Wednesday, October 30, 2013

Information for Food Decisions

   The Dietary Guidelines for Americans recommend that calories be monitored on a daily basis.  The recommendation is based on the importance of consuming the appropriate amount of calories to prevent 'over fatness' - which appears to increase the risk for several diseases.
   To be fair, clear and honest, many of us do not know our calorie needs - the amount that balances with our energy expenditure.  This lack of knowledge needs to be addressed, but is not the focus of this post (calorie needs are assessed on an individual basis).  For now, lets pretend that everyone does know their personal needs- and agree that for most of us its between 1800 and 2500 calories a day (NOTE: if you need 1800 calories a day and consistently eat 2500 calories a day, you will have excess fat!)
   Presuming you need 1800 calories a day and you know this, and you obtain many of your meals away from home, to stay on target you need access to nutrition information at the point of purchase at those places . 
    I feel it is imperative that nutrition information be available everywhere  food decisions are made, but it is not.  The national menu labeling law (passed within the Affordable Care Act) amends an older law, the Nutrition Labeling and Education Act which excluded ready to eat foods, like those at restaurants- from nutrition labeling.  This oversight was a mistake and it took a new law to fix it.  The fact that the new law does not include all places that sell ready to eat foods, e.g., entertainment venues, is dumbfounding.  The FDA can fix this - they are responsible for the final rules.  It needs to be fixed now, not 20 years from now.  This is a real fight and certain industries and labeling advocates are battling it out - leading in some part to the delay of national labeling.
   The Center for Science in the Public Interest is lobbying for the expansion of nutrition labeling and today they shared the picture below from a New York City cinema.  NYC has a much broader labeling law, however, the federal law will override state and city laws.  That means even the NYC policy will not include movie theaters, (or theme parks, bowling alleys, etc.) if the federal law doesn't include them.  Take a look at the numbers below and see how important this information is to the person trying to stay in their limits.  BTW, we should all try to stay in our limits, at least most days.   

To take part in the campaign to expand labeling - click HERE

Just a note, the Nutrition Labeling and Education Act is the one that mandated nutrition information and nutrition facts panels on the foods you find on grocery store shelves.

Thursday, October 24, 2013

What foods are healthy and how can you tell from a menu?

To see the summary abstract of the study I refer to in this blog post, please click here.
The lead author is Lillian Sonnenberg.

   The purpose of this particular post is to share the results of another menu labeling study that used the Multiple Traffic Light (MTL) system to help customers identify "healthier" items.  I have a concern and a point to make regarding overall menu labeling, the federal legislation and why my point probably won't make a difference, but first.. a digression.
   Notice that in the above paragraph I put the word healthier in quotation marks.  I did this because in the research publication the authors assessed purchasing of items deemed healthier if they met criteria to be labeled as green. Two of the 5 criteria for a green label were low calorie (e.g., 500 or less for an entree) and low in saturated fat (i.e., < 2 grams).  The researchers also surveyed the customers before and after they introduced the labels.  The foods sold before and after the introduction of the labels were the same and the researchers knew if a person bought a green labeled food even during the time when no labels were posted.  When the researchers asked customers to answer a few questions after their purchase, the researchers also took their receipts.  Therefore, the researchers could match the survey answers with the items purchased.  A funny thing.. even customers who said that they always or almost always choose 'healthy' items were buying foods that were most often red (or unhealthy).  After the labels were placed, the 'healthy' eaters did only slightly better at purchasing green labeled foods.
   The researchers point out that customers do not seem to know what determines a foods healthiness.  I am not at all surprised and to be fair, isn't 'healthy' subjective and likely to change with every news headline?  Instead, I think that the researchers could have defined healthy in their question. They might have asked how often the customer chose foods low in calories or low in saturated fat (but even here a person must possess some nutrition knowledge to know what constitutes low, which is why MTL labels are effective - green = low).  The researchers failed to mention another likelihood for why people who said they chose healthy items did not in fact buy them. It is possible that they said it because it was the socially correct answer, not because it was what they actually do.
   Ok, now my main point.  Since the Affordable Care Act was passed with a National Restaurant Association supported nutrition menu labeling law included, new research has indicated that calorie disclosure alone (as per the law) is not sufficient to change selections.  Instead, menus using the MTL as the Sonnenberg et al study and many others have found, are more effective.  The law should be amended to incorporate these new findings, but it won't be  - nor will it be overturned - even if the ACA is.  I make both assertions for the same reason.  The National Restaurant Association is in large part responsible for the passing of the law - which in many ways is great.  It probably would not have happened without their endorsing it.  They will make sure that the law stays in place because it prevents states and cities from requiring restaurants to do anything different - it mandates a nationally standardized format that a restaurant chain can implement across its regions.  One law - one format.  And the format won't change (even if it isn't effective, or maybe for that very reason)  because if the MTL was used, the menus would be covered in RED and that would be bad for business.  (I think it would force restaurants to revise their recipes - in a good way-, but I just don't see this getting any industry support)

Friday, October 18, 2013

Does vegetarian = low calorie?

   If you are considering a meat free diet specifically to reduce the number of calories you consume, this post is for you.
   There are several reasons why national dietary guidelines, the American Cancer Society and the American Heart Association recommend that 
  1. red meat be limited(this includes pork no matter what you tell yourself)
  2. processed meat be avoided or extremely restricted (this includes all lunch meats, bacon, sausage) and 
  3. a plant based diet be chosen (lots of vegetables, fruits and whole grains).
    Two words in the start of that sentence explain the dietary advice, heart and cancer.  Evidence suggests that saturated fat in red meats may lead to high blood cholesterol and thickening or hardening of the arteries, and that processed meat increases the risk of colon cancer.  Fruits, vegetables and the fiber from whole grains has been shown to reduce the same problems or diseases.
  Meats also have more calories per gram than plant based items and limiting them can make it easier to consume fewer calories. However, this is only true when all things are equal- (and they never are - equal). Look at the table below, which I created using Jimmy John's gourmet sandwiches - this is a list of the seven 8" sub sandwiches on their menu.  I put them in order from least to most calories per sandwich.

JJs 8" sub sandwiches
 As you can see, the vegetarian sandwich has the most saturated fat and nearly the most calories.  All of the sandwiches, with the exception of the Vito, which is made with Italian lunch meats and an oil and vinegar, contain MAYONNAISE.  I can tell you how the vegetarian sandwich ended up to be so high in calories, but first note that all the sandwiches are a significant source of calories because of the bread - a salad would be a better choice (if not loaded with a mayonnaise based dressing).  The vegetarian option is described on the menu as having 'layers of provolone cheese and an avocado spread,' plus the mayonnaise and a few veggies for a grand total of 640 calories! The cheese, avocado and mayonnaise are the main source of calories, followed by the bread - I suspect.  A more reasonable lunch would have 400 calories, and mine usually have 100 or 200 because I eat small meals often.

All food has the potential to be high in calories and nutrients that are harmful in excess (i.e., saturated fat, sugar, sodium). In order to make sure that when you intend to eat a low calorie meal you actually do, read the menu labels, ask the restaurant staff to hold things like mayo, ask if butter is used on the 'steamed' vegetables and consider skipping butters, breading and sauces when preparing food for yourself.

BTW, this post was inspired by a meeting I am going to next week.  We were given these 7 options to choose from for our lunch.  I replied to the host that I would be bringing my own lunch.  
(That's right.  It doesn't matter that the lunch is free - it doesn't matter if everyone else is going to order from that menu - what matters it what I need for my body and my health.  Surely you feel as interested in your health as I do mine.  Be brave and remember not to eat to please others but to fuel your body - while enjoying the choices you make.)

Thursday, October 10, 2013

The Power of Oatmeal

No not as a miracle cure for weight loss... surely by now you know that I don't endorse such nonsense.
I mean the power of oatmeal (oat bran for me) to satiate.  To leave you with a feeling of fullness which lasts for hours.  
I knew that my oat bran with almond milk breakfast was very filling, but now there is research to support this personal experience and to explain why it occurs.

The researchers in this study collected information on how the participants were feeling, e.g., if they 'felt full,' 'were hungry' and what was happening to the oatmeal and the comparison food - ready to eat cold cereal - in the body, i.e., how it was being digested.  The participants reported their feelings at several different time points up to four hours after they ate their assigned breakfast.

It is important to note that the participants each ate both meals, but in random order and about a week apart.  The meals were 1) Quaker oatmeal and 2) Honey Nut Cheerios.  The meals were served with the same amounts of skim milk and had the same amount of total calories.  I do not eat Quaker Oatmeal - but I think they used the kind that you cook with hot water.   I use oat bran which I cook with water and eat with low cal almond milk (+aspartame).  I can say with certainty that if I had equal calories of cheerios and oat bran the cheerios would be half the volume of my oat bran.   And I believe that what you see has an effect on your feelings of satisfaction and fullness.

Anyway,  the study was well done.  The lead author/researcher is Candida Rebello - a nutritionist.  You can read the summary abstract here.

Putting the reports from the participants together with the lab results, the researchers could assert that the oatmeal breaks down more slowly, is thicker going through the small intestine, among other things and is more satiating than the cereal.  There are a lot of details in the article that I am not taking the time to explain, and some I could not explain even if I had the time.  But I think I have shared enough to give you the evidenced based take home message.  Choose oatmeal over cold cereal.

As for myself, I never eat cold cereal as a breakfast.  I believe that it offers too many calories per ounce (it is energy dense) and as this research suggests, doesn't stay with you very long.  I do sometimes have a taste of it as part of my discretionary (treat) calories.

Wednesday, October 2, 2013

Eating to Please... the Slippery Slope

No matter where you live in the world, society has certain norms about food.  In addition, your family or church culture might have traditions or customs about food.
Some things are easy.  If you are going to a function where food is to be served, whether its an official party, or just a visit to your Auntie's house where food is not to be refused! - go hungry (go to the event hungry).  In other words, don't add to the days calories, include what you eat or drink there as part of your day's total intake.

But what about the social norms that you can't prepare for?  What if someone bakes a cake and brings it in to work?  Or you just drop by a friends house and he or she brings out cookies?  Is it right to eat just to please someone else?  Is it right (smart) to eat just because 'everyone else is'?   I say no.  I think we are on a slippery slope when we start eating to give other people pleasure.  Consistently eating for reasons that are far removed from the main purpose which is to fuel our bodies and brains is dangerous.

To be absolutely 100% clear, food is to be enjoyed!  Tasted, savored, shared - I always enjoy eating but I do not eat to feel enjoyment.  Does that make sense?
Eating to feel good is a very dangerous habit to get into and eating just because someone suggests it, or you are bored, or you want to celebrate.. when you are really not hungry.. that is risky.  It can condition the brain to use food as a crutch or as a feel good medicine.. food should not be used as a security blanket.

It is okay to tell someone that you are too full to try their cake, or heck, that you have allergies, or that you are fasting for religious purposes, tell them anything you do not have to eat to please someone else. But if you know a food event is coming, it makes more sense to go there hungry or to bring a low calorie item to share rather than offend your host.

Please give this post some thought.  One of the reasons - and there are many - that a majority of people weigh more than is healthy for them (70% of US adults), is because they consume more calories than they need, and that is sometimes because they eat for the wrong reasons. (sometimes they eat too many calories by accident, but that is related to food labeling)