a lot of people over my years. I’ve taken care of many patients over decades and come to know their intimate thoughts as the privilege of doctoring uniquely allows and requires. So I know firsthand that most of us are endowed with our fair portion of both sense and sensitivity. Formal education, the color of a collar, degrees and credentials don’t distinguish us nearly as much as some might like to think. In most ways that matter, most people have that practical brand of folksy wisdom and intelligence that serve most handily on any given day.
And yet, as a matter of routine we are fed a steady diet of both food and food for thought as if we were abject morons. That’s how it’s served to us — but of course, only we get to decide whether or not to swallow such insalubrious slop. It’s a New Year, and time for new chances. Here’s our chance to stop the slop.
It’s been clear for more than a decade that trans fat is a dangerous substance that increases the risk of heart disease. Denmark banned its use in 2003. Several American cities and states have followed suit, but the use of trans fat is still widespread despite the availability of suitable substitutes.
Over the past 10 years, trans fat consumption is thought to have contributed to an estimated 70,000 needless American deaths. Given that universal, voluntary cooperation to eliminate trans fat hasn’t happened, the Food and Drug Administration (FDA) is justifiably seeking to designate trans fats as unsafe.
A nationwide ban on artery-clogging artificial trans fat is a long-overdue first step toward improving American diets, fighting obesity and limiting the risk of chronic disease. But it is just the first step in what should be a far broader campaign to help consumers make healthier choices at mealtime.
Public lack of awareness of the impact of prepared foods on individual health is not limited to trans fat. When dining out, even in establishments that avoid trans fats in preparing food, Americans face a range of health risks often without realizing it. People are routinely served far more calories than they can burn.
They are routinely served too many low nutrient foods and insufficient quantities of fruits, vegetables, and whole grains. What should become routine instead is the availability of menu options that put people’s health first.
Hopefully, the FDA’s trans fat initiative will succeed – previous city/state bans and labeling improvements have already managed to cut daily consumption by Americans from 4.6 grams in 2006 to 1 gram in 2012 – and pave the way for the creation of other standards and regulations regarding the quantity and quality of food that is offered to diners in restaurants.
The lack of such standards makes it difficult, if not impossible, for most people to recognize when they are being put at risk for a chronic disease. If people are served too much of something (like calories), they would have to compensate by eating less later; conversely, if they are served too little of something (like vegetables), they would have to eat more later to neutralize the risk of chronic disease.
But most people lack the information they need to judge or track the quantity and quality of the nutrients they consume.
Since the new paper is just a commentary — one doc’s opinion — and not a new study, and since this opinion has been asserted many times already, I’m not sure I really get the reaction. But hey, I just work here. Let’s deal with it.
Is it, in fact, time to absolve saturated fat? No, it’s not. But then again, it was never time to demonize it in the first place. I will lay out my case that we are ill-served to think of saturated fat as either scapegoat or martyred saint.
1) Ancel Keys was never really wrong.
The case against saturated fat, its implication in the development of atherosclerosis, inflammation, and chronic diseases, notably heart disease, involves a vast expanse of research over many years by thousands of researchers around the world. But dealing with all of that in this column would be a terrible bother, so let’s just blame it all on Ancel Keys. Keys was certainly among the first to emphasize the association between saturated fat intake and heart disease.
Keys looked at rates of disease around the world and correctly noted that heart disease was more common in societies that ate more meat and dairy. His mistake may have been to look past that dietary pattern for the “active ingredient” in it, which led to the convictions of dietary cholesterol, saturated fat, and to a lesser extent overall dietary fat.
There’s much that could be said about this. Whole columns could be written about dietary cholesterol, dietary fat, and saturated fat and ways we went wrong. In fact, I — along with innumerable others — have written just such columns. Simply click the inserted links.
Last week House Republicans voted to cut benefits to the Supplemental Nutrition Assistance Program, or SNAP, slashing $39 billion in benefits over the next ten years in a vote of 217 to 210. All members of the Democratic caucus voted against the bill, which would affect 4 million people.
In June, fiscal conservatives squashed the Farm Bill that would have cut spending by $20 billion over ten years after determining the decrease was too meager. This new bill is their response to that. If successful, half of the cuts will put a stop to food aid after three months to people between 18 and 50 with no minors living with them if they are unable to find work, a move that makes little sense.
Poverty and health are inextricably linked, and food security plays a central role in this. Not only does poverty affect a family’s ability to buy food, it prevents them from buying healthy food. In the United States, lower income individuals are more likely to be obese, putting a strain on the healthcare system. Currently, beneficiaries of SNAP are eligible for SNAP-Ed, a nutrition education program designed to promote healthy eating on a limited budget. It is unclear how these cuts will affect SNAP-Ed.
African-Americans, no strangers to health inequalities, will be disproportionately affected by this change if successful. A new study shows that 90 percent of African-Americans benefitted from food stamps at one point or another in their lives. One in four African-American households faces food insecurity, and make up about 23% of all SNAP recipients.
Growing paranoia is the hallmark of the aging process for me. Although I am a generally affable sort (I know, it doesn’t always seem that way from my writing), I am also a fairly suspicious person. I am starting to think that all the food industry’s sweet talk about the innocence of sugar is really just icing on a toxic cake and that we’ve all been sold a bill of goods. In particular, I wonder — and part of me hopes — that Big Sugar might soon replace Big Tobacco as the favorite target of our most underappreciated and misunderstood national resource…the plaintiff’s bar. There is no question we eat way too much sugar and that the increase in consumption has coincided nicely with both our rise in obesity and decline in health status even though we are living longer.
Not that I think the Tobacco Settlement (TS) was great social policy. You can read my full view here; but, to summarize, as an immigrant and a person of color, a part of me resents the TS because all it did is push the burden of fulfillment of the financial terms into the hearts and lungs of people in Africa, Asia, and Latin America. The smug satisfaction of tobacco opponents in the US and their glib dismissal of the impact on predominantly poor people of color around the world is first order racism.
Any analogous move against Big Sugar (BS) could be quite interesting. There is, of course, the delectable duality of “what did they know and when did they know it?”. Recently published opinions and data have forced me to think harder about just what goes on in the labs of companies like Coca Cola, Pepsi, Kellogg’s, Nestle, Domino, Mars, Hershey’s, etc. No doubt BS defenders will say that sugar is “all natural” (ahem, so is tobacco), and safe when used as intended…and, that is where things will start to go awry for them.
As a nutrition researcher tracking portion sizes and labels manufacturers use to describe such sizes, I have seen food portions not only grow larger over the years, but the labels to describe foods and drinks have also changed.
For example, when McDonald’s opened in the 1950s, the company offered one size soda, which was 7 ounces; today’s 12 ounces is labeled a kid’s size and the 16-ounce is labeled small. Similarly, when Burger King opened, the company offered a 12-ounce small and a 16-ounce large soda. The 12-ounce is no longer sold and the 16-ounce comes as part of the value meal. Burger King’s small soda is now 20 ounces, the medium is 30 ounces, and the large is 40 ounces.
Does anyone pay attention to these label descriptors? And do they influence how much we really eat? Apparently yes, according to a new study published in Health Economics by Cornell University researchers David Just and Brian Wansink.
The study found that labeling a food as “regular” or “double size” affects how much consumers will eat, regardless of how big or small the portion size actually is.
The researchers served subjects two different portions of pasta in either a one cup-portion or a two-cup portion. For some of the subjects, the two different size portions were labeled “half-size” and “regular.” For the other subjects, the identically-sized portions were labeled “regular” and “double-size.” The labels for the first group of subjects indicated that the two-cup pasta portion was the regular size, while it was suggested to the second group of subjects that the one-cup pasta portion was the regular size.
The study concluded that varying the “regular” portions affected how much the subjects actually ate. Subjects ate more food when the portion was labeled “regular” than when it was labeled “double-size” despite the fact that the two sizes were actually the same size.
The subjects were also willing to pay more for a larger sounding portion size.
If all of us were simply to make better use of our feet, our forks, and our fingers — if we were to be physically active every day, eat a nearly optimal diet, and avoid tobacco — fully 80 percent of the chronic disease burden that plagues modern society could be eliminated. Really.
Better use of feet, forks, and fingers — and just that — could reduce our personal lifetime risk for heart disease, cancer, stroke, serious respiratory disease, or diabetes by roughly 80 percent. The same behaviors could slash both the human and financial costs of chronic disease, which are putting our children’s futures and the fate of our nation in jeopardy. Feet, forks, and fingers don’t just represent behaviors we have the means to control; they represent control we have the means to exert over the behavior of our genes themselves.
Feet, forks, and fingers could reshape our personal medical destinies, and modern public health, dramatically, for the better. We have known this for decades. So why doesn’t it happen?
Because a lot stands in the way. For starters, there’s 6 million years of evolutionary biology. Throughout all of human history and before, calories were relatively scarce and hard to get, and physical activity — in the form of survival — was unavoidable. Only in the modern era have we devised a world in which physical activity is scarce and hard to get and calories are unavoidable. We are adapted to the former, and have no native defenses against the latter.
Then, there’s roughly 12,000 years of human civilization. Since the dawn of agriculture, we have been applying our large Homo sapien brains and ingenuity to the challenges of making our food supply ever more bountiful, stable, and palatable; and the demands on our muscles ever less. With the advent of modern agricultural methods and labor-saving technologies of every conception, we have succeeded beyond our wildest imaginings.
So now, we are victims of our own success. Obesity and related chronic diseases might well be called “SExS” — the “syndrome of excessive successes.”
Never mind the media hype. Here’s what the authors conclude:
The published literature lacks strong evidence that organic foods are significantly more nutritious than conventional foods. Consumption of organic foods may reduce exposure to pesticide residues and antibiotic-resistant bacteria.
Isn’t reducing exposure to pesticides and antibiotic use precisely what organic production is supposed to do? Continue reading…
Its purpose is to exempt supermarkets and convenience stores from having to post calorie information on prepared foods. This would allow pizza chains to list calories per serving, thereby defeating the entire purpose of the menu labeling law.
The pizza industry learned that it could get Congress to do what it wanted. Even a dab of tomato paste on pizza now counts as a vegetable serving in school meals.
If you thing calorie labeling on pizza might be a good idea, now is the time to write your congressional representatives. Here’s how.
Marion Nestle is the author of What To Eat and is the Paulette Goddard Professor of Nutrition, Food Studies, and Public Health at New York University. Nestle blogs regularly at Food Politics.