The editor of the San Francisco Chronicle magazine invited me to write about what restaurants could do to make it easier for customers to make more healthful choices.  Here’s what I said:

As a nutritionist who cares deeply about the effects of food on health, I am often asked to speak to groups of owners of restaurants and restaurant chains. I accept such invitations whenever I can because I have an agenda for restaurant owners. I want them to make it much easier for customers to make healthier food choices.

Yes, I know. Restaurants are in the business of selling food. Restaurants must offer choices and give customers what they want. But restaurants bear some responsibility for encouraging people to eat too much and, therefore, contributing to obesity and its consequences.

As someone who loves to eat and eats in restaurants several times a week, I am all too aware of efforts to get me to eat more than I ordinarily would. Rather than resisting those efforts on my own, I’d appreciate some help.

Here’s what I wish restaurants would do:

Give a price break for smaller portions. Larger portions are a huge barrier to healthful eating. Larger portions have more calories, of course. But they also encourage people to eat more, and they fool us into thinking that we aren’t eating so much. Controlling weight means eating smaller portions. I’d like restaurants to offer half-size servings for, say, 70 percent of the price of “normal” size. That would work better for me than taking home a doggie bag.

Make healthy kids’ meals the default. Why not put tasty and healthful meals on the menu as the only options for kids’ meals? If parents want their kids to eat junk food, they can always order it, but restaurateurs do not need to aid and abet that choice. Kids should be eating grownup food anyway – restaurant meals offer a chance to expand their food experience.

Cook with less salt. Put salt shakers on the table. If customers don’t think your food is salty enough, they can always add their own. But those of us who are trying to keep our blood pressure under control would appreciate food that did not already have so much added salt.

Notice that I’m not asking restaurants (other than fast food chains) to post calories or nutrition information, to label meals as heart-healthy or to do anything else to turn customers off. I’d be happy with just these three changes. Other suggestions, anyone?

I can hardly believe it but just having drinking fountains in schools (and no sugary drinks) seems to be enough to reduce the risk of obesity in kids by 31%.  This astonishing result is reported in the latest issue of Pediatrics. Investigators arranged to have drinking fountains installed in about half of 32 elementary schools in “socially deprived” areas of Germany.  They also prepared lesson plans encouraging water consumption.  Kids in the intervention schools drank more water and reported consuming less juice.

Could we try this here?  The barriers are formidible.  First, the water fountain problem.  Water fountains must (a) be present, (b) be usable, (c) be clean and sanitary, and (d) produce water that is free of harmful chemicals and bacteria.  All of these are problematic.  I once tried to find out whether the water in school drinking fountains in New York City had been tested and was known to be safe to drink.  I had to file a FOIA (freedom of information act) request to get testing data.  This came from only a few schools and from water going into the fountains, not coming out of them.

And then there is the soda problem.  Schools in Germany do not have vending machines all over the place and kids do not have access to sodas, juice drinks, and other such things all day long.  Ours do.

But doesn’t this study suggest that if we got rid of vending machines and junk foods in schools – and made sure water fountains worked, were clean, and distributed clean water – that we could make a little progress on preventing childhood obesity?  Worth a try, no?

In 2005, the FDA required certain categories of manufacturers to keep records about the source, transporters, and recipients of their products.  Recently, the Inspector General of the FDA’s parent agency, the Department of Health and Human Services, conducted an exercise to see whether traceability was working.  Inspectors bought 4 samples of 10 different food products (e.g., bottled water, oatmeal, tomatoes) at retail stores and attempted to track their supply chains.  Oops.  It only could trace 5.  For another 31, it could make educated guesses.  But nearly 60% of food facilities handling these products could not complete the tracing and 25% did not know they were supposed to.

The FDA, says the Inspector General, needs statutory authority to require producers to know their supply chains and everybody involved needs some education about how to do this.  No wonder we are still getting daily recalls of products containing peanut better.  Statutory authority means Congress.  I wish Congress would get busy on this!

The interesting part about this latest recall – now 2 million pounds and involving 74 products so far – is how the Salmonella contamination was discovered.  According to a lengthy account in USA Today, a small nut company in Illinois, Georgia’s Nut, routinely tests for Salmonella and found the bacteria in nuts purchased from Setton Pistachio of California.  Georgia’s Nut recalled products distributed in the Chicago area.  This company also produces a trail mix for Kraft Foods.  It notified Kraft Foods, which also promptly recalled its products.

I’m guessing that Georgia Nut must follow a HACCP (Hazard Analysis and Critical Control Point) plan.  HACCP is a science-based food safety procedure that requires analyzing where contamination might occur in production processes (hazard analysis), taking steps to prevent contamination at those critical control points, and using pathogen testing to make sure the steps were followed and the plan is working.

HACCP, as I keep complaining, is only required for meat and poultry production on the USDA regulatory side (where is it poorly enforced) and for sprouts, fresh juices, seafood, and eggs on the FDA side.  The producers of everything else are supposed to follow Good Manufacturing Processes, which are considerably less rigorous and, as we saw with the peanut butter recalls (more than 3,800 products from 200 companies) and their health consequences (nearly 700 sick, at least 9 deaths), clearly do not work.

How about HACCP for all foods?  Worth a try?

April 3 update: USA Today reports that Setton Pistachio has not yet issued its own recall (note: this is a good reason why the FDA needs the authority to order recalls), that its California plant passed recent inspections with relatively minor violations, but that its sister plant on Long Island is a mess.  USA Today also reports that Setton Pistachio has had positive tests for Salmonella for months.  What did the company do with the contaminated pistachios?  A mystery.

Nutritionists are always telling everyone to eat more fruits and vegetables.  You might think this would be harder to do when the economy goes bad, and you would be right.  The United Fresh Research and Education Foundation, an arm of the produce industry, keeps track of such things.  Its latest report makes interesting, if depressing, reading.  People bought about 3% less produce in 2008 than they did in 2007, but paid about 2% more for that smaller amount.  No wonder people are complaining that they can’t afford to buy fresh fruits and vegetables.  Don’t we need to do something about this?

The FDA is announcing the “voluntary” recall of certain pistachio products.  Certain, in this case, means a mere million pounds of products from Setton Pistachios of Terra Bella, CA.  These appear to be contaminated with multiple strains of Salmonella. As with the peanut butter recalls, pistachios are used in many different kinds of products.  The FDA learned about the problem from Kraft Foods, which found Salmonella in its Back to Nature Trail Mix. Nobody has gotten sick yet, but stay tuned.  The FDA has a brand new pistachio recall page on its website.  Now you can keep track of pistachio recalls along with the peanut butter recalls which continue to come in every day and now add up to nearly 4,000 products.

Will this ever end?  While waiting for Congress to approve the appointment of Dr. Margaret Hamburg as FDA Commissioner, her deputy, Joseph Scharstein, has just taken over as acting commissioner.  These new officials will have plenty of work to do to get this mess under control.

Antioxidant nutrients are so important as marketing tools that they constitute their own brand, say British experts on such questions.  Apparently, up to 60% of consumers who see an antioxidant claim on a product label will buy it for that reason.  Despite lack of evidence that additional antioxidants make people healthier (and may actually do some harm), these claims are so popular that food companies introduced nearly 300 new antioxidant-labeled products into U.S. supermarkets last year.  I’ve been collecting choice examples: breakfast cereals, of course (they are always at the leading edge of nutritional marketing), but also jelly beans.  The marketing has become so competitive that unprocessed fruits and vegetables have to get into the act.  I’ve seen ads for blueberries, tomatoes, and artichokes advertising their high antioxidant content.  Of course they have antioxidants.   All fruits and vegetables contain antioxidants, and theirs may actually do some good.

The Trust for America’s Health and the Robert Wood Johnson Foundation announce the release of a new report on how to fix the food safety system.  The report, Keeping America’s Food Safe: A Blueprint for Fixing the Food Safety System at the U.S. Department of Health and Human Services (HHS), makes a bunch of suggestions for strengthening the FDA.  The FDA, it says, needs to concentrate resources on the highest risks, enforce existing rules (what a concept), establish a position with authority over all food safety programs in the agency, and work with Congress to establish a Food Safety Administration within HHS.

Wait a minute: I thought two agencies were involved in food safety regulation.  Yes, HHS regulates most foods through the FDA, but the USDA regulates meat and poultry.  These are not two separate food systems. Wastes from food animals (USDA-regulated) contaminate fruits and vegetables (FDA-regulated).

Don’t we need one system?  I think we do.

And buried in the mess of bills submitted to Congress and currently under consideration (handily summarized by Bill Marler), are several aimed at doing just that.  This is a great time to weigh in on them, especially since polls show that nearly 75% of Americans are more afraid of food than they are of terrorists.