tag:blogger.com,1999:blog-61994027776134145532024-02-19T04:08:49.378-04:00Your Health EducatorMaking the latest health and wellness recommendations understandable, relevant, and possible.deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.comBlogger1399125tag:blogger.com,1999:blog-6199402777613414553.post-1047421431547320942020-03-14T19:01:00.001-03:002020-03-14T19:01:25.813-03:00COVID 19 - Take Precautions - Avoid PanicAs most readers or former readers of the blog know, I haven't been writing in any regular sense since 2016 or 2017. But I felt it important to post something about the current global health crisis.<br />
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I am a college professor with degrees in public health and that means I have training in disease transmission and prevention. My faculty appointment is with the College of Public Health at Temple University. This post refers to the strain of coronavirus (one word!) that began affecting people in December 2019, or COVID-19. There is a lot of information available about the virus and not all of it is accurate. I encourage you to follow the guidance of trusted sources - people who speak from science and medical backgrounds. Authorities, such as the WHO and the CDC -even my colleagues at <a href="http://temple./">Temple.</a><br />
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So do be prepared, do take precaution, and don't panic.<br />
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COVID19 is not the flu or a cold, it is more serious because it is likely to spread more broadly (no wall of protection from a vaccine), but the symptoms may FEEL like a bad cold or the flu. Most healthy people, those without chronic disease or compromised immune systems, can fight off the virus within 5 or so days just like they do with colds or flu. People who have been exposed to the virus, with or without symptoms, could transmit it to others and those others may not be able to fight it off in a few days. The severe cases - when the virus goes from upper respiratory to lower respiratory (lungs) - require hospitalization and it appears, have a higher mortality rate or case fatality rate, than the flu.<br />
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Social distancing - not hanging out with people - is what you do when you are well - quarantine is what you do when you are exposed - and isolation is needed when you are sick. Please please don't go around anyone if you have symptoms. Many work places are closing and the US Congress is working on a emergency resolution that will provide sick pay to people who do not have it with their jobs.<br />
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And you have probably heard that we are trying to flatten the curve - that is what these social distance measures are for... stopping a spike in cases and mortality. It is spreading the disease out - so COVID-19 might be around longer, but less people get sick and die - and less people get sick at the same time. It also prevents us from over burdening the health care system. If we have a lot of cases in the hospital, then doctors cannot treat everyone and all the other reasons people go to the hospital are still happening - it would overwhelm the system. Read more <a href="https://www.npr.org/sections/health-shots/2020/03/13/815502262/flattening-a-pandemics-curve-why-staying-home-now-can-save-lives" target="_blank">here. </a><br />
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I don't need to repeat or try to say things differently than the CDC so you can read the latest info at <a href="https://www.cdc.gov/coronavirus/2019-ncov/index.html" target="_blank">this website</a>. I will say, there are 5 steps for washing hands and the last one is important too.<br />
1) wet hands 2) use soap 3) rub and scrub hands, 4) rinse hands 5) DRY YOUR HANDS thoroughly with a paper towel/clean towel. Wet hands are NOT clean hands. If you cannot wash your hands this way, use hand sanitizer.<br />
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Take care of yourselves and try to avoid the hysteria and false information.deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-39494370535734116752018-11-24T20:52:00.001-04:002018-11-24T20:52:29.788-04:00The 'new' Physical Activity Guidelines for Americans, and what they got wrong<span style="font-size: large;">Early this month, the Department of Health and Human Services released an update to the 2008 Physical Activity Guidelines for Americans. The recommended amount of physical activity needed to maintain good health really hasn't changed. Children should get 60 minutes of physical activity a day and most of it should be moderate to vigorous aerobic activity (i.e., increased heart rate, hard to carry on a conversation) and they need muscle strengthening exercises, too. Little children, and their caregivers, should stay active throughout the day. That is subjective, but it means less screen time!</span><br />
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<span style="font-size: large;">The amount of moderate to vigorous physical activity and strength training that adults need is still 150 to 300 minutes of aerobic activity a week, less if it's vigorous (like running at a 10 m/m pace or faster), and twice a week weight training. The Guidelines say that this amount of physical activity is beneficial, but to really improve health and prevent disease MORE is necessary. That goes for </span><span style="font-size: large;">strength training (e.g., lift weights)</span><span style="font-size: large;">, too. The least amount Americans need to do is twice a week for 20 minutes. Older adults, say 50+ should consider weight training imperative, as it will slow age related muscle loss (i.e., sarcopenia). </span><span style="font-size: large;">Read more from the DHHS <a href="https://www.hhs.gov/fitness/be-active/physical-activity-guidelines-for-americans/index.html">here</a>. And for an announcement on the changes from NPR, read <a href="https://www.npr.org/sections/health-shots/2018/11/12/666744493/new-physical-activity-guidelines-urge-americans-move-more-sit-less">here</a>.</span><br />
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<span style="font-size: large;">So what has me all riled up... so much so I am writing a blog post when I have pretty much stopped making time for them? Well, the Guidelines now claim that any large muscle motor activity/movement can count toward your aerobic goal. So if you walk from your car to a building and it takes 5 minutes, good for you!! Only 295 more to go. If you mop the floor for 10 minutes - you are AWESOME, 285 more to go. And so forth.</span><br />
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<span style="font-size: large;">As I perceive it, that is not exercise. And here is why I think the DHHS wants to say it is. Because, as a nation, we have been woefully behind in meeting the PAGA (physical activity guidelines). According to the <a href="https://www.cdc.gov/nchs/fastats/exercise.htm" target="_blank">CDC</a>, less than 1/4 (25%!) meet the combined aerobic and strength training minimum goal. But if the government says all those little things DO count, then when they ask people about meeting the per week aerobic goal, more can say yes. So the next time the CDC reports results form a survey, the percent of the population meeting the aerobic goal might jump from 50% to 75%, only because the definition has changed, not because people became more active. </span><br />
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<span style="font-size: large;">Imagine our trend lines - there could be a sudden spike in the number of Americans who meet the goals, but it won't be because people are exercising more, it will be because they are counting things that probably shouldn't count. Be wary when looking at trend data when the definition of the behavior being tracked or the question being asked, has changed.</span><br />
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<span style="font-size: large;">I absolutely 100% believe we need to move more and sit less and that by doing so, we will be healthier, but come on. If you get up and go to the toilet at night, can you count that too?!? Lowering the standards is not going to reduce chronic illnesses related to sedentary behavior.</span>deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com2Philadelphia, PA, USA39.9525839 -75.1652215000000339.5633584 -75.810668500000034 40.3418094 -74.519774500000025tag:blogger.com,1999:blog-6199402777613414553.post-40406739598747463722018-05-04T13:46:00.000-03:002018-05-04T13:46:10.942-03:00It is happening!<span style="font-family: Georgia, Times New Roman, serif; font-size: large;">It has been eight years, but the National Restaurant Menu Labeling Law (part of the Patient Protection and Affordable Care Act) will be in effect on Monday. Restaurant chains with over 20 locations will be required to post the calorie content of their standard offering on menu boards and print menus. The goal is to raise awareness of the amount of calories in the items we choose - and to do so before we make that choice. This law has the potential to change our behavior as consumers as well as the behavior of those providing us with food and beverages. Will the calories available to purchase decline? Will we purchase AND consumer fewer calories? If the answers are yes, will the country's obesity rate plateau or decline? I sure hope so - but that's a lot of ifs. </span><br />
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<span style="font-family: Georgia, Times New Roman, serif; font-size: large;">Meanwhile, the recommended changes to the Nutrition Facts Panel have been delayed to 2020 - here we go again. The main change on those labels is an emphasis on total calories and added sugar and a de-emphasis on total fat. </span><br />
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<span style="font-family: Georgia, Times New Roman, serif; font-size: large;">On a personal note, sorry I don't post much anymore, but my students require a substantial amount of my time!</span>deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-19987873073015525502017-07-23T21:17:00.000-03:002017-07-23T21:17:42.263-03:00Eating for the 'wrong' reasons and important links<div class="MsoNormal">
<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;">Even though I don’t have time to maintain my blog, I am
reluctant to shut it down. So today I am writing for two reasons. The first is to
remind readers about the danger of eating when you aren’t hungry and the
second is to share a couple of health news sources. These news sources will be
of particular interest to those who have enjoyed my blog topics, and I will
share the links at the end. The sources have free email subscriptions and I
believe they are two of the best (i.e., credible, relevant, current) out there.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;">As I thought about writing (my posts often percolate in my
head a few days), I remembered that I started my blog as a newsletter back in
2004 (approximately) when I was working at a hospital and taking classes to
earn my Master’s in Public Health. Many readers followed my journey from that
point (i.e., to Florida as a Tobacco Treatment Specialist, to UNCG for more graduate studies in Public Health, to Beasley School of Law to complete a post doc in Public Health Law Research) to now – 13 years later. <o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;">Today, I am an Assistant Professor at Temple University in
the Department of Social and Behavioral Sciences. My teaching responsibilities
include a course about substance use disorders and addiction (that should make
sense if you’ve read the blog over the years) and a course on nutrition as it
relates to the health of populations (i.e., I am still not a registered dietician
and do not give individual diet advice). I teach additional courses and conduct
research/program evaluations, but this blog has foremost been about behaviors
that impact our health and the laws that make those behaviors harder or easier
to accomplish (e.g., that darn national menu labeling law that can’t seem to be
implemented, soda taxes, new food labels). </span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;">Dietary intake and health status
(including obesity) has probably been of most interest to my readers, and to
me. </span></span><span style="font-family: Georgia, "Times New Roman", serif; font-size: 12pt;">So, I want to talk about a specific area of risk regarding dietary
intake. Eating for non-hunger reasons. It is often when we eat for the ‘wrong’
reasons that we gain weight. I think what sets me apart from a lot of people is
that I don’t do that. I primarily eat to fuel my body when I am hungry. Or
better put: I do not eat to socialize. I do not eat because I am bored. I do not
eat because I am sad. I do not eat because I am high (haha, just kidding – bc I don’t
get high). I do not eat just because everybody else is eating or to be polite.
To be clear, I LIKE food, and enjoy meals and snacks and alcoholic beverages,
but I don’t respond to social (including work meetings) or familial pressure to
eat for the sake of fitting in.</span></div>
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<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;">Now that I think about it, I did blog about this many years
ago – about how to eat in a social context without gaining weight. I suggested
that when you are going to an event (family traditions included) where it is
expected that you ‘eat to be social,’ or you know your favorite foods will be
available, you plan it so that the food you eat at the event is part of your daily
intake (and if its occasional, maybe it’s a little more than your daily intake).
But eating when you are sad, bored, or unexpectedly confronted with someone’s ‘oh
I had to get these out of my house, please have some’ cookies is a sure path to
over consumption/excess calories. This over consumption is especially likely because the food
associated with those ‘eating but not for hunger’ reasons are usually high in
sugar, saturated fat, salt and calories. So, just think about that – and decide
how you want to handle it.<o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;">That’s all I have for you on diet and health today. Most
importantly are the links I promised you at the start of this post. Here they
are: <o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;"><a href="https://www.statnews.com/category/the-regulars/morning-rounds/page/7/">STAT
News Morning Rounds</a> <o:p></o:p></span></span></div>
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<span style="font-size: 12.0pt; line-height: 107%; mso-bidi-font-size: 11.0pt;"><span style="font-family: Georgia, Times New Roman, serif;"><a href="http://conscienhealth.org/category/news/">ConscienHealth
blog</a> (the subscribe option is on
the top right of the page)</span><o:p></o:p></span></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-39519198157665008052017-03-11T14:15:00.002-04:002017-03-11T14:15:46.751-04:00Diet and Health: The Big Picture<span style="font-family: Georgia, Times New Roman, serif;">After teaching an undergraduate public health nutrition course (i.e., not a course for aspiring dietitians) for a couple of years, I realize that there are a few points that are most important. The first is that healthy is a very squishy word and must be defined when used. In fact, at this very minute the <a href="https://www.fda.gov/food/guidanceregulation/guidancedocumentsregulatoryinformation/labelingnutrition/ucm520695.htm" target="_blank">FDA is taking public comments</a> as they consider whether food companies can continue to use the word on their products and what exactly it would mean if they did (same for the word natural). I define healthy in the spirit of the<a href="https://www.cnpp.usda.gov/dietary-guidelines" target="_blank"> Dietary Guidelines for Americans</a>. Therefore, a healthy food would be high in nutrients that we need and do not get too much of (e.g., we need sodium/salt but we easily get plenty, so a food high is sodium is not considered healthy), and low in calories and things we need less of (e.g., solid fats and added sugars). So healthy foods are usually whole foods (i.e., produce, whole grains), lean proteins (e.g., some fish, legumes), certain oils (e.g., olive oil, omega 3, flaxseed) and some low fat dairy products. Unhealthy foods would be ones likely found in a box or bottle (e.g., sugar sweetened beverages) with high calories, high sodium (e.g., 10% or more of the daily value on a food label), and added sugar. Unhealthy would also include whole foods that were prepared in a way that adds excess calories, sugar or sodium, and cooking with healthy oils instead of adding a small portion (less than a tablespoon) of raw oil after preparing the food.</span><br />
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<span style="font-family: Georgia, Times New Roman, serif;">The remaining points are these:</span><br />
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<ul>
<li><span style="font-family: Georgia, Times New Roman, serif;">Just because something is good for you (aka healthy) does not mean it is free of calories and that you can eat as much of it as you like.</span></li>
</ul>
<ul>
<li><span style="font-family: Georgia, Times New Roman, serif;">Just because something is bad for you (aka unhealthy) doesn't mean you should NEVER eat it (with a few exceptions, e.g., raw fish or unpasteurized milk).</span></li>
</ul>
<ul>
<li><span style="font-family: Georgia, Times New Roman, serif;">Calories matter no matter what you tell yourself and its important to have a general idea of how many you need and how many are in the foods and beverages (including alcohol) that you consume. On that note, the national calorie disclosure law for restaurant chains and vending companies has NOT BEEN REPEALED and is due to take effect in May.</span></li>
</ul>
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deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-75063868140030604152016-12-31T21:09:00.000-04:002017-01-01T09:05:36.617-04:00Start the New Year Informed<span style="font-family: "georgia" , "times new roman" , serif;"><span style="font-size: large;">Like many or most of you, I am preparing for the new year. What might be different is that to be healthy I simply (or not so simply) need to keep doing what I have been doing. Whereas, many others start every year pledging - resolving - to do things differently. With that in mind, I want so share some truths with you.</span></span><br />
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<span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">The most important things that any of us can do are these (listed, not necessarily, but maybe, in order of impact):</span><br />
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<ol>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Do not smoke tobacco (don't start or do quit).</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Exercise - everyday (30 to 60 minutes of activity that increases your heart rate).</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Maintain a healthy weight (this is relative, but for most people it means losing weight).</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Eat within a calorie appropriate (controlled) recommended dietary pattern, e.g., the <a href="https://health.gov/dietaryguidelines/2015/guidelines/appendix-4/" target="_blank">Mediterranean Diet</a>, which is plant based.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Get some sun, but not more than 10 minutes without protection (also relative to time of year, your skin pigmentation and where you live).</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Avoid alcohol in excess (for some this means any alcohol, for others excess means more than 1 or 2 a day or 7 to 14 a week (never more than 3 or 4 in one day).</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Get vaccinated according to the <a href="https://www.cdc.gov/vaccines/schedules/" target="_blank">CDC recommendations</a> for your sex and age (and take your children in for their shots).</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Practice safer sex - i.e., use condoms and discretion.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">For those suffering from any substance use disorder, <a href="https://www.samhsa.gov/find-help" target="_blank">SAMHSA </a>can direct you to supportive services</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Do not fall for diet and supplement scams - nutrition comes from food and weight control comes from balancing intake with expenditure. If whatever supplement or plan you are hearing about was as much of a break through as the ad says, we would NOT have an obesity epidemic. Please believe me.. there is NO pill for you. Reread numbers 1 - 9 above, this is the key to health.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Remember these final words of truth:</span></li>
<ol>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Non-GMO only means something does not contain genetically modified ingredients, not that its low calorie or necessarily good for you.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Organic means something has been raised according to <a href="https://www.usda.gov/wps/portal/usda/usdahome?navid=organic-agriculture" target="_blank">specific standards</a>, and so the plant or animal was not treated with chemicals or antibiotics. Organic foods are not scientifically better for you than conventional foods (though there IS concern about antibiotics in the food chain). Organic foods are not necessarily or <i>ever</i> lower in calories than similar non-organic foods.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">All natural is finally being defined by the FDA - but stay tuned for the final rule and then years before companies have to comply. Even if something is truly natural - not at all processed - that does not mean it is good for you, wont' hurt you, or is low in calories.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">There are <a href="http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm064911.htm" target="_blank">legal definitions</a> for low calorie, low fat, low sodium, etc.. and 'lower' means something different than low.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Read the nutrition facts panels, think about serving sizes.. pay attention to calories (usually a lower calorie item will also be low in sugar). Hopefully, the added sugar declaration will be added to labels this year and that will lead manufacturers to reformulate their products.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Some fat is good for you! Especially consider adding omega 3 fatty acids from food, like salmon.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">ONLY 1% of white people in the United States have <a href="https://www.ncbi.nlm.nih.gov/pubmed/22850429" target="_blank">CELIAC DISEASE</a>, and even fewer people of other races/ethnicities do. That means, YOU probably don't need a gluten free diet.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Gluten free does NOT mean low in calories or good for you.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">The health promoting property of olive oil is destroyed when you cook in it. To get the nutrition you are seeking, drizzle a teaspoon over your cooked veggies instead.</span></li>
<li><span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Get your fiber from plant based foods and whole grains, not mixes and pills.</span></li>
</ol>
</ol>
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<span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">On a sad note, the national <a href="http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm515020.htm" target="_blank">vending and menu labeling law</a> which is NOW set for compliance in May of 2017 is part of the Affordable Care Act - and may or may not survive the next presidency. That means that local and state laws could once again begin to populate which could be better for us and a nightmare for industry. Stay tuned</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">Lastly and sincerely, I wish you the healthiest of New Years....remember, though I focus on food, physical activity is the sine qua non of health... make sure you get plenty this year... all year.</span></div>
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<span style="font-family: "georgia" , "times new roman" , serif; font-size: large;">~ Deirdre</span></div>
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deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com2tag:blogger.com,1999:blog-6199402777613414553.post-84472586930017412222016-05-23T21:10:00.001-03:002016-05-23T21:10:13.890-03:00Added sugar and other changes to the back of the pack nutrition label<span style="font-size: large;"> I wrote this post on May 20 -21, 2016 after the FDA announced new labeling requirements for packaged food manufacturers. The manufacturers will be required to provide additional information and modified information on the Nutrition Facts Panel (NFP). This applies to all companies, but smaller ones have longer to comply. The FDA announced July 2018 as the official effective date, but we know from past FDA associated labeling initiatives that this date could change.</span><br />
<span style="font-size: large;"> The FDA press release - which you can access <a href="http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm502182.htm" target="_blank">here</a> - offers highlights of the changes, and many news sources have covered the story. What I want to do is put the changes in the context of my blog re: nutrition disclosures that help us consume fewer calories across venues.</span><br />
<span style="font-size: large;"> So does this change help? Probably - or to some extent. First, the revised labels have an increased 'reference serving size'. The noted serving size may merely be a declaration to allow the nutrient content to be calculated, because people rarely (if ever) dole out cups, ounces, or grams and even if they did, it would be more cups, ounces, or grams than the label suggests. The update, a slightly larger serving size, appears to be a compromise between what people are actually eating and what they are supposed to be eating. In other words, it is probably still not realistic. One example of a serving size change involves ice cream. Instead of a 1/2 cup, a label will say 2/3 cup. I imagine most people scoop out more than 2/3 a cup of ice cream for themselves, therefore, if a person wanted to know the actual calories or sugar they consumed, they'd have to do the math (just as before). Also people may think that the label refers to an actual cup of some sort, not a measuring cup. </span><br />
<span style="font-size: large;"> A similar issue with serving sizes is unchanged. They are not exactly uniform across similar products - the serving sizes may all be a 1/2 cup but the weight - the precise measurement - will vary. Boxes of cereal and cartons of ice cream, as opposed to say, a can of soda, are actually figured by weight, grams usually. So a serving size might be 2/3 cup on five cartons of ice cream but the weight of each 2/3 cup could be different. So to be frugal with our calories like we are with our dollars, we need to know the calories per unit. You don't get to see an orange shelf tag with this information but you can do the math, e.g. calories per serving divided by grams in a serving gives you the calories/gram.</span><br />
<span style="font-size: large;"> Another change on the NFP is that sugar grams will come with a % DV. I've never been much of a fan of the % daily value disclosure on a label. It is based on a 2000 calorie/day diet and the majority of women, myself included, require less, say 1500 to 1800, so again, math is required. There is a trick that can make the percentages useful. If the item on the label is a nutrient of concern (meaning we get too much of it, like calories, sugar and sodium), look for a low %DV. Low is 10% or less. There are very few nutrients that Americans lack, but for those, look for high %DV. For example, it would be great to have products with vitamin D and calcium at 20% or higher.</span><br />
<span style="font-size: large;"> Small packages, ones that people are likely to consume all at once even if they 'technically' contain 2 or 3 servings, will now have dual labels. There will be a column with the serving size nutrient information and a column with the whole package nutrient information. </span><span style="font-size: large;">For items like a 20 ounce soda, where the expectation or custom is to drink the entire bottle in one 'sitting' the nutrient and calorie content will only be for the entire package (who drinks 8 ounces of a 20 ounce soda and saves the rest for tomorrow?). BTW, that is why I go for diet sodas in 12 ounce cans, I do not need 20 ounces, its too much; and for some diet sodas, the trace calories will become meaningful beyond 12 ounces.</span><br />
<span style="font-size: large;"> There are a couple more changes, </span><span style="font-size: large;">which are not as relevant to the theme of my blog. You can review them by</span><span style="font-size: large;"> clicking on the above link.</span><br />
<span style="font-size: large;"> I'll end with two important things the new labels do not address. The information is still on the back of the package and the rule doesn't amend the new vending machine law to include sugar grams with the point of purchase calorie disclosure. Because the Nutrition Facts Panel is still on the back of the package the prospective buyer has to pick up and turn each product around (the new rule does not mandate or standardize front of pack labels and this is a disappointment). And consequently, this rule won't help us purchase low 'added sugar' snacks from vending machines because we can't see the back of the package at the time of purchase.</span>deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-21032156771890264332016-05-03T22:50:00.001-03:002016-05-03T22:50:15.034-03:00Why we focus on food deserts and not food swamps<span style="font-size: large;">Most people have heard the term food desert. A food desert is a place where people live and do not have reasonable access to whole foods, or fresh produce. Often this is measured by some distance to a grocery store. For example, in some places people live close to convenience stores and fast food restaurants, but would have to travel several miles, sometimes 10 or 20, to get to a grocery store. In these same areas, there may be high rates of obesity - however, there are high rates of overweight and obesity across the USA. Some speculate that not living close to a grocery store where one can access produce is a 'cause' of obesity (i.e., they associate food deserts with obesity). And it is not just availability, it's affordability, too. If the fresh produce costs more than processed foods, they are less accessible. If children have to try foods several times to like them, and a parent is on budget, it makes it hard to buy more expensive items that might not be eaten.</span><br />
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<span style="font-size: large;">Access and affordability are things that public health advocates work to change AND that the electorate/society supports. Right? Of course we should make sure everyone has access to nutritious foods that are often low in calories. YAY! Let's do it.</span><br />
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<span style="font-size: large;">Research has not always supported the intuitive, however, and sometimes people who have access to fruits and vegetables still don't purchase or consume them. Why not? Well, my educated/informed opinion is because a good many people live in food <i>swamps</i>. I am not sure where I first heard or read the phrase, but I describe a food swamp as an area where high calorie foods - often low in nutrients - are in abundance, are cheap, easy to locate, highly advertised, branded (e.g., KFC, Doritos, Pepsi) and popular among children, adolescents and adults. Actually, these foods and their promotions (e.g., all you can eat buffets, $1 hamburgers, 3 for 1 honeybuns, 32 ounce sodas) are hard to <b>avoid</b>. </span><br />
<span style="font-size: large;"><br /></span><span style="font-size: large;">As noted above, the popular strategy for dealing with a food desert is to bring more fresh foods in - build a grocery store or a farmers market, add produce to the convenience store checkout, send in a mobile produce truck - and hope people will purchase, prepare wisely and eat more nutritious foods. Oh and here is the most important part... eat them <i>instead of</i> the high calorie non-nutritious foods they have been eating. Every one agrees, yes - those are all good strategies... yay, lets fund them! [They don't work so well, but they seem smart and non-paternalistic, therefore, it must be right.]</span><br />
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<span style="font-size: large;">The strategy for food swamps (which is as unpopular as the food desert strategy is popular) is policy and regulation. I believe that food swamps are the bigger problem and that regulation and policy are our best bet at trying to reduce over consumption of calories (often occurring passively, i.e., not intentionally eating extra calories). Examples include, limiting the number of fast food/quick casual restaurants that can surround neighborhoods, schools, and worksites (zoning laws), putting a sales tax on high calorie, low nutrient items, like sugar sweetened beverages (specifically I say a sales tax because consumers are more likely to notice a sales tax than an excise tax and sales taxes cannot be 'eaten' by the manufacturer unless they literally lower the prices of their products), putting calorie counts out in front on everything, everywhere (menu boards, front of packages, sodas) and educating people on what is considered a 'high' amount of calories (e.g, a dinner entree over 500 calories is high, if it is part of a days worth of meals), portion caps - like suggested in NYC might work, and limiting ads for high calorie foods or ad space (e.g., TV, public transit, magazines, websites, social media). I think our grocery stores should have makeovers as well. The cheap, high calorie foods should not get prominence and promotion. This is one of the main reasons I believe that strategies to add fruits and vegetables to neighborhood stores or whole grocery stores to neighborhoods, fail. It is hard to get through the mire of junk - physically, emotionally, socially, parentally - to the better for you items. </span><br />
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<span style="font-size: large;">And before anyone points out that the food swamp policies I mentioned are regressive (i.e., they will have a bigger impact on persons of lower income) I say YES, and obesity and its related disease conditions is also regressive and has a greater impact on persons of lower income. </span><br />
<span style="font-size: large;"><br /></span><span style="font-size: large;">My point is, that though it might sound good (especially politically) to make fruits and vegetables and other nutritious foods available and accessible, what we really need is to make low nutrient (junk) foods and drinks LESS available and accessible (less cheap, less popular, less in our face). And as that annoying prince on the TV show Outlander says, "mark me" I am right about this.</span><br />
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<span style="font-size: large;"><br /></span>deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-43368503830491012832016-04-01T22:42:00.001-03:002016-05-01T18:15:44.680-03:00Exercise for Weight Loss?<span style="font-size: large;">No.</span><br />
<span style="font-size: large;">Exercise for exercise. Exercise for a long, healthy, active live.</span><br />
<span style="font-size: large;">Exercise for functional capacity, mood stability, improved attention and learning.</span><br />
<span style="font-size: large;">Exercise to prevent disease. Exercise to improve your quality of life.</span><br />
<span style="font-size: large;">Exercise because not exercising increases your risk of all causes of death and all disease states.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">If you exercise only because you think it will help you lose weight, and exercise is your only weight loss strategy, chances are you won't lose weight. And then you will think exercise failed you. You will be wrong. Exercise is the sine qua non of health; it will never fail you. if you do it for the right reasons. There are many reasons, see the first paragraph and the research studies below.</span><br />
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<span style="font-size: large;">If you want to lose weight, change your eating patterns. Many people need to lose weight.</span><br />
<span style="font-size: large;">If you want to be healthy, exercise - daily.. Everyone, regardless of their weight status, needs to do this.</span><br />
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(NB. this was posted a few weeks later http://www.vox.com/2016/4/28/11518804/weight-loss-exercise-myth-burn-calories)<br />
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<div style="margin-left: .5in; text-indent: -.5in;">
Janssen, I., & LeBlanc, A. G. (2010). Review Systematic review of
the health benefits of physical activity and fitness in school-aged
children and youth. <i>International Journal of Behavioral nutrition and physical activity, 7</i>(40), 1-16. </div>
<div style="margin-left: .5in; text-indent: -.5in;">
Nocon, M., Hiemann, T., Müller-Riemenschneider, F., Thalau, F., Roll,
S., & Willich, S. N. (2008). Association of physical activity with
all-cause and cardiovascular mortality: a systematic review and
meta-analysis. <i>European Journal of Cardiovascular Prevention & Rehabilitation, 15</i>(3), 239-246. </div>
<div style="margin-left: .5in; text-indent: -.5in;">
Penedo, F. J., & Dahn, J. R. (2005a). Exercise and well-being: a
review of mental and physical health benefits associated with physical
activity. <i>Current opinion in psychiatry, 18</i>(2), 189-193. </div>
<div style="margin-left: .5in; text-indent: -.5in;">
<span style="text-indent: -0.5in;"> Warburton, D. E., Nicol, C. W., & Bredin, S. S. (2006). Health benefits of physical activity: the evidence. </span><i style="text-indent: -0.5in;">Canadian medical association journal, 174</i><span style="text-indent: -0.5in;">(6), 801-809.</span></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com2tag:blogger.com,1999:blog-6199402777613414553.post-25915362399143910312016-02-15T22:15:00.001-04:002016-02-15T22:15:06.407-04:00February Reminder: You said you would eat 'better' this year!<span style="font-size: large;">It's the middle of February, how are you doing with your goals to eat healthier in 2016?</span><br />
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<span style="font-size: large;">Here are a few reminders and helpful hints:</span><br />
<span style="font-size: large;">Remember that calories still count and there are plenty of ways to eat delicious, full plates of food if you make some clever choices. For example, when eating out you can order your fish or meat with little to no oil, butter, glaze or sauce and ask for your vegetables to be steamed without butter. (note, pasta is never low calorie and bottomless bowls of it are a mistake) At home, you can prepare your food the same way - without lots of sauces, breading or butter.</span><br />
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<span style="font-size: large;">Some vegetables are more nutritious than others - high in nutrients but not high in calories, as long as you do not bread, fry or coat them in butter. </span><span style="font-size: large;">For example, summer squashes, spaghetti squash, eggplant, cauliflower, broccoli, asparagus, butternut squash, Brussels sprouts, green beans, greens (kale, broccoli rabe, etc). Use </span><a href="http://ndb.nal.usda.gov//" style="font-size: x-large;" target="_blank">this link</a><span style="font-size: large;"> to find other low calorie foods, and remember just because they start out low calorie doesn't mean they end up low calorie (how you or the chef prepares them is a crucial factor).</span></div>
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<span style="font-size: large;">Alcohol and caffeine(particularly in coffee) can be a part of a health promoting diet, but be mindful of two things: 1) excess alcohol and caffeine can have adverse effects on your health (excess is more than one or two drinks a day depending on your sex and size, and probably 3 to 4 8-ounce cups of coffee); 2) both alcoholic beverages and coffee that is flavored with cream and sugar, bring in calories and those calories count towards your individual daily requirements. </span></div>
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<span style="font-size: large;">I enjoy a good cup of arabica coffee, black no sugar in the morning (okay 2) and decaffeinated, almond milk infused cappuccino in the evening. (sugar free milk ~ 30 cals a cup). </span><span style="font-size: large;">For alcohol, I stick to one 12 ounce light beer, one 4 to 6 ounce glass of wine OR one shot of liquor mixed with a no calorie beverage. I recently made a batch of limoncello which I am enjoying several nights a week! Pictured above.</span></div>
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<span style="font-size: large;">I hope this post has helped get you back on track or keep you on track and given you some new information for meeting your goals.</span></div>
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deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-91148422961519640372016-01-24T22:01:00.002-04:002016-01-24T22:01:43.423-04:00What we eat still matters<span style="font-size: large;">Obesity is a complex disease. I have come to appreciate this even more over the last 5 years, and what I am about to say in this post is NOT a refutation of that complexity. </span><span style="font-size: large;">Instead, I want to make a point that though obesity [whether becoming obese in the first place or remaining obese after an effort to lose weight] is an intricate mess of bad decisions, bad environment, genes, social pressure, family customs (not traditions, but the every day way of preparing foods or eating that we learn from our families), lack of physical activity, metabolism, gut microbes, infections, injury and things we haven't even discovered yet - even though this is true, on its own, what we eat still matters.</span><br />
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<span style="font-size: large;">Yesterday, I was waiting for my train to arrive at 30th St Station in Philadelphia PA. I had been traveling over the weekend. I had an hour wait and was standing - standing - at a table, eating a salad that I had prepared and carried with me. I am a small person, slight of build, low weight. I am this way purposefully, not genetically; I share the same food environment, social pressures, and family cooking practices as most of you - some of whom are normal weight, and if the CDC is to be trusted, most of whom are not. As I ate my salad (which I found delicious with its ample amount of lean protein), I looked across the room and saw a person who was not slight of build and they were also eating. Eating from a box. A box of dunkin donuts. This is not a judgement, several of the things I listed in the first paragraph factor into the decision for that person to buy donuts. My point is, the food we eat still matters and even if it is not that simple in the grand scheme, it certainly is at some level. The small person was eating the salad. Maybe the small person routinely eats low calorie foods and doesn't exceed the calorie requirements to maintain a normal weight - and the large person routinely eats calorically dense foods and does exceed the amount they need.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">NB: I didn't post this right away, its been a week since I was at the train station. So I have another observation to add. I was at dinner with friends the other night where I ordered a beautiful steamed seafood and vegetable entree. The man to my left, who is somewhat overweight (we had to trade seats at the movies recently because he was too large to sit comfortably unless in the aisle seat) was the first to request and be disappointed that the restaurant did not serve dessert. Not a judgment, an observation.</span>deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-33231530522826383142015-12-31T15:00:00.000-04:002015-12-31T15:00:16.964-04:00USE BY and other interesting package DATES<div class="MsoNormal">
<span style="font-size: large;">Year ending. Year beginning. So let’s talk about calendar
dates – not weight loss goals or New Year’s resolutions, but dates on packages,
cans, cartons of food and what they may or may not mean for you.<o:p></o:p></span></div>
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<span style="font-size: large;"><br /></span></div>
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<span style="font-size: large;">The information that I am providing today (the upshot) is
freely available in more detail from the USDAs Food Safety and Inspection
Service. I am not covering infant formula which has separate rules, and I
notice that tuna and other canned fish are not specifically mentioned in the
fact sheet. If you want more info on those products you might have to use the
AskKaren.gov feature.<o:p></o:p></span></div>
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<span style="font-size: large;">Here are the take home points on those package dates, some
may surprise you:<o:p></o:p></span></div>
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<span style="font-size: large;">There is no federal – or country wide – law regarding dates
on food packages. Meaning, they ae not required at all, by the federal
government.<o:p></o:p></span></div>
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<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">Around 20 states have laws regarding dates on food items,
but the laws vary.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;">An open date – just the date, no words to describe it – and
a sell by date – are not meant for use by us. These are more a message from the
manufacturer to the store owner letting them know that the foods will be of the
highest quality if sold by – displayed until – whatever that date is.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;">If a package has a date and with that date are the words USE
BY, you should – use it by that date. The food will be of better quality if you
use it by then, and if you are not going to use it by that date, you can freeze
it. Foods can stay in the freezer indefinitely, but be mindful of how you
package them so they don’t get freezer burn.<o:p></o:p></span></div>
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<span style="font-size: large;">Eggs are interesting. A few states require sell by or
expiration dates and some others forbid them! If an egg carton has USDA stamped
on it, you will find a package date. The date the eggs were put in that carton.
And it’s a little unusual. It only contains 3 numbers. This 3 digit date
indicates the number of days since the start of the year that the eggs have
been packaged. So if you buy a carton of eggs and it says 145, the eggs were
put in the carton on the 145<sup>th</sup> day of the year – year starting
January 1<sup>st</sup>. If there is a sell by date on this same USDA carton of
eggs, it cannot be after that package code date.<o:p></o:p></span></div>
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<span style="font-size: large;">Also interesting, eggs can be stored in the fridge and used
for 3 to 5 weeks while maintaining great quality – even after a use by date. Of
note, the eggs should remain in the carton and at the coldest part of the
fridge (so much for all the refrigerator egg gadgets!) <o:p></o:p></span></div>
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<span style="font-size: large;"><br /></span></div>
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<span style="font-size: large;">If there is not a use by date, the USDA provides advice on
when to use the food by, and offers a chart <a href="http://www.fsis.usda.gov/wps/wcm/connect/19013cb7-8a4d-474c-8bd7-bda76b9defb3/Food_Product_Dating.pdf?MOD=AJPERES">here</a>.
The thing that stood out to me when I looked at the chart is that opening the
product is the kiss of death, and that almost everything should be used within
2 days of breaking the seal (except milk and produce). It’s like time is
suspended until the seal is broke and then it rapidly accelerates. <o:p></o:p></span></div>
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<span style="font-size: large;">Other important food safety and shelf life considerations:
If you leave a product out of refrigeration, like hot dogs you are waiting to grill,
the use by date is void, they are not safe anymore. Thawing something out at
room temperature for over two hours is also frowned upon. Notice this is not
about quality anymore, it’s about safety via contamination. Other safety issues
mentioned in the handout involved not washing ones hands before preparing
foods.<o:p></o:p></span></div>
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<span style="font-size: large;">BTW, there was no specific mention of yogurt, milk or
cheeses, but USDA/FSIS indicated that the foods should be fine if kept
refrigerated– and until you notice an off odor, color or perhaps mold </span><span style="font-family: Wingdings; font-size: large;">J</span></div>
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deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-29405109163117411882015-12-21T20:11:00.004-04:002015-12-21T20:11:52.212-04:00How The 2016 Federal Budget impacts nutrition, dietary advice and calorie labeling<div class="MsoNormal">
<span style="font-size: large;">If you are confused about what foods to eat and which
constitute a healthy routine diet, you are not alone. In fact, this year has
been extraordinary for its confusion and contention surrounding nutrition
science and dietary guidelines. In fact, the experts - nutrition and public
health – do not agree. The controversy was simmering even before the release of
the 2015 Dietary Guidelines Advisory Committee Report, an update to the
Guidelines I meticulously explained and passionately promoted 5 years ago –
before I joined the rank of researcher (i.e., became a more critical reviewer).
<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">Did the uproar over the Committee’s recommendations make its
way into your daily news briefs? If so, you’ll know that the contention was
strongest around the recommendation to lower meat intake, not just for health,
but for the planet – for sustainability.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">After the report was released, a non-scientist, nutrition
journalist published a scathing article on the recommendations, which led to a <a href="http://www.cspinet.org/new/201511051.html">crusade</a> by the Center for
Science in the Public Interest and a point by point response letter signed by
over 100 experts, researchers and scholars (myself included) that was <a href="http://www.bmj.com/content/351/bmj.h4962/rr-41">posted</a> just about a
week ago.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">There is not just dissent on the recommendations, which
include less salt, less saturated fat, less sugar, but also on the scientific
evidence used and the scientific process itself. So much so, that the recently
passed Omnibus Appropriations Bill 2016, delays the release of the guidelines!
Read for yourself (selected text from the Congressional directives):<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<span style="color: #323232;"><span style="font-size: large;">Congress continues to be concerned about the
quality of scientific evidence and extraneous factors that were included in the
2015 Dietary Guidelines Advisory Committee's Scientific Report. <o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<span style="color: #353535;"><span style="font-size: large;">To ensure the guidelines adhere to the
nutritional and dietary scope of the law and are based upon sound science, bill
language has been included clearly stating that <i>the final guidelines cannot be released or implemented unless they are
based upon significant scientific agreement and adhere to the statutory
mandate.<o:p></o:p></i></span></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<span style="font-size: large;"><span style="color: #353535;">Questions have been raised about the
scientific integrity of the process in developing the dietary guidelines and
whether balanced nutritional information is reaching the public. The entire
process used to formulate and establish the guidelines needs to be reviewed
before future guidelines are issued. </span><span style="color: #353535; font-family: Arial, sans-serif;">It </span><span style="color: #353535;">is imperative that
the guidelines be based upon strong, balanced science <i>and focus on providing consumers with dietary and nutritional
information that will assist them in eating a healthy and balanced diet.</i> At
a minimum, the process should include: full transparency, a lack of bias, and
the inclusion and consideration of all of the latest available research and
scientific evidence, even that which challenges current dietary
recommendations.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<br /></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<span style="color: #353535;"><span style="font-size: large;">The agreement (the Budget) provides $1,000,000
to review the dietary guideline process.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin: 0in 0in 0.0001pt 0.5in;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="color: #353535;"><span style="font-size: large;">And that’s not
all! The Omnibus Appropriations Bill takes aim at school nutrition and calorie
labeling as well. The federal government by enactment of this bill, further
delays calorie postings for grocery stores and ‘similar retail establishments,’
which I am assuming are the bowling alleys, movie theatres and convenience
stores. My colleagues tell me that the FDA had already made those postponements
and the Budget Bill just makes it a mandate. I might have been too focused on
vending – which was already set for 2016 – to have noticed. What I am thinking
is 1) this calorie labeling is never gonna happen and 2) if the federal law is
not in place, state and local laws can’t be pre-empted, thus they can remain
more restrictive… good for Philadelphia.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="color: #353535;"><span style="font-size: large;">With regard to the
school lunch program, schools can have more time to figure out how to increase
the whole grain content of meals – though 95% of schools haven’t suggested that
they need more time, so this is dumb. Also, the rule to lower the sodium
content to a new lower goal has been halted pending scientific evidence that it
is necessary to do so for health.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="color: #353535;"><span style="font-size: large;">Here are a couple
of links re the budget that was just passed.<o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-size: large;"><a href="http://www.restaurant.org/Downloads/PDFs/advocacy/20151215_omnibus_summary">Summary</a><span style="color: #353535;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-size: large;"><a href="http://docs.house.gov/billsthisweek/20151214/CPRT-114-HPRT-RU00-SAHR2029-AMNT1final.pdf">Pretty much the
whole thing</a><span style="color: #353535;"><o:p></o:p></span></span></div>
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<span style="font-size: large;"><a href="http://docs.house.gov/meetings/RU/RU00/20151216/104298/HMTG-114-RU00-20151216-SD002.pdf">USDA-FDA
specific budget language</a><span style="color: #353535;"><o:p></o:p></span></span></div>
<br />
<div class="MsoNormal" style="margin-bottom: 0.0001pt;">
<br /></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-13890781408598539842015-12-02T21:21:00.000-04:002015-12-03T22:32:00.018-04:00Food as tradition vs Food as reward<div class="MsoNormal">
<span style="font-size: large;">Food has many meanings and purposes. Food can soothe the
soul as well as sustain the body. It may even heal and restore. It is a source
of nourishment, especially, or perhaps only – when it contains protein, carbs,
fats and nutrients, not empty calories (e.g., high sugar, high salt and <b>high</b> saturated fat). And food is a
source of pleasure, helping us to recall happy moments, favorite people, and
traditions.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">For many of us, the act of preparing, cooking and serving
food is an expression of love: familial, social, charitable. Within cultures,
broad and refined, certain foods celebrate, symbolize, crystalize (as in rites
of passage, milestones). There is room in all our lives for these occasions<a href="file:///C:/Users/Deirdre/Desktop/Box%20Sync/blog-reasons%20to%20eat.docx#_ftn1" name="_ftnref1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , serif; line-height: 107%;">[1]</span></span><!--[endif]--></span></a>,
these moments of food as something more than or other from, sustenance. There
is no room in any of our lives for abandoned consumption of even our cherished
foods. To be honest, gluttony sort of ruins the whole appeal. But this blog
post is not about moderation or counting calories. I am hoping that in time, soon,
it will no longer be necessary to even mention calorie moderation, not because
we have found a magic pill that lets you eat whatever you want, or because exercise
suddenly causes easy weight control, but because we will have learned, as a
nation, that calories MUST be part of the strategy.<span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , serif; line-height: 107%;"><a href="file:///C:/Users/Deirdre/Desktop/Box%20Sync/blog-reasons%20to%20eat.docx#_ftn2" title="">[2]</a></span></span><a href="file:///C:/Users/Deirdre/Desktop/Box%20Sync/blog-reasons%20to%20eat.docx#_ftn2" title=""><!--[endif]--></a></span><o:p></o:p></span></div>
<div class="MsoNormal">
<span class="MsoFootnoteReference"><span class="MsoFootnoteReference"><span style="font-size: large;"><br /></span></span></span></div>
<div class="MsoNormal">
<span style="font-size: large;">These other than sustenance reasons for eating that I
described above, fall into the appropriate practices of most societies
throughout time. But there are less salubrious reasons for eating and sadly,
these unhealthy, psychologically damaging reasons are often situated and
cemented in childhood: pacification, reward, boredom. Recently, I observed one
of these unhealthy uses of food, which I’ll describe in a moment, and that
scene triggered a few other memories of the misuse of food, memories that are
at least 20 to 30 years in the past – I’ll share them too.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">The first and recent example uses food as reinforcement. This
particular example can be thought of as either negative or positive
reinforcement, which is unusual and psychologists might disagree with me, but I’ll
explain my reasons and why I call it negative reinforcement. Negative
reinforcement is an action that takes away an unpleasant thing, while positive
reinforcement provides a reward or something pleasant when a particular
behavior is exhibited. In my interpretation, one is meant to extinguish and the
other is meant to encourage. I think that using food to take away an unpleasant
emotion would be using it for negative reinforcement – a really bad idea. In
the case I witnessed, a child was crying – throwing a pretty good tantrum – and
the dad said to the mom, “Give her a lolly pop.” WHOA. – I most certainly did
cringe. More distally, when I was a young adult babysitter, I observed what the
parents clearly meant to be positive reinforcement when they gave their child a
cookie for using the potty. To this day I have wondered if that girl grew up to
have an eating disorder. And a little more recently, but still 20 or more years
ago, I remember watching a friend constantly hand her son food to eat
as they rode around in the car – visiting people. He was bored and eating chips
and drinking soda kept him occupied. He is a (heart breaking) morbidly obese
young adult now. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">Food is not meant to drown out our feelings, teach us to do
things, or keep us from being bored.
Parenting is hard - I get that,
but food as a parenting strategy is a dangerous mistake. Though I am firm in my
belief that food not be a reward, food can certainly be a pleasure and serving
it rewarding. When foods become embedded with our culture, our traditions, and
our families <i>it is a good thing</i>. But
using food to treat a bad mood, stress or mental illness is ineffective and
it’s unhealthy. If you’ve found yourself using it this way, instead, try
exercise, talking to confidants or professionals, writing, meditating, praying,
and other positive coping mechanisms. Heck, even medicine if all else fails, but
not food. Food is not the answer nor the treatment for emotional or physical
pain.</span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<br />
<div>
<!--[if !supportFootnotes]--><br clear="all" />
<hr align="left" size="1" width="33%" />
<!--[endif]-->
<br />
<div id="ftn1">
<div class="MsoNormal">
<a href="file:///C:/Users/Deirdre/Desktop/Box%20Sync/blog-reasons%20to%20eat.docx#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , serif; font-size: 11.0pt; line-height: 107%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">[1]</span></span><!--[endif]--></span></a> Note: this is not the same
thing as having style of cooking that consistently creates excess calories or
uses large amounts of nutrients/substances of concern (i.e., sugar, fatty and
or fried/breaded foods and salt/sodium)<o:p></o:p></div>
</div>
<div id="ftn2">
<div class="MsoNormal">
<a href="file:///C:/Users/Deirdre/Desktop/Box%20Sync/blog-reasons%20to%20eat.docx#_ftnref2" name="_ftn2" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "times new roman" , serif; font-size: 11.0pt; line-height: 107%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">[2]</span></span><!--[endif]--></span></a> Forgive me for another
small aside, but as I wrote the sentence above regarding the pill that lets you
eat whatever you want, I had a little epiphany. The ads for pills and
supplements do say, ‘eat whatever you want and lose x pounds.’ And that is not
the real issue. It is less about WHAT one eats and a lot about HOW MUCH; so the
magic pills have to let us eat what we want, as much as we want and keep us
thin and metabolically healthy – good luck waiting on that.<o:p></o:p></div>
<div class="MsoFootnoteText">
<br /></div>
</div>
</div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-12719402616312924072015-11-23T16:16:00.000-04:002015-11-23T16:16:02.787-04:00Resisting a challenging food environment<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">As the years have progressed and research findings amassed,
it has become obvious to most people – experts and non-experts – that obesity
is not caused by one thing. However, certain factors seem to have a greater
impact on whether or not a person consumes more calories than they need or burn
than others. For example, genetics have less of an impact than lack of physical
activity. And a combination of risk factors intensifies the impact of any one.
For example, a genetic risk, not exercising (or being sedentary), being female
and using antidepressants is a perfect storm for gaining weight. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">The risk factor that my research and my public health
efforts focus on is the environment – the food environment, which I define as
anywhere we make a decision about what to eat immediately or what to buy to
cook or eat at home. Within this huge
food decision space, individual level factors (knowledge, stress, social and
family norms, income) interact to make it harder for some to ‘resist’ what is
sometimes called a toxic or obesogenic (obesity causing) environment.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">To advance my goals – reducing caloric excess in the
population - I support policy that aims to change the environment. Policy that
changes the space where we make so many food (and beverage) decisions. I have
spoken a lot about information policy, but that doesn’t directly change the
environment (indirectly it could lead restaurants to supply lower calorie meals
through a change in recipes or serving sizes). Strategies/laws that directly
change the environment would include the failed NYC serving cap on sodas. Other strategies, softer ones some will say,
fall into the category of ‘choice architecture.’ In other words, someone (and
this someone can be a contentious issue) decides that in order to help a person
choose the healthier (? – definition pending) option, this healthier option needs
to be easier to access or displayed more attractively than the non-healthy one.
For example, instead of the huge display of 50 cent white bread at the front of
the store, the owner places a display of whole wheat bread. Strategies that I
am particular enamored with include taxes (price manipulations), zoning
restrictions (do we need 10 fast food restaurants w/in a mile of a neighborhood
or school?), and advertising constraints (do transit busses really need to
advertise 2 dozen donuts for the price of 1?). The point of these efforts is to
change perceptions about food consumption and the pressure to consume more food
than we need. The changes of what is normal developed in response to our
environment over the past 30 years. We have new social norms.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">Changing the environment means reducing the amount of or
display of ‘desirable’ foods.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">I hadn’t realized that what I was talking about is also
called ‘desire reduction.’ In other words, if the things – no the triggers -
that lead us to overconsume calories are taken away, then our desire to
overconsume is reduced. Take my donut example. If the ads for donuts are taken
off the bus, then this might reduce my desire to go buy donuts. Certainly, if
your work place bans junk food at office meetings, this would reduce the desire
to eat those junk foods. I like these strategies because they attempt to
reverse something that happened without our asking it to happen. The
environment changed around us and what was normal changed. Now it is ‘normal’
to be served supersized meals. It is ‘normal’ to sit for hours. It is ‘normal’
to drink a 20 ounce sugary beverage or an 8 ounce glass of wine. And pushing
back against the new normal in our social context is often met with shock and
disapproval. Still, this push back, this resistance, is yet another strategy –
an individual level strategy that some people promote. I am not convinced. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">The ‘new’ term for this type of individual level strategy or
intervention is ‘desire resistance.’ I became familiar with both of these terms
(desire reduction and desire resistance, but not the concepts) only recently,
when I read an article by Dutton, Fontaine and Allison <a href="http://journals.lww.com/nutritiontodayonline/Abstract/2015/09000/Desire_Resistance_and_Desire_Reduction_in_Public.9.aspx">(abstract
here</a>). I am a pretty big fan of Dr.
Allison, he is the co-director along with Dr. Fontaine, of the Nutrition
Obesity Research Center at the University of Alabama, and I pay attention to
what he has to say. This is one of the few times I disagree with him.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">In their discussion of desire resistance, the authors offer
this example of the skills an individual might need to posses in order to resist their ‘internal
desires’ or ‘external challenges’ (eg those brownies someone left in the break
room):<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal" style="margin-left: .5in;">
<span style="font-family: inherit; font-size: large;">“Desire resistance skills include
strategies such as self-monitoring, meal planning, asking for social support,
wearing a physical activity monitor, cognitive restructuring, making a public social
commitment, <b>and preparing oneself to
anticipate, tolerate, and accept feelings of deprivation when they are encountered.”<o:p></o:p></b></span></div>
<div class="MsoNormal" style="margin-left: .5in;">
<span style="font-family: inherit; font-size: large;"><b><br /></b></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">I understand that the authors are advocating for both desire
reduction and desire resistance, but desire resistance, to me, is going back to
the individual focus that others have already found to be extremely challenging.
Programs that work at this level usually do not produce lasting change. Yes,
there is some evidence that teaching people to count calories or plan their
meals will work for the short term and maybe in the long term, for some people,
but it is rare. In my experience and in the literature, finding people who can
actively, consistently and perpetually resist this 'in your face, food pushing
society’ is unusual. I AM one of those people, so if I am against desire resistance as an
obesity prevention strategy, it’s worth noting!</span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">This idea of resisting cues to eat calorically dense foods
or drinks, or any food or drink when you are not hungry, reminds me of the time
I spent teaching people how to resist the trigger to smoke a cigarette when
they were trying to quit. What worked the best was when there were LESS
triggers. In other words, successful quitters are more likely to be around others
who did not smoke, work and recreate in smoke free environments and live in a
‘space’ where smoking is not ‘normal.’ The environmental changes – and taxes on
tobacco – have done far more to assist in smoking cessation than all the desire
resistance programs!<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">It’s also ironic to me that in the Allison article, where the
authors introduce the desire reduction and desire resistance terms, that they
also point to the 2010 Recommendations from the US Surgeon General regarding
obesity prevention as misguided. They note that most of the strategies are in
the desire reduction category, as if that were a bad thing. I see it as a
response to the years – decades – of efforts that did not include the
environment at all. Still, in the end, the authors suggest that both strategies
– reduce desire by modifying the space and increase resistance by teaching
skills – be employed. And in their closing comments they make a valid,
important point. The same point is true with smoking or in their example,
managing anger, and it is: there is no world in which all temptation or
triggers will be absent at all times. In those situations where temptations
exist, a person will either indulge, relapse or resist.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">Personally, I plan to do a little indulgence in a few days….
Thanksgiving here I come!<o:p></o:p></span></div>
<div class="MsoNormal">
<br /></div>
<br />
<div class="MsoNormal">
<br /></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-42691587602528867842015-11-11T17:46:00.002-04:002015-11-15T12:09:34.386-04:00What do you think 'natural' means? <div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">Remember past blog posts where I discussed the
meaningless ‘all natural’ label declaration (see <a href="http://yourhealtheducator.blogspot.com/2010/09/un-naturally.html" target="_blank">here</a> and <a href="http://yourhealtheducator.blogspot.com/2012/03/why-you-have-to-stir.html" target="_blank">here</a>, for example)? Well, it looks like enough people,
or I should say, industries, have voiced similar concerns and with their clout,
have moved this issue into the FDA action phase.<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">The FDA comments portal opens tomorrow and you can participate
by clicking on <a href="http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm">this
link</a>. The three main questions posed
are:<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal" style="margin-left: .5in;">
<span style="font-family: inherit; font-size: large;">Is it appropriate (for the FDA) to
define the term “natural”? <o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in;">
<span style="font-family: inherit; font-size: large;">If so, how should natural be
defined (in regards to food/beverage products)?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in;">
<span style="font-family: inherit; font-size: large;">How should the FDA determine if a
manufacturer is using the term correctly on its food or beverage labels?<o:p></o:p></span></div>
<div class="MsoNormal" style="margin-left: .5in;">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">I have had two broad concerns with the labeling of an item
as all natural (because that is the point of this, food companies want to boast
a product as <b>all</b> natural, not just natural or containing natural ingredients).
The first is that the term gives the product a ‘health halo’ that may not be
justified. In other words, all natural just means all natural (except of course
we don’t KNOW what that means). It does not mean health promoting, or nutrient
rich, or low sodium/salt, or trans-fat free, or low calorie. None of the things
that I want my purchases to be are described by the term natural - though I certainly want minimal processing. My second concern is within the parenthetical comment above- we don’t know
what natural means! The old standard, but unenforced ethos from the FDA, was
that it meant minimally processed, free of artificial dyes and such. That is
far too subjective a definition. For something to be truly all natural, I
believe it has to be a whole food, maybe it can contain preservatives, but
surely it can’t come in a box. There are so many things that natural isn’t that
I am of the mind that the word should NOT be allowed on any labels and thus it
doesn’t have to be defined by the FDA. I think that is going to be my official
comment. Instead of defining the term, I think that it should be banned from labels altogether.<o:p></o:p></span></div>
<br />
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">What would your comment be? Speak up <a href="http://www.fda.gov/Food/GuidanceRegulation/GuidanceDocumentsRegulatoryInformation/LabelingNutrition/ucm456090.htm">here</a>…
or the food industry will speak for you!</span><o:p></o:p><br />
<span style="font-family: inherit; font-size: large;"><br /></span>
<span style="font-family: inherit; font-size: large;">Update - 11/15/15 Oh my goodness, how could I have forgotten my favorite All Natural product - YES, peanut butter that isn't fortified or processed, that counts :)</span></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-79132821689324727762015-11-06T16:20:00.001-04:002015-11-06T16:24:05.411-04:00Front of Pack Labels vs Labeling Laws<span style="font-size: large;">There is a difference in the requirements for vending operators when they post calorie counts for all items in their machines, starting December 2016, and what some candy, chips and pastry manufacturers are doing now - voluntarily.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">According to the law, the font type, size and color have to be large enough and stand out enough to get the attention of the customer while the customer is deciding what to buy. I suppose if you go to the snack machine with nothing but Reese's peanut butter cups on your mind, you may not slow down to read calorie counts, but if you are browsing.....</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">The snack manufacturers, likely because they make their snacks for grocery and convenience stores too, have begun placing industry designed - industry criteria based - front of pack labels on their packages. On the face, this sounds really good. I love calorie disclosures as a general rule. And it looks like the manufacturers are giving counts for the full packages. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">From the pictures below, you can see some problems.</span><br />
<br />
<ol>
<li><span style="font-size: large;">The labels are too small</span></li>
<li><span style="font-size: large;">The numbers do not stand out on the packages</span></li>
<li><span style="font-size: large;">If the package is not placed in the spiral correctly (especially this happens with beverages) you can not see the label at all</span></li>
<li><span style="font-size: large;">Sometimes the spiral actually covers the label</span></li>
<li><span style="font-size: large;">Only some of the items have labels - how can you compare? </span></li>
<li><span style="font-size: large;">The labels are not in the same spot, so you can't really scan efficiently, and</span></li>
<li><span style="font-size: large;">In this particular machine, the snacks with the most calories do not have labels (eg honey buns and tasty kake)</span></li>
</ol>
<br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">By the way, there doesn't seem to be any detectable pricing scheme - two items of equal calories or 'healthiness' can cost from $ .60 to $1.00. Or maybe there is, the chips or salty snacks in the machine below are 60 cents and the higher calorie items, the honey bun and pop tarts, are a dollar. Contrary to what we are told - the worse items cost more, not less.</span><br />
<br />
<br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1YfIbSHD8TDfq9TWz_LR2vn178U5j1J0cE6gg574va1IwO3YNUVuVs8N6iNYYxf2EBOUT7b59FT-xHyXFfdZ4hCuZLm_Km4E3nVLJAXAyENrBiHIPkl7UUd5uXxdkcw780wIUO-PM0SE9/s1600/vend1.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj1YfIbSHD8TDfq9TWz_LR2vn178U5j1J0cE6gg574va1IwO3YNUVuVs8N6iNYYxf2EBOUT7b59FT-xHyXFfdZ4hCuZLm_Km4E3nVLJAXAyENrBiHIPkl7UUd5uXxdkcw780wIUO-PM0SE9/s640/vend1.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Here the Cheetos and Oreos are labeled, possibly the pop tarts too</span></td></tr>
</tbody></table>
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiul-Zg6UrLoWGFe1BsPGlnPazlKxlYbYKMx1PV_0Ju2ZP4zXZCCwZsL9m7yvt-hzPzbFSqPaeR-396o-LsGiz3Hh4GdYd8ObVZWUDy-dxPQ9Z11AwY3qdBcHn4qreuNjuT17I6TG3U3u33/s1600/vend2.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiul-Zg6UrLoWGFe1BsPGlnPazlKxlYbYKMx1PV_0Ju2ZP4zXZCCwZsL9m7yvt-hzPzbFSqPaeR-396o-LsGiz3Hh4GdYd8ObVZWUDy-dxPQ9Z11AwY3qdBcHn4qreuNjuT17I6TG3U3u33/s640/vend2.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Notice the different label placements, upper right hand corner and lower right hand corner, and even the small side of a package</span></td></tr>
</tbody></table>
<br />deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-17047336201046447212015-09-10T11:51:00.002-03:002015-09-10T11:51:21.184-03:00Health Halos, Calorie Labeling, and Vending Machines <div class="MsoNormal">
<span style="font-size: large;"> Vending Times, a trade magazine for, you guessed it, the
Vending Industry (machines, coffee service and micromarkets), recently
announced that Mrs. Freshley’s has a new product, 7 Grain Cookies. You can read
a little about them <a href="http://www.vendingtimes.com/ME2/dirmod.asp?sid=EB79A487112B48A296B38C81345C8C7F&nm=&type=Publishing&mod=Publications%3A%3AArticle&mid=8F3A7027421841978F18BE895F87F791&tier=4&id=CC26969E765248DB922D4B4B76B3C6F1">here</a>,
but the important information (i.e., nutrition content) is not yet posted.
Other cookies by this company have, on average, 200 to 300 calories per package
– the serving size. <o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-size: large;"> Without my explaining, can you guess the problem with a 7
grain cookie? Here is a hint and a term nutrition and obesity prevention researchers
often use – “health halo.” You probably figured it out. By saying that this
high sugar, high calorie item has 7 grains, people are distracted from the fact
that it is still an item that should be consumed in extreme moderation.
Cookies, pastries and such are in the discretionary category and I believe the
latest version of US Dietary Guidelines suggest that discretionary calories
take up no more than 10% of a day’s worth of calories (actually the new guidelines
refer to added sugar not being more than 10% of calories). Therefore, if you
were a small, active women consuming 1800 calories a day, this pack of cookies
would be all you were allotted in discretionary calories for the day. The fact
that the cookies might supply you with some whole grains, a positive thing,
doesn’t change the fact that they are cookies. (BTW, other health halos you
might see on discretionary food and beverage items, REAL sugar, raw sugar, honey,
molasses– it’s all sugar, and in this context, not different than corn syrup or
table sugar).</span></div>
<div class="MsoNormal">
<span style="font-size: large;"> Label declarations such as these (e.g., 7 grains) can give
us a false sense of the healthiness of an item. Of course, healthiness is a
moving target, but let’s stick with sugar and calories – we do want to limit
them across the board, throughout each day. In a similar fashion to label 'nutrient disclosures', researchers have found that some Front of Pack labels (of
which I am a huge fan) can also create a health halo! </span><span style="font-size: large;"><a href="http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9850410&fileId=S1368980014002997">Hamlin, McNeill and Moore</a>(</span><span style="font-size: large;">2014) conducted an experiment on choices people make after seeing different
types of Front of Pack labels and found that across all types (2), having a
label led people to buy that product more often than if it did not have a
label, regardless of what the label said. This is only one study, and others
show that the labels can be helpful in leading to a reduction in calories, salt
or sugar purchased, but it is definitely something that should give us pause,
especially because one of the label formats tested was my favorite, the
multiple traffic light. </span></div>
<div class="MsoNormal">
<span style="font-size: large;"> When I think of this in the context of our soon to be
implemented calorie disclosure law for vending machines, it occurs to me that
maybe, simpler IS better. In other words, if every single product has a label
and the only thing on the label is calorie content – then choosing the smallest
number would be the (usually) right thing to do. I have that parenthetical
usually, because a 100 kcal pack of cookies might not be a better choice than
the 200 kcal package of granola bars, BUT – it would still be the least
caloric.</span></div>
<div class="MsoNormal">
<span style="font-size: large;"> Lastly, the 2016 calorie label law (passed in 2010) is very
specific about the placement, color, font and size of the calorie disclosure.
If you take a look at the pictures below, you can see why that is important.</span></div>
<div class="MsoNormal">
<span style="font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-size: large;">I took these photos at vending machines where I work and
offer some comments in the captions. </span><o:p></o:p></div>
<div class="MsoNormal">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
</div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: 1em; margin-right: 1em; text-align: left;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-Rm1oKLxz2mb_preXJNttXJ9e10bdVFFVz2lh48UUB9iAiMCKgke5f78mVzguWA1tBeKY_JaktsTnq8yDFFHdqpqdU7Ijpbvw0xVC0MALaKV4aX4J4VwhZlZZ51t4T_zI8QyGczQmI5k4/s1600/smart+choice.JPG" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEj-Rm1oKLxz2mb_preXJNttXJ9e10bdVFFVz2lh48UUB9iAiMCKgke5f78mVzguWA1tBeKY_JaktsTnq8yDFFHdqpqdU7Ijpbvw0xVC0MALaKV4aX4J4VwhZlZZ51t4T_zI8QyGczQmI5k4/s400/smart+choice.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">This is industry criteria, notice the calorie, sugar and sodium limits to be called a Choice Plus snack</span></td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: 1em; margin-right: 1em; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhf0dzt3zSyZR1z8A9o3JcQbnxO8UFJ_Yr7js1dCl_cIflDyiWZlmV2BH8FhWE8imgD0gUamysyA56QizcJdMIX9sHzW66nrL4JmwfZEmmLd8A5dTsxQ5HVDHv-Cb1LxV4IJDBAqzTeHtWT/s1600/FOP_smart+choice+not.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhf0dzt3zSyZR1z8A9o3JcQbnxO8UFJ_Yr7js1dCl_cIflDyiWZlmV2BH8FhWE8imgD0gUamysyA56QizcJdMIX9sHzW66nrL4JmwfZEmmLd8A5dTsxQ5HVDHv-Cb1LxV4IJDBAqzTeHtWT/s400/FOP_smart+choice+not.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Notice the sodium - its too high to be a Choice Plus but the snack is in a Choice Plus Slot. Also this snack has a Front of Pack label which could be a health halo.</span></td></tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUS3EV8YhcM8ehPKUxX0Q0lS8kMOFQvEj3Be0d_l1_StRvcAJd93B1mbGbJCUh3XuQ9atMMzkKnynfcshluZ_Ec51RFn-3w-nYSA5OvPLLAuLHeAbBk7eCapAHMANkIsA0dh91sLHMuoIg/s1600/snacks.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgUS3EV8YhcM8ehPKUxX0Q0lS8kMOFQvEj3Be0d_l1_StRvcAJd93B1mbGbJCUh3XuQ9atMMzkKnynfcshluZ_Ec51RFn-3w-nYSA5OvPLLAuLHeAbBk7eCapAHMANkIsA0dh91sLHMuoIg/s400/snacks.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Great example of how different a Choice Plus snack can be and if you look closely you see some calorie disclosures on the package. You have 250, 190 and 100 here. Importantly, they are ALL the same price ~ busting that myth.</span></td></tr>
</tbody></table>
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDdeuB55J3yvxVr8eBnJFF8l5MshgjXcGTVmNF-YxYRqiPHlSJLsflTmHOFXM19H9AkSX9yzpZ78B8Zpw2fWtqbIi0CYu3cwbgFdbztuFfuQYUQlqmNXbkGZZluC81dxMM5PtLQA0Z2YFJ/s1600/soda+label.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhDdeuB55J3yvxVr8eBnJFF8l5MshgjXcGTVmNF-YxYRqiPHlSJLsflTmHOFXM19H9AkSX9yzpZ78B8Zpw2fWtqbIi0CYu3cwbgFdbztuFfuQYUQlqmNXbkGZZluC81dxMM5PtLQA0Z2YFJ/s400/soda+label.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="text-align: start;"><span style="font-size: large;">In my opinion, this is not as helpful as the machines with the calories on the front inside the picture of the sodas. I was within inches of this display when I took the picture and you can barely read the calories on these sugar sweetened ice teas (120 per 20 oz)</span></span></td></tr>
</tbody></table>
<div class="MsoNormal">
<br /></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-9581202617437618942015-08-27T22:41:00.001-03:002015-08-27T22:41:29.952-03:00Food Purchases and a Right to Know<span style="font-size: large;">Some while back, I listened to an interview of Richard Cordray, head of the Consumer Financial Protection Board, on the Diane Rhem Show. During the conversation, he said something about consumers having a right to full information when they were making a purchasing decision, whether that was an appliance, house or a loan. I made a note to myself to go back and find the transcript when time allowed, because what he was saying also made sense as an argument for why we should disclose information about the foods we purchase, even if - or especially if - they are completely prepared by a third party. I do not focus on vaguely defined terms like All Natural or Organic, and though I don't think a product with GMO (genetically modified organisms) is bad simply because it contains GMOs, I do concede to my friends who insist the products be labeled as such.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Instead, my labeling interests are about ingredients (and their amounts) and caloric content - at the very least calorie amounts, because that seems to be the best place to start with regard to weight control. I did find the recording and transcript of the interview, you can view both <a href="http://thedianerehmshow.org/shows/2015-07-22/a-conversation-with-richard-cordray-head-of-the-consumer-financial-protection-bureau" target="_blank">here</a>, and I believe it is this excerpt that caught my attention back in July.</span><br />
<li class="list-item l-pair-sm"><div class="txt-bd">
<blockquote class="tr_bq">
<span style="font-size: large;">For consumers,
the ability to understand more clearly what the costs and risks are that
they face as they make choices, I have great confidence in consumers'
ability to make decisions for themselves. Nobody can stand in their
shoes and understand their circumstances as well as they do themselves.
But at the same time, there are things they need to know about what the
choices really are and whether the choice that's being presented to
them is the deal that they will actually be able to live with next year
or the years after or whether it will have changed in ways that are not
clear to them in the fine print.</span><span style="font-size: large;">These
are all ways in which consumers, if they have their eyes open and if
they can clearly see the futures, will make pretty good choices for
themselves. But if the future is obscured, if they're being tricked and
if there's deceptive marketing, as was often the case, then they will
make bad decisions and they'll regret them and none of us wants to see
that and consumers most of all. </span></blockquote>
</div>
</li>
<br />
<div>
<span style="font-size: large;">A lot of what Mr. Cordray discusses has to do with loans - its a great interview regarding financial protection and regulation. I encourage you to listen.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">But if you think about all the decisions we make regarding food - every day - the same message applies. Do we know what will happen to our future selves if we eat, for example, meals with very high calorie, sugar or salt content? And if we do know what will happen - for example, that we might gain weight or our blood pressure become dangerously high - shouldn't we be able to make an informed choice? A choice made by easily identifying the foods and beverages that are high or low in those things? It is our future 1) to understand and 2) to protect.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Full disclosure is a purchasers legal right.</span></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-4491434640191202642015-08-04T22:30:00.001-03:002015-08-04T22:30:09.771-03:00Calorie Awareness While Traveling<span style="font-size: large;">I recently spent a week at a Residence Inn in Alabama. I attended a research methods workshop for obesity prevention and treatment. On several occasions, I was aware of the 'conspicuous' absence of calorie disclosures. The biggest one... the hotel 'free breakfast.' Except for the cartons of yogurt and milk, nothing was labeled. Considering that a slice of bread can have as little as 40 calories (if you search hard) and as many as 100+, that's a big deal. I imagine the range for the available muffins, bagels and waffles make them equally hard to 'estimate.' Sure a day or two of incidental over consumption should't have lasting effects on your health, but if you travel - and eat away from home - often, the information will come in handy. </span><br />
<span style="font-size: large;">When I travel, attend workshops, meetings and just go to work, I try to keep within the bounds of what is healthy for me. That is another observation I had while at the workshop. It is not enough for the planners to serve 'healthy' food, because healthy, especially these days, is a relevant term and a moving target. Healthy for me mostly meets with the updated recommendations from the Dietary Guidelines Advisory Committee: </span><br />
<blockquote class="tr_bq">
<span style="font-size: large;">The overall body of evidence examined by the 2015 DGAC identifies that a healthy dietary pattern is higher in vegetables, fruits, whole grains, low- or non-fat dairy, seafood, legumes, and nuts; moderate in alcohol (among adults); lower in red and processed meat;i and low in sugar-sweetened foods and drinks and refined grains. Vegetables and fruit are the only characteristics of the diet that were consistently identified in every conclusion statement across the health outcomes.</span></blockquote>
<span style="font-size: large;">*The fruits and vegetables are highlighted as being prepared with spices and without adding salt and saturated fat. See the full report <a href="http://www.health.gov/dietaryguidelines/2015-scientific-report/" target="_blank">here</a>.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">So for me, healthy is not about organic or 'all natural,' and healthy doesn't mean no artificial sweeteners, but that is exactly how some others might define healthy for themselves. My healthy diet includes mostly whole foods, minimally processed; no meats, lots of vegetables, soy based lean protein, fish, almond milk and no or low fat dairy (yogurt, cheese, ice cream), fruit, coffee, plenty of whole grains, like popcorn!, fiber and yup, alcohol and diet soda. So to eat the way I like, I usually bring my own food, and in Alabama, though I ate out a few nights, I went to the grocery store and prepared my lunch and dinner in the nice hotel room kitchen. (The reason the workshop lunches weren't 'healthy' to me is because they were often sandwiches, pasta, or meat based. I did enjoy the fruit and diet soda though!)</span><br />
<span style="font-size: large;">Interestingly, my friends and I were out walking one evening and one or two got very excited when we passed the Insomnia Cookies store. (remember this was an obesity prevention workshop, and cookies can be part of a calorie controlled diet). So, my friend was more than a little excited as she went into the store - there was quite a line at the counter - but she came right back out, with a brochure (for me) and disgust. WHY? THEY POSTED THE CALORIE CONTENT! HAHAHAHA, she said that seeing the calories took all the fun out of it. Hilarious. (BTW, we have one of these Insomnia Cookie food trucks at Temple University, and the shop in Alabama was within a mile of the UAB campus. Sense a theme?)</span><br />
<br />
<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1hK1ihKV60fOduzSZGpQUh16x8U72J4lzLm9hynzN5gsWIppitsSv3ZuuaAHEc7Wksey0H7fy3HAT91qbiP-IhBKEeumi-IQq3b1ynrgm5rYTxhxdVDWmdAB6tIfkkUxUb-mGuViZNNl-/s1600/cookies.cal.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1hK1ihKV60fOduzSZGpQUh16x8U72J4lzLm9hynzN5gsWIppitsSv3ZuuaAHEc7Wksey0H7fy3HAT91qbiP-IhBKEeumi-IQq3b1ynrgm5rYTxhxdVDWmdAB6tIfkkUxUb-mGuViZNNl-/s640/cookies.cal.jpg" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Notice the ranges, also on the right is ice cream</span></td></tr>
</tbody></table>
<br />deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-66515103767152285192015-07-13T21:08:00.000-03:002015-07-13T21:08:29.934-03:00The delay is NOT the demise of menu labeling<span style="font-size: large;">The FDA has granted restaurants and similar retail establishments a delay in posting calorie amounts - how that delay actually came about and why, warrants some clarification.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">The National Restaurant Industry, like the National Automatic Merchandising Association for vending machines, supports calorie disclosures on menus and menu boards as mandated for large (20 or more) chain restaurants. Large chain restaurants are probably ready to roll with the disclosures - several cities and at least 1 state already have calorie (+) disclosure laws in place (though they are preempted by the federal law). It is not likely that restaurants need or even want the delay, after all, the industry(through its trade group) supported the federal law; a nationwide, preemptive law is good for them.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">What is really going on is that the 'similar retail establishments,' ones that sell ready to eat food as a major part of their enterprise, for example, grocery stores, movie theatres, bowling alleys, convenience stores, tried to get out of the mandate. Once they realized the law did indeed apply to them, they asked for and received more time to get their act together.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I do not see the delay as a bad thing and I do not read it as the demise of the legislation. Too many big players AND consumers want calorie displays across the many places where food choices are made. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Including the similar retail establishments (and vending machines) in the law makes it 1) fair to the sellers of the food - why should some have to disclose and other not? and 2) easier - possible - for us to monitor our calorie intake if we so choose. Whether we will choose to do it or understand how to do it, is a separate discussion.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Researchers and proponents of the law do not know if calorie disclosure by itself is going to change the behavior of people most in need of changing their behavior (i.e., people who exceed their average daily calorie needs), but it makes it possible and before we can do anything else (e.g., tell people how many calories, from which types of foods, are too many), we have to put the information out there. The early positive change that I, and many others envision, is that the retailers are going to reformulate recipes or reduce serving sizes in order to 'present' calorie counts that are more reasonable. Hey, there is a thought, maybe one of the things that 'similar retail establishments' will do with their extra year is reduce calories - say in that bucket of popcorn!</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Anyway, I am not disheartened and as a researcher, I hope to take advantage of the extra time to conceptualize some new evaluation studies!</span><br />
<br />deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-79405374189170583122015-06-30T22:32:00.000-03:002015-06-30T22:32:16.638-03:00Seen about town, ads pushing calorie dense items and calorie disclosures, etc<div class="separator" style="clear: both; text-align: center;">
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<span style="font-size: large;">It was really challenging to come up with a title for this blog post, which is a good sign that I am trying to say too much in one post. Nonetheless, I am stubborn and have been holding on to these photos and these thoughts for at least a month.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">First, calorie disclosures are coming, they will be the law of the land, but probably not fully so until 2016. In other words, the congress persons representing businesses will get the law delayed, but they will not get it appealed (I understand from my sources).</span><br />
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<span style="font-size: large;">Second, it is becoming clear that 'a calorie is a calorie' is not quite true - even for weight. You may recall a post from me some years ago that implied that as far as weight was concerned 1800 calories of twinkie are the same as 1800 calories of vegetables. I went on to say, and this part remains true, that a person will be a lot healthier and feel much better if they refrain from eating 1800 calories of twinkie. I think we've all known that the body handles macronutrients differently, i.e., refined carbs are metabolized differently than fats or fibers - but more recently science has established that the number of calories might be the same in say a twinkie and a piece of salmon, but once our body digests and metabolizes these foods, the calorie end point is not the same. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Some people have suggested that calorie monitoring may be less necessary, and to that point I strongly disagree. Many people who have lost weight and kept if off do eat better and maintain high levels of exercise but they also remain vigilant to consuming a sensible range of calories.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I am not abandoning calorie monitoring. However, I am not involved in research on metabolism - nor am I a nutritionist- so I will stick to watching what happens when calorie disclosure laws go into effect. For example, I anticipate changes in availability of lower calorie options and changes in purchasing behavior. I am not going to keep trying to describe the science on the relationship between calories and weight gain. Instead, I assure you that we cannot eat with reckless abandon and many of our away from home meal purchases are ridiculously high in those wrong kind of calories.</span><br />
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<span style="font-size: large;">Now my pictures and why I chose to take and share these in particular.</span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrGVx-5qj9Aabl3YMIZOHVlVA1a0p0DSrHBU1VlUBX3qMdVIwzDu1dmMFpwzsT4IiLgcceuht1FZC5JrwhlLVsGuwFoOjVppbKC5DkFtroJF0bhatMyAEMSMfqVQ5HAqZC4wYtxfz81sNF/s1600/adBGR.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgrGVx-5qj9Aabl3YMIZOHVlVA1a0p0DSrHBU1VlUBX3qMdVIwzDu1dmMFpwzsT4IiLgcceuht1FZC5JrwhlLVsGuwFoOjVppbKC5DkFtroJF0bhatMyAEMSMfqVQ5HAqZC4wYtxfz81sNF/s640/adBGR.jpg" width="481" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">This ad was presented to me while I was listening to Pandora Radio - not so targeted considering I am a calorie controlled vegetarian!</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWGwlqFU_pbQ7a1BZTwMzmAs4_yRjLYd-7hSyc_5UHcB1c9IvjsbXlE7TTM9MfRPMkGsniohXEFEmfsK_cGEly15sLa-I09Sw-Iu_NDYaBFXxndvyXyl2iQwdCv1s1-E-N5czPK6fD7SBc/s1600/busad.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="300" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjWGwlqFU_pbQ7a1BZTwMzmAs4_yRjLYd-7hSyc_5UHcB1c9IvjsbXlE7TTM9MfRPMkGsniohXEFEmfsK_cGEly15sLa-I09Sw-Iu_NDYaBFXxndvyXyl2iQwdCv1s1-E-N5czPK6fD7SBc/s640/busad.jpg" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">I was 'exposed' to this ad on the Philly transit bus; a bargain for two high calorie items. PLUS I am a NYG fan :)<br /></span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgARYGSvglFumWEFX0lxcv8Dj1Y2XYANUWClpJ0gRQb35hCSyPuByoxBjY7FAHu8CIWaSFyKYCFTtQyI4c1yM9_hIQNw9f6yh24mPLn7zaQ52ssRlFHs1jfGqmR3GvybpnqZ-VhOPZorcK/s1600/chik.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjgARYGSvglFumWEFX0lxcv8Dj1Y2XYANUWClpJ0gRQb35hCSyPuByoxBjY7FAHu8CIWaSFyKYCFTtQyI4c1yM9_hIQNw9f6yh24mPLn7zaQ52ssRlFHs1jfGqmR3GvybpnqZ-VhOPZorcK/s640/chik.JPG" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">You may have heard that grocery stores do not want to put calorie labels on their prepared food; that is unfair to restaurants and leaves customers lacking important information for food choices.</span><span style="font-size: large;"> </span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZmVI0USQKTfpoQojrcDTUxRdWAJgl2AI3xB79K1iHxjv2NI3b2i2R3oId5L9cx7eJiImnebeoJ0cI70tROMQ0oXDjnHQcgVeWdo83y0nxmw4zfeF2650JaJj40236KdJTcwvRfv17HklQ/s1600/tsts.JPG" imageanchor="1" style="font-size: medium; margin-left: auto; margin-right: auto;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjZmVI0USQKTfpoQojrcDTUxRdWAJgl2AI3xB79K1iHxjv2NI3b2i2R3oId5L9cx7eJiImnebeoJ0cI70tROMQ0oXDjnHQcgVeWdo83y0nxmw4zfeF2650JaJj40236KdJTcwvRfv17HklQ/s640/tsts.JPG" width="480" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Manufacturers update their labels from time to time, they may reformulate a product which changes the calorie amount, they may change the serving size which would change the calorie amount or they may fear scrutiny and revisit the accuracy of their label. These side by side boxes are both Jacobsens Blueberry Snack Toasts, but the calories INCREASED from 40 each to 45 each. Everything else appears to be the same. When I find older version with less calories listed, I buy them, but I am just fooling myself!<br /></span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBN8iLVi4-sGCrV32A9x1jnWZ62xIJ_JlKpko0Qm8ssu3YL5ts8uLslNawapPhgRXf9BuRYE6wld3uX89tNR80cixbhy-r7jLBeovtGZaygsBjVfgNhDblyOVeJWDVFdhrrRMYaaShk-bA/s1600/rest.jpg" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="640" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiBN8iLVi4-sGCrV32A9x1jnWZ62xIJ_JlKpko0Qm8ssu3YL5ts8uLslNawapPhgRXf9BuRYE6wld3uX89tNR80cixbhy-r7jLBeovtGZaygsBjVfgNhDblyOVeJWDVFdhrrRMYaaShk-bA/s640/rest.jpg" width="584" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">This is my favorite! This restaurant is in Philadelphia where a calorie disclosure law has been in place for several years. The menus also have to display sodium/salt content. This is one positive outcome of calorie disclosures! </span></td></tr>
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deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-85314844342876883272015-06-01T12:37:00.002-03:002015-06-01T12:37:50.187-03:00Calorie Mindful or Drunkorexia<span style="font-size: large;">I recently came across a research article discussing a phenomena (possible 'disorder') called drunkorexia. The term and what it means caught me off guard and to be honest, disturbed me. It disturbs me for a couple reasons. The first is that I am loathe to think that my advising persons - as a public health educator - to consider how they spend their calories in a given day might in some way suggest that I think people should drastically cut their calories in order to 'fit in' highly caloric (and dangerous) binge drinking. Of course, I expect that the primary audience for my blog and YouTube channel are not mostly college aged females - the group that engages in this behavior the most - and is instead, people doing their best to consume the right amount of calories to keep themselves at a health promoting weight. So when I say that I personally consider the 1 beer, glass of wine or alcoholic beverage (~ 100 cals) in my daily total, and thus have a smaller lunch or breakfast in order to have that drink, I am NOT advocating skipping meals or 'starving' in order to 1) drink on an empty stomach for a quicker high or 2) or to consume 500 or more calories in alcohol and not gain weight.</span><div>
<span style="font-size: large;"><br /></span></div>
<div>
<span style="font-size: large;">I am also concerned when people medicalize/diagnose behaviors, like the dumb one I just described, into psychological problems - at least too quickly. Labeling people, in my experience as a social worker (not a psychiatrist/psychologist or nutritionist), too soon or maybe at all, can cement the problem; the person becomes the problem - the illness manifests because someone said it was there.</span></div>
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<span style="font-size: large;"><br /></span></div>
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<span style="font-size: large;">My area of expertise and research is not eating disorders. The main point of this post, and the point I will reiterate and end with is: being smart about the calories you consume does not include - never includes - not eating. It is easy to reduce a breakfast and or lunch by 50 to 100 calories by changing its ingredients. <b>I do not advocate any of the behaviors associated with this 'drunkorexia.'</b></span></div>
deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com2tag:blogger.com,1999:blog-6199402777613414553.post-73820707503784250362015-05-19T21:58:00.001-03:002015-05-19T21:58:25.679-03:00The proliferation of calorie disclosures<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">In one of my recent posts, I mentioned that calorie
declarations for restaurant items were beginning to show up on TV and in web
based ads. It appears that the industry is gearing up for the calorie
disclosure mandate that goes into effect this December (see the Final Rules for
ACA sect 4205<span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="line-height: 107%;">[1]</span></span><!--[endif]--></span>). I have noticed that up-front calorie
disclosures are becoming more prevalent in grocery stores as well.<o:p></o:p></span></div>
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<span style="font-family: inherit; font-size: large;"><br /></span></div>
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<span style="font-family: inherit; font-size: large;">The grocery store calorie proliferation is likely due to
several factors, including the Affordable Care Act’s wide reaching mandate.
Food manufacturers began adding front of pack labels some years ago (with
declarations THEY are comfortable with, i.e., not every manufacturer includes
calories or sugar amounts on the front of every one of their products), but one
voluntary version <a href="http://www.factsupfront.org/AboutTheIcons">Facts Up
Front</a> does provide info on calories and select nutrients, and it has
potential. If you click on the link
above, you can scroll through some of the examples. As an example, I have
noticed that most sliced bread brands have Facts Up Front labels now - with the
calories displayed - but BE CAREFUL sometimes its calories per 2 slices and
sometimes per 1 slice. The Institute of Medicine has recommended a
standardized, mandatory front of pack label with an interpretive design, for
example, 3 stars vs 1 star (I wrote about this recommendation a few years ago).
I believe that the more customers see
calorie disclosures, the more they will demand them - up-front. (The new calorie disclosure law is about
ready-to-eat foods at grocery stores, restaurants and similar establishments,
not packaged foods. But again, people are now expecting to see calories more
easily because of laws like this.)<o:p></o:p></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;"><br /></span></div>
<div class="MsoNormal">
<span style="font-family: inherit; font-size: large;">One of the issues in labeling, especially for packaged or
self-serving foods (e.g., ice cream), is a push to present easily, or commonly,
understood serving sizes. The serving
sizes (usually) accompany the calorie counts on front labels, e.g., half a cup,
2 tablespoons. I think it would be a disservice to customers, however, not to
also include the weight in grams or number of ounces of that particular ½-cup
or tablespoon; a ½- cup of one item may not be commensurate with ½ a cup of
another item. Recently, I was choosing
between cookie brands. For each brand, the calorie amount per 3-cookie serving
was 130, but the serving for one brand had 20 grams and the other had 30 grams,
so in essence, I would get to eat MORE food for the same calories if I chose
the heavier product. I owe my ‘per unit’ calorie comparisons to lessons I have
gleaned from using UPC shelf labels, price per ounce, as I’ve mentioned in the
past. <o:p></o:p></span></div>
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<span style="font-family: inherit; font-size: large;"><br /></span></div>
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<span style="font-family: inherit; font-size: large;">I think that emphasizing serving size can also be context
specific. One place it makes sense for
the majority of people to see calories per serving ‘size’ instead of serving
‘weight’ is the vending machine. I say
this because, the usual serving size of a snack purchased from a vending
machine, or the amount customarily consumed, is the whole package. The package
is the serving size. Most people intend
to eat all the M&MS, Fritos, or Lays, so by scanning across all products
and knowing how many cals per pack, a person can, if they choose, pick the
lowest calorie package and be done with it.
(In time, I suspect, savvy customers will figure out that even here,
they can get more or less calories per package based on weight/volume.)<o:p></o:p></span></div>
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<span style="font-family: inherit; font-size: large;"><br /></span></div>
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<span style="font-size: large;"><span style="font-family: inherit;">So that is very cool.
Calories are showing up more (this is good for people who are trying to
limit calories or who simply want to choose items with fewer calories - can’t
do it if you don’t know the numbers!).
The national law (again see ACA section 4205) covers more than foods –
restaurant chains under the laws jurisdiction will also have to display
calories for their alcoholic beverages!
Not the gin and tonic you order at the bar, but the Bahama Mama or
Margarita from places like Red Lobster and Chili’s. This is one place that the restaurant
industry in general, is not giving us a prelude with its on line menus. I went to the websites of more than 10
restaurant chains while writing this blog, and only one, Red Lobster, had its
alcoholic beverage calories posted. Some of these drinks have more calories
than my meals; I expect many drinks will be reformulated when the law goes into
effect. If you want to get an idea,
check out </span><a href="http://www.redlobster.com/health/nutrition/nutrition_facts.pdf" style="font-family: inherit;">Red
Lobster’s</a><span style="font-family: inherit;"> menu – see page 2. Else, stick with lighter beers and wine or
traditional drinks, gin and tonic should have about 100 calories as does my
favorite Dee Dee Sour (Seagram’s seven and Fresca). BTW, the Red Lobster </span>Caramel<span style="font-family: inherit;"> appletini has 160
cals and the chocolate martini has 330 – how could anyone know this without a
calorie disclosure on the menu, when you are ordering? Unless of course, it’s that ONE day a year
when none of this matters (smile face!)</span></span></div>
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<a href="file:///C:/Users/Deirdre/Dropbox/blogcals.docx#_ftnref1" name="_ftn1" title=""><span class="MsoFootnoteReference"><!--[if !supportFootnotes]--><span class="MsoFootnoteReference"><span style="font-family: "Times New Roman",serif; font-size: 10.0pt; line-height: 107%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">[1]</span></span><!--[endif]--></span></a>
<a href="https://www.federalregister.gov/regulations/0910-AG57/food-labeling-nutrition-labeling-of-standard-menu-items-in-restaurants-and-similar-retail-food-estab">https://www.federalregister.gov/regulations/0910-AG57/food-labeling-nutrition-labeling-of-standard-menu-items-in-restaurants-and-similar-retail-food-estab</a><o:p></o:p></div>
<div class="MsoFootnoteText">
<a href="https://www.federalregister.gov/articles/2014/12/01/2014-27834/food-labeling-calorie-labeling-of-articles-of-food-in-vending-machines">https://www.federalregister.gov/articles/2014/12/01/2014-27834/food-labeling-calorie-labeling-of-articles-of-food-in-vending-machines</a><o:p></o:p></div>
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deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0tag:blogger.com,1999:blog-6199402777613414553.post-4362839368650941642015-05-11T21:54:00.000-03:002015-05-11T21:54:04.608-03:00Label Claims<span style="font-size: large;">In the past, I have cautioned that ingredients, serving sizes, and calorie content can change over time, making it a good idea to keep a watch on even your staple products. For me, Smuckers All Natural Peanut Butter has been a staple for years. I noticed when I got home from the grocery store today that both the Nutrition Facts Panel in the back and the Front of Pack (jar) declaration had changed. To be truthful, I did not notice the Front of Pack calorie declaration on the jar in my fridge before today, but it says 210 cals per 2 tablespoon serving - kudos for 1) disclosing calories up front and 2) including a serving size that we can understand. Also, on the standard NFP, the type of fats are broken down on the older jar. I have often pointed out that Smuckers All Natural peanut butter is a source of 'good' monounsaturated fat, but the tides and the (interpretation of) science have changed on fat - and no matter the kind of fat - the calories are the same. (BTW, this is one of those rare occasions where the term natural really means natural.)</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">The reason I started comparing my two jars of peanut butter was because on the front of the jar I bought today there was a declaration of 8 grams of protein per serving. Peanut butter is usually a good source of protein - that is not new- declaring the grams on the front of the label is though. I guess there is a shift underway and protein is the macronutrient of the day. Because it was highlighted, I did think maybe the amount changed, but no, both jars have 8 g per serving. The older peanut butter does have more calories, just a few, but its weird that it went from 210 to 200 - same serving size. AND, other nutrition related fads (oh I mean concerns) are addressed on the new label, too. I'll let you pick them out below. BTW, the ingredients - peanuts and salt - are unchanged.</span><br />
<span style="font-size: large;"> </span><br />
<span style="font-size: large;">Here are the two jars and yes, I still LOVE this peanut butter.</span><br />
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxhbT2O1zunW2Yy0bRPqQlOXtUUGEDBeQ7EpCtp5h7N_kvGCn0feHWRizlp-m4hqxFdfQhogvP8GdDiLZvt_bLteN5WfsSqBsyEhx9GOVEuF0kfgyKZ8Xe9sDykwtF59aQWtMl81jJFHsd/s1600/pb1.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="480" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjxhbT2O1zunW2Yy0bRPqQlOXtUUGEDBeQ7EpCtp5h7N_kvGCn0feHWRizlp-m4hqxFdfQhogvP8GdDiLZvt_bLteN5WfsSqBsyEhx9GOVEuF0kfgyKZ8Xe9sDykwtF59aQWtMl81jJFHsd/s640/pb1.JPG" width="640" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">This picture shows that the newer label doesn't break down the good fats.</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBrOelrSH9rkkQ4waEQ_x7rq7F7QlAqTVI2yZhsV0hCNx4bjYClwoiOOnlB2St0A0mt3AKbEaedkDh9Sw-0iAAhOJ3bltKSF4vR28aI7VwSKJzNbR5Lw8yvQjwc8CWOksABVWycVr84zQk/s1600/pb2.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgBrOelrSH9rkkQ4waEQ_x7rq7F7QlAqTVI2yZhsV0hCNx4bjYClwoiOOnlB2St0A0mt3AKbEaedkDh9Sw-0iAAhOJ3bltKSF4vR28aI7VwSKJzNbR5Lw8yvQjwc8CWOksABVWycVr84zQk/s400/pb2.JPG" width="300" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Old calorie declaration</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqc9B4cPvaFuBNwOovt5xFZIsC11h6IgEfB9gDiNDmdmNbq5qESMR3xF4hhf4-s5xK3rb1dSKXWKOqTEBG0NNPyEERD7i1UDWXBPufZGzajngPbORQWtyWtLzYl4XiTs_PkexYFv5tN0QO/s1600/pb5.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgqc9B4cPvaFuBNwOovt5xFZIsC11h6IgEfB9gDiNDmdmNbq5qESMR3xF4hhf4-s5xK3rb1dSKXWKOqTEBG0NNPyEERD7i1UDWXBPufZGzajngPbORQWtyWtLzYl4XiTs_PkexYFv5tN0QO/s400/pb5.JPG" width="351" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">New calorie declaration plus 2 more declarations</span></td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1judwmI4e8rGw2jLMeZ4g-RwCHmWuhOLjlNRyxUQf0j6YwEmHm3VDr9uNL1vD0XtD4VNty7NYG8qhFXcOwQyLzy1pMX-hz64Oko5n1czKqQiJnT8v0hRZ3-nTIh4yDHKFqvCRAjpCxnrf/s1600/pb4.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="400" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg1judwmI4e8rGw2jLMeZ4g-RwCHmWuhOLjlNRyxUQf0j6YwEmHm3VDr9uNL1vD0XtD4VNty7NYG8qhFXcOwQyLzy1pMX-hz64Oko5n1czKqQiJnT8v0hRZ3-nTIh4yDHKFqvCRAjpCxnrf/s400/pb4.JPG" width="368" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;"><span style="font-size: large;">Protein highlighted</span></td></tr>
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<br />deedeeskihttp://www.blogger.com/profile/08590036730651038977noreply@blogger.com0