Food Politics

by Marion Nestle
Jun 28 2016

My Time Magazine op-ed: We are still confused about calories

While I was in Israel last week, Time Magazine published an op-ed it had invited me to write.  Here it is.

Even in ‘healthy’ foods, calories can tick up fast

Nutrition professor that I am, if I could teach just one thing to the American public, it is this: Larger portions have more calories.

Please don’t laugh.

If we all understood this, the United States would not have an obesity problem. And the recent revelation that places like Chipotle and Panera serve meals with more calories than McDonald’s would surprise nobody. We would realize the former’s “health” aura blinds people. But this basic rule applies to those places, too.

We would also, strangely, thank McDonald’s for at least one thing: It limits portion sizes. It’s easy to pile on calories by asking for a little more of this, then a refill of that—without realizing that the calories surpass those in McDonald’s meals.

It’s not easy to understand calories. They are not intuitive because they’re abstract. They cannot be seen, tasted or smelled, and are extraordinarily difficult to count accurately, even for scientists. My colleague Lisa Young, author of The Portion Teller, once asked an entry-level nutrition class to guess the calories in 8-ounce and 64-ounce soft drinks. We didn’t expect students to know that an 8-ounce Coke has 100 calories—but we certainly expected them to multiply whatever they guessed by eight for the 64-ounce drink. But the average multiplier was three.

The unintuitive relationship between amounts eaten and calorie intake is one of the reasons behind public health campaigns like the new soda tax in Philadelphia, which in part aims to get people to think twice before drinking sugary beverages. No nutritionist worries about an occasional 90-calorie mini-can of soda. But many people drink sugary beverages in 12-ounce, 20-ounce or liter sizes. Bigger sizes mean more calories, and more calories means more weight unless you compensate with physical activity.

But exercising off calories takes a lot of work. That was the message of aNew York City health department campaign demonstrating the need to walk the three miles from Union Square to Brooklyn to compensate for the nearly 300 calories in a 20-ounce soft drink.

And let’s not forget that all of the calories in soft drinks come from sugars, which provide nothing but calories—no vitamins, no minerals, no fiber. They may be delicious, but they have no redeeming nutritional value. That’s why their calories get called “empty.”

Does where calories come from make any difference? Yes, but in complicated ways. Weight balance depends on calories. But managing weight—and overall health—very much depends on where those calories come from. It’s not so easy to overeat vegetables, fruits and whole grains, or relatively unprocessed foods of any kind, because these tend to be bulky and fill you up before you eat too much. You can still gain weight on these healthy foods, but it’s harder. Chipotle may have healthier calories than McDonald’s, but its calories still count.

Sugars post particular problems because they induce insulin production, but also because they make foods taste good. We eat something sweet and want more of it. We start loving sweet tastes in infancy. Breast milk is sweet; it contains a tablespoon of lactose per cup and that’s there for a reason—to make babies do the work of nursing.

But sodas are very sweet. A 12-ounce soda contains more than threetablespoons of sugars—and the calories that go with them.

It’s also very hard to separate the effects of sugars from their calories. If scientists want to know whether the calories from sugars are worse than those from any other foods, they need to feed people precisely the same number of calories from diets widely varying in their content of sugar, other carbohydrates, protein, and fat for a long enough period of time to get meaningful results. The only way to do something like this would be to keep the study subjects under lock and key for as long as it takes—inconvenient, to say the least, and very expensive.

Until the science is resolved, we can all agree that eating less sugar is a good idea for just about everyone. Sugars are nutritionally empty, are hidden in foods, and encourage overeating.

Notice that I said less, not none. Personally, I love desserts and would never want to give up sugars entirely or ask anyone else to do so. I just follow my own dietary advice: eat lots of vegetables and other relatively unprocessed “real” foods, and for everything else, pay attention to portion size. This way, an occasional sugary treat is a pleasure and nothing to worry about.

Marion Nestle is professor of nutrition, food studies, and public health at New York University and co-author of Why Calories Count. Her most recent book is Soda Politics: Taking on Big Soda (and Winning).

Jun 27 2016

Israel’s solution to peanut allergies

While in Israel, I kept hearing that peanut allergies are virtually unknown in that country.  Nobody I met knows anyone with problems with peanuts—not Jews, Arabs, children, nor adults.

The explanation?

Bamba (and its Arabic equivalent).

These things are peanut puffs.

Because they melt in the mouth, they are often fed to babies as a first food.  Apparently, babies love them.

How do they taste?  Just as you might expect (peanut-flavored straw?  peanut-flavored Cheetos?).  They are sold everywhere as a snack and I met adults who love them too.

Do they really prevent peanut allergies?  Indeed, there might be something to this idea.

Introduction of peanut products into the diets of infants at high risk of developing peanut allergy was safe and led to an 81 percent reduction in the subsequent development of the allergy, a clinical trial has found…Researchers led by Gideon Lack, M.D., of King’s College London, designed a study called Learning Early About Peanut Allergy (LEAP), based on observations that Israeli children have lower rates of peanut allergy compared to Jewish children of similar ancestry residing in the United Kingdom. Unlike children in the UK, Israeli children begin consuming peanut-containing foods early in life.

Translation:  Bamba.

These researchers also found that allergic reactions did not return even if the children in that trial stopped eating Bamba for a year.

Their studies were funded mainly by NIH and the UK Department of Health, but the researchers also report that their clinical trials unit was supported by the National Peanut Board, Atlanta, and that the manufacturer of Bamba supplied the products.  The lead author, Gideon Lack, reports holding stock in DBV Technologies, the maker of Viaskin Peanut, a product that helps people with peanut allergies tolerate exposure to peanuts.

I’d like to see these studies repeated by fully independent researchers.

In the meantime, pediatric allergists are advising parents to let their babies eat peanut butter (but not peanuts because babies can choke on them).

These allergists—and the authors of the Bamba studies—participated in an American Academy of Pediatrics consensus statement:

There is now scientific evidence (Level 1 evidence from a randomized controlled trial) that health care providers should recommend introducing peanut-containing products into the diets of ‘‘high-risk’’ infants early on in life (between 4 and 11 months of age) in countries where peanut allergy is prevalent because delaying the introduction of peanut can be associated with an increased risk of peanut allergy.

If these studies are right, introducing babies to the widest possible variety of foods as soon as they can handle solid foods (usually at 4 to 5 months) may well help prevent allergies later on.

Addition

A reader just sent another paper from the same authors, this one a randomized trial of six allergenic foods given to breastfed babies at 3 or 6 months of age.  By one analysis, allergies developed 1 to 3 years later in 7.1% of the later-introduction group and 5.6% of the earlier-introduction group—a result that was not statistically significant.  By another, allergies were much lower in the early-introduction group (2.4% vs 7.3%), especially with respect to peanut and milk allergies.  

Jun 24 2016

Israel food: more random observations

Lunch in the old Yemenite section of Tel Aviv, now the up-and-trendy Kerem Ha Teymanim.

The restaurant is Shlomo Doron’s The Joy of the Wipe.  This doesn’t quite get at the meaning, which is what you do to eat hummus with pita bread.

The restaurant is near the Carmel Market.  These are great bowls of dates, dried fruits, and nuts.

Entire stalls are devoted to halvah, the candy made with sesame seed paste.

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I did a day trip to the completely improbable Rutenberg restaurant: unexpectedly lovely food in a place remote from major cities, next to ruins of an electric plant and a bridge that used to cross the Jordan “river” (now a brackish small stream).  The restaurant is smack on the border with Jordan, 200 feet below sea level, and 45 degrees centigrade (112 degrees Fahrenheit—I’m not kidding) on the afternoon I visited.  The far end of the nearby stone bridge is in Jordan, and so is the watchtower on the hill in the back.

 

Beautiful food.

The chefs with a portrait of the eponymous Rutenberg, who had something to do with the nearby electric plant, now in ruins.

If ever there were a destination restaurant, this is it. Camels, maybe, but foot traffic?  Hence: improbable.

Jun 22 2016

The food scene in Israel—some early observations

Wandering around in the Rehavia neighborhood in Jerusalem, I saw a local park with a just-starting composting program.

Down the street from the official residence of the Prime Minister (that would be Benjamin Netanyahu), is the headquarters of the International Jewish Vegetarian Society.

I’m surprised at how little food advertising I’m seeing.  This restaurant overlooking the crater at Mitzpe Ramon is an example that seems typical.  Nestlé (no relation) ice cream bars are everywhere.

Coca-Cola is everywhere too, but this venerable truck is the only one I’ve seen.  This one was in Tel Aviv.

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Jun 21 2016

The Sugar Association’s latest spin on the science

I’m in Israel this week where “eat-less-sugar” is just as big an issue as it is in the United States (translation: “without sugar”)

The U.S. Sugar Association is using an article in JAMA about the rising prevalence of obesity to argue that sugar cannot be responsible.  Sugar intake has declined in the U.S. since 2000, largely because of the decline in consumption of soft drinks.

Sugar, says the Sugar Association, cannot cause obesity (it’s energy balance).

Evidence?  The numbers don’t add up.

Oops.  Better take a look at the actual data from the JAMA paper:

What this figure shows is only a small increase in obesity over the last 10 years for men (on the left) and women (on the right)—for those above the 50th percentile of body mass index.

My interpretation:

  • Yes, sugar consumption is down.  That’s excellent progress but there’s still a long way to go.
  • Yes, calories count, and physical activity is good for health.
  • But—the decline is sugar consumption correlates with a leveling off of obesity in adults, just as would be predicted.
  • Even so, eating less sugar is a good idea for just about everyone.

Most Americans consume twice the sugar recommended.  Less would be better, but the “10% of calories” recommendation still leaves plenty of room for dessert.

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Jun 20 2016

The food scene: Tel Aviv

I’m in Israel this week at a meeting on Sustainable Food Systems* along with some basic food tourism.

The trip started with a visit to the small-but-impressive farmers’ market at the Port of Tel Aviv.

The market is under umbrellas to protect people, sprouts, and other vegetables from the intense Mediterranean sun (it’s hot here).  

The market is in two sections, separated by an indoor section with stalls for an amazing array of (mostly) locally produced artisanal food products.

And here’s Shir Halpern who developed this market, runs others, and is doing everything possible to encourage young farmers.

This is a great way to start any visit to a new country.

*Just for fun, here’s my interview in today’s Haaretz—-in Hebrew.   And here’s an English translation (thanks to Hemi Weingarten of Fooducate)

Jun 17 2016

Philadelphia passes soda tax!

 

Of course, it’s not over yet.

Jun 16 2016

Today’s big news: the Philadelphia soda tax vote

The Philadelphia city council votes sometime today on whether to pass a soda tax, with most—but not all—of the revenues targeted to pre-kindergarten education.  I’m getting on an airplane pretty soon and will miss the vote, but it is widely assumed to pass.

The decision is up to the city council.  Although the soda industry spent more than $4 million on public relations to urge the council to vote no, and promised to fund the first year of pre-K, its efforts don’t seem to be working.

To put this in context: Sodas are an easy target for public health measures.  Nobody needs them, they are candy in liquid form, and they have no nutritional value.   But it seems as though their makers are willing to spare no expense to stop any city that attempts to tax them.  The total in Philly is $4.9 million by the latest rumors.

Americans are highly likely to support taxes that are earmarked for social purposes, as the Philly tax mostly is.

Every other city council can see that Berkeley gets more than a million a year for discretionary child health programs.  Philadelphia is a bigger city and will get more, but is using it to fill budget holes as well as Pre-K.  I’m guessing lots of places will figure out that they can do this too.

At the very least, the soda industry will be willing to donate huge amounts of money to get city councils to delay or block measure, as it did in Philadelphia.

This vote is worth watching closely (you can do that here).  I’m sorry to be missing it but will try to catch up with it later.

References

Politico’s deep dive is here.