by Marion Nestle

Currently browsing posts about: Activity

Jun 7 2013

Chicago’s self-cancelling health program

A reader writes that she rode by this ad on her way to work yesterday.  It’s on Chicago’s beautiful lakefront walking-and-bike path.

Chicago

It’s for a Big Gulp 32-ounce drink, and a bargain at 69 cents.

The Chicago Park District explains that it:

partnered with Chicago-based AdTraction Media to develop a temporary outdoor advertising solution that adheres to concrete areas and will be displayed April through October.  The additional revenue from this agreement will help the Chicago Park District enhance the programs, projects and events offered to Chicagoans and visitors.

Did nobody in the Park District consider the irony?

Better get moving!  It takes at least 4 miles of running and 8 to 10 of biking to work off the 400 calories in that 32-ounce soda.

Aug 5 2012

Low carb or low fat: Do calories count?

Here’s my once a month on the first Sunday Food Matters column for the San Francisco Chronicle, out today:

Nutrition and public policy expert Marion Nestle answers readers’ questions in this column written exclusively for The Chronicle. E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.

Q: I’m confused about calories. If I cut calories to lose weight, does it matter what foods I eat? Or are all calories the same?

A: As the co-author of “Why Calories Count: From Science to Politics,” I hear this question all the time.

The short answer: Calories matter for weight. The choice of foods that provide the calories matters a lot for health and may make it easier for you to diet successfully.

To lose weight, reducing calorie intake below expenditure works every time.

To prove this point, a professor at Kansas State University lost 27 pounds in 10 weeks on the Twinkies diet – one Twinkies every three hours with occasional snacks of chips, sugary cereals and cookies. Even so, he cut his usual calorie intake by 800 a day. Anyone would lose weight doing that.

Only four dietary components provide calories: fat (9 per gram), carbohydrate and protein (4 per gram each) – and alcohol (7 per gram).

Does the particular mix of these components make any difference to weight loss? Yes, say proponents of diets low in carbohydrate, especially rapidly absorbable sugars and refined starches.

Low-carbohydrate diets are necessarily high in fat, and somewhat higher in protein. Do people lose weight on them because of the effects of carbohydrates on insulin levels or because low-carbohydrate diets help reduce calories?

This question does not have an easy answer, but not for lack of trying. Weight-loss studies are hard to do. Estimating calorie intake is notoriously inaccurate, and measuring calories is difficult and expensive.

The first measurement study I know of took place in 1964. Investigators from the Oakland Institute for Medical Research studied weight loss in five obese patients in a hospital metabolic ward. They calculated the number of calories needed to induce rapid weight loss in each patient, and fed each of them a liquid formula diet containing that number every day. Every few weeks, they changed the formula to vary the proportions of protein (ranging from 14 percent to 36 percent of calories), fat (12 percent to 83 percent), and carbohydrate (3 percent to 64 percent).

Regardless of the proportions, all patients lost weight at a constant rate. The investigators titled their study “Calories Do Count.”

This study was conducted under rigidly controlled conditions of hospitalization and involved actual measurements – not estimations – of calorie intake and body weight.

But what about weight-loss studies involving people who are not incarcerated? Since the early 2000s, numerous clinical trials have shown low-carbohydrate diets to produce greater weight loss than low-fat diets. Some also have observed improvements in blood pressure, blood glucose levels and blood lipids.

But it is so inaccurate to estimate calorie intake in such studies that most didn’t bother to try. This means they can’t say whether the weight loss was due to composition of the diet or to calorie reduction.

It’s possible that low-carbohydrate, high-fat diets make people less hungry, but the evidence for this is mixed. Most studies of extreme diets of any type report high dropout rates or failure to stick to the diet for more than six months or so. And even though initial weight loss is rapid on low-carbohydrate diets because of water loss, these diets are low in fiber and some vitamins.

One problem with losing weight is that it takes fewer calories to maintain smaller bodies. Dieting also reduces energy expenditure.

One recent study of that problem involved taking detailed measurements for several years, and illustrates the difficulties of obtaining definitive answers to questions about diet composition and energy balance.

The researchers wanted to know whether diet composition affected energy expenditure in very obese people who had just dieted off up to 15 percent of their weight. They found that a low-carbohydrate diet did not slow down energy expenditure nearly as much as a low-fat diet, meaning that low-carbohydrate diets might make it easier for people to maintain weight loss.

On this basis, the investigators said, “The results of our study challenge the notion that a calorie is a calorie from a metabolic perspective.”

Perhaps, but study subjects were fed prepared calorie-controlled diets for only four weeks, and lost and maintained weight under highly controlled conditions. Does diet composition matter for weight maintenance in the real world? Longer-term studies by other investigators show that diet composition makes little difference in the ability to maintain weight loss.

Most reviews of the subject conclude that any diet will lead to weight loss if it cuts calories sufficiently.

Obviously, some diets are better for health than others.

Face it. The greatest challenge in dieting is to figure out how to eat less – and to eat healthfully on a regular basis – in the midst of today’s “eat more” food environment. And that’s a much more important research problem than whether low-carbohydrate or low-fat diets work better for weight loss.

Marion Nestle is an author and a professor in the nutrition, food studies and public health department at New York University. She blogs at foodpolitics.com. E-mail: food@sfchronicle.com

 

 

Jul 27 2012

Should soda and fast-food companies sponsor the Olympics?

On the eve of the Olympics, The Lancet has published a special issue on physical activity.

Since this is too small to read:

Physical activity:

Worldwide, we estimated that physical inactivity causes 6-10% of the major non-communicable diseases…physical inactivity seems to have an effect similar to that of smoking or obesity.

The issue is packed with carefully researched commentaries and papers on the benefits of physical activity.

But it starts out with a tough editorial,  Chariots of Fries:

The Games should encourage physical activity, promote healthy living, and inspire the next generation to exercise. However, marring this healthy vision has been the choice of junk food and drink giants—McDonald’s, Coca-Cola, and Cadbury’s—as major sponsors of the event

Health campaigners have rightly been dismayed. On June 20, the London Assembly (an elected body that scrutinises the work of the Mayor of London) passed a motion urging the International Olympic Committee (IOC) to adopt strict sponsorship criteria that exclude food and drinks companies strongly associated with high calorie brands and products linked to childhood obesity.

Meanwhile, the UK’s Academy of Medical Royal Colleges has said that the presence of McDonald’s and Coca-Cola at the 2012 Games sends out the wrong message to children.

This morning, I received an e-mail from the Coca-Cola Civic Action Network (CAN), described on its website as

a non-partisan group whose purpose is to provide information to the Coca-Cola family about national, state, and local issues that could affect us.  Whenever an issue comes up that could change our day-to-day lives, CAN goes to work getting important information to its members.

The message lists Coca-Cola’s Olympic actions:

  • Olympic Torch Relay
    Integrated Marketing Campaign, Move to the Beat
  • Global Anthem, Documentary & Global TV Commercial
  • Coca-Cola Presents, Beat TV
  • Digital & Mobile Application
  • Games-time Refreshment
  • Powerade Sports Academy
  • Physical Activity Programs
  • Legacy in sustainability

The e-mail says:

Coca-Cola will be refreshing and hydrating the 14,000 athletes, 7,000 officials, 20,000 workers and volunteers and more than 6 million spectators that are expected to flock to the Olympic Park. From one product in one size offered at the 1948 Olympic Games, to today’s more than 500 brands at the London 2012 Games, Coca-Cola will provide the widest range of drinks and sizes ever offered at an Olympic or Paralympic Games, to suit every lifestyle and hydration need.

Should soda and fast-food companies be sponsoring the Olympics?  Is this the message we want sent to kids?  I don’t think so.  You?

Oct 25 2011

Happy Food Day!

Center for Science in the Public Interest (CSPI) launched Food Day yesterday with a splendid lunch right in the middle of Times Square.  I got to be one of the lucky eaters.

The purpose of Food Day is to promote discussion of critical issues in agriculture, food, nutrition, and health.  Its goals:

  • Promote healthy eating.
  • Support sustainable farms.
  • Expand access to food and alleviate hunger.
  • Reform factory farms.
  • Curb junk-food marketing to kids.

For half an hour, it got big-time billboard coverage.

The lunch was nutritionally correct and quite delicious, thanks to Ellie Krieger who did the menus and is posed here with Mario Batali.

Tom Farley, director of New York City’s Health Department, gave the opening speech with updates on his department’s new “cut down on sodas” campaign.  For example: One soda a day translates to 50 pounds of sugar a year, and you have to walk three miles to burn off the calories in one 20-ounce soda!  He’s here with Michael Jacobson who has directed CSPI since the early 1970s.

Tom Chapin sang from his album for kids, “give peas a chance.”

It was all anyone needed to be inspired to join the food movement and sign up for the food day campaign!

Later addition: Mike Jacobson sent this one with Morgan Spurlock.

Jun 7 2011

Sedentary work and obesity: another view

On May 26, the New York Times published a report of a new study on causes of obesity.  The study examined changing rates of physical activity in the workplace. Its conclusion?  Sedentary work is a major cause of rising rates of obesity in the United States.

The shift translates to an average decline of 120 to 140 calories a day in physical activity, closely matching the nation’s steady weight gain over the past five decades, according to the report.

Eric Schlosser and I wrote a letter to the editor pointing out a few flaws in that argument.  The Times did not publish our letter, but here it is:

To the editor:

It makes sense that sedentary work is a factor in the current obesity epidemic (May 26). But it cannot be an important cause. The changing American workplace cannot explain why the obesity rate among the nation’s preschoolers has doubled in recent years and that among elementary schoolchildren has tripled.

The rise in obesity worldwide is linked to the embrace of the American diet, not to a decline in manufacturing.

In China, childhood obesity has increased at least five-fold since 1985.

Simplest explanations are usually best. Reversing obesity means eating less and making healthier food choices.

It also means making it easier to do that by setting policies that promote smaller portions, lower prices on fruits and vegetables, restrictions on marketing food to children, and healthier school meals.

Of course, an increase in well-paid manufacturing jobs would help too.

—Marion Nestle and Eric Schlosser

 

 

 

 

Feb 10 2010

Michelle Obama’s campaign against childhood obesity: Applause!

I had best comment on this before anyone asks.   First Lady Michelle Obama wants to do something about childhood obesity and has gone into action.  She announced her “Let’s Move” initiatives accompanied by much fanfare.  Check out:

This is big news.  I see much to admire here.  The campaign focuses on kids.  It is sensitive to political realities (it’s called the uncontroversial “Let’s Move,” not the inflammatory “Let’s Eat Less” or “Let’s Eat Better”).  It’s brought a large number of groups on board (the New York Times account emphasizes this point).  It aims to do something useful about school food and food “deserts” (areas without grocery stores).  And it derives directly and explicitly from the White House garden.

I wasn’t able to watch the press conference but I hear that Will Allen was an invited speaker.  Allen is the charismatic and highly effective head of Growing Power, which runs urban farms in Milwaukee and Chicago.  I’m told he said:

  • It’s a social justice issue.
  • Every child in this country should have access to good food.
  • We have to grow farmers.

Yes!

Before the announcement, Marian Burros wrote in Politico.com about the barriers this effort will face (I’m quoted in her article).   And the Los Angeles Times discussed the enormous and enormously successful lobbying effort undertaken by the soft drink industry against soda taxes.  It predicted that the First Lady would not mention soda taxes when she announced her obesity campaign.  Indeed, she did not.

But she did say:

The truth is our kids didn’t do this to themselves.  Our kids didn’t choose to make food products with tons of fat and sugar and supersize portions, and then to have those foods marketed to them wherever they turn.

So let’s call this campaign a good first step and give it a big round of applause.  I hoping everyone will give it a chance, help move it forward in every way possible, and keep fingers crossed that Mrs. Obama can pull it off.

Feb 8 2010

The Surgeon General’s Vision for a Healthy and Fit Nation

I recently received this request from Daniel posted to Feedback:

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.

Jun 5 2009

Pediatricians say: let kids move!

I usually don’t say much about the physical activity side of the obesity equation, mainly because overeating calories is so much greater a contributor to weight gain.  But don’t get me wrong.  I favor “move more” as much as “eat less,” especially for kids.

I’m dismayed by how kids these days are basically under house arrest.  So, apparently, is the American Academy of Pediatrics, which has just produced a thought-provoking report about how to create a kid-friendlier “built environment” (public health-speak for sidewalks, playgrounds, and the other ways cities are constructed to discourage physical activity).

My favorite statistic from the report: In 1969, about 41% of kids walked to school on their own.  Today it is 13% on average and just 5% in some areas.

Try this for comparison: When I was 8 years old and living in Manhattan, I walked 6 blocks to school in the morning, came home for lunch, walked back to school after lunch, and then walked home, got my bicycle, and headed off to the park – unsupervised – and lived to tell about it.  I took subways – by myself – to piano lessons.  After school, I was sent out to play and expected to stay out until dinner time.

Well, society has changed and it is hard to imagine letting children so young do that today.  The question is what to do about it.  Pediatricians urge us to ask that question.  And about time, too.

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