Even for consumers who know better, highly processed and adulterated grain can be challenging to avoid. Cereal and milk is the number one breakfast served at many schools. LAUSD offers a range of breakfast choices each day, but cereal and milk remains the most popular option, with many kids skipping the milk and opting to eat the cereal as a snack. The same holds true for other school breakfast initiatives, such as Breakfast after the Bell.
Today the New York Times reports that federal health officials are disappointed as Americans continue to get fatter despite all the effort to demonize fast food, soda, and sugar, as well as the continuous harping everyone to eat less and exercise more. The report stated that, “Ab0ut 38 percent of American adults were obese in 2013 and 2014, up from 35 percent in 2011 and 2012.” Surprised? Not me, for two reasons.
First, too much of the weight loss propaganda out there sets people up for failure. Basically the energy balance equation is dead, yet most diets pivot on some angle to get people to eat less without adequately addressing hunger, satiety, and a multitude of other lifestyle factors that can effectively help their body burn fat for fuel.
Over decades, Americans have navigated mostly on their own in a quest to lose weight, mostly because we never made nutrition counseling a cornerstone of conventional medicine. In addition, just about anyone who eats thinks they are qualified to offer nutrition guidance.
From doctors, nurses, therapists and most health professionals, to fitness trainers, coaches and health teachers, and now the ubiquitous but less than adequately prepared life coaches and food bloggers, everyone wants to believe that they have the goods to offer food and nutrition counseling. To add to the confusion, anyone who has ever lost weight has a story to tell and advice to offer. I don’t blame all these well meaning people, they’re just stepping into a void created by a medical establishment that failed to acknowledge the central role of food and nutrition in both health and disease. Dietitians and qualified nutritionists have never been adequately staffed nor reimbursed in formal medical settings such as hospitals, clinics, and doctor’s offices.
Second, we measure a completely unreliable metric, weight–or its evil twin, body mass index (BMI) and pretend we are measuring health. Why? Because it is easy. Period.
Weight is a poor measure of health, but try telling that to the legions of health care providers, public health workers and policy wonks that insist on measuring a notoriously unreliable number and pretending it is a valid indicator of anything.
Ideally we would measure true bio-markers of health or more reliable measures assessing risk of disease. But even with better metrics, we may still lose the war on obesity because we have failed to commit adequate resources. We want to believe that lives and eating habits change with enough information, with enough cheer leading, or just because it is the right thing to do. Good luck with that.
If we were to get serious about improving the overall health of Americans, we have a lot of work to do. Here are a few suggestions:
- Stop subsidizing crops used to produce the junk (think corn and soy)
- Subsidize fruits and vegetables, as well as animal products grown in a biodynamic fashion, allowing for the efficient nutrient cycling in nature to work for us
- Fund every school lunch program to build or open a kitchen and cook whole foods from scratch–and then make sure the kids have enough time to eat.
- Eliminate use of antibiotics in food animals
- Ban use of artificial pesticides, herbicides and other agents that compromise life: human, animal and microbial and the health of the planet. We know what we need to do; stop waffling and pretending we need more studies.
- Establish a moratorium on genetic engineering and genetic modification in the food supply until studies can assess potential risk to all life forms, not just humans. We are interdependent and connected to all.
- Reward farmers and ranchers for employing sustainable and regenerative methods that restore soil ecology, minimize use of chemical inputs, enhance water flow and increase organic matter via carbon sequestration.
3. Simplify dietary guidelines and make them meaningful
- Stop making calories the enemy. Let’s teach people how to honor hunger and satiety. People want to feel good and enjoy good energy. Effective nutrition counseling can help consumers connect the dots between what they eat and how they feel.
- Emphasize whole foods and stop demonizing animal foods. There is no good data for current recommendations to limit saturated fat and red meat.
- Most critically, step away from the idea that there is one best way to eat, and more specifically one best way to lose weight. There are too many factors that influence energy metabolism, hunger, satiety, and energy partitioning for any one approach to work for all of us. Ideally we support each consumer as they figure out what approach to food works best for their personal metabolic needs and fitness goals.
4. Make meaningful nutrition education and counseling available to all
- Require all health care plans to reimburse nutrition counseling by qualified professionals to their members right along with other preventative screening and treatment. Current underwriting for most insurance companies routinely covers only diabetics.
- Require Medicare to reimburse RD’s and qualified nutritionists for nutrition counseling for obesity and all other conditions influenced by diet and metabolic health–and reimburse the professionals adequately. Why are we asking doctors and other primary care providers–the most expensive people in the room– to provide counseling to obese patients in 15 minute time slots with an abysmal $27.50 of reimbursement? To make matters worse, most PCP’s admit they don’t have the counseling skills, subject matter expertise, nor time and capacity to do the job in the first place.
5. Reset expectations: We don’t value the skills required to eat well, and then ridiculously assume that people are just going to figure it out on their own. Even if one learns all there is to know, knowledge is not the same as behavior.
We need to come clean and acknowledge the time required to plan and shop regularly for fresh food, cook from scratch and clean up. Pretending it is simple or takes no time at all sets up everyone except the dedicated foodies. If we are truly serious about tackling poor metabolic health, we need government, private industry, non government agencies, and educational institutions to demonstrate a value for the time, energy, and skills required to eat well.
- Integrate life skills education in the classroom–including budgeting, savvy food shopping, food preparation, and eating mindfully– both in middle and high school, and college, too. There is no greater skill set to enhance one’s quality of life as an independent adult.
- Re-establish a more modest work day so that consumers can enjoy food’s rightful place, along with adequate physical activity, recreation and a better quality of life
- Require that institutions and extracurricular activities honor time to prepare and consume regular meals and healthful snacks.
It’s times like this I think we need to revisit the notion of nuclear families. Does every household need to dedicate the resources, time and energy to do what could be accomplished so much more efficiently –and maybe more enjoyably– together?
Maybe tribal culture could teach us a bit about tapping into community resources so the benefits of eating well reach everyone, regardless of means or circumstances. Until then, it will be up to each of us to dedicate the time tending to one of our most basic needs, and hopefully appreciate what it takes to eat well every day.
In 1958 the Food and Drug Administration (FDA) passed the Safe Food and Drug Act. The act specifically detailed a list of food additives that the government scientists determined could be ‘generally regarded as safe’ (GRAS). Today research assaults the thinking of those innocent times, framing the scientists and regulators as either clueless, evil, or rather naive.
THE STORY WITH TRANS FATS
At the time the FDA grandfathered in partially hydrogenated fats (also known as trans fats) with GRAS status since little data showed harm and they had been around since the early 1900’s–what one researched called “a really long time.” No one seemed to distinguish that “little evidence of harm” didn’t mean evidence of no harm.
Currently FDA charts a course for these fats to lose their GRAS status, but not quite yet. First they are gathering public comments.
FDA is well aware of the harmful effects of trans fats, having proposed labeling of trans fats in 1999 and finally mandating labeling in 2006. Is it any wonder that health professionals and the public alike question FDA’s alliances?
MORE QUESTIONABLE ADDITIVES: EMULSIFIERS
As science advances, researchers are sounding the alarm regarding several other additives in food, especially as consumers purchase more highly processed food according to a 2012 NPR report.
A recent study claims two commonly used emulsifiers in food, polysorbate 80 and carboxymethylcellulose may interfere with gut health. In essence, when fed to mice in amounts approximating human consumption, the emulsifiers “changed the species composition of the gut microbiota and did so in a manner that made it more pro-inflammatory.”
Emulsifiers basically keep components in a sauce or food from separating over time. You can tell when an emulsifier breaks down. The oil and water components of mayonnaise, salad dressings, pudding and sauces separate. It’s no surprise that food producers use emulsifiers in a variety of processed foods, and when Americans consume more highly processed and pre-prepared food they consume more emulsifiers.
The researchers from Georgia Tech suggest that the emulsifiers promote the development of inflammatory bowel disease and metabolic syndrome. These conditions are increasingly linked to poor metabolic health, obesity, diabetes and many gastro-intestinal diseases on the rise today.
The emulsifiers are thought to influence microbiota exhibiting an enhanced capacity to digest and infiltrate the dense mucus layer that lines the intestine which is normally largely devoid of bacteria. A compromised intestinal barrier results. Today the researchers are investigating other emulsifiers and directly looking at their impact in humans.
ANOTHER ADDITIVE IN QUESTION
Last year, the Environmental Working Group (EWG) turned the spotlight on propyl paraben in its Dirty Dozen Guide To Food Additives because the federal Food and Drug Administration listed its use in food as “Generally Recognized As Safe.” EWG specifically notes evidence that propyl paraben disrupts the endocrine system, and that the FDA has failed to take action to eliminate its use in food or reassess its safety.
Propyl paraben alters hormone signaling and gene expression, and consumers are exposed to propyl paraben in a variety of cosmetic, baby and food products. The researchers conclude that although the parabens enjoy GRAS designation based on a 1972 decision by the FDA (FDA 2013). Maybe FDA should reconsider that standing. In 2006 regulators removed propyl paraben from the list of food additives authorized for use in the European Union.
HOW CAN CONSUMERS TAKE ACTION?
The FDA struggles meet the needs of consumers as many of their actions defer to the interests of business. I lost my trust in the capacity for the FDA, USDA, and EPA–our nation’s primary regulatory agencies impacting the food supply and environment–years ago.
When confronted with our increasingly abundant and adulterated food supply, I have a simple recommendation for most of my clients. Eat close to the earth. Purchase mostly whole fresh food, and take time to prepare meals from scratch. If you’re not a cook or just want a night off, purchase foods from suppliers who are cooking with ingredients you would find in your own kitchen. Sometimes that will mean enjoying prepared food from trusted purveyors at a farmer’s market, your neighborhood grocery, or a favorite restaurant.
The Georgia Tech researchers suggest that current means of testing and approving food additives may not be adequate to prevent use of chemicals that promote diseases driven by low-grade inflammation and/or which will cause disease primarily in susceptible hosts. With the advent of mapping our microbiome, my sense is that we need to revisit everything. I can’t help but wonder, what else is the FDA missing?
Keira Butler at Mother Jones continues her assault on fast food this week, calling out hospitals that house a McDonald’s restaurant. The Physicians for Committee for ResponsibleMedicine (PCRM) is behind much of this effort, creating a public health nightmare for anyone who dares to consume anything served from a fast food counter. But there may be a silver lining to the sloppy science and sloppier journalism.
PERCEPTION DRIVES EVERYTHING
I consult for the owners of McDonald’s in Southern California and spoke to Kiera Butler at the 2014 CDA convention last year. I recall a biting article slamming dietitians for allowing McDonald’s to exhibit at their conference that conveniently omitted any information that countered her agenda. On March 18 of this year Kiera reported that the board at CDA declined to invite McDonald’s back, this time exposing how a decades long public health campaign that frames fast food as public enemy #1 triggered fear in health professionals who shouldn’t be caving to a smear campaign.
The pervasive perception that fast food drives obesity lives on despite research that tells us otherwise. Too often medical and public health entities continue to press their arguments even as research points to a multitude of factors that contribute to the rising incidence of obesity and poor metabolic health.
Kiera’s latest piece insinuates that hospitals which house a McDonald’s restaurant promote poor health and irreparable harm to patients, visitors and staff alike. Public perception trumps science again. Despite the best efforts of food service administrators to emphasize healthier food choices, hospital cafeterias serve plenty of refined starch, sugar, salt, and fat on their own.
WHAT ELSE IS SERVED AT THE HOSPITAL?
A graduate student who interned with me years ago visited hospital cafeterias in Southern California to assess how their fare differed from fast food. The first whiff in every facility led her to a grill station that serves hamburgers and French fries. Inevitably the grill station also sported the longest line of visitors and staff.
Today I take the time to visit hospital cafeterias at every opportunity. Most sell sugared cereals, donuts, and pastries in the morning. They serve hamburger and fries for lunch, dinner and in between. Soda, chips, candy, and other snacks are readily available all day long. So exactly how is fast food more likely to harm the health of the infirm, the visitors or the staff?
PERPETUATING POPULAR SENTIMENT THAT PASSES FOR JOURNALISM
I’d love to see Ms. Butler step up and actually exercise her investigative reporting skills. The action by CDA didn’t resolve the issue of commercial interests exhibiting at health conferences. It merely triggered a knee jerk reaction. My bet is the same will occur with hospitals tripping over themselves to avoid a negative spotlight of their own.
Instead of a serious discussion regarding the range of issues impacting poor metabolic health and disease, the public is exposed to a contrived message regarding fast food in hospitals. Why didn’t Kiera investigate the food served in hospital cafeterias in order to more honestly address the bigger picture?
FAST FOOD BASHING MORE POLITICAL SPORT THAN SCIENCE
Much of the grandstanding about doing away with fast food in hospitals has everything to do with politically correct behavior and calming the ruffled feathers of image conscious donors. I’ve learned that hospital administrators and medical officers recognize the disconnect between public beliefs and what the science tells us. They just don’t have the backbone to stand up to unsubstantiated public health assumptions or the journalistic bullying that finds it fashionable to perpetuate myths about fast food.
In a recent study funded by McDonald’s teens reported eating fewer calories from hamburgers, less pizza and less fast food overall between 2003 and 2010, accounting for about 1/2 of the 220 fewer calories consumed per day. A JAMA study looking at the same time period found, “There have been no significant changes in obesity prevalence in youth or adults between 2003-2004 and 2011-2012 [and] obesity rates haven’t budged” This data isn’t surprising. I’ve written previous blogs that poke holes in the decades-long distortion linking fast food and obesity. (see articles listed below)
WHAT HAPPENS WHEN FAST FOOD INCLUDES HEALTHIER OPTIONS, TOO?
While many celebrate the decline of fast food, they conveniently disregard the increasing availability of fresh produce, whole grains, and more healthful choices at these same establishments. They fail to recognize the significant impact that fast food exerts on how we grow our crops and raise our animals. It is not lost of the rest of us when McDonald’s announces it will stop using antibiotics important to humans in chickens, Carl’s Jr.’s decides to offer grass fed burgers, and Chipotles sources as much sustainably grown food as possible.
Closing fast food restaurants and reducing food intake from fast food will not likely impact the health of patients, visitors, or staff, mostly because the rest of the food environment remains abundant and adulterated, and people still eat everything else. McDonald’s is no longer available at Children’s Hospital LA, but the hospital now offer visitors a guide that identifies local eateries…including McDonald’s. As I scan the list, I wonder how many restaurants on the list swap French fries for fruit or salad at no extra charge?
MAYBE A SILVER LINING
The last 20 years of public health efforts to reduce obesity hinges on wishful thinking. (ie: If only we could get rid of fast food.) Research never demonstrated anything more than an association between fast food and child obesity. That’s different than establishing cause and effect. Sloppy science, sloppy journalism. Contrary to PCRM’s agenda, we need everyone who touches food to be part of the solution, including fast food.
The conventional way we farm and produce food today is not sustainable, but change is messy. Both individuals and corporations balk at change unless they are uncomfortable, and this is where all the bad press may have some positive outcome. A Grist article highlighting how the palm oil industry is changing gives me hope. I have come to understand that shrill voices condemning fast food take on the antagonistic role of NGO’s in this plot. They are the agents of discomfort. Dietitians like myself provide the cooperative support to help food companies change in ways that makes sense for the health of their customers, as well as their bottom line. One thing for sure, there is more change to come.
For additional discussion of related issues:
1. Determining what is and isn’t junk food http://muchmorethanfood.com/blog/who-gets-to-determine-what-is-junk-food/practices/
2. Which came first? Industrial farming or fast food? http://muchmorethanfood.com/blog/is-fast-food-driving-industrial-farming-practices/
3. Challenging the popular notion that fast food makes you fat http://muchmorethanfood.com/blog/the-elephant-in-the-room-fast-food-doesnt-make-you-fat/
4. Fast food and the kid’s meal toy ban http://muchmorethanfood.com/blog/san-francisco-supervisors-vote-to-pass-kid%E2%80%99s-meal-toy-ban/
Last week Time Magazine featured chef and NY Times Columnist Mark Bittman’s rant regarding “The truth about home cooking.” He wants you to know that cooking is no mystery, but I found his words far more than mysterious. Mostly I found his diatribe condescending, shaming, and contradictory.
As I read his finger shaking admonishments, I wonder if he convinced anyone watching TV food shows to start cooking for themselves. Did anyone stopped eating away from home?
I am mostly disturbed by distortions and disconnects throughout the rant. Mr Bittman trashes the iconic fast food hamburger and ridicules folks for eating too much pizza. Then later in his article he recommends preparing that same hamburger at home or throwing a few vegetables on a pizza so that cooking “feels more accessible”. And the difference is???
People are also ridiculed for eating too many “food like substances”. I couldn’t help but roll my eyes as he encouraged everyone to shop at the local market–without the slightest acknowledgement that the grocery store is exactly where most people are buying those “food like substances.” Hmmmm.
THE COST OF EATING POORLY
You would need to be living in a cave to not realize that the increasing incidence of disease in the US is linked to poor food habits. As Mr. Bittman suggests, most of us benefit from eating a good enough balance of whole foods. But I encourage Bittman and anyone one else trying to tackle this challenge to dig much deeper and address core barriers to the task at hand.
1. Most people I know who are not cooking are either too tired, too busy or don’t know how. It is not enough to tell these folks to try harder. They are already exhausted or overwhelmed. In order to help people find the time and energy to prepare food at home from scratch we need to role back our expectations of the work day, of homework, or commute times. We need to re-examine our expectations and how much we are supposed to accomplish. Shopping, preparing and eating good food takes much more time day after day than Bittman admits. Learning how to do it will take even more.
2. We have spent decades ignoring food’s rightful place. Everyone needs to step up in order to change this culture. That means every work place, every school setting, every sports club or venue needs to stop expecting people to work or play right through meal time. Any one individual will struggle to establish healthier boundaries until social expectations change.
3. Ironically eating out was a part of Mark Bittman’s youth, and is probably still a part of his life today. He doesn’t seem to recognize his double standard, enjoying street food as a kid yet criticizing young Millennials enjoying food away from home today. Why is it not possible to both eat out more healthfully and cook at home?
There are more and more opportunities to eat well eating out. Even at fast food establishments. It is time to call out tired euphemisms for what they are: lies. Fast food is not one monolithic pile of junk and eating at home does not automatically translate to good nutrition. Highly refined starch, sugar and fat is abundantly available everywhere food is sold.
Mr Bittman quotes one study which claims eating in restaurants can increase calorie intake an average of 200 calories a day. But averages don’t tell the whole story. Enough 3000 calorie entrees from a sit down restaurant can horribly skews the data.
Ironically many fast food restaurants serve more modest portions. They offer fresh fruits and vegetables, lean protein rich foods and increasing sources of whole grains. It is possible to eat better at restaurants–especially when eating at home means polishing off a bag of chips and a bottle of soda in front of the TV. Instead of chastising people for eating away from home, encourage them to make better choices. It’s not where you eat; It’s what you eat when you get there.
4. Poor metabolic health will continue to compromise many consumers. Food is only one piece of the problem. Time and opportunity to be physically active along with more effective time and stress management are key pieces of the puzzle. In addition, we need to acknowledge the increasing impact of pharmaceutical drugs and other environmental chemicals that influence energy metabolism. Cooking is a wonderful idea, but the remedy for most consumers struggling with poor metabolic health may not be as simple as cooking dinner at home.
Overall Mark Bittman wants you to appreciate that cooking at home is something that can be a source of comfort, pride, health, well being, relaxation and socialization. I agree. Let’s figure out a way to focus on the process of helping people develop the skills to prepare food at home. Let’s support a culture shift that allocates enough time and energy to enjoy good food no matter where we are eating.
I’ve yet to witness a successful behavioral shift from a torrent of shame and blame. Next time he gets all fired up, I invite Mark Bittman to use his formidable platform to engage with consumers in the process. When he needs to vent, Mr. Bittman can start by addressing the very real challenges everyday people face when it comes to feeding themselves and their families.
Last week the newswires lit up as consumers were warned, “People who eat out consume an average of about 200 calories more a day than when they cook at home.” At the same time the The National Restaurant Association reports and forecasts ever increasing sales and consumers spend about 47% of every food dollar away from home–a stark contrast to the 25% reported in the 1950’s.. We eat out a lot and we like it. Is obesity inevitable?
CALORIES AND FOOD QUALITY OF FAST FOOD VS SIT DOWN RESTAURANTS
The good news is that we are finally getting honest about the restaurant world. For over thirty years public health types have railed against fast food as the nemesis in our battle with the bulge. Today the advent of menu labelin means that sit down restaurants also get their fair share of scrutiny. In this study both quick service and sit down venues get skewered. We eat more at both locations than at home, and we eat more saturated fat, sugar and sodium as well:
- At a fast-food restaurant, there was a net increase of total energy intake (194.49 kcal), saturated fat (3.48 g), sugar (3.95 g) and sodium (296.38 mg)
- Eating at a full-service restaurant was also associated with an energy intake (205.21 kcal), and with higher intake of saturated fat (2.52 g) and sodium (451.06 mg)
And that’s when the reported findings of this study made me laugh (maybe cry?) out loud. Let me explain.
UNDERSTANDING PUBLIC HEALTH NUTRITION RESEARCH
The researchers, Lisa Powell from the School of Public Health at University of Chicago, and Dr. Nyugen of The American Cancer Society, looked at data collected from 12,000 adults interviewed in the 2003 National Health and Nutrition Examination Survey (NHANES). They assessed the results from a dietary tool known as a food frequency questionnaire (FFQ) that assesses how frequently you eat a food. Science Daily reports that the researchers went on to compare food intake consumed at home to food intake from fast-food and full-service restaurants on two successive days.
Most public health nutrition research are studies of large populations. By definition the study design is observational rather than interventional, so researchers use statistics to attempt to control for key variables that can influence an outcome. But we all know what is said about statistics. Even in the best of circumstances, this kind of research is limited to assessing the extent to which two things are related. The research cannot by definition determine cause or effect.
In the NHANES study large numbers of people are asked to recall what they ate years ago using a (FFQ). The researchers assess the results, and everyone wants to believe the findings–except we are relying on people remembering what they ate, and most of us are not reliable reporters.
PROBLEMS WITH RECALL
WHAT”S IN THE FOOD: Food can be complicated and people don’t always know what they are eating or what ingredients are used. If you are not familiar with shopping and you don’t prepare your own food, how do you begin to deconstruct a recipe or mixed meal?
HOW MUCH IS CONSUMED: Overweight people often get framed for under-reporting their food intake, but body size doesn’t really have anything to do with it. There is evidence that most of us under-estimate what we consume. In one seminal study at NYU by (then doctoral candidate) Lisa Young, even the dietetic students couldn’t reliably estimate portions sizes. Years ago I tested this theory at a conference with dietitians, asking them to estimate the weight of an apple, potato, muffin and cookie. I remember the answers ranged wildly (ie: the 3 ounce muffin estimates came in at less than 2 ounces and more than 5 ounces.) Even dietitians utterly failed to accurately size up portions.
WHAT IS REMEMBERED: Many of my clients struggle to tell me what they ate yesterday, so I am not surprised that sometimes people just make stuff up. I remember talking to nurses who participated in The Nurse’s Health Study who basically admitted getting so frustrated with the questionnaire that they just filled in whatever they thought they should. How would you answer, “For each food listed fill in the circle indicating how often on average you used the amount specified between 13 and 18 years of age.” Basically I am baffled that anyone reports results using such flawed data to the hundredths place with a straight face.
COUNTING CALORIES: MORE PHYSIOLOGY, LESS PHYSICS
Measuring the energy value of food is not the science everyone thinks it is. Since we don’t assess the the actual energy value of food using a metabolic model, it is likely we overestimate the energy in foods that don’t digest as completely. These include whole foods: vegetables, fruit, whole grains, beans, nuts and seeds. And we probably underestimate the metabolic mess resulting from a diet of highly refined starch, sugar and fat. Counting calories doesn’t begin to address what happens to calories once they are consumed. For too many of those highly processed calories are easily stored as fat.
Calorie counts on food labels can also be very misleading. The FDA allows a 20% margin of error in either direction to accommodate the variable nature of food. Sunlight, varietal strain, and a host of other factors influence the nutritional qualities of food, including the calorie yield. In effect, the calories listed on the nutrition label can over or underestimate by as much as 20% and still be printed as a “Nutrition Fact”. Has anyone else ever wondered if food manufacturers actively gamed the generous margin of error?
THE CALORIE BALANCE EQUATION IS FLAWED
We are foolish to continue to lean on the very flawed science of calculating calories and estimating calorie intake to tackle our metabolic challenges. Certainly calories count, but they are not the only thing that counts. A very good 2004 article published in Harvard Magazine outlines the many ways metabolism is much more complicated that a simple math problem. I am waiting for the day researchers stop assuming that calorie intake is the most critical factor determining weight status.
At the core of the problem, calorie counting misses the point. Ideally we eat with our bodies, not just with our brains. Calorie counting distracts us from what really matters: What mix of food takes our hunger away? Helps us feel satisfied? Provides us with the energy we need to tackle the tasks of the day? How much does flavor, texture, and presentation play a role? A preoccupation with counting calories limits the opportunity to truly nourish and nurture ourselves.
Ultimately each of us needs to figure out an approach to food that works. How will you step into eating better, not just less?