Archive for the ‘Nutrition and Diet’ Category

Hidden in the Health Care Bill–Calories on the Menu Nationwide!

Wednesday, March 24th, 2010

About a month ago, I wrote how calorie information can help guide diners’ food choices and how California has adopted a program similar to New York City’s,  in which caloric information must be listed on menus and indoor menu boards. Well, California and New York aren’t alone in this venture anymore.  Thanks to a bit of fine print in the Democrat’s Health Care Bill, menus nationwide will now carry caloric information!

Under the new legislation, restaurant chains with more than 20 outlets will be required to furnish caloric information as well as guidelines for how many calories a healthy person should consume daily. That means, whenever you go to McDonald’s, whether in Oregon or Oklahoma, you will know just how many calories your Big Mac really contains. Will this change people’s eating habits? No one knows, but as I chronicled in Calories On The Menu–Coming Soon!, research suggests that caloric information, in the context of recommended daily caloric intake, does influence food choices.

So when will these changes take effect? That’s up in the air. The Health Care Bill requires that the FDA propose specific regulations no later than a year from now, but legal challenges could tie up the legislation after that. So, for the time being, you’ll just have to get your caloric info online or in the brochures some chains have available.

On another note, every once in a while the public health doc in me chuckles at a news story that crosses the wire. And yesterday, I had to laugh at Last Supper Paintings Supersize the Foods. As you know from reading my blog, portions and plates have gotten bigger over the last seventy years (see January’s Avoiding Portion Distortion). But I never thought distortion of the portion would insinuate itself into the Last Supper! As reported yesterday in the Associated Press, a new study which examined paintings of the Last Supper over the last one thousand years shows that food and serving ware have indeed gotten bigger. By as much as 69%! Scientifically meaningful? I’m not sure. Kinda funny? You bet. Check below and decide for yourself.

Leonardo Da Vinci's Famous Fresco, 1495-98

Supersized by Bassano Jacopo in 1542?

Understanding Organic Labeling

Wednesday, March 17th, 2010

Ah, Spring is in the air! Our Northern California hills are green. Wildflowers carpet the ground. And it’s time for me to do my own type of Spring-cleaning– responding to post requests!

Several months ago, I received a request to explain the whole organic labeling process. How do you know the food you buy is truly organic? And what does ‘organic’ on the label really mean? 

Most people, when asked, can list a few characteristics of organic food: no synthetic pesticides, antibiotics, or growth hormones. Only natural fertilizers (no petrochemical-based fertilizers). Avoidance of genetically-modified organisms. 

Yes, all true, but organic agriculture production is more than that. Organic agriculture is as much a philosophy as a production technique. Organic growers view their role as being part of a greater ecosystem rather than just producers of a specific crop. As a consequence, there is an emphasis on promoting ecological balance by using renewable resources rather than artificial, one-time use inputs like petrochemical-based fertilizers. Organic farmers use techniques such as crop rotation or naturally-occuring fertilizers to keep soil fertile. They promote natural pest management strategies like the placement of owl houses in fields to control gopher populations or the release of beneficial insects to counteract harmful insects. Basically, true organic farmers view crop production as one part of a natural, environmental whole rather than with the narrow focus of isolated crop production.

That being said, the ‘organic’ label has enormous marketing cachet because people are willing to pay more for synthetic pesticide-free, environmentally-friendly food. To counteract fraud in the market place, the US Department of Agriculture now requires food that is labelled organic to meet certain criteria. Those products labelled ‘100% Organic’ must be made entirely with certified organic ingredients and methods. ‘Organic’ on the label means that the product contains at least 95% organic ingredients. Both of these types of products can carry the USDA Organic Seal.

This Seal Guarantees Minimum 95% Organic Ingredients

There is one other category of organic labeling. Those products containing at least 70% organic ingredients can carry the claim, ‘Made With Organic Ingredients.’ Certification is by government-approved certifiers such as the CCOF or other state, non-profit, or private agencies.

The best way to ensure you get what you pay for, whether in the supermarket or the farmers market, is to look for the words certified organic or the USDA Organic seal. That way you’ll know the products for which you’re paying extra have gone through the rigorous requirements of organic certification, which you know now, is as much about production philosophy as being pesticide-free.

Pedrick Produce–Fresh Fruit in a Quonset Hut

Monday, March 15th, 2010

My family are hardcore skiers. Not in the sense that we swoop down the slopes like experts, but rather in that we ski nearly every weekend. If you’ve ever travelled on Interstate 80 during ski season, you know that requires extreme dedication. The traffic is horrendous!

To break up the monotony of what can be an endless drive we look for new places to stop along the way, and I wanted to share one with you: Pedrick Produce. It’s not a fancy place, but if you’re like me and like farm fresh produce, this is the place for you.

Pedrick Produce's Original Metal Quonset Hut (courtesy of daviswiki.org)

Located in a metal barn set alongside I-80 in Dixon, what immediately strikes you is that Pedrick’s parking lot is full. And so is the store inside. Four cashiers ring up produce purchases for patient customers. The store’s interior is crammed with bags of fruits and vegetables, as well as flavored and plain nuts of all varieties (a nut fan’s heaven!).  The prices aren’t bad either. Asparagus for a dollar a pound. Apples for 49 cents a pound. Off-season tomatoes for $1.19 a pound. A whole lot cheaper than Safeway and without the spit-shine production that makes Safeway’s produce seem a little too slick.

As I walked around this flourishing produce stand, I was struck by the similarities to another produce stand institution along I-80–Ikeda’s in Auburn. If you’ve ever stopped at Ikeda’s for a burger, you know the produce stand there has expanded beyond fruits, vegetables, and nuts to included baked goods, wine, and seafood. Give Pedrick’s a few years, and I’m sure they’ll head the same way, opening a restaurant and bakery. Which is fine by me. I’m always on the look out for a new place to eat…

Note to Locavores: Not all of Pedrick’s produce is local. Some comes from other parts of California, Washington state, and even Mexico. If local production is important to you, stick to farmers markets. However, Pedrick’s is still worth a visit, if only to check out the vast selection of nut snacks!

Calories on the Menu–Coming Soon!

Thursday, February 25th, 2010

If you’re a Californian, you may have noticed that restaurant chains are now offering nutritional and caloric information about menu items, usually in a brochure shoved off to the side. That’s great, if you’re like me and are curious about what you’re eating. But does nutritional information actually change food purchase decisions? Up to now, the answer has been unclear, but an intriguing new study from Yale suggests that, yes, in the right context, people definitely eat less when they know more.

The study, published in December 2009’s American Journal of Public Health, divided study participants into three groups. The first group was given a regular menu at a restaurant and told to order dinner. The second group was given a menu with caloric information and was similarly told to order. The third group was given the caloric information menu that also contained the statement, “the average daily caloric intake for an adult is 2000 calories.” Not surprisingly, the two groups with the caloric information menus wound up eating less calories at dinner than the regular menu group. But did they wind up eating less calories overall during the day? The answer, surprisingly, is no. The group with the caloric information menu but no daily caloric intake statement went home and had an after-dinner snack, overall ingesting the same amount of calories as the  regular menu group. However, the caloric information menu group that also had the daily caloric intake statement, did not snack after dinner as much, and on average ate 250 calories less than the other two groups. The take home message: context matters. Remind a diner of their daily caloric needs and not only will they eat less at dinner, but they will likely eat less when they go home.

Now, what do you do if you want to make smart choices, but the menu doesn’t show caloric counts? As of January 1, 2011, all chain restaurants in California will be required to list caloric information on menus and indoor menu boards. You won’t have to hunt around for brochures. That means when you order your reduced-fat banana chocolate chip coffee cake at Starbucks, the sad facts will be up front and center: reduced fat doesn’t mean reduced calories. That delicious thing has nearly 400 calories!

As for the daily caloric intake statement, there are no requirements that it be included on menus. Although maybe it’s not a bad idea given that 16 million Californians are considered overweight or obese…

Three Books For The Educated Eater

Monday, February 22nd, 2010

I’m still compiling the list of recommended books that you all so graciously submitted. There are a lot of them–which is reassuring given that books must now compete with so much electronic media for our precious free time.

But before I proceed with that all-inclusive list, I wanted to jump ahead to recommend three must-reads for those interested in food production (which should be everyone, since food is one of the most basic human needs). They are, in no particular order:

1) The Omnivore’s Dilemma–Michael Pollan’s 2006 bestseller is probably one of the trendiest books around. Pollan recently showed up on Oprah to discuss his latest book, Food Rules, which is a follow-up to this book. Basically, Omnivore’s Dilemma examines food production in America–the most shocking of which is the intrusion of corn into almost everything we eat, whether it’s corn-fed beef, high-fructose corn syrup, or even the chicken nuggets we love to feed our kids (which are bits of corn-fed poultry glued together with modified corn starch, covered in corn flour-containing batter, fried in corn oil…you get the picture). After reading this book, you will look at food labels a WHOLE lot closer.

2) Fast Food Nation–Eric Schlosser’s 2001 cult classic examines the social, economic, and environmental impact of fast food. The thing that will absolutely turn your stomach, however, is Schlosser’s portrayal of the meatpacking industry. You won’t eat at McDonalds for a year.

3) The Jungle– Upton Sinclair’s 1906 book about the Chicago meatpacking industry is a classic and still reads grippingly today. Exposing not just the hidden horrors of meatpacking (agh– rats in your sausage!), the book also portrays the ineluctable downward spiral of immigrants ensnared in an inhumane industry. Sinclair originally intended the book to illustrate the plight of powerless and exploited workers, but The Jungle’s lasting legacy has been better food safety laws.

The beauty of these books are that they are both eye-opening and good reads. If you’ve got any other must-read food books, please share. Transparency in food production should be a right to which we are all entitled– after all, don’t you want to know what you are really eating?

World Ag Expo 2010

Friday, February 12th, 2010

Sorry I haven’t posted recently. As with all of us, life sometimes just gets busy! But I did want to share a photo and some thoughts about the World Ag Expo 2010, which just ended yesterday. For the uninitiated, the World Ag Expo is an enormous three-day agriculture show that takes place in Tulare, California. If you’re curious about tractors, ploughs, high-tech irrigation systems, or dairy management software, this is the place for you. More than 100,000 visitors, many of them from overseas, converge on the expo to see the newest and slickest stuff in ag.

Dad and I at World Ag Expo 2010

I went down with my mother and father to check out “Big Ag” and found myself a little overwhelmed. The scale of the expo, the scale of the tractors, the scale of the farms in the San Joaquin Valley just dwarfs Northern California. As my father said, “Compared to these guys, we’re just gardeners.” But nonetheless, all that scale is pretty impressive.

I signed up for a Citrus Tour, in which a citrus grower took a bus-full of us on a tour of a packing plant, juice facility, and orchard. And I have to say, it was pretty enlightening.  I’ve said before that we live in a food “black box” society. Most Americans have no idea how their food is produced; they just buy it at the store and eat it. So checking out the packing and juice plants to find out how that navel orange in the orchard is converted into the the slick shiny thing you buy or into the premium juice that takes up a huge refrigerated space at Safeway opened up the black box for me a little.

Yes, your navel oranges are washed, dipped in fungicide, and waxed before they head to the grocery store. They may be gassed with ethylene gas, although only if there is green still left in the peel. They are routinely subjected to pesticide while still in the orchard to protect against pests that attack the peel (but not the fruit underneath). All this is done to make the fruit look good, because as one farmer said, “People like pretty fruit.”

While in the orchard, I sampled one of the oranges off the tree, and it was delicious. But it was a dull sort of orange with a tiny bit of green in the peel.  No gas and no wax yet. Definitely not as pretty as those on display in the grocery store.  The farmer assured me it was safe to eat, because the last application of pesticide was a month earlier. I listened to him chat about ”nitrogen” he added to the irrigation water to fertilize the trees.

It wasn’t an organic tour; that’s for sure. But the manipulations were pretty small if you compare it with juice production. It takes millions and millions of dollars to buy all the technology to make orange juice. I’ll save that for a later post, though…

Simple Pleasures–Fresh-Squeezed Orange Juice

Thursday, January 7th, 2010

Sometimes when I read about the processing of food in America I find myself overwhelmed. Michael Pollan’s exposure of the cornification of our country in The Omnivore’s Dilemma and Eric Schlosser’s descriptions of the perverse manipulation of food flavors in Fast Food Nation make me look at food with an anxious, uncertain eye. What am I eating? And does it bear any resemblance to what I really think it is?

As a farmer’s daughter, I grew up knowing where my food came from. We had our own cattle slaughtered and stored the packaged meat in our freezer. My mother laboriously prepared green beans straight from the field, which we packaged and froze for the coming months. I never had a jar of jam that didn’t come from our own produce. But now? I live in the city, and my father, though he still produces multiple crops, doesn’t grow the diversity necessary for a well-balanced diet. Both of us are patrons of supermarkets and all the brightly packaged products there.

Like many others, I yearn for a clearer, more transparent vision of one of the most basic aspects of life–eating. I guess I’ve reached the point where I don’t care if there’s a pound of butter in the recipe. I just want to know what the ingredients are. And if I don’t know what half the ingredients in a processed food are– then why am I eating it? It might as well be Soylent Green. 

Which brings me to the topic of fresh-squeezed orange juice. I’ve never been a big juice drinker, but I love fresh-squeezed orange juice. The taste is unmatched. And I’m lucky, as the daughter of a citrus-producer, to have access to as many organic mandarin oranges as I want. My father hooked me. He drinks fresh-squeezed mandarin juice every day in season, squeezing it with a simple old electric juicer ($20.99 at Target!).

The beauty of fresh-squeezed juice is that not only does it taste so outrageously good, but you also know exactly what it is. The processing is simple and done by you. Not only that, the nutrition is outstanding. An 8-oz glass provides 100% of the RDA for Vitamin C,  as well quality amounts of thiamine, folate, and potassium. It’s good for you, it tastes great, and it’s pure. What’s not to like about that?

If you contrast that with some of the reconstituted orange juices in the store… well, I won’t go into that beyond to say there’s nothing local about that juice (think Brazil) and some of the ingredients aren’t listed on the container. So again, as mantra for 2010, I keep coming back to Keep It Simple. There’s something really lovely about going slow, knowing where you’re going, and savoring the steps along the way.

New Year’s Resolution–Avoiding Portion Distortion

Sunday, December 27th, 2009

It seems we’re doomed to be fat. I know this might not be what you want to hear when you’ve just come off a Christmas caloric binge, but a recent article in the Annals of Internal Medicine shocked me. Just when you thought the only safe nutritional path left was to make your own food, it turns out that even our old beloved cookbooks have been betraying us, packing more calories into old-time favorite recipes.

According to the article, which examined 18 recipes in successive editions of The Joy of Cooking published over the past 70 years, calories per serving has increased by two-thirds, from an average of 268 calories in 1936 to 437 calories in 2006. These are for the same recipes! The difference was attributed to portion size and to the actual ingredients. For example, the same amount of ingredients that formerly made 12 waffles now only makes 6. And recipes today might include more sugar, butter, and add-ins, such as raisins and nuts, to assuage our increasing cravings for sweetness and fat.

Throw in the increasing size of plates and utensils and you’ve got even more danger of portion distortion. According to a July 2007 article in the the Journal of the American Dietetic Association, plate size has increased by 36% since 1960. With bigger plates, there’s a lot more room to pile on those bigger portions. Even well-meaning experts aren’t immune to the deception of the bigger dinner plate. In a September 2007 article in the American Journal of Preventive Medicine, nutrition experts, when given bigger bowls, unknowingly upped their food consumption by 31%. Similarly, bigger spoons led to a 14.5% increase in serving size ingested.

So is it any wonder that average daily caloric intake is up? It is, and it’s awful. According to this month’s edition of the American Journal of Clinical Nutrition, Americans ate an average of 500 calories more per day between the early 1970s and the early 2000s. Children’s caloric consumption increased by an average of 350 calories in the same time. This might explain why Americans gained, on average, 19 pounds in the same period, while children gained nine.

So how about those New Year’s Resolutions? Smaller plates, bowls, and spoons? And watch for the good old cookbooks. Those calories are coming at you from everywhere!

Food Philosophy– How Cuties Got So Cute

Wednesday, December 2nd, 2009

Now that Thanksgiving 2009 is safely tucked behind us, I can get back to the case of the Cuties– which is not, though it may sound like it, an infectious disease but rather the case of  how even relatively simple sounding “whole foods” like oranges are processed to look so pretty and appealing. How you feel about the following will probably differ, but the processing of a non-organic mandarin orange is worth thinking about, if only to illustrate how powerful our manipulations have become to get fresh produce to people all year round.

Processed for Shelf-Life and Appearance
Processed for Shelf-Life and Appearance

The investigation began for me when I was looking for packaging for my father’s certified organic mandarins. I’d casually flip over 5-lb boxes of Cuties mandarin oranges to find the box manufacturer, and the labeling I saw instead shocked me: Cuties are treated with Imazalil or Thiabendazole. As a physician, I recognized thiabendazole as an anti-fungal that is also sometimes used to treat roundworm and hookworm. What was an anti-fungal doing in my mandarin orange, and how in heaven’s name did they apply it?

IMG_0742

It turns out that the antifungals are applied within the wax that coats Cuties. I didn’t know Cuties were waxed; I thought only cucumbers and apples were waxed. But apparently waxing is widespread throughout the non-organic produce section. In non-organic mandarin oranges, wax is applied after the fruit is washed because washing removes the fruit’s naturally-occurring protective wax.  Without this wax coat, mandarins becomes vulnerable to ”loss of aroma and weight” and fungal rot. In other words, they start getting old, fast. With a wax coat and antifungals, mandarin oranges can be stored in a climate controlled storage unit for nearly a month.

Wax Keeps Your Orange Youthful
Wax Keeps Your Orange Youthful

 It doesn’t stop there, either. Some mandarin oranges are gassed. That’s right, gassed. Ethylene gas is a naturally occurring gas given off by fruit, which acts as a ripening hormone. When gas levels are high enough, the fruit ripens. In the non-organic mandarin orange business, however, external ethylene gas is sometimes added to perfect the mandarins’ orange color. People in the business call this “degreening.” which is considered desirable because consumers associate a mandarin’s orange color with ripeness and sweetness. Green just doesn’t sell well.

So there you have it, the non-organic mandarin’s path to the produce aisle: it may be gassed to look orange and pretty. It will probably be waxed and treated with antifungals to stay looking pretty. The orange you eat may be a month old. Is this so bad? You decide. Some may call all this processing a great leap forward– you can get your mandarins for a longer season and they look awfully good. Others might say that it’s just one more step away from nature, that we are increasingly divorced from how our foods are produced and processed. I merely bring it up to encourage people to develop a food philosophy. How much processing is too much?

American Life–How Sweet It Is

Monday, November 2nd, 2009

My eleven-year old son brought home an astounding seventeen pounds of Halloween candy after trick or treating this year. I know, because we weighed it. I immediately formulated an eating plan, not because I thought the matter out, but rather because I was reflexively parroting what another parent had said.

“Jack,” I said. “You can have three pieces of candy a day. That’s it.”

At that rate, it would take a year to get through all that candy, so my son helpfully offered up some other options. “You could buy it from me so I don’t eat it. Or you could just let me sell it to my friends.”

I love that he’s at the age where his greatest vice is eating candy, but as a doctor I didn’t like either of his offered solutions. I bought two bags of candy to hand out myself. Why should I buy more candy from my son? And if I did buy it from him, what would I do with it? Throw it away? Or eat three pieces a day myself for the next ten months?

It turns out that I was a bit of a candy under-buyer this year. I did an informal poll with my neighbors to see how many bags of candy they bought to hand out. The going range seemed to be about six to eight bags of candy. Naturally with so much candy, these friendly people were giving out two to three little snack-sized bars to each little goblin and witch who came to their door. No wonder my son, who views trick or treating as a sort of acquisition sport, was able to gather seventeen pounds in a little less than two hours.

Which brings up a health issue: too much sugar is bad for you. The American Heart Association took the bold step this year of actually making specific sugar intake guidelines. I say this is bold because there is an enormous amount of industry pressure to stop such guidelines. It could cost our multi-billion dollar food industry millions in lost revenue if people cut the amount of sugar in our diet.

So what exactly are the guidelines? Women should eat no more than 25 grams of added sugar each day. Men should limit it to 37.5 grams. Admittedly these aren’t guidelines for children, but if you crudely extrapolate you can figure out that kids should eat even less.

So what are added sugars? They are sugars that are added to foods, not the naturally occurring sugars like fructose in fruit or lactose in milk.  Unfortunately our food labeling system doesn’t distinguish naturally occurring sugars from added sugars. They all fall under ‘Sugar’ on the nutrition facts label. To distinguish between the two requires a little detective work. Look at the ingredients list. Any product that has syrups (corn, high fructose corn, or malt), sugar, honey, molasses, evaporated cane juice, or fruit juice concentrate has added sugar. That includes a lot of products.

To get back to our Halloween candy, I decided to investigate exactly how much added sugar there is in a snack-sized candy bar. Each candy differs, but here are some examples to consider: one Snickers fun size candy bar has 7 grams of sugar; one Reese’s Peanut Butter Cup has 8 grams of sugar; a Hershey’s Milk Chocolate fun size candy bar has 7.6 grams of sugar.

So, if my son eats one of each of the above he will have 22 grams of added sugar right there. His three fun-sized candy bars a day nearly equal the recommended daily limit advised for grown women.  There’s no additional room for the added sugar in his yogurt or applesauce or peanut butter or ketchup. He’s blowing his sugar limit just with his Halloween candy. 

I worry about our country. 64% of Americans are either overweight or obese. The data available doesn’t implicate added sugar as the sole culprit for our runaway obesity rates. But with added sugar in so many products now, it’s hard to deny that sugar doesn’t play a role in the fattening of America.

Maybe that three pieces a day rule isn’t such a good one after all.