Food | Bonnie Modugno, MS, RD

An Open Letter to Mark Hyman, MD

February 21, 2013 by Bonnie

I received an invitation today from Mark Hyman, MD, author of The Blood Sugar Solution to help him “change the future of food” . On February 26 he is publishing The Blood Sugar Solution Cookbook, version 2013. (There is a 2006 version of The Blood Sugar Solution Cookbook I found on Amazon, and I don’t quite know the difference) He shares that:

“The consumption of industrial fast and processed foods is driving our
epidemic of obesity, diabetes, and chronic disease that now affects EVERY other American.
We need a food and cooking revolution to change this!”

His answer is simple enough: we all need to cook more. I think that is mostly true, but there is much more to this story and I told him so in a return email. Here is my response:

Prepping for Albondigas Soup

Dear Dr. Hyman,

I admire your efforts, but there is something disingenuous in asking people to cook more when so much is already asked of their time and historically we have never valued the time and energy to purchase, prepare and eat food as daily sustenance. Cooking and shopping have been mostly considered women’s work, something that is supposed to just happen despite the radical changes in how women live their lives since the 1900′s when only 2% of food was eaten outside of the home (Dr. Hyman’s quote, not mine).

The shift from cooking to “assembling” is a result of the pressures and expectations of our society, not just a cause of poor health. I prepare most of my family meals from scratch and shop primarily at farmer’s markets. It is an enormous task, taking hours every day. My family prepares food to take to school and the office from whole foods purchased and prepared at home. I feel lucky to have the time and flexibility to make this happen. I’m not sure the infrastructure is in place for everyone to access the time and energy it takes to eat this close to the earth.

WHAT SUPPORT IS NEEDED FOR PEOPLE START COOKING MORE?

People need support to cook more. That means employers need to honor a reasonable work day. People need to limit themselves to reasonable commutes. Schools need to limit students to reasonable homework and families need to push back on the ridiculous expectations of extracurricular activities that mean no one is home for dinner– and rarely home to enjoy family meals on the weekend. There needs to be a way for people to have the time and energy to engage with their families while still being valued in the workplace. No one should have to fear losing a job because they attempt to live a balanced life. Too many people need to learn how to cook because their parents were too busy or unable to teach them.

While I am all for cooking more, I’m not sure what your answer is for all those folks who don’t like to cook in the first place. It is likely that restaurants–even fast food establishments– serve more whole food, wonderfully prepared, than what people throw together for their “meal” at home when they are not ready, willing or able to cook for themselves. But that is another letter….

SURVEY YOUR COLLEAGUES

Check out the status of your colleagues. People working in the medical field are known for long hours with the same challenges eating well as people working in other demanding careers. But health care providers are supposed to know better. How many shop for their own food and prepare their breakfasts, lunches and dinners from scratch working typical 40+ hour work weeks?

On the other end of the spectrum, how many people work two jobs just to pay rent and get food on the table? Too many people in this country live below the poverty level despite working long hours. And what about all the working middle class and single parents who don’t enjoy the privilege of help at home and juggle everything on their own? The challenge of cooking more is a much bigger issue than just cooking more.

You have a strong platform. Start the conversation, raise awareness. Cooking is an honorable goal, but it is the back end of the conversation. I am hoping for a bit of honesty and candid conversation about what we are really asking people to do—and then ask all stakeholders to step up and support the effort. Let’s encourage everyone to cook more. More importantly, let’s push for a cultural environment that values food–and everything it takes to purchase, prepare and eat food– in its rightful place.

Warm Regards,

Bonnie Y. Modugno, MS, RD

www.muchmorethanfood.com

Filed Under: Blog Tagged With: commutes, cooking, diabetes, disease, farmer's markets, fast food, food, groceries, health, industrial food, jobs, life balance, Mark Hyman, obesity, poverty, processed food, smfms, stress, work

Cultivating Stress: What are we really teaching our kids?

January 31, 2013 by Bonnie

There is no escaping escalating levels of stress these days. Two weeks ago I sat in a room of parents listening to college counselors at our school tell us what is ahead. My son is a junior and we have steadfastly avoided jumping into the college bound fray, but last Thursday night I felt like I got sucker punched. I came away from the event thinking, “This is a system created by and for the adults.”

I find myself struggling to accept that it will be necessary to research and visit dozens of schools, for my son to take classes to prepare for an SAT, for my son to plan to take the SAT multiple times, and then stare down the cost and process of applying to 14-20 different institutions in a particularly scaled pattern. I wonder if all of this is truly just serving the students. As kindly as possible we were told to be prepared for what amounts to a second job. The stress in the room was palpable.

AN INVITATION FOR MORE STRESS

Even for students who manage to pass the high stakes course of college acceptance, the costs are enormous. Psychological services at college campuses are overwhelmed. This particular report suggests that mental health services are overwhelmed because more kids are getting to college with a predisposition towards mental health challenges. I’m not so sure it isn’t the other way around. Maybe we are creating mental illness as our current academic environment–and society at large–continues to raise the bar. It seems that expectations escalate in tandem with a multitude of barriers overwhelming all but the highest functioning students.

A CONTINUUM OF STRESS FROM SCHOOL TO THE WORKPLACE

There is plenty of evidence that overwhelming pressure continues in the workplace. This past Monday (ironically the same day the LA Times ran a story about stress and a child’s brain development), an article in the business section unwittingly framed the problem. The writer gushed at the daring and prowess of one young executive as he was quoted, “I’m a manic manic. I’ve got one button, and it’s on.”

The cost of a relentless pressure to push harder, go faster, be more, and do more may be more than we can bear without significant fallout. There are a few of us trying to push back. In the academic world, the efforts of Vicki Abeles and the Race to Nowhere movement continues to gain momentum. She adeptly addresses the consequence of unrelenting pressure in the academic world. Too often the best and brightest students are pressed to cheat and lie to get the grades that are expected of them. Lesser students are known to give up and drop out. Most of the kids figure out a way to decompress and compensate: binge drinking and other forms of substance abuse are commonplace. Disordered eating is so tightly woven in the fabric of daily life that it is often not recognized until the behavior is diagnosable.

In the adult world, overwhelming stress seems to be the norm. Sixty-plus hour work weeks are commonplace. Employees have vacation time they don’t or can’t use. Others call in sick, show up late or find ways to check out as they struggle with depression and burnout. But companies continue to downsize and hoard cash and everyone is pressed to do more with less–except the architects of all the cost savings that result in better earnings for stockholders, and bigger bonuses for themselves. Too often overwhelmed adults fall back on whatever coping mechanisms they learned when they were young. Ironically, the costs to business are astronomical.

CAN WE PUSH BACK?

People know they need to manage stress. The tough part is figuring out how to bridge the gap between knowledge and behavior. First, it is not enough to talk about how debilitating overwhelming stress can be, we need to reset the bar.

The cost of stress can be measured in every dimension: mentally, emotionally, physically and physiologically. Unfortunately, stress is typically acknowledged by everyone but the stress junkies. I am fascinated that in most organizations, it is the stress junkies that get to set the bar. It is patently unhealthy to expect everyone to match the intensity of the most intense person in the room.

The counterpoint is that we need to appreciate the need for enough stress. Being bored, disengaged and isolated is also very stressful. We need to figure out how to navigate a “good enough” level of stress to keep us alert, focused and engaged with life, especially since the target zone is different for different people.

MORE IS NOT NECESSARILY BETTER

Second, we need to reconsider how much is enough. More is not necessarily better. Period. Changing this mindset will take some doing as the illusion “more is better” seems embedded in the American psyche. Research highlights the cost of stress in terms of lost productivity, epidemic lifestyle disease and the skyrocketing costs of health insurance and health care. The stats should give every employer pause, and permission to reset priorities.

Third, we need to adjust our expectations and allow everyone–children, students and adults– time to tend to our basic needs: safety, shelter, enough sleep, adequate food, and regular physical activity. What would change if you fell asleep early enough to wake rested–without feeling deprived of time for yourself? How would you feel if your day allowed time to move in a joyful way, whether that movement included scheduled exercise, recreation or play? What would it mean for you to have the resources you need to purchase, prepare, and enjoy food it in it’s rightful place? Maybe each of us can find a way to start pushing back today. Where will you push back first?

Filed Under: Blog Tagged With: brain, business, child development, costs, expectations, food, health, physical activity, Race to Nowhere, safety, school, shelter, sleep, stress, time, Vickie Abeles, work

BEYOND CALORIES: Why the ratio of carbohydrate, protein and fat counts, too

November 11, 2012 by Bonnie

I have a client I am seeing currently that embodies why it can be important to discern what balance of carbohydrate, protein and fat works better for any one person. I have worked with hundreds, if not thousands, of clients with similar outcomes. But to listen to many nutrition experts, calorie counting is king. Not so fast.

A TRUNCATED CASE HISTORY

MB is a 40 something married woman with two children, Asian American descent. She eats mostly whole foods, vegetables and beans with small amount of animal protein. Exercises regularly. Splurges occasionally with wine, bread and cheese with girlfriends and a few sweets, but that didn’t use to be a problem. Gained 10 pounds over the last few years. Not happy.

MB showed me weeks of tracking intake on MyFitnessPal. Carbohydrate intake ranged 55-70%, but was especially high in the morning. Calorie intake ranged 1200-2000 per day.

We chatted about what was important to her and what changes made sense. MM shifted to more protein, less carbohydrates–especially in the mornings. In one month, she lost 4.25 pounds. She measures about 2.5 inches less at her waist and 1.5 inches less at her hips. She is shopping in her closet and wearing pants that she had given up on.

MM reports that food finally makes sense to her. She understands why she feels bloated after eating more carbohydrate than she can handle. She is currently navigating her cultural holidays without gaining weight. She anticipates refocusing her efforts once the festivities are over next month.

THERE IS MORE TO WEIGHT LOSS THAN COUNTING CALORIES

When someone’s diet is abysmal, eating more whole foods and fewer calories will always make a positive impact. These changes are important, but they are the easy call. What happened to MM is not unusual. There are many people who do “everything right” and still gain weight or can’t lose weight that they want to lose. Often people slip up because they feel hungry or at least not content. It is too hard to be constantly fighting the sense, “I need something.”

Eating more protein in the morning with Greek yogurt, berries, nuts and a sprinkling of granola

I focus on hunger and satiety. Calorie counting rarely does. My more insulin resistant clients often find that an adequate intake of protein and fat with moderated carbohydrate intake enhances satiety–that sense that you are satisfied after eating– and minimizes overeating at night. They crave less sugar and/or other refined carbohydrates. These are core reasons they are able to eat less and lose fat weight. I like to think they are learning to work with their body.

Many calorie counting proponents forget or maybe just don’t pay enough attention to many other factors that influence energy metabolism. Calories count, they just aren’t the only thing that counts. I recently heard scientists report that the global obesity epidemic can no longer be explained by energy intake. Endocrine disruptors, sleep debt, use of psychoactive agents and other factors influence how our body uses energy.

BEYOND CALORIES

Despite all the diet chatter, it is important to remember that there is not one single right way to eat. The critical goal for each of us is to figure out the approach to food that works.

Filed Under: Blog Tagged With: Asian Indian, belly fat, breakfast, calories, carbohydrate, counting calories, diet, endocrine disruptors, food, hunger, inches, insulin resistance, metabolic syndrome, night eating, protein, psychoactive drugs, satiety, sleep debt, weight loss

Anti-obesity Ads: Help or Hindrance?

October 16, 2012 by Bonnie

Anti-obesity advocates are turning up the heat. Anti-obesity ads are on the airwaves and posted on you tube. The spots are compelling–and chilling. They target parents. They target junk foods. They are not honest.

Blue Cross and Blue Shield are behind the ads in Minnesota. Children’s Healthcare of Atlanta promotes different ads in Georgia. The UK and Australia have their own versions. All of the ads reinforce the belief that obesity is a math problem. Eat less, exercise more, and just stop buying all those unhealthy foods.

THE ANTI-OBESITY ADS LIE

While the ads may be thought provoking to some, others find them shaming and judgmental. I find them dishonest. Why only target overweight? Not everyone who eats poorly is overweight. Not everyone who is overweight eats poorly. You can be fit and fat. You can be skinny and sick.

Research tells us that obesity is much more complex than a simple equation. Calories do count. But they are not the only thing that counts. The issues are complicated by a myriad of forces. Genetics, food subsidies that influence food costs, food access, food storage and safety issues, as well as the time, energy and skill to cook more healthful meals.

There are even bigger issues. We live with an abundant and adulterated food supply. Food technology has done its best to deliver a food supply that is too tasty and appealing. Our overly refined food supply influences biological regulators that lead to overeating. And as one of the ads painfully illustrates, too many people use food to soothe, cajole and bribe. Doing the easy, quick or convenient thing has cultivated a population with less than adequate self regulation and resilience.

MORE THAN FOOD

And there are big questions looming about the role of endocrine disruptors (ED) and other persistent organic pollutants (POPs) that contaminate our environment and obesity. These agents influence the very hormonal processes that regulate how our body uses energy.

Many pesticides interfere with estrogen receptors. Estrogen plays an important role in fat metabolism. I don’t think it is coincidental that the growing incidence of obesity parallels the chemically driven green revolution and plastics industry. Yet these industries spew the very ED and POPs that are detected in our air, water and soil and eventually in our food. They accumulate in the fat stores in our bodies and are linked with glucose intolerance (which can lead to diabetes), thyroid disease, cancer and host of other maladies.

REAL SOLUTIONS

So lets stop pretending that obesity is the issue. Lets stop pretending that only heavy people eat excessive amounts of refined starch, sugar and fat. Let’s stop pretending that judging and shaming people is an effective way to change behavior.

If the folks at Blue Cross/Blue Shield were really interested in helping people, I wonder if they would consider covering nutrition and lifestyle counseling–before someone is diagnosed with diabetes?

Filed Under: Blog Tagged With: advertisements, blue cross, blue shield, BMI, calories, cancer, child obesity, diabetes, endocrine disruptors, estrogen, exercise, food, food access, food subsidies, food technology, genetics, HAES, health, health at every size, metabolism, overweight, persistent organic pollutants, pesticides, public health, resilience, self regulation, skinny, thyroid

Why We Need Labeling of Genetically Modified Foods

June 5, 2012 by Bonnie

Today Californians vote in our state primary elections, but November’s election is the bigger deal–on both the political and food front.

Californians are set to vote in November on a law to require mandatory labeling of all GMO (genetically modified organisms) and GE (genetically engineered) ingredients in processed foods and to also ban the routine industry practice of mislabeling foods containing GMO ingredients as “natural”. As reported by Digital Journal, so far, polls show that almost 90% of California’s voters plan to vote “yes”. I’m hoping it stays that way.

Mother Jones, May 31, 2012

As a nutritionist I have been somewhat alarmed about GE foods, but even I felt the issue was mixed. For years, I have encouraged clients to eat “close to the earth”. I avoid most highly processed foods and that naturally keeps me away from most GE products. After reading The Unhealthy Truth by Robyn O’Brien, I am paying more attention than ever.

We don’t know all the risks regarding GE foods because the studies haven’t been done. FDA has failed to require basic studies to determine potential risk of the GE foods we eat. I have to come to believe our supposedly safe food supply isn’t.

As the election season continues to churn, expect lots of money to be poured into California, hoping to change our minds about labeling GMO/GE foods. There are three common positions that proponents of GE use to muddle the issues. Here are fundamental arguments why we should resist all the propaganda.

1. GE/GMO foods are designed to improve upon nature

The proponents of GE foods celebrate that old tag line, “better living through chemistry”. I don’t think we are living better today because our food supply has been chemically transformed over the last fifty years. We live with an obscenely adulterated food supply. In some ways it was easier to eat when we were hunting and gathering. Man just had to worry about getting enough. Most chronic diseases today are linked to a poor diet and other lifestyle factors.

2. Genetic engineering isn’t all that different than the breeding and grafting farmers have engaged in for hundreds of thousands of years.

There is nothing that farmers could do to resemble genetic engineering. What is natural about using foreign proteins from different species to change the nature of a food? GE foods are designed by breaching the natural barriers between species. DNA from bacteria, insects and other food species are forcibly inserted into the DNA of the target food. There is little control over how this happens, nor any collateral damage to the rest of the DNA sequence. The characteristics of GMO foods could never be cross bred in the traditional way.

3. Genetic engineering is a way to feed the world and reduce hunger and malnutrition

Even the USDA has acknowledges that GE crops yields may not increase, and some GE hybrid crops that produce their own pesticides have decreased yields, something called yield drag in agricultural circles.

Ironically inadequate access to food is the result of problems regarding the global food supply, not the cause. Skewed agricultural policies, misguided development, and lack of social resources contribute to the myriad of factors that divert land and other resources from people to produce their own food. From my reading, I gather that relying on GE foods will only increase the distortions in the marketplace.

POTENTIAL RISKS, LITTLE DATA

GE foods have been commercially produced since the mid 1990′s. Foreign proteins are introduced into more than 11 GMO produced foods, including soybeans, cotton (cottonseed oil), corn, canola, sugar beets, potatoes, tomatoes, rice, flax, squash/zucchini, papaya, and chicory (radicchio).

Questions swirl about the safety of these foods, but few studies have been done. Proteins are at the root of most food allergies and food sensitivities. Are GE foods involved with rising incidence of both?

Inflammation is the underlying condition linked to most major life cycle diseases: heart disease, diabetes, auto-immune diseases, even cancer. Do GE foods increase our body’s state of inflammation as well? With Monsanto’s virtual monopoly on GE seeds, very little independent research is likely.

CONSUMERS DESERVE TO VOTE WITH THEIR DOLLARS

Many other countries have followed a more prudent course called the precautionary principle. The precautionary principle simple expects “as long as you don’t know how it’s going to affect us, don’t put it in our food.” (O’Brien, 2009) Until labeling becomes mandatory, choosing organic sources of the big 11 is one way to avoid genetically modified foods. Given that soy and other ingredients are found in most processed foods, it is more important than ever to eat “close to the earth.”

All of Europe and Great Britain, Australia, Japan and Russia require GE foods to be labeled. Let’s make sure California is next.

Filed Under: Blog, Uncategorized Tagged With: allergies, asthma, cancer, consumers, diabetes, farming, FDA, food, food labeling, genetic, genetically engineers, genetically modified, gmo, heart disease, immune function, inflammation, Monsanto, organic, Robyn O'Brien

Another Distorted Reason to Avoid Fast Food

October 18, 2011 by

Today you can read Another Reason to Avoid Fast Food by Dr. Joseph Mercola. The subject is about toxic chemicals–specifically fluorocarbons– in our food, our water and measured in our body. His answer is to avoid fast food. What a distortion of the truth.

Fast food bashing is quite popular and an intensely emotional exercise today. Some people love to hate and revile fast food despite growing sales. I find the hysteria both misguided and disingenuous.

CONSULTING FOR A FAST FOOD LEADER

First, a disclaimer. I have consulted for the McDonald’s Owners and Operators of Southern California (MOASC) for over 18 years. Some people jump on that fact as proof of biased alliances. Rather than striking down my credibility, I think the close up view I get of the food at McDonald’s is a unique vantage point. It serves to amplify the distortion of those bent on framing fast food as the culprit of all that is wrong in our food supply. The elitism and lack of critical thinking from fast food critics is appalling.

I have learned much in my work with the McDonald’s entrepreneurs and the employees of their small businesses. Mostly I have learned that the food they serve is much the same as the food most people buy in their local supermarket. For those of us who choose to buy organic, grass fed, sustainably grown, or more locally produced food, those brands don’t quite fit the bill. But those brands feed America.

There is not enough organic, grass fed, unprocessed food to feed the masses today. It is important to keep a personal effort to eat “close to the earth” in perspective. We are cultivating a slow moving revolution. It takes time. Reviling every other food source in the meantime creates harm and distrust. What is everyone else supposed to eat?

FAST FOOD BASHING JUST NOT HONEST

I find the incessant harping about fast food just not honest. Dr. Mercola’s article is a case in point. A quick review leads the reader to believe fast food wrapping is the source of the fluorocarbons PFOS and PFOA while conveniently letting the reader assume that other food packaging is somehow not a problem. Not true.

REGULATION OF FLUOROCARBONS

The Environmental Protection Agency (EPA) is belatedly tracking and regulating fluorocarbons and other chemical substances. Granted, maybe theses substances should have never been allowed to be manufactured in the first place, but that could be said about most plastics. Imagine everyone trying to turn back the clock to live in that world.

We are way past being able to recreate the past. In the meantime, more accurate data in EPA reports shows overall body burden of these fluorocarbons (the amount of the chemical that accumulates in our body and can be measured in our blood) is decreasing. The voluntary industry efforts to reduce usage are working. So what else can be done? Is cutting out fast food the answer?

WHERE ARE THE FLUOROCARBONS?

I have many questions. On top of the list is, “Which industries use the most fluorocarbons?” and “How do we get the most exposure?”

The Center for Disease Control tells us:

Perfluorochemicals (PFCs) are a group of chemicals used to make fluoropolymer coatings and products that resist heat, oil, stains, grease, and water. Fluoropolymer coatings can be used in such varied products as clothing, furniture, adhesives, food packaging, heat-resistant non-stick cooking surfaces, and the insulation of electrical wire.

Consumer products like Teflon coated pans and breathable synthetic outdoor wear are easy to identify, but fluorocarbons are found everywhere. Data from EPA tells us that PFOA fluorocarbons are employed in hundreds of products in almost all industry segments, including the aerospace, automotive, building/construction, chemical processing, electrical and electronics, semiconductor, and textile industries. They are used in surfactants and as surface treatment chemicals in many products, including fire fighting foams; personal care and cleaning products; and oil, stain, grease, and water repellent coatings on carpet, textiles, leather, and paper. Hmmm.

Nothing in these documents implies that fast food wrappings are a primary source nor is there indication that cutting out fast food would demonstrably make a difference in the total body burden of fluorocarbons.

FLUOROCARBON TOXICITY IS MORE THAN A FAST FOOD ISSUE

So why the disproportionate attention to fast food wrappings? What about all food wrapping materials? What about wrappings for take out food from sit down restaurants? Packaging for doggie bags? The majority of wrapped food products in grocery stores? If there is a problem, it would seem to be with with every source of food contact, not just one that is convenient to demonize.

Food wrapping and fluorocarbons are not a fast food issue. The presence of fluorocarbons in our environment is a food issue and much more than a food issue. It is important to appreciate the difference.

NOTE: This writing reflects the personal and professional position of Bonnie Modugno, MS, RD. All comments and opinions expressed in the blog are my own.

Filed Under: Blog Tagged With: body burdon, fast food, fluorocarbons, food, Huffington Post, Mercola, toxic

FOODINC: Pollan and Schlosser point the way to sustainable food supply

October 18, 2011 by

Evan Kleiman elegantly interviewed Michael Pollan and Eric Schlosser at the Vision and Voices presentation at USC last week. The conversation was mostly a celebration of the current food movements that emphasize eating “close to the earth.” Mr. Pollan’s mantra: “Eat food. Not too much. Mostly plants.” prevailed throughout the evening.

I celebrate so much of this message. The Omnivore’s Dilemma was a seminal read for me. I went on to read a half dozen related books and continue to step up my game. As a dietitian it was confronting to realize how little attention I paid to how food is raised.

Today I am mostly horrified at the deterioration of our food supply. Only the staunchest of USDA conformists clamor that we have the safest food supply in the world. The word safe in used in the narrowest of contexts, and we fall down even in the realm of minimizing food contamination and food born illness. Big agriculture and corporate food interests have created an abundant and adulterated food supply that no longer keeps us healthy, but is easily over consumed and contributes to poor health.

The quality and sheer quantity of highly processed foods that are subsidized by USDA Farm policy is a big part of the problem. This is the arena that Michael Pollan and Eric Schlosser effectively argue for change.

CONSUMERS CAN FOCUS ON THREE IMPORTANT FACTORS TO DRIVE CHANGE IN OUR FOOD SUPPLY

1. Avoid human antibiotics in animals. Purchase meats that state no hormones or antibiotics used as growth enhancers. Let your dollars make a statement.

2. Press for better access for everyone. I am privileged to access farmer’s markets 4 days a week. Other regions have nothing close by. I visited a new farmer’s market in South Culver City last Saturday. It is a fabulous press into an under served neighborhood. I hope the community supports this effort.

3. Pay attention to next year’s farm bill. It will be time for all of us to speak up. It is not OK that a few farm states drive this bill. These states depend on federal subsidies to overproduce crops that contribute to our abundant and adulterated food supply.

Lastly, as we work to improve our food supply, it is important to not let proponents of the status quo distort the conversation. Pollan and Schlosser make some key points.

KEEP THE CONVERSATION FOCUSED

1. American farmers grow about 4000 calories per capita annually–twice as much as is needed

2. Hunger is about food access, not yield

3. Our current food supply does not prevent hunger. There are about 1 billion people hungry, and about 1 billion people obese.

4. We consume about 12.5% of what is grown. 12.5% is wasted. The rest feeds livestock. For many reasons it is time to let the animals eat their natural diet.

Each of us needs to ask ourselves, “What can I do to promote a more sustainable and nutrient dense food supply?” Please share what is your next step in Eating Close to the Earth?

Filed Under: Blog Tagged With: antibiotics, Culver City, Eric Schlosser, farm bill, farmer’s market, food, Food Inc, grass fed, hormones, hunger, Michael Pollan, sustainable, USDA

Dueling Dietary Guidelines: The Weston Price Foundation challenges the USDA

October 18, 2011 by

March is National Nutrition Month. Recently both the USDA and Weston Price Foundation published dueling dietary guidelines.

People are confused about food. Too many studies, too many experts, and all sorts of contrary ideas are floated as evidence of the right way to eat. Makes me wonder if there is a single “right” way to eat that works for everyone.

The Weston Price Foundation (WPF) threw down the gauntlet on February 14, 2011, introducing “Healthy 4 Life” in direct competition with the recently released USDA 2010 Dietary Guidelines. Why are food recommendations so controversial?

WPF followers see significant harm in the current approach recommended by the committee who drafted the USDA guidelines. They are not the only ones heaping criticism on the latest rendition of the guidelines. Comments by Walter Willet and Marion Nestle charge that USDA guidelines are overly influenced by commercial and corporate interests. Both Drs. Nestle and Willet contend that food interests are very powerful in this country. They say it is all a matter of following the money.

USDA RECOMMENDATIONS FOCUS ON CALORIES AND NUTRIENT-DENSE FOODS

USDA opens with two over-arching concepts. The first is a statement about Calorie balance and sustaining a healthy weight, basically committee speak for too many Americans are fat and need to lose weight. WPF states that meeting energy needs with recommended whole foods eliminates the need to count calories and will naturally lead to a healthier weight.

Secondly USDA recommends focusing on consuming nutrient-dense foods and beverages. WPF also encourages eating nutrient dense food, but their Food 4 Health guide looks remarkably different than the USDA 2010 Dietary Guidelines. Both organizations herald experts in their respective disciplines. How do they come to such differing positions on something as basic as what we eat?

WHAT IS A NUTRIENT DENSE FOOD?

USDA tends to focus on nutrients and nutrition science. USDA is very quantitative and evidence based. The Weston Price Foundation hones in on the quality of the soil, methods of food production and food preparation.WPF reinforces the value of eating traditional foods in a traditional way, pointing out that the last 40 years of nutrient based science parallels alarming increases in lifestyle disease states and obesity in this country and the world.

Both groups encourage the consumption of fruits and vegetables. USDA presses for more fiber, WPF presses for eating whole foods, organically grown.

WPF encourages beans and legumes in the diet as a compliment to animal products. USDA Dietary Guidelines suggest eating beans and legumes as a healthy substitute for animal products, which they say contribute excessive fat, saturated fat and cholesterol to the diet.

WHAT ABOUT FAT AND SUGAR?

Beyond these basic concepts, the rest of the guidelines couldn’t be more disparate. The USDA Dietary Guidelines continue to admonish Americans to avoid saturated fat, cholesterol, sugar and salt. WPF disagrees with most of these positions, encouraging healthy fats like butter and whole milk from grass fed animals. Ironically, WPF’s position is most aligned with current scientific thinking. Both of the groups agree trans fat is a problem. Interestingly, the FDA (a co-regulator of the food supply) continues to allow trans fats GRAS status. This means that in the world of food additives it is “generally regarded as safe”.

Both groups discuss the problem of excessive sugars and refined starches, but WPF definitely has the stronger voice. The USDA guidelines still allow for 10% of Calories from refined sugar. The USDA guidelines encourage Americans to eat more fiber, but not enough is said about eating less refined starch. Again, FDA’s position does not help. The FDA allows high fructose corn syrup along with a growing list of alternative sweeteners GRAS status, despite significant research linking these substances to metabolic issues and health problems.

FOCUS ON NUTRIENTS LITTLE MORE THAN BIOCHEMICAL MANIPULATION

I respect the science behind the USDA Dietary Guidelines, but the focus on nutrients often misses the point of eating. The science is easily manipulated into reductionist sound bites. The focus on nutrients distracts attention from critical aspects of soil ecology, farming, and food production.

Consumers have been taught to be preoccupied with the nutrient label. They often miss the big picture as they are eating mostly packaged foods. I have clients who eat berries for antioxidants, eat cottage cheese for leucine, avoid meat because of saturated fat and cholesterol, and drink sodium ladened sports drinks while telling me how they avoid salt in the diet. This is not eating. It is little more than biochemical manipulation.

CELEBRATING WHOLE FOODS

There is much to celebrate with the whole foods approach of Healthy 4 Life, as outlined by the Weston Price Foundation. Likewise, an argument can be made that there is value in learning about the role of individual nutrients in foods as encouraged by the USDA Dietary Guidelines. A problem occurs when preoccupation with individual nutrients trumps the value of eating whole foods.

Given the polarized nature of these two different sets of recommendations, the enduring challenge for consumers will be to determine an approach to food that works. This is the public health nightmare. It may be that there is no one right way to eat. The question remains, what approach to food works for you?

Filed Under: Blog Tagged With: calories, cholesterol, Dietary Guidelines, eating, farming, fat, FDA, fiber, food, food label, food nutrient, fruit, health, high fructose corn syrup, Marion Nestle, public health, satruated fat, sodium, soil, starch, sugar, trans fat, USDA, vegetable, Walter Willet, weight, Weston Price Foundation

Who’s Paying Attention to the Food Pyramid?

October 18, 2011 by

Not consumers.

Melissa Abbott, director of culinary insights for the Hartman Group, a market research company in Seattle, knows something about what consumers buy in stores and how they prepare and eat it at home. In a recent interview for Marketing Daily she explains the dilemma.

Very few consumers pay attention to the government directives. I know. I am one of them.

THE DIETARY GUIDELINES ARE NOT FOOD PRESCRIPTIONS

For starters, directives like the 2010 Dietary Guidelines were never meant to be prescriptive. They are not supposed to be static directions for everyone to eat the same way. I wonder how many people have that bit of knowledge? I wonder how many doctors, nurses, dietitians and public health officials realize that truth?

Last week I spoke with Roger Clemens, PhD. He was a member of the task force charged with preparing recommendations for the 2010 Dietary Guidelines. He is very aware that there are huge holes in our understanding of nutrition and food and the human body. The scientists who draft the recommendations are working with less than perfect information.

THERE IS A LOT WE DON”T KNOW

The 2010 committee working on updating the Dietary Goals for Americans set forth 23 nutrient recommendations. At the same time they submitted over 70 recommendations to direct future scientific research. There is a lot we don’t know.

There is no one right way to eat for everyone. Instead of bickering about which diet is better, we should be much more interested in helping individuals figure out an approach to food that works for them.

It is important to remember that just because a certain diet works for one person, it will not work for everyone. It is important to remember that simplistic sound bites pretending to be the truth can cause more harm than good. It is critical to acknowledge that our food supply is more abundant and adulterated than ever. That alone does not make this easy.

FOOD IS COMPLEX, OUR LIVES ARE COMPLICATED

It is not surprising that people are tuning out messaging that pretends nutrition is a one size fits all arena. While the scientists who drafted the recommendations understand this, I’m not sure the folks writing and marketing the guidelines got the memo.

Food is more complex, our lives are more complicated, and information is more confusing than ever. Very little seems simple about good nutrition advice today, but it doesn’t have to be so noisy.

Eating well means paying attention to a few basics and then fine tuning the process until it works well enough. It may be helpful to note that this path doesn’t lead to perfection. We looking for “good enough”.

THE BASICS

1. Eat when you feel hungry. Stop when you are satisfied.

2. Eat a mix of foods so that there is enough carbohydrate for your muscles to work and your brain to focus, enough protein so you feel satisfied, and enough fat to feel satisfied until your next meal or snack.

3. Honor foods in their rightful place. Food is rich medium. Food is our fuel, but it is also social and cultural.

WHEN SIMPLE DOESN’T GET YOU WHERE YOU WANT TO GO

If the simple approach doesn’t work, professional support may be helpful. Look for someone who understands that a sheet of paper or pamphlet is not what you are looking for. Work with someone who is willing to hear your story and help you cultivate an approach that works for you.

This means nutrition counseling will be more challenging, take more time and feel messier for everyone.

MORE HONEST NUTRITION SUPPORT

Doctors won’t get away with simply telling patients to lose some weight or cut out the sugar. Nurses will not get away with handing out a pamphlet. Dietitians will not get away with a standard riff on any one dietary approach. Chiropractors will not get away with a list of supplements that they can sell.

Nutrition counseling will need to be focused and client centered. Effective counseling will probably best handled by referring patients to a professional, possibly a registered dietitian who has learned and is allowed to truly counsel clients, not just tell them what to eat.

MORE EFFECTIVE NUTRITION COUNSELING

Insurance companies will need to examine why they think four 15 minute sessions a year are supposed to be enough to help diabetics effectively navigate the process. They’ll also need to figure out how to pay for everyone who needs nutrition support, not just the diabetics and folks with renal disease. (Although preventing a few amputations or heart surgeries will pay for a bundle of nutrition counseling.)

Health care policy will need to adjust so that people get support as they are developing problems, not just after the disease is diagnosed.

Nutrition information and support needs to be more honest. Only then can it be more effective.

Filed Under: Blog Tagged With: 2010 Dietary Guidelines, balance, carbohydrate, chiropractors, cultural, diabetes, diet, dietitians, doctors, fat, food, food pyramid, government, hunger, insurance, Melissa Abbott, nurses, nutrition guidelines, protein, Roger Clemens, satiety, social

The Limitations of the 2010 USDA Dietary Guidelines

October 18, 2011 by

Last week I heard Dr. Roger Clemens speak at the California Dietetic Association meeting in Pasadena. Dr. Clemens is a member of the 2010 Dietary Guidelines scientific advisory committee.

I am grateful for the candid discussion. I would never know the limitations of the 2010 USDA Dietary Guidelines if I only read materials printed by the USDA. Dr. Clemens spoke with honesty and humility. We really don’t know much about human nutrition. We only think we do.

NUTRITION IS A YOUNG SCIENCE

Nutrition is a young science, studied for a bit over 100 years as a specific scientific entity. Vitamins were discovered in the early 19th century. We didn’t appreciate the role of fiber until the 1970′s.

We are still debating how carbohydrate, protein and fat influence metabolism and energy utilization. We want to believe calories count, but maybe not as much as the hormones and other regulators that determine what we do with those calories.

During Dr. Clemens talk, five key messages resonated with me.

1. The 2010 Dietary Guidelines are not prescriptive. The guidelines are developed as a public health policy tool. It is a recommendation for the population, but not necessarily for individuals. This means there is plenty of range for people to figure out what balance of carbohydrate, protein and fat works for them. We do not all need to be on a lower fat diet.

2. Calories count, but no one is looking at hunger and satiety. There is not enough data to tell us which diet is better. Research shows that if you restrict calories, every diet works well to help people lose weight.

The problem is that no one is asking the dieters what they think and how they feel. We really don’t know more than calories count. Knowledge is not the same as behavior. It is time we look at what behavior science can tell us.

3. Too much refined sugar and starch is a problem, but the research that was considered didn’t find any distinctions between the impact of high fructose corn syrup, sucrose in white table sugar or any other sweetener. This is a situation where the time lag is glaring.

The dietary guidelines were drawn from research that is about 5-10 years old. The guidelines are always looking backwards at what we know, not what we are finding out. The onerous time lag makes it very difficult for me as a practicing dietitian to support the static position of the guidelines–especially since the current ones will be around for another five years.

4. The 2010 Guidelines continue to tell us to eat less fat, less saturated fat and cholesterol even as more current research tells us that fat is not the problem .

This is exactly the kind of rear view mirror thinking that is inherently a part of public policy that relies on research that takes decades and longer to plan, fund, conduct, and then publish results. It takes even longer to understand. No one study is significant by itself, so we need additional research for corroboration.

One saturated fat, stearic acid, is already vindicated. Stearic acid is naturally found in ruminant animals (cattle, goats, sheep, bison), along with milk and milk products from the same animals. It is also found in cocoa and chocolate. Stearic acid is not associated with increased risk of cardiovascular disease.

Milk, cheese, and red meat have been vilified for decades–and now we know better. In his talk, Dr. Clemens remarked that if you subtract the stearic acid component of saturated fat from beef and cows milk, there would no longer be enough saturated fat to be a problem, even by the old standards.

Interestingly, 8 of the top 16 sources of stearic acid in the American diet are high carbohydrate foods like grain desserts, mixed Mexican dishes, pizza, and candy. I’ve often wondered if it is the refined sugar and starch with added fats that are more of the problem, not the fat itself.

5. Sodium intake may be high, but it is not always a problem. It seems only people already predisposed to elevated blood pressure benefit from reduced sodium intake. In addition, whether someone actually develops hypertension due to the sodium in the diet depends on many other elements. Hypertension is not a single nutrient disease.

Total calorie intake, specifically overeating, is the biggest source of excessive sodium intake. If people started to eat just the energy they needed, sodium intake will drop right along with the excess poundage.

Highly processed and pre-prepared foods contribute 77% of all sodium in our diets. These foods are a major source of all sodium intake.

Just about 10% of our sodium comes from cooking and another 7-10% from the salt shaker. We don’t have to eat food that is less tasty or well prepared to reduce sodium content.

The best way to reduce sodium in the diet is to stop overeating. It is also helpful to purchase less highly processed and prepared foods. Lastly, we can learn how to season food for full flavor, not just to taste salty. By eating more fresh foods prepared at home, sodium intake will plummet even if we use the salt shaker.

GRATEFUL FOR A FLAWED BUT USEFUL TOOL

I am grateful for the impressive efforts of all the scientists, researchers, clinicians and academics who contribute to these Dietary Goals. They provide a framework for us to think about food, nutrition and health.

It is valuable to have the Dietary Goals as a reference, but it is equally important to remember the Dietary Guidelines are limited. We are still learning. The Guidelines can only tell us what was understood before 2010.

Filed Under: Blog Tagged With: calories, cholesterol, diet, dietary goals, fat, food, hunger, nutrition, public policy, Roger Clemens, satiety, saturated fat, sodium, stearic acid, sugar

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