Nov 3, 2010
Just yesterday the San Francisco Board of Supervisors voted to pass a toy ban for meals that they deem unhealthy. This law presumptuously determines that no toy may be given if a meal contains more than:

• 600 Calories

• 35% Calories from fat, 10% saturated fat (except if fat is in nuts, nuts butters, seeds, eggs and reduced fat cheese)

• 0.5 gm trans fat

• 640 mg sodium per meal or 480 mg sodium for a single item

• 10% of sugar based Calories and 35% of fat based Calories in beverages

Meals must also contain:

• 1/2 cup fruit or 3/4 cup vegetable

There is no parameter for the source of the foods, level of processing, or adequate protein. There is no discussion of total calories from refined sugars and/or starches in the food.

When compared to nutrition data that the government collects, very few kids eat like this. Over 5500 children’s meals were analyzed from 2002-3 NHANES data by Univ of Washington’s School of Public Health. The analysis included the original requirement that each meal contain 1/2 cup of fruit and 3/4 cup of vegetable. Less than 1/10 of one percent of meals met these specific guidelines.

There is a big problem with such seemingly sound recommendations. No science is available to show that this particular meal composition will decrease child obesity. There is no science, but lots of good intention. Good intention is not good enough.

NO INSIGHT INTO METABOLISM, HUNGER OR SATIETY

What is horribly missing in the discussion regarding child obesity is the incredibly complex and not yet fully understood mechanism of satiety (a sense of feeling satisfied after a meal) and energy partitioning. The key question is why does the body compel us to keep eating even after we have enough, and where do are those calories go?

The short answer is that eating more has historically been advantageous and linked with survival. The human body has exquisitely evolved to adapt to survive scarcity. Chilean miners are a case in point.

Without rapid metabolic adaptation in response to the minimal food intake available to the miners after the cave in, they would have been dead before they were found. Within days of near starvation, the body shifts to preferentially burning fat for fuel. You won’t feel great, but you will be alive.

TOO MUCH REFINED SUGAR AND STARCH IS THE PROBLEM

Research has begun to suggest that excessive intake of refined sugars and starches is probably more of the problem in child obesity than either total fat or saturated fat intake. We are at a nutritional crossroads and it is time for some clarity in the health and nutrition debate.

1. There is no one right way to eat. It is simplistic and over-reaching to think that the nutrition parameters outlined in the toy ban are appropriate for all children. It is important to hold parents and caregivers accountable and responsible for what children get to eat. They know their children better than any politician.

2. We do not have the research that tells us what is healthy for all children. Did the supervisors ever consider that the nutrition information they are working with is not all there is to know?

3. Thin kids drink the same amount of soda as heavier kids. They also eat about the same amount of calories, carbohydrate, protein and fat. So is the issue that heavy kids eat and drink too much, or is it that some kids just get away with it? Maybe it’s time to stop using body size as the litmus test for what kids get to eat.

4. There is no refuge in the neighborhood supermarket. People can make poor food choices anywhere.

5. Knowledge is not behavior. It is easy to talk about what you should eat. The real test is what you do eat. Too many people—including health professionals– don’t walk the walk.

6. It’s not where you eat; it’s what you eat when you get there. At many sit down restaurants the fries come in one pound servings and the beverage refills keep coming at no extra cost. The portions are not small, medium and large—just mostly very large.

7. Fast food restaurants were the first restaurants to offer “choose your side” menu options for kids so that they could also enjoy fruits and vegetables on their plate. In 2004 McDonalds adopted the Happy Meal option nationally, allowing families to choose 1% low fat milk and apple dippers instead of soda and fries at no extra cost.

In 2005 I surveyed 14 sit down restaurants with a kid’s meal menu located in Los Angeles, California. Less than 7% of offerings on these menus offered a fruit or vegetable in the meal. By 2007 the landscape had changed dramatically. 70% of the same restaurants were now offering a fruit or vegetable option on the kid’s menu. By 2009 the National Restaurant Association made healthier kids meals a priority.

SOME CHANGE CAN BE GOOD

When I suggested the Happy Meal option to McDonald’s Owner Operators of Southern California (MOASC) in December of 2002, I was encouraged by the reception and willingness of these business owners to be part of the solution

Today McDonald’s is one of the largest sellers of apples and salads. McDonald’s adopted standards for animal welfare and feeds championed by animal scientist, Temple Grandin, PhD. McDonald’s is already answering Michelle Obama’s call for every player in the food and nutrition community to address factors that contribute to child obesity.

McDonald’s creates impact with even small changes. I wonder why public health proponents, journalists and the public at large cannot see the opportunities to work with McDonald’s, instead of pretending that if fast food went away there would be no child obesity.

STUMPED BY A FIXED MIND SET

Anne Dweck, PhD, a professor of psychology at Stanford University talks of a fixed mind set versus a growth mind set. I’d like to think health professionals embrace a growth mind set, learning new things and incorporating that new knowledge into their current thinking.

Too many public health pundits, public and clinical health care workers, teachers and other “influencers” continue to denigrate the food at McDonald’s no matter what it is and how it has changed. This is a sign of a fixed mind set. The fixed mind set is marked by refusing to consider new information.

These same influencers continue to believe that all fast food is bad as if all other choices are good. Not only is this not true, but this simplistic thinking leads people to believe they are eating well as long as they are not eating fast food. This is a sign of a fixed mind set.

These influencers continue to extol the virtues of full service supermarkets without considering how people shop and what they really eat at home. This is a sign of a fixed mind set.

CULTIVATING A GROWTH MIND SET IS A MORE CHALLENGING JOURNEY

It is challenging to shift from a fixed mind set into the murkier territory of a growth mind set. The certainty and absolute nature of a fixed mind set is seductive and compelling. And it is often wrong.

Public health advocates have been blaming fast food for increasing child obesity for decades. Today the San Francisco Board of Supervisors voted to ban toys from kid’s meals that don’t meet their specific definition of “healthy.”

There is no science that has determined that their prescribed meal will improve the situation, but the public health pundits would like us to believe that the changes they propose will mean all children eat more healthfully.

The average McDonald’s Happy Meal customer eats two meals a month at McDonald’s. I don’t know that banning toys from meals that don’t meet these nutritional guidelines is going to dramatically change the health status of these kids. I certainly don’t want to be the mom who decides today her kids get to eat fries—but they don’t get a toy.

Please note: I consult for the Owners and Operators of McDonald’s in California. This blog is an independent enterprise and my personal and professional opinion. It is not the position of McDonald’s Corporation or any individual owner.