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“Minimally processed food a health goal” is the title of today’s Food Matters column in the San Francisco Chronicle.

Q: I may be preaching to the choir here, but isn’t eating a variety of unprocessed (or at least minimally processed) foods the best way to make sure your diet is healthy?

A: Indeed it is, and processing is the healthful food movement’s new frontier. Processed is code for “junk” foods – foods of minimal nutritional value. These crowd the center aisles of supermarkets, add loads of unneeded calories, rely on added nutrients for health benefits, last forever on the shelves and generate enormous profits for their makers.

Sodas are the obvious examples. They have no nutrients (unless fortified), and all their calories come from added sugars.

The food industry will insist that practically everything you eat is processed in some way. Unprocessed foods are rare exceptions – fruits direct from the tree or vine, vegetables pulled from the ground, nuts from wherever they come from, and raw meat, fish, eggs or milk.

Everything else is at least minimally processed – washed, aged, dried, frozen, canned, pasteurized or cooked. But these cause little, if any, loss of nutritional value and make some nutrients more available to the body.

In contrast, more extreme processing changes foods. It reduces the nutritional value of basic food ingredients, adds calories from fats and sugars, and disguises losses in taste and texture with additives such as salt, colors, flavors and other chemicals. Manufacturers add vitamins, minerals, antioxidants, omega-3s and probiotics expressly to make health claims.

Manufacturers say they make the products to give you what you demand: cheap, easy-to-eat-anywhere foods that require no preparation and give you the tastes you love. They back these contentions with increasingly far-fetched health claims, billions of advertising dollars and lobbyists galore.

The big issue is “ultra-processing,” says Carlos Monteiro of the University of São Paulo in Brazil. Writing in the November issue of the online Journal of the World Public Health Nutrition Association, Monteiro ranks the effects of food processing on health as the most important issue in public health nutrition today.

Ultra-processed foods, he says, are the primary cause of the rapid rise in obesity and associated diseases throughout the world.

He charges the food industry with creating durable, convenient, attractive, ready-to-eat or ready-to-heat products that are so palatable that they are habit-forming. And they are meant to be eaten everywhere – in fast-food places, on the street and while watching television, working or driving.

Ultra-processed foods are much higher in calories for their nutrients than unprocessed and minimally processed foods. They have loads of fat, sugars and salt, but are low in vitamins, minerals and fiber.

They are often cheaper than relatively unprocessed foods, especially when sold in supersize portions at discounted prices. And they are often the only foods available in convenience stores or vending machines.

He notes that virtually unregulated advertising identifies ultra-processed foods and drinks as necessary – and, when nutrients are added, as essential – to modern lifestyles and health. Overall, Monteiro says, their high palatability, along with aggressive and sophisticated marketing, undermine the normal processes of appetite control and cause adults and children to overeat.

This is just another way of saying what former Food and Drug Administration head David Kessler says in his provocative book, “The End of Overeating.” Kessler argues that processed and fast foods high in fat, sugars and salt have turned us into a nation of “conditioned overeaters” unable to recognize hunger or satiety.

Current policies ensure that ultra-processed foods stay cheap, and it’s no accident that the relative cost of fruits and vegetables has gone up by 40 percent since the 1980s, while the relative price of sodas and fast food has declined.

If you can afford it, choosing relatively unprocessed foods is good advice. As I wrote in “What to Eat,” it’s best to stick to the real foods around the supermarket perimeter. My only slightly facetious shopping rules: Avoid processed foods with more than five ingredients, ingredients you can’t pronounce, and those with cartoons on the package aimed at marketing to kids.

Marion Nestle is the author of “Food Politics,” “Safe Food,” “What to Eat” and “Pet Food Politics,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com, and read her previous columns at sfgate.com/food.

This article appeared on page L – 3 of the San Francisco Chronicle

My first-Sunday-of-the-month San Francisco Chronicle Q and A column, Food Matters, is out.  This month it’s about figuring out what “whole wheat” labels mean on food packages.

Q: I pay $4 for multigrain or whole wheat breads because I’ve heard white bread isn’t as healthy. But when I compare nutrition labels, $2 white breads look much the same. Are they?

A: My Talmudic answer: yes and no. You are asking about commercial sliced breads. Bread may be the staff of life, but you would never know it from reading the ingredient lists of most commercial products.

Commercial breads are indeed much the same, with only a few differences that matter.

To decide whether these have anything in them worth eating beyond their calories, you must inspect labels to make sure the first ingredient is whole grain, the total number of ingredients is small and devoid of unpronounceable chemicals, the fiber content is at least 2 grams per 1-ounce serving and the label says 100 percent whole wheat. Anything less is reconstituted white bread with occasional pieces of the original grain added back.

And then there is taste. Artisanal breads begin with just four ingredients – flour, water, salt and yeast – and turn them into loaves so crusty, chewy and fragrant that you cannot stop eating them. If they have some whole grain in them, even better.

But handmade breads take forever to make and quickly go stale. Commercial bakeries deal with these problems by rushing the bread-making process and compensate for the loss of flavor by adding stabilizers, dough softeners and preservatives, and covering up the chemical tastes with sweeteners. Breads with 30 or more ingredients are not unusual and violate my rule: Never buy processed foods with more than five ingredients.

To compare breads, you must read labels. Bread companies do not make this easy. Some list the serving size as one slice, some two, and their weights can vary by twofold. When you convert everything to ounces, the nutrient content of supermarket breads looks much alike.

An ounce provides 70 to 80 calories, a trivial difference. The grain is what counts.

Wheat grains have three components – the nutrient-rich bran and germ (“chaff”), and the endosperm, which is mostly starch and protein. One hundred percent whole wheat flour contains all three in the same proportion as in the original grains.

White flour contains about 80 percent of the original components. It is mostly endosperm.

Nutrients in the chaff are lost, so bakers are required to replace the five nutrients least likely to be available from other foods: niacin, riboflavin, thiamin, folic acid and iron. The others are not replaced.

Neither is fiber. White flour contains only trace amounts of fiber.

Because high-fiber diets promote healthy bowel function and appear to reduce risks of heart disease and bowel cancers, dietary advice is to eat at least three daily servings of whole grains – 3 ounces of 100 percent whole wheat bread, for example.

Food labeling rules do not make it easy to figure out fiber content. Some white breads list 1 gram of fiber, but watch out for serving size. It takes two slices to reach half a gram, which can be rounded up to 1.

Whole wheat bread with 2 grams of fiber per 1-ounce slice may have four times as much fiber as white breads. But watch out for breads listing 3 grams fiber; their slices may weigh nearly 2 ounces.

In response to dietary advice, commercial bakeries have introduced whole grain breads acceptable to white bread eaters. These grind the wheat bran super fine, add extra dough conditioners to keep the bread soft, and toss in some bran or cracked wheat to make the bread look like whole wheat. Check for fiber grams and the position of chaff ingredients on the list. The further down the list, the smaller their contribution.

And where is the Food and Drug Administration to help with whole grains? Alas, the FDA has not set rules for grain content. It permits manufacturers to make statements such as “100 percent whole grain” as long as the statement is true and does not imply that the food is an “excellent source.”

The FDA’s nonbinding guidance says anything labeled “100 percent whole grain” must contain all three components of the original wheat seed, in proportion.

This regulatory gap permitted creation of the industry-sponsored Whole Grain Council. The council issues a certifying stamp in two forms: 100 percent and Basic. One hundred percent means all grains are whole. But the more prevalent Basic stamp allows refined grains and disproportionate additions of bran or germ.

This article appeared on page K – 3 of the San Francisco Chronicle.

Note: E-mail your questions to food@sfchronicle.com, with “Marion Nestle” in the subject line.  Read previous columns at sfgate.com/food.

This month’s San Francisco Chronicle column evolved in answer to a question from a former colleague at the UCSF School of Medicine.

Q: What do you think doctors should be telling patients about how best to care for themselves and their families, nutritionally?

A: I had my chance when, long ago, I ran a nutrition education program for medical and other health professions students and practitioners at UCSF.

Then, as now, it was obvious that just about every patient who landed in the hospital needed nutrition intervention. Practically everyone who visited the outpatient clinic either wanted or needed nutrition advice.

Then, as now, few doctors were taught anything about nutrition, let alone the details of what they needed to know to help patients address dietary concerns.

In today’s health care environment, even doctors with advanced nutrition training do not have time to use it. Blame this on how our health care system systematically rewards doctors for treatment of disease, not its prevention.

What doctors need to tell patients about nutrition depends on who the patients are. If people are sick, doctors need to talk to them about how dietary changes and improvements will help them recover and prevent further illness.

But I’m guessing that your question refers to healthy patients who want to stay that way. With these people, what doctors do and say can have profound effects. Doctors are authority figures and their advice is taken seriously.

As a standard part of patient care, doctors routinely ask about drugs, cigarettes and alcohol. Even if they only have a minute, adding one more question about diet can do much good. If nothing else, it conveys that diet matters to health.

Given the reality of time constraints, my wish list for what to do next is necessarily short.

Tell patients that healthy eating simply means three things: variety, minimal processing and moderation.

Variety means choosing many different kinds of foods from the various food groups: meat, dairy, fruits, vegetables, grains. It counts because foods vary in nutrient content. Varying foods within and among food groups takes care of needs for nutrients without having to think about them. People who consume adequate amounts of varied diets rarely exhibit nutrient deficiencies. It’s the most restrictive diets that are likely to be deficient in one or another nutrient.

Minimal processing means that the foods should be as close as possible to how they came from the animal or plant. The greater the level of processing, the less the foods resemble their origins, the less nutritious they may be, and the more salt, sugar and calories get added to disguise the changes.

Minimal processing excludes foods high in salt and sugars and low in fiber, as well as sugary sodas and juice drinks, those popularly known as junk foods.

My definition of minimal processing is only slightly facetious: Don’t eat anything with more than five ingredients or an ingredient you can’t pronounce.

Moderation is about balancing calorie intake with expenditure and maintaining a healthy weight through food choices and physical activity.

These are general principles. Beyond them, nutrition advice must be personalized to the particular individual or family. To do that quickly:

• Ask patients what they and their children eat. You can start with a waiting-room questionnaire that probes typical intake of foods and supplements.
• Screen the responses for variety, minimal processing, moderation and excessive or unusual supplement use. Note whether body weights are within healthy ranges.
• Reassure patients whose diets are varied, minimally balanced and moderate that they are doing wonderful things for their health and should keep doing what they are doing.
• Refer observations that need further discussion to a nutritionist.

Doctors: You don’t have to do it all. Making it clear that diet matters is often enough to encourage patients to make better dietary choices. Use the services of a nutritionist. Nutritionists are professionally trained to answer patients’ questions about diet and health and to counsel them on dietary interventions.

Patients (meaning everybody): Tell your doctors that you want their advice about diet and health and expect them to know something about it.

My monthly Food Matters Q and A column in the San Francisco Chronicle appears this weekend:

Are 8 glasses of water a day really necessary?

Q: It’s such a hot summer and I’m sweating all the time, but I don’t feel thirsty. Do I have to force myself to drink eight glasses of water a day?

A: San Franciscans: Please, no complaints about summer fog. Where I live, it’s hot and humid, and staying hydrated takes work.

Everybody needs water to replace the amounts lost through breath, sweating and excretions. In comfortable temperatures, the amounts lost conveniently come out to about a quart of water for every thousand calories consumed. If you eat 2,000 calories a day, you need about 2 quarts of water.

But water equivalents – juice, coffee, tea, soda and anything else with water in it, including food – work just as well. Watermelon is called watermelon for a reason. It is mostly water and perfect for hot summer days.

Mostly, you don’t have to keep track of how much liquid you drink. Thirst takes care of it. If you need water, you feel thirsty and you get something to eat or drink. Problem solved.

But thirst doesn’t work very well at times when it is most needed – in very hot weather, at high altitudes or during heavy exercise. People in hot climates, mountain climbers and athletes have to force themselves to drink.

How can you tell when you need water? This is easy. Look at your urine. If you are dehydrated, your urine is bright yellow and smelly. If you are getting enough water, your urine is pale and practically odorless.

Except for these exceptions, hardly anyone needs to worry about how much water to drink. That “hardly anyone,” however, also includes children and the elderly, who tend not to regulate water balance very well. Beyond these exceptions – as you shivering San Franciscans can attest – thirst works well as a guide to how much to drink.

Q: A young woman I know got a nasty combination of altitude sickness and electrolyte imbalance when she was hiking in the Sierra Nevada. She sipped water constantly, ended up drinking too much, and got so sick from lack of salt that she had to be airlifted out. Are those Gatorade-like drinks that replenish electrolytes any better than plain water when you are hiking or exercising hard?

A: Those drinks might help, but your friend also must not have been eating much on that hike. Foods are excellent sources of electrolytes.

Electrolytes are minerals like sodium, potassium and chloride that help balance blood acidity. They are lost in sweat, which is why sweat tastes salty. Our bodies have plenty of electrolytes. Salt, for example, is usually eaten in great excess. Normal sweat losses don’t matter much, unless we are vigorously exercising or sweating profusely.

But sweating is easy to miss at high altitudes because it evaporates so quickly. The higher the altitude, the easier it is to overlook fluid and electrolyte losses.

High altitude also disrupts normal appetite, so climbers don’t feel hungry or thirsty. Elite climbers know to pack lightweight foods and supplements made especially for that purpose, and to force themselves to eat and drink frequently.

Drinks advertised as electrolyte supplements do indeed contain electrolytes. Gatorade Orange Sports Drink, for example, contains water as the first ingredient, followed by sugars (sucrose syrup, high-fructose corn syrup), flavors and three sources of electrolytes – salt (sodium chloride), sodium citrate and monopotassium phosphate – along with color additives and thickeners.

If you are an athlete working out for an hour or more, Gatorade might replenish your sodium, potassium and chloride more quickly than food can, but not by much. An 8-ounce Gatorade serving provides just 1 percent of the daily value for potassium (30 milligrams) and 5 percent of the daily value for sodium (110 milligrams).

Gatorade is a sweetened drink supplemented with a few salts, but with less sugar and fewer calories than a regular soft drink. On the basis of electrolytes, PepsiCo, its parent company, markets Gatorade as a better choice than any other drink, including water. Nothing, says PepsiCo, rehydrates, replenishes and refuels athletes better. According to Advertising Age, the company backs up that contention with a hefty advertising budget – $118 million in 2009.

Studies do show that replenishing electrolytes is a good thing to do at high altitude or during any other extreme activity. But hikers can do this with food or supplements without having to carry additive-laden sugary drinks in a backpack.

An average carrot, for example, provides 230 milligrams of potassium and 50 milligrams of sodium. Many other vegetables have similar electrolyte profiles. Nobody wants to carry heavy foods up a mountain, which is why sports shops sell dehydrated foods and special supplements for high-altitude climbers.

It’s a good idea to drink water at high altitude, but also to eat plenty of good food at regular intervals.

Marion Nestle is the author of “Food Politics,” “Safe Food,” “What to Eat” and “Pet Food Politics,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com, and read her previous columns at sfgate.com/food.

http://sfgate.com/cgi-bin/article.cgi?f=/c/a/2010/07/30/FDD51EK7K0.DTL

This article appeared on page K – 5 of the San Francisco Chronicle

My monthly Food Matters column in the San Francisco Chronicle answers readers’ questions and these tend to be about nutrition rather than food politics.   Today’s column is about diets aimed at controlling the amount of acid excreted in urine:

Low acid diet may not prevent bone loss

Q: I’ve just read “Building Bone Vitality: A Revolutionary Plan to Prevent Bone Loss and Reverse Osteoporosis,” by Amy Lanou and Michael Castleman.

The writers contend that a high acid diet causes bone loss and other negative health outcomes. The book is so well documented and the theory so logically explained that I find it compelling.

However, I am not a scientist and would appreciate your opinion.

A: Ordinarily I would not bother to read a book with the word “Revolutionary” in its title. In diet books, “revolutionary” invariably means using a grain of scientific truth to construct a dietary theory that contradicts current thinking but cannot be proven by current research.

But two readers asked about this book and I was curious about it for another reason. Last year, I gave a talk at a spa where I was seated at dinner next to a couple who announced that they were following a low-acid diet. To my amazement, they excused themselves during the meal to measure the pH of their urine.

Stay with me: pH is a measure of acidity or hydrogen ion concentration. pH 7 is neutral. Above 7 is basic or alkaline. Below 7 is acidic.

I could not believe that anyone would bother to measure urine pH, let alone leave dinner to do so. The pH of blood is tightly regulated and must stay within a slightly alkaline range of 7.36 to 7.4. Bicarbonate buffering systems keep it that way, and excreting excess acid is exactly what the kidney is supposed to do.

The authors are proponents of vegan diets. Here, they argue that small increases in blood acidity cause calcium to be leached from bones to help neutralize it. Over time, these small losses weaken bones and lead to osteoporosis.

Adding calcium to the diet, they claim, is not enough to replace the losses. They parse the results of 1,200 research studies to argue that dairy foods cannot protect against osteoporosis. Instead, low acidity – meaning too much meat – provides the best current explanation for worldwide rates of osteoporosis.

The authors provide an entertaining list of the acid-producing potential of more than 100 foods. As they put it, “flesh foods”- beef, chicken and fish – produce the most acid, with grains coming in second.

Dairy, oddly, is low-acid, except for cheeses. They produce the most. Four ounces of Parmesan, for example, yield 34 milliequivalents (mEq). Compare this to 4 ounces of trout (11 mEq), beef (8), cornflakes (6) or yogurt (1).

Acidity depends largely, but not exclusively, on protein content. All proteins form acid, but “flesh” proteins yield more. They contain more sulfurous amino acids than do plant proteins. Meat and grains also have more acid-forming phosphates.

In contrast, fruits and vegetables contain loads of alkali-producing potassium and magnesium. They have minus numbers: apples (-2 mEq), potatoes and cauliflower (-4), and avocados (-8), with the alkali prize going to raisins (-21).

To prove this theory, research must demonstrate four things: foods have differential effects on urine pH, acid-producing diets cause calcium to be excreted, calcium excretion reflects loss of calcium from bones, and acid-induced calcium losses lead to osteoporosis.

Research easily confirms that animal foods and grains produce more acid than do fruits and vegetables and cause calcium to be excreted in urine. Evidence for everything else, however, is much less certain. Although some studies find bone losses with high-acid diets, a recent “meta-analysis” published in the Journal of Bone Mineral Research concluded that urine calcium does not reflect bone calcium. It found little justification for the idea that alkaline foods prevent bone calcium losses.

Kidney specialists agree. I asked Dr. Jerome Lowenstein, author of “Acids and Basics: A Guide to Understanding Acid-Base Disorders,” for comment. He says bone calcium is involved in maintaining normal blood pH, but so are many other factors.

Normal kidneys maintain normal blood pH over a very wide range of diets. Diet may affect acid-base balance in people with damaged or diseased kidneys, but matters less to people with normal kidneys. Bone losses do occur in kidney disease but not because bone serves as an acid buffer.

“If it did, patients with advanced kidney disease would become invertebrate within a couple of years,” he says.

How to make sense of this? To prevent osteoporosis, the authors promote a vegan diet based on low-acid fruits, vegetables and beans, with no or minimal acid-producing meat, poultry, fish, eggs, cheese and grains.

Revolutionary? Hardly.

Last month’s report from the 2010 Dietary Guidelines Advisory Committee called for a shift in food intake patterns to a more plant-based diet, one with more vegetables, beans, fruits, whole grains, nuts, seeds, seafood and low-fat milk products, and only moderate amounts of lean meats, poultry and eggs.

Eat healthfully, and you automatically eat low-acid.

So: eat vegetables with your meat, forget about pH testing, and enjoy your dinner.

This article appeared yesterday in the Datebook section.  The dogs loved the food—a huge relief because we had not tested the recipes (oops).

Challenging the pet-food dogma

Meredith May, San Francisco Chronicle, June 23, 2010

In her best-selling food industry exposés “What to Eat” and “Food Politics,” Marion Nestle taught the nation how to shop smarter at the supermarket. Now the New York University nutrition professor and Chronicle Food Matters columnist has teamed with animal nutrition expert Malden C. Nesheim to examine the $18 billion pet food industry in “Feed Your Pet Right: The Authoritative Guide to Feeding Your Dog and Cat” (Simon & Schuster; $16.99).

Their research-based work examines the politics, marketing and science behind pet food, and offers pet owners advice on how best to feed America’s 172 million cats and dogs. She recently visited The Chronicle’s test kitchen, where canine tasters wolfed down an easy-to-prepare recipe from the book.

Q: This book began when you couldn’t understand the ingredients on pet food labels?

A: I couldn’t! I was in a supermarket in Ithaca (N.Y.), and the pet food aisle was 120 feet long. I was stunned by the amount of real estate devoted to it. This had to be some huge industry, and it surprised me because I didn’t think dogs and cats had taken over the world. I looked at the label and it didn’t make any sense at all: stuff about guaranteed analysis, profiles and health claims all over it. We gathered all the books we could find on feeding pets, and they were so dogmatic – saying you have to feed your pet this one way and everything else was poison. They were enormously contradictory, and none seemed to be based on actual research.

Q: Is it in the best interest of the pet food industry to confuse us?

A: Of course – they are selling products that are inexpensive to make and profitable to sell, and all they have to do is convince pet owners if they don’t use their products, they are making a big mistake.

They would prefer you don’t think about what’s in there – the byproducts of human food products. There are billions of pounds of leftover parts of cows, pigs, chickens and sheep after they are slaughtered for human consumption, and something has to be done with it or it will be wasted. One way is to feed it to dogs and cats. They don’t care what part of the animal it comes from.

Q: Give us a cheat sheet. What should we look for on the label?

A: If you want one-stop shopping that meets all the nutritional needs of your cat or dog, look for the words “complete and balanced” on the package. That’s code for meeting all the nutritional standards set by the Association of American Feed Control Officials (AAFCO) – the non-regulatory agency that sets the pet food standards.

Next is the ingredient list. Our rule of thumb is to check the first five ingredients; after that, the ingredients are so small, they do not amount to much. The first five should be real foods – not wheat gluten or something that doesn’t sound like real food. A lot have meat byproducts in them that are quite nutritious, but a lot of people think they are disgusting.

Beyond that, if you are concerned about the quality and interested in organic, seasonal and locally grown, you can find a commercial pet food that meets those standards, but typically you will pay more.

Q: Is there some truth to the claims that some foods are for aging pets, puppies, weight loss, organic, premium?

A: You can pretty much trust it the way you can human food labeling. There will be cheats every now and then.

Q: Is price an indicator of quality?

A: We were rather surprised by what we found. We bought a collection of chicken dinners for pets that were all premium brands, which is a code for higher price. We compared the first five ingredients, the health claims and price, and although the ingredients were all the same, there was a threefold increase in price. So there’s some heavy marketing going on here. The word “premium” has no regulatory meaning, so you have to read what’s in the product.

Q: What are the main things we are doing wrong when it comes to feeding our pets?

A: Overfeeding.

Q: Should we just be cooking for our pets?

A: People who do say it is healthier. One of the funniest things we found was a big clinical research book for cats and dogs put out by Hills Co. that had a very long chapter about how dangerous it is to cook for your pets, then it gave generic recipes for cat and dog food that were easy to follow. We put the recipes in our book!

Q: Since the invention of commercial pet food, is there any evidence that pets are healthier or living longer? Or the opposite?

A: We were curious what did people do before commercial pet food. But there was little information and an astonishing lack of research about pet life spans. In the last 10 years, there’s been some preliminary evidence that life spans of dogs and cats have increased a little bit, but I wouldn’t want to push that too hard. There’s certainly evidence that pets are not doing any worse since commercial pet food was invented.

Q: The top five pet food companies control 80 percent of the market – who is regulating them?

A: All of those five companies are also either human food companies or consumer product companies. Governing them is a complicated regulatory system comprised of the (Food and Drug Administration’s) Center for Veterinary Medicine, AAFCO and states. States have their own rules, AAFCO sets models it wishes all states would follow but about half do, and the FDA regulation is minimal. But that’s changing.

Q: Is that because of the pet food recalls in 2007 that were traced to melamine in China?

A: Yes, it made everyone realize we only have one food supply – and it feeds humans, pets and farm animals. If we have a problem with pet food, then there will likely be a problem with all food. Sure enough, melamine showed up in baby formula in China and in a lot of products that were supposed to be containing milk. We need a food-safety system covering the whole thing, and the FDA is not unsympathetic to that approach. We need food labels on pet food that we can read, and calorie counts should be on them.

Q: What foods are deadly to pets?

A: Raisins, grapes or macadamia nuts, onions, garlic and chocolate. Little amounts really won’t do any harm; it’s pounds that causes problems.

Q: If you want to cook for your pet, how do you do it properly?

A: Follow a recipe.

Q: On your book tour, what are the most common questions people have?

A: A lot of questions about poop and how to keep the amount down – all these people in Manhattan apartments want to know. I tell them feed a high-premium, low-residue product with not much fiber in it. PetCo even has a sign showing the poop size comparisons using these kinds of products.

Recipes: Homemade food that gives pets the nutrition they need. E5

Homemade Dog Food

From “Feed Your Pet Right,” by Marion Nestle and Malden C. Nesheim (Simon and Schuster; $16.99). This recipe, adapted from guidelines in “Small Animal Clinical Nutrition” (2000), feeds one 40-pound dog. Amounts should be adjusted to the size, age and condition of the animal.

• 8 ounces cooked grains (rice, cornmeal, oatmeal, pasta and other grains and cereals)
• 4 ounces cooked meat (beef, lamb, pork, chicken, turkey, fish)
• 2 teaspoons fat (beef fat, chicken fat, vegetable oil, olive oil, fish oil)
• 1 ounce raw or cooked vegetables
• 1 teaspoon bone meal (or dicalcium phosphate supplement, see Note)
• 1/4 teaspoon potassium chloride supplement (salt substitute)
• 1 human adult daily multi-vitamin, multi-mineral tablet

Instructions: Combine the ingredients in a bowl. Mix well and serve.

My latest San Francisco Chronicle column is about calorie labeling going national and what the FDA is going to have to do to write regulations that make it work effectively.

While we are waiting for all that, how about what Burgerville is doing.  Burgerville, a fast-food chain in the Pacific Northwest, now does personalized calorie counts.  When you get your food, your receipt displays the calories for each item you ordered.  It also makes suggestions for ordering lower calorie items: “if you like the blueberry shake, you might consider getting a blueberry smoothie next time.”

Will doing something after-the-fact like this affect future food choices?  Researchers: get busy!

Two articles I’ve written are in journals this week: a short one in Newsweek (!) and my monthly Food Matters column in the San Francisco Chronicle.

New York’s Calorie Counts: A Good National Model (Newsweek, April 30 online and May 10 in print)

The new health-care law contains an overlooked boost for nutritionists like me: by next year, all national chains with more than 20 locations must offer “clear and conspicuous” calorie information. It’s the most important obesity-related public policy since the USDA’s food pyramid. But reception to the new mandate has been muted so far, largely because the benefits of New York City’s similar 2008 law seem minor: one study found just 15 fewer calories were consumed per meal; another reported it was 30; and a third found that people ate more.

The problem with these studies is that they focus on Starbucks customers and fast-food goers in low-income neighborhoods—patrons who often care about convenience and value above all. They also fail to capture the long-term benefits of calorie counting, namely education and social pressure. Labels will offer case-by-case lessons in exactly what 1,000 calories looks like, and they may even spur restaurants to ease up on sugar and fat. (Denny’s, McDonald’s, and Cosi, among others, have debuted lighter fare in New York City.) Of course, much depends on the definition of “clear and conspicuous.” Still, the country’s nutritional literacy is about to improve—making my job a lot easier.

Sugary school meals hit lobbyists’ sweet spot (San Francisco Chronicle, Sunday, May 2)

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

Q: I’m stunned by the amount of sugar my daughter is served routinely in school: candied cereals, flavored milk, Pop Tarts, breakfast cookies, fruit juice – 15 teaspoons of sugar, just in breakfast. Why no standards for regulating sugar in school meals, especially when obesity and diabetes are such concerns?

A: Politics, of course. The U.S. Department of Agriculture spends $12 billion a year on school meals. Kids buy foods from snack carts and vending machines. Food companies fight fiercely to protect their shares in that bounty.

If you watched “Jamie Oliver’s Food Revolution,” you witnessed the struggle to get sugary foods out of schools. Fifteen teaspoons – 60 grams and 240 calories – is a lot for breakfast, but kids get even more sugar from snacks, treats from teachers and birthday cupcakes.

Sugars were never a problem when we supported school lunch programs decently. That changed when schools ran out of money, sought vending contracts with soft drink companies and encouraged kids to buy sodas and snacks. Schools evaded restrictions on snack sales during lunch periods. Nobody paid much attention to what kids ate in schools – until kids began getting fatter.

Why no standards? Nobody wants to take on the sugar lobbyists.

In 1977, a Senate committee recommended an upper limit of 10 percent of calories from added sugars. This was so controversial that from 1980 to 2000, the Dietary Guidelines gave no percentages when they said “eat less sugar.” The 1992 food pyramid said “Use sugars only in moderation.” It defined moderation in teaspoons – for example, 12 a day in a diet of 2,200 calories, which comes to less than 10 percent of calories. By then, health officials in at least 30 countries had adopted the 10 percent sugar guideline.

A committee of the Institute of Medicine undermined that consensus. Because science provides only circumstantial evidence for the effects of sugars on obesity and other health problems, the committee suggested a safe maximum of 25 percent of calories. Sugar trade associations happily interpreted this percentage as a recommendation.

In 2003, the World Health Organization issued a research report restating the 10 percent guideline. Using the IOM report as evidence, sugar trade associations enlisted senators from sugar-growing states to lobby U.S. government officials to withdraw funding from WHO. They also lobbied governments of sugar-growing countries to oppose the 10 percent guideline. WHO dropped the 10 percent sugar guideline.

Dietary guidelines are the basis of federal nutrition policy. The 2005 guidelines advised limits on sugars without stating a percentage. In a footnote, the guidelines said that sugars could be part of a day’s “discretionary calories,” defined as 2 to 8 teaspoons a day. This is less than 10 percent of calories, but the guidelines do not say so explicitly.

Neither does the USDA’s 2005 pyramid, which personalizes diet plans based on age, activity level and gender. I, for example, am allowed 195 discretionary calories for added fats and sugars. If I use them all for sugars, I get to eat 12 teaspoons – about 10 percent of my daily calories. This is less than the amount your daughter ate for breakfast or the sugars in a 20-ounce soda. Hence: lobbying.

Will we get an explicit sugar policy when Congress gets around to reauthorizing the Child Nutrition Act? The draft bill says nothing about sugars but does require school foods to adhere to “science-based” nutrition standards based on the dietary guidelines. If so, this means a maximum of 10 percent of calories from added sugars.

The IOM has just released a “School Meals” report. This says that with careful planning, 10 percent should provide enough sugar discretionary calories to permit sweetened low-fat milk, yogurt and breakfast cereals. The IOM warns that without these sweetened foods, student participation rates and nutrient intakes might decline.

Sorry, but I don’t buy the “kids won’t eat it” argument. I’ve seen plenty of schools where kids eat unsweetened foods. Somehow, they survive. Kids will eat healthier foods when meals are prepared by adults who care what kids eat, as Oliver has demonstrated.

As for legislation, California led the way with the 2007 school food nutrition standards bill, which regulated soda sales and the amount of sugar in snacks. Companies responded by reducing the sugars in their products. Passing the Child Nutrition Act will help, but its big drawback is funding. The draft bill increases school reimbursements by only about 6 cents per meal, not enough to meet costs in many school districts and much less than the $1 increase that many believe necessary.

But with luck, 2010 will bring us national legislation and improved editions of the dietary guidelines and pyramid. Let’s hope these make it easier for schools to help kids cut down on sugars.

Note: Nestle and Malden Nesheim will speak about their new book, “Feed Your Pet Right,” at 3 p.m. May 22 at Omnivore Books in San Francisco and at 3 p.m. May 23 at Point Reyes Books in Point Reyes Station.  Addition: Holistic Hound, Berkeley, Tuesday, May 18, 6:30 p.m.

Marion Nestle is the author of “Food Politics,” “Safe Food” and “What to Eat,” and is a professor in the nutrition, food studies and public health department at New York University. E-mail her at food@sfchronicle.com and read her previous columns at sfgate.com/food.  This article appeared on page K – 8.