Would you mind writing a blog post on the new surgeon general’s obesity report? …Is there a food politic element to why this has gone under the radar? …I find it ironic that Michael Pollan’s Food Rules generated substantially more press than a report by the United States Surgeon General.

I’m not surprised.  Pollan’s book is a hot best seller (it’s #1 on Amazon books, and for good reason, in my opinion).   The need to prevent obesity and how to do it is not exactly front-page news.  And the new Surgeon General, Dr. Regina Benjamin, is still relatively unknown as a political force.

But let’s give Dr. Benjamin credit for taking on obesity in one of her first public actions: the release of “Vision for a Healthy and Fit Nation.“   The Vision, which comes with a press release and a fact sheet, recommends these actions to prevent obesity:

1. Reduce consumption of sodas and juices with added sugars.
2. Reduce consumption of energy dense foods that primarily contain added sugars or solid fats.
3. Eat more fruits, vegetables, whole grains, and lean proteins.
4. Control your portions.
5. Drink more water.
6. Choose low-fat or non-fat dairy products.
7. Limit television viewing time and consider keeping televisions out of children’s rooms.
8. Become more physically active throughout the day.
9. Breastfeed exclusively to 6 months.

These are all useful suggestions but we have heard them before.  The real issue is how to achieve them.  Here, the report disappoints.

The first two items should have grabbed attention: targeting soda reduction as as the first line of defense against obesity, and eating less junk food (my translation) as the second.

But Dr. Benjamin assigns parents the responsibility for feeding kids healthfully.  Fine, but what about about public health approaches to reducing soda consumption?  To pick a non-random example, soda  taxes are under intense debate right now.  Does Dr. Benjamin weigh in on such approaches?  Alas, no.  Only on the second-to-last page does she summarize suggestions from the Centers for Disease Control and Promotion (CDC), among them:

• Increase availability of healthy, affordable food and beverage choices in public service venues.
• Improve geographic availability of supermarkets in underserved areas.
• Improve access to fresh fruits and vegetables by providing incentives for the production, distribution, and procurement of foods from local farms.
• Limit advertisements of less-healthy foods and beverages.

I wish the report had focused on such ideas, instead of leaving them to an afterthought and personal responsibility. It’s great that the nation’s doctor cares about obesity but her Vision isn’t nearly as tough or realistic as it needs to be.  For that, we need the CDC or the report on food marketing to kids that the Institute of Medicine produced in 2005.

In 2001, Surgeon General David Satcher released the first government report on preventing obesity.  It got press. If this one didn’t, it could well be because it doesn’t break enough new ground.  Surely, it’s high time we got beyond blaming parents and instead started focusing on the need to create a food environment that makes it easier for parents and everyone else to make better food choices and be more active.

I hear that Michelle Obama will soon announce (tomorrow?) a new program to address childhood obesity.  I’m hoping that her program will take on some of the factors in the food environment that make it so difficult for everyone to eat healthfully.

These were fun to see in this wonderfully curated tiny exhibit.  The few cases displayed books, pamphlets, photographs, and some enviable chicken-raising collectibles, old and new.  The early 20th century books on backyard poultry raising look just like the ones being produced today.  In between, of course, came massive industrial chicken production, as the curator’s notes explained.

The curator, Liz Brown, says the library is working on a permanent, online version, which should go up on the Mann Library site sometime this summer.

In 2002, I was lucky enough to be invited to speak at the Yale conference on “The Chicken: Its Biological, Social, Cultural, and Industrial History from Neolithic Middens to McNuggets.”  That conference, keynoted by a then relatively unknown journalist, Michael Pollan, made it clear that chickens were a key component of the food revolution and well worth the attention of activists and advocates, as well as scholars.

You think this idea is too far-fetched?  I have to admit not quite getting it until Sabrina Lombardi, a student in my Food Sociology/Social Movements class at NYU last semester, wrote a terrific paper on chicken raising and pointed me to the new magazine, Backyard Poultry (“have you hugged your chicken today?”) and the Chicken Revolution website.  This last comes complete with a logo that says it all.   Happy weekend!

How would you feel if you had to pay $8.50 a gallon for gasoline?

Then why on Earth would you pay that much for water and high-fructose corn syrup?

That’s how much Coke costs in those new 7.5-ounce, 90-calorie cans.  Calorie-counters may appreciate the small size (90 calories) but dollar-counters beware:  We did a little math and it turns out that Coke in the new can costs between 50- and 140-percent more than Coke in the old 12-ounce cans.  Basically, Coke is charging two or three cents more per ounce for Coke in a smaller can—and this from a company that throws temper tantrums when lawmakers propose a one-cent-per-ounce tax on soda!

I once asked a group of retailing executives why the cost of smaller size containers was so high (surely the containers don’t cost that much.  They said: “if customers want smaller portions they ought to be willing to pay for them.”  Oh.

First a review of the research: FoodNavigator.com has published a series of pieces on the importance of salt reduction to health and the implications of doing so for the food industry:

• January 15: a summary of a Japanese study linking high salt diets to cancer.
• January 26: a review of studies on several conditions affected by salt intake.
• January 27: a discussion of the economic effects of reducing salt intake.
• January 28: an overview of how the salt issues are viewed in Europe.
• January 29: a discussion of the purported benefits of sea salt.
• Also on January 29: a report on Kellogg’s salt-reduction initiative in Europe.
• February 1: a review of the arguments over the science.
• February 2: an account of how Ireland is dealing with the salt issue.

Jane Brody of the New York Times weighed in on the benefits of salt reduction.

Salt in restaurant meals: On January 31, an intrepid New York Times reporter had the bright idea of sending some restaurant meals off to a lab to test for sodium.  Ouch.  Large clam chowder 3100 mg, two slices of pizza 2240 mg, steak with creamed spinach 2660 mg, Katz’s corned beef with pickles 4490 mg.  Stroke anyone?  No wonder it’s so hard to avoid sodium.

The “leave salt alone” crowd: JAMA has just run an editorial from Michael Alderman arguing that salt reduction does no good, might do harm, and should be tested in clinical trials before moving forward.  And Greg Miller of the National Dairy Council sent me this piece from Dr. Judith Stern of U.C. Davis, a member of the advisory board of the Salt Institute, saying much the same thing.

These are old arguments. What I find remarkable about them is that despite such individual opinions, every committee that has ever reviewed the research over the years has consistently come to the same conclusion: salt reduction is a good idea.  Are the committees delusional?  I don’t see how.  As for clinical trials, how could anyone do one?  There is already so much salt in the American diet that it will be hard to find a population of people able (even if willing) to reduce salt intake to a level where differences in health will be measurable.  The research disputes are difficult to sort out I don’t see how they can be easily resolved.

Under these circumstances, you could take your pick of whose research interpretation to believe – if you actually had a choice.  But you don’t.  If you eat processed food or in restaurants, you are eating a lot more salt than you need.

I’d like the default to  be a lower salt environment.  Drs. Alderman and Stern can always add more salt to their food.  I have no way of removing it from mine.

Stay tuned.  We will be hearing a lot more about this one.

The program is coming soon and here’s Dr. Freedhoff’s political cartoon of what it is likely to look like .  No, this isn’t real.  Dr. Freedhoff’s point is that it could be.

What, you might ask, are the criteria for the heart check?  Let’s just try sodium: 720 mg per serving.   Even the late and not lamented Smart Choices program did better than that (480 mg per serving).

You think Dr. Freedhoff is exaggerating and this is improbable?  Alas, not so.  In Australia a couple of years ago, I took this snapshot at a McDonald’s on the Adelaide beach.

The check marks come from the Heart-Tick program of the National Heart Foundation of Australia.  So Canada is just now catching up.  Canadian readers: can’t you do something about this?  And American Heart Association: clean up your act too!

Addendum: Thanks to Lisa Sutherland for pointing out that what gets heart-checked in Canada is comparatively low in U.S. terms.  She sends McDonald’s nutrition information as proof.   Practically everything is higher in sodium than 720 mg.  When it comes to sodium, everything is relative, I guess, but all of it is way high.

Update February 2: Thanks for Dan M. for posting this site as the source: “The Future in History.”

Update January 30: FoodNavigator.com did a report on reaction to the soda tax bill, “Fresh New York soda tax plans stir up the obesity debate.”  It’s got a great quote from the American Beverage Association:

What’s particularly disconcerting about this proposal is that the tax on a 12-pack of non-alcoholic beverages, like soft drinks, would be more than 9 times higher than the state tax on a 12-pack of alcoholic beverages, like beer.

This, as you might expect, has stirred up some counter-proposals, the most obvious being to increase the tax on alcoholic beverages.  Now that ought to generate some additional revenue!

While we are on the subject of alcohol, a forthcoming paper by Barry Popkin is said to have some interesting trend data:

Among adults aged 19 and over, SSB [sugar-sweetened beverage] consumption had almost doubled from 64 to 142kcal/day and alcohol consumption had increased from 45 to 115 kcal/day [from 1977-2006].

Popkin’s conclusion: “The consumer shift towards increased levels of SSBs and alcohol, limited amounts of reduced fat milk along with a continued consumption of whole milk, and increase juice intake represent issues to address from a public health perspective.”

Obviously, acrylamide has been around in foods for a long time.  But now that everyone knows how bad it is, what should be done about it?

A new toxicology study provides estimates for an upper level of intake that can be considered safe: 2.6 micrograms per kilogram of body weight. This would be equivalent to 182 micrograms for a 70 kg human to prevent cancer.  Much higher levels are required to cause neurological problems: 40 micrograms per kg per day, or 2,800 micrograms per day for a 70 kg human.  But since you have no idea how much is in the foods you are eating, these figures don’t help much.

But maybe you don’t need to worry?  Even the lower of the toxic levels is much higher than intake levels estimated by health agencies.  The average exposure of adults to acrylamide in food has been estimated to be below 0.5 micrograms per kilogram of bodyweight, which is five times lower than the upper limit considered safe.

That is somewhat reassuring but how come a European Expert Panel has unanimously decided to put acrylamide on the list of “substances of very high concern?”  This makes it sound as if acrylamide is well worth avoiding at any level of intake.

How to avoid?  A recent study points out that foods low in sugars and high in antioxidants have lower levels of acrylamide.  This translates into standard dietary advice.  Eat lots of fruits and vegetables, and don’t eat too much junk food, and you can cross acrylamide off the list of food issues you need to spend much time worrying about.

1. The study of food marketing by Dale Kunkel for Children Now

2. Elaine Kolish’s December speech in response to the Children Now study.  She is the head of the industry kids’ self-regulation unit at the Better Business Bureau.  Her conclusion: self-regulation is working.

3. The Rudd Center’s cereal marketing study summary

4. CSPI’s studies on food industry self-regulation

Enjoy, but also put to good use!