by Marion Nestle

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Feb 9 2010

Confused about nutrition? Eat food!

I can’t resist dealing with the questions just asked by Elliot and Johannes.  From Elliot:

A meta-analysis of prospective epidemiologic studies showed that there is no significant evidence for concluding that dietary saturated fat is associated with an increased risk of coronary heart disease or cardiovascular disease (see: American Journal of Clinical Nutrition, January 13, 2010)…[but] in his book, Good Calories Bad Calories, Gary Taubes clearly attributes most of our chronic disease problems — including heart disease — to carbohydrates (see page 454).  In contrast, Colin Campbell in his book The China Study (pages 113-133) forcefully argues that animal proteins contribute to CVD.  Yet, Dr. David Katz in his book Nutrition in Clinical Practice (pages 130, 133) asserts that to prevent heart disease, “saturated and trans fat should be restricted to below 7% (or even 5%) of total calories . . . .”  Who’s right?  We badly need your unbiased wisdom on this topic.

Joannes says that according to the Weston A Price Foundation,

it seems as if (naturally-occurring) saturated fats are almost better for you than the unsaturated fats we get fed these days, which mainly consist of rancid oils which more than anything contribute to heart disease, whereas many saturated fats are actually quite beneficial.

OK.  Here’s my “unbiased wisdom” (if such a thing exists).  I like to ask: What do saturated fats, sugars, and animal proteins have in common as factors in the development of heart disease?   Answer: They are all single nutrients.

Recall that nutrition research is difficult to do because diets contain many foods, foods contain many nutrients and other chemicals that affect health, and other behavioral, socioeconomic, and genetic factors influence heart disease.  Studies of single nutrients take these chemicals out of their food, dietary, caloric, and lifestyle contexts and are, therefore, reductive.

Such studies tend to produce ambiguous results that demonstrate small differences, if any.  Small differences create situations ripe for interpretation.  Interpretation depends on the viewpoint of the interpreter.  That is why it helps to know who is doing the interpreting and who sponsored the studies.

Short of that, you would have to read every study cited by these authors and come to your own decision about how to interpret them – a daunting task.

My approach to conflicting research?  I look for points of agreement. The authors cited here do not disagree about the basic principles of healthful diets: variety in food intake, moderation in calories, largely plant-based (although not necessarily exclusively), and minimally processed.  Eat according to those principles and you do not have to worry about nutritional details.

All of that boils down to the advice I propose in What to Eat: eat less, move more, eat plenty of fruits and vegetables, and don’t eat too much junk food.

Let the scientists and their interpreters fight it out over single nutrients.  Eat food and enjoy your dinner.

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.

Feb 7 2010

San Francisco Chronicle: Vegan Diets

My post on vegetarian and vegan diets elicited so many comments that I thought it was worth recycling for my monthly (first Sunday) column in the San Francisco Chronicle.  It appeared today.

Feb 5 2010

Backyard chickens: an art, a science, a social movement

Just before it closed last weekend, I got to see the delightful exhibit on the history of backyard chickens in the lobby of Cornell’s Mann Library.  Cornell, it seems, houses a major collection of items on chickens in its Rice Poultry Collection.  This collection, named after James E. Rice, the first professor of poultry husbandry in America, contains more than 800 pre-1900 volumes on poultry science.

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!

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Feb 4 2010

The real cost of Coke

I received this note yesterday from Michael Jacobson, director of the Center for Science in the Public Interest, about his latest column in The Huffington Post:

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.

Feb 3 2010

The research on salt

Since Mayor Bloomberg started going after salt, my inbox is overflowing with commentary on all sides of the salt debates.

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.

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Feb 2 2010

Oh those Canadians: heart-checking McDonald’s!

Thanks to Dr. Yoni Freedhoff for keeping me current on Canadian food politics. His latest post is about the Canadian Heart and Stroke Foundation’s new program to heart-check fast food meals.  The Foundation hasn’t officially announced the program yet, although you can  find it buried in an obscure questionnaire on its website.  Pizza Hut also mentions its participation in the program on its website.   [Update February 3: Pizza Hut has now announced its participation in the program]

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.

Feb 1 2010

The Supreme Court and food politics: update

I commented earlier on the Supreme Court’s decision to allow unlimited corporate spending on election campaigns on the grounds of free speech.  If a picture is indeed worth a thousand words, try this (I wish I knew its source):

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