Health

coauthored with Elle Alexander–

To wrap up Nutrition Awareness Month, here is the second half of this blog post, answering questions 6-10:

1. Which sweetener is the best for human health and has minimal environmental impact?
2. How can eating behaviors change to support health?
3. How have prepared and packaged foods changed in the last decade to promote nutrition?
4. Is yogurt a health food?
5. How useful are currently serving size recommendation?
6. Should energy drinks be marketed to kids?
7. Where in the world does our food come from?
8. What lessons can we learn from abroad?
9. The other, other white meat?
10. How have food companies shifted their products to promote healthier options?

6. Should energy drinks be marketed to kids?

The WHO has warned that marketing fast food to kids has been “disastrously effective,” and has ultimately directly contributed to the global obesity epidemic. The American Academy of Pediatric recommends that children and teenagers never consume energy drinks, citing high levels of sugar and caffeine as unhealthy for children while providing no nutritional benefits. In spite of that, Yale University Rudd Center reports that 31% of American youth (age 12-17) consume energy drinks, many of which have on average more sugar than soda and are not required to disclose information on caffeine content.

7. Where in the world does our food come from?

Tracing our food items from production to consumption helps to understand where things really come from. Sourcemap visually displays the journey of products, with some examples having no less than 16 stopovers from source to shelf.

8. What lessons can we learn from abroad?

Brazil has introduced new food based countrywide guidelines, now open for comment, to promote health.  The rules they propose can be applied to the US and other countries:

• Make foods and freshly prepared dishes and meals the basis of your diet.
• Be sure oils, fats, sugar and salt are used in moderation in culinary preparations.
• Limit the intake of ready-to-consumer products and avoid those that are ultra-processed.

9. The other, other white meat?

Fish are a tremendous source of protein and consumption is growing; to meet the demand in the US means importing 91% of the aquaculture. NOAA address questions about healthy eating and sustainability best practices. Concerns about health, safety and global ecology all come to play when eating fish and equally important is purchasing seafood from reliable sources. Greenpeace ranks retailers based on environmental practices.

10. How have food companies shifted their products to promote healthier options?

Food companies are shifting their portfolios to address the regulatory pressure and consumer interest in healthier items. Smaller portion sizes of classic items can be seen in stores and stealth strategies include product reformulation to reduce sodium or replace refined flour with whole grains, or developing ingredients to increase satiety and flavor without the calories (read more about these trends here). Interestingly, the Hudson Institute found that food and beverage companies with more sales of healthier products were more financially successful than companies with lower sales of healthier items.

When addressing these questions it is essential to consult credible sources, investigate credentials of authors, and recognize source bias.

A few of our current favorite places for nutrition updates are below – or just check back here for future posts on the subject!

http://www.hsph.harvard.edu/nutritionsource/

http://www.yaleruddcenter.org/

http://www.utsouthwestern.edu/education/medical-school/departments/center-human-nutrition/index.htm

http://www.foodpolitics.com/

coauthored with Elle Alexander–

March kicks off national nutrition awareness month, a great opportunity to feed our curiosity. With that in mind, we curated some of the top 10 questions around nutrition, and will share five now and five at the end of the month.

1. Which sweetener is the best for human health and has minimal environmental impact?
2. How can eating behaviors change to support health?  
3. How have prepared and packaged foods changed in the last decade to promote nutrition?
4. Is yogurt a health food?
5. How useful are currently serving size recommendation?
6. Should energy drinks be marketed to kids?
7. Where in the world does our food come from?
8. What lessons can we learn from abroad?
9. The other, other white meat?
10. How have food companies shifted their products to promote healthier options?

1. Which sweetener is the best for human health and has minimal environmental impact?

There has been much discussion on high fructose corn syrup vs. cane sugar from health and environmental perspectives. Marion Nestle sheds some light on the debate:

“Sucrose (table sugar) and high fructose corn syrup (HFCS) contain the same sugars—glucose and fructose—and do much the same things in the body.  I think everyone would be better off eating a lot less of either.”

2. How can eating behaviors change to support health?

When presented with numerous food choices, people tend to pile plates high with calories.   Choosing smaller plates helps to reduce calorie intake since people tend to stop eating based on visual cues rather than internal satiety cues.

See Brian Wansink’s “Bottomless Soup Bowl” Experiment:

3. How have prepared and packaged foods changed in the last decade to promote nutrition?

In November of 2013, the FDA banned trans-fat, a decision that many – including the Scientific American – considered long overdue and with an impact of saving lives at a minimal cost to industry. Decisions to eat healthier are easier for consumers when information about health and a variety of healthy options are available.

Further work is also needed to reduce sodium intake in the US population, as only 5% of intake is added during cooking and 6% at the table; 75% is from packaged foods.  Companies must take the lead to reduce sodium in packaged foods for consumers while ensuring food safety and taste.

4. Is yogurt a health food?

For hundreds of years humans have consumed yogurt across cultures. The protein rich and bacteria filled product has experienced a renaissance of sorts since the 1900s and with the mass popularization of “Greek” yogurts. A New Yorker article in November documented the growth of Chobani; the recipe is modified for consumer enjoyment, including added sweeteners in many products. The benefits of yogurt include probiotics, calcium and a hearty dose of non-animal based protein.

5. How useful are currently serving size recommendation?

According to the CDC, portion sizes have increased, impacting health. There are new devices on the market to help guide consumers toward eating ‘recommended’ quantities, including the Silo which pours 1 cup, 1/2 cup or 1 tsp. There is also a recent proposal to the FDA to make the Nutrition Facts label easier for consumers to understand, highlighting calories, recalibrating serving sizes and including added sugars:

Stay tuned for the next installment at the end of the month. Your thoughts are welcome!

– See more at: http://thevitalityinstitute.org/top-questions-in-nutrition/#sthash.epBr4Uwd.dpuf

Change is hard– especially behavior change in a context not designed to support it.  New Year’s resolutions, like those mentioned by Taubes in his New York Times Sunday Review piece, are usually forgotten. It isn’t just that they are ambitious. The problem is that we live in an environment where healthy choices are challenged by increasingly cheap, ubiquitous and tasty treats.

For example, twenty years ago, a typical cheeseburger contained 333 calories, compared to 590 today. According to a new FDA report pizza also accounts for 4% of all calories consumed by American adults daily. Additionally, our lifestyles are more sedentary–average Americans spend nearly nine hours in front of screens.

Source: CDC, “Making Health Easier” (click image to enlarge)

Together, our diet and lack of physical activity put us at risk for lifestyle-related diseases, like hypertension, type-2 diabetes and obesity. Addressing these requires efforts from multiple sectors as health is affected by everything from policies set by governments, to products developed and marketed by companies, and corporate policies impacting employee health. The argument of ‘willpower’ falls away when powerful outside forces act in concert.  

We are more likely to consume more calories when we eat outside the home. According to the USDA in 2012, more than 40% of meals in America are eaten away from home and 82% of adults eat out at least once a week. Fundamentally changing the foods offered at restaurants can improve the food landscape and promote health. Efforts led by the Culinary Institute of America in partnership with Harvard’s School of Public Health are underway to develop Menus of Change. Consumers want more vegetable options, lean meats, and seafood, and Menus of Change is updating menus to give it to them.

A complementary initiative is Grow Your Family Strong, whose mission is to encourage mindful cooking at home by providing nutritious recipes, shopping lists and most importantly, support from other participants in building healthy meals for their families. Founder Monique Nadeau says “We need practical ideas that are simple to execute, automate and delegate; are value for money, nutritious and include meals our families will enjoy. I’m looking for something that makes my life easier and my family healthier.”

If making a change is hard, maintaining it is even more challenging. New technology, like Stickk can help individuals make ‘commitment contracts’ to a healthier lifestyle. Participants use the WebApp to publicize their commitments to quit smoking, eat healthier and exercise more frequently and then receive support from an online community. Building a community through health technology is an effective way to achieve personal goals.

Finally, addressing short-termism – where consumers tend to discount the future impacts of their decisions for immediate comfort or pleasure – can be built into polices and private sector commitment to health. For example, there is an opportunity to make healthier foods more affordable and accessible at point of sale. A few pilot programs, including Healthy Food Here, are making it easier (and cost effective) for retailers to provide fresh produce. Resolving to eat well and a landscape of support go together like (low-fat) milk and (wholegrain) cookies.

In President Obama’s State of the Union address earlier this week, he commended the First Lady’s efforts to get Americans, and particularly children, moving.  The Let’s Move campaign combines getting active with healthy eating and is a great example of partnerships between the US government, NGOs, and industry.  Additional collaborations are needed to promote healthy eating in federally supported programs such as the Supplemental Nutrition Assistance Program (SNAP).  The Farm Bill was omitted from Tuesday night’s address despite being a key to the future of agriculture, food and health in America.

Graph (click to enlarge) created by Brad Plumer, The Washington Post, January 28, 2014.

The majority of spending of the Farm Bill – nearly 80%, or $756 billion – is allocated to support nutrition and food security for low income Americans (see graph), although the funding does not explicitly support healthy eating or nutrition for recipients.   Improving the SNAP programs is an occasion for the US government to codify the link between agriculture production and healthy food consumption.

Importantly, shifts in diets could reduce the burden of disease and chronic disability which now account for nearly half of the US health burden.  Improving availability of fresh fruits and vegetables can help replace high-calorie, highly processed foods with less energy intensive production.  It is also important to understand the relationship – or lack thereof – between subsidies and crop insurance support and retail costs of the healthiest foods

Land use for farming is not currently driven by health indicators. Harvard School of Public Health calculates that it required about 40 acres of farmland to produce 1,000 kilograms (approx. 2,200 pounds)  of ground beef while only 3/4 of an  acre to produce the same quantity of potatoes and even less — 1/16 of an acre to grow 1,000 kilograms of carrots.  The Farm Bill should support the production of more sustainable protein sources over energy intensive meat production. Further, by subsidizing fruits and vegetables instead of grain, corn and soy used predominantly for animal feed, the Farm Bill can be an effective lever to reduce the quantity of highly processed foods going to market and concurrently reduce the ecological footprint of the food system.

There is a tremendous opportunity to improve SNAP to help guide healthier food decisions.  Additionally, bolstering Michelle Obama’s efforts for healthier children, SNAP-Ed can complement the national Fresh Fruit and Vegetable Program helping children form healthy habits early in life. The road ahead to reforming SNAP and revising the Farm Bill may by rocky, but shifts to promote health will benefit all and result from businesses, government, and local organizations supporting healthy and cost effective food choices promoting health.  Let’s get moving on this together.