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Getting to the Milan Food EXPO by subway is not for the out-of-shape.

From the subway stop at Rho Fiera, the walk to the security gates is short.  But then!

Up the escalator to the walkway over the railroad tracks:

Then to the next overpass to the fairgrounds:

Continue to the end of that overpass:

Enter the fairgrounds:

Walk all the way to the end of that section.

Counting the walk to the subway station, it’s been 2 miles to that point (by step-counter).

At last!  The main drag of the Expo, the mile-long Decumano with the country pavilions aligned on both sides.

The U.S. Pavilion is almost at the end, on the left, just after Kuwait’s.

By then, it’s been nearly 3 miles.  And just getting started!

To get to the U.S. Pavilion with less effort, take a taxi to the East security entrance.

The big surprise in Michael Moss’s tough look at health claims on coconut water in today’s New York Times—worth looking at online for the terrific video—is this:

One Last Comparison

These days, coconut water’s big rival may be plain old water. How do they compare? Scientists are still wrestling with the question, and while their findings vary, water is starting to look just fine for most people. A 2012 study (funded by Vita Coco) in the Journal of the International Society of Sports Nutrition found that neither coconut water nor sports drinks were better than water in hydrating young men after hourlong workouts.

Really?  An industry-funded study that comes to a conclusion against the interest of the funder?

This requires a look at the original paper.

So a round of applause please for the authors who did this funded study, “Comparison of coconut water and a carbohydrate-electrolyte sport drink on measures of hydration and physical performance in exercise-trained men,” and nevertheless came to this conclusion:

Our data indicate that both coconut water (natural, concentrated and not from concentrate) and bottled water provide similar rehydrating effects as compared to a carbohydrate-electrolyte sports drink.  Moreover, none of the beverages impacted treadmill exercise performance differently during the rehydration period.

Lest there be any ambiguity about what this means, their data clearly show that VitaCoco, a sports drink (not named but I’d bet on Gatorade), and coconut water from concentrate all rehydrated men who spent 60 minutes on a treadmill to the same extent.

In other words: for rehydration, water works just as well as coconut water or sports drinks.   No surprise, really.

VitaCoco must be disappointed, but it still has one thing going for it: coconut water tastes really good.

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.

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.

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

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?

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.

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

 

 

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:

• The USDA Secretary’s promise to ask Congress to get junk food out of schools and provide breakfast and lunch to more kids (the New York Times discusses some of the reactions)
• The President’s appointment of a task force on childhood obesity
• The Ad Council’s public service announcements
• USA Today’s neat graphics on rising rates of childhood obesity
• USA Today’s maps of the environment of childhood obesity
• The USDA’s website atlas of the environment of food choice
• The American Beverage Association’s promise to put calories on the front of soft drink packages
• The American Academy of Pediatrics commitment to aid the White House effort
• And the Surgeon General’s Vision that I commented on two days ago

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.