The Best Field Trip Ever: The White House Garden

Sam Kass

I am compelled to share this slightly off-topic experience because I feel so honored to have had the opportunity yesterday to tour the first lady's garden with White House chef, Sam Cass. I was presenting on marketing healthy foods to adolescents to a conference of food service managers and a trip to the White House happened to be on our conference agenda. And it was the best field trip ever.


A baby papaya tree.



It was a beautiful September day and after a little shuffling around the White House because of a helicopter landing and issues at security, we made our way through the garden and had the opportunity to ask questions. According to Mr. Cass, the Obamas like simple, fresh foods; ingredients come from the garden every night; while organic practices are used while gardening, the garden is not certified organic; and the glamour of being the White House chef eventually wears off.

After the White House tour, we headed back to the hotel for more presentations. A woman named Corey, whose job title is urban farm coordinator, gave an amazing presentation about farming at her Job Corps center. The center was awarded an ARRA grant to develop an acre of farmland on their inner-city property. On the farm, Corey, a friendly San Francisco native, not only grows all of the standard fruits, vegetables, and flowers, she also has a fish pond and a chicken coup. Corey also provides a much bigger service to the at-risk youth at her center; she uses the farm to teach them about growing food, healthy eating, and opportunities to decrease health disparities, like food deserts, in poor communities.

Admittedly, I have a bit of a black thumb. In fact, I made a joke about it several years ago and touched a leaf on a plant. A few weeks later, that leaf was dead. I'm not even kidding. But my trip to the White House (even if I didn't get to meet Michelle) and Korey's presentation made me want to get out there and rent a piece of an urban farm. Any tips for those of us who aren't naturals in the botanical world?





Why do people choose healthy foods?

For our fifth anniversary, my husband and I went to Top Chef runner-up Mike Isabella’s new restaurant, Graffiato. In preparation of our big dinner, I read every Yelp review written about the place. I wanted to order just right. The restaurant serves small plates—a little bigger than tapas, a good bit smaller than a meal. A lot of the reviews were divided; many people loved the chicken thighs with pepperoni sauce that was called “orgasmic” by Top Chef judge Gail Simmons; others referred to it as overrated. The pizza was also polarizing; some called it perfect; others called it bland and overpriced. Nearly every dish has as many lovers as haters, except for the roasted cauliflower, that is.

Yelpers raved about the roasted cauliflower. Perfectly cooked so it was crisp on the outside and creamy in the middle in a good quality olive oil with pecorino romano cheese, lemon zest, and mint. I couldn’t wait to order this vegetable. It most certainly didn’t disappoint. I truly could have eaten 10 times the portion of this wonderful cauliflower. And, as an added bonus, it might possibly be the healthiest thing on the menu.

Graffiato is no Applebee’s. There’s no Weight Watcher’s menu and no little heart icon pointing people to the healthy dish, yet a lot of customers are noshing on this delight. So why is this $6 mini plate of cauliflower so popular?

For starters, it’s delicious. In order for people to choose a healthy dish it has to taste good. Vegetables aren’t cooked properly so much of the time. They are often over or undercooked and almost always under seasoned.

Second, people order this cauliflower because other people like this cauliflower. Yelp and the DC food blogs have seen to it that people know about this dish. People order it because others like it.

Mike Isabella’s intention wasn’t to convince people to eat their vegetables. His purpose is to sell food of all kinds that tastes good. It just happens that he makes a rocking cauliflower. But could the lack of a health claim be the reason why people fawn over the dish?

Companies market so many foods, from chips with whole grain to sugary cereals with immunity boosters to organic blueberries, with health claims. In this series of posts, I’m going to explore what makes people choose to eat a healthy food.


Stay tuned for part two "Do health claims on food make a difference?" 

Why are cigarettes legal and raw milk illegal?

After reading impassioned documents from the FDA about the potential harm of raw milk, equally passionate rebuttals from the Campaign for Real Milk, and somewhat-unbiased scientific-research articles, I have decided that unpasteurized milk has gotten a raw deal (pun intended). A classic tale of intrigue, unpasteurized milk is a victim of money, power, and politics.

In the briefest of summaries, raw milk carries some risk of food-borne illness, as do all foods, but also comes with health benefits. The potential risks are miniscule when compared to the risks of, say, cigarettes, yet still raw milk is illegal in many states. The rational behind the laws governing raw milk are convoluted, as are the answers to the following Q and A.

Question #1: Is raw milk safe?

Totally convoluted answer #1: For the most part. The FDA provides a good number of case studies describing the ill effects of raw milk, including serious food-borne illness and an occasional death. Proponents of raw milk find fault with each of these case studies and disagree that raw milk was the real culprit. After reading these studies, raw milk appears to be safer than lunchmeat (which I may never eat again).

Bottom line: The safety of raw milk depends on how cows are raised, a sanitary milking procedure, and frequent testing of milk for harmful bacteria. Every raw milk advocacy website strongly recommends that consumers “know their farmer.” Incidentally, if raw milk were made legal and regulated, it would be a lot safer than the current black market milk. There are valid and reliable bacteria testing procedures, that when uniformly applied, effectively screen out any contaminated raw milk samples.

Question #2: Why is raw milk illegal in some states?

Totally convoluted answer #2: On the surface, raw milk is illegal because of controversy surrounding the safety, but I don’t think that this is the real reason. Like big oil and big pharm, big dairy has a good deal of pull. Regional big dairy associations (the “Got Milk?” people) have launched ad campaigns under the guise of public service announcements to outline the hazards of raw milk, most notably in Texas where legislation supporting raw milk has been introduced. A rise in consumer confidence in raw milk translates to revenue loss for mainstream dairy farms. Laws tend to follow the money and obviously big, factory farms out earn your small, organic, free-range dairy farmer by about a zillion to one (citation needed).

Question #3: Is raw milk a magical health food?

Totally convoluted answer #3: We’ll probably never totally know. There are a good number of studies that show that kids who are raised on farms with lots of dirty farm animals and germs are healthier than their counterparts raised in Lysol-polluted homes on pasteurized skim milk. These kids suffer fewer allergies to pollen, animals, and food; less asthma; and are overwhelmingly healthier.

As for the other health claims…. There’s a good chance that we won’t know for some time as, like laws follow the money, so does scientific research. The FDA, the same agency that vehemently opposes raw milk, funds much of the research on health benefits of foods. It’s my guess that organic, free-range dairy farmers could write grant proposals until the cows come home (again, pun intended) without receiving funding.

Question #4: Can people with lactose intolerance drink raw milk?

Totally convoluted answer #4: Not people with true lactose intolerance, but a lot of people who get an upset stomach after drinking pasteurized milk who are not truly lactose intolerant can handle raw milk. Click here for a good summary.

Question #5: Would I buy a raw-milk product again?

Finally a straightforward answer: I would need to know about where it came from, bacteria testing procedures, and refrigeration and shipment processes. In short, I do not plan on buying retail raw milk again and feel that I would need to better know my farmer.

Coming back to my original question, why are cigarettes legal and raw milk illegal? Cigarettes with their extremely well documented cancer-causing properties are legal because of money. Raw milk, with its somewhat sketchy documentation of food-borne illness and potential health benefits is illegal because it is going against big money. And in our society, those with money win.

Raw Milk: Cuddly Disease Preventing Hero or Death Causing Uber Villain?

The yogurt in question.

A few weeks ago, I went grocery shopping at an Amish market. This market is a completely unique experience with all of the cute Amish 10 year olds breaking child labor laws serving up stuffed pork chops, fruits and veggies, baked goods, and this amazing pit roasted turkey, all while wearing their traditional attire. Vendors from various farms set up shop in the open-area building and the customer pays for his or her selections in each department. A section of the market is dedicated to breads, another section to meat, other sections to furniture and jewelry, etc. My story takes place in the dairy department.

Upon entering the market, a case of prepared salads, including my husband’s favorite, Amish macaroni salad, beckons. I knew that I might as well not return home if I forgot the Amish macaroni salad, so I made a beeline for the counter. The counter wraps around into the cheese and dairy section. I grabbed a few cheeses, paid for my goods and moved to the bread department. It was after I visited the produce and meat vendors that I realized that I missed my Saturday morning farmer’s market and didn’t have yogurt for breakfast. By that time, I was in a hurry and rushed back to the dairy department, grabbed a maple yogurt off the shelf and went on my merry way.

It wasn’t until a few days and half the yogurt container later when I was preparing my breakfast at work that I fully comprehended the label. I had bought yogurt made with raw, unpasteurized, fresh-from-the-farm milk. First, I sent an email to a coworker to inform him that if I suddenly died, he should point the investigators toward the yogurt in the fridge. Then I set about eating my breakfast. This maple, full-fat, unprocessed yogurt was admittedly pretty awesome. In fact, it was awesome enough that I threw food-borne illness caution to the wind and finished the container that day. It’s now a week later and my stomach is a-okay.

I first became interested in the raw milk controversy in May when a Facebook friend posted pictures from the Rally for Food and Farm Freedom on the National Mall. People gathered for this rally to protest the government’s regulation of raw milk. For the past two years the FDA has been organizing stings on Amish farms that illegally sell or ship unpasteurized milk. The rally was organized to help protect the small farms affected by these laws and the consumers who prefer to drink raw milk.

Confusingly, both state and federal laws regulate raw milk sales. There are a myriad of baffling, ever changing state laws on the books about raw milk. (I have to disclose that the concept of state laws confuses me. I don’t grasp the purpose of different laws in different states, like why you can buy beer and wine in grocery stores in both the District and Virginia, but not in my current state of Maryland. That being said, my analysis of these state laws should be taken with a grain of salt.) Apparently cows, and their milk, are healthier and carry less bacteria in some states than others. It appears by this fancy color-coded map that cows are very dangerous in Maryland, West Virginia, Nevada, Louisiana, Montana, Michigan, the state southwest of Michigan, and New Jersey and cows in the other states are relatively safe. Unfortunately, I bought my apparently illicit raw-milk yogurt in Maryland. Damn! I can only hope that it was smuggled illegally (per FDA federal regulations) across state lines from Pennsylvania Amish country, where apparently the cows are happy and healthy. Of note, Ron Paul, an unlikely advocate for the hippie-base of raw milk consumers, recently introduced a bill in Congress to allow raw milk transport across state lines.

So, why go to all of the trouble to smuggle and protest to buy raw milk? Proponents of raw milk feel passionately that it prevents allergies, asthma, heart disease, cancer, and autism, and that it does not cause more food-borne illness than pasteurized milk, as long as it is handled correctly.

The FDA claims that raw milk is responsible for a lot of lost bodily fluids from outbreaks of salmonella, E. coli, listeria and campylobacter.

Both sides are passionate and throw journal articles and case studies around like it’s nobody’s business. Get ready for a throw down like no other!

Lessons in Artifical Sweeteners and Humility

Emerald nuts have
artifical sweeteners.

Last year, I went out for a run in the trails near my house. On the way back, about two miles from my home, I thought, “I feel great. I am a really good runner. I’m going to run even faster.” About 30 seconds later, I found myself splayed on the ground, leg scraped, elbows bleeding. I no longer felt quite as good about myself. The same thing happens to me every time I try to fix something with HTML code. I feel really good about my computer skills and then, when I preview my work and the font has suddenly increased to bold, italicized, 42 pt midparagraph, I realize that there’s a reason why I’m not a computer programmer.

Low and behold, I was feeling all proud of myself and superior about my general avoidance of artificial sweeteners last week. Then I visited my parents this weekend and they had the ginormous size of Emerald Cocoa Roast Almonds from Sam’s Club. (These’s almonds are nutastic, BTW.) I got out my trusty Fooducate app to see the nutritional report card while I was devouring the nuts. They got a B+. I felt even better about myself.

Then I looked at the Fooducate assessment. The dark-chocolate roasted delights contain “controversial artificial sweeteners and preservatives.” Upon closer inspection of the ingredient list, I found the culprit—the dreaded sucralose (codename Splenda). I had so many questions about this. Why would you add artificial sweetener to a product that isn’t marketed as diet? Are artifical sweeteners even cheaper than corn syrup? Why did Fooducate give this product a B+ if it contains artificial sweeteners? How much artificial sweetener do I eat without knowing?

There are really two morals to this story. First, if you avoid artificial sweeteners, make sure you check the label closely. Even if it’s not a “diet” food, it still might contain these brain-altering chemicals. Second (my personal lesson that I apparently will never learn no matter how many times I repeat it), the universe will always conspire to prove me wrong every time I think too highly of myself. Sorry universe. I am not a great runner, a computer programmer, or a perfect eater. Please stop tripping me.

This is Your Brain on Diet Soda

Can your brain be easily duped? Take this test. In the video below count how many times the team wearing white passes the ball. (Make sure you watch the whole thing).

Did you see it?

About 50% of people are fooled by this video. The brain is clearly susceptible to an occasional blond moment. In fact, the brain is a lot like Sarah Palin when asked a tough question about North Korea or Paul Revere’s ride—perpetually confused.

As it turns out, diet soda and other artificially sweetened “foods” aren’t diet after all. There are nearly 4,000 artificially sweetened products on the market right now and they are not doing a darn thing to help the obesity epidemic. In fact, obesity is increasing as fast as diet products can flood the marketplace. People who switch from regular soda to diet soda fail to lose weight, even though they remove 100s of calories from their diets. Why is this the case?

First, feeling that it has avoided calories in regular soda, the perplexed brain convinces Diet Cokeheads reward themselves with a treat. Diet soda drinkers tend to take in nearly as many calories as regular soda drinkers while they think they’re taking in less (Yang, 2010). There have been a few studies that have contradicted this (Stanner, 2010), but the majority show that people who drink diet soda eat the calories back (Yang, 2010).

That diet soda as an afternoon treat may also be responsible for a future brownie craving. Sugar works a lot like drugs—the more we eat, the more we want. The brain recognizes artificial sweeteners as sugar (dumb, dumb brain) and craves more sweetness as a result (Yang, 2010).

On the rare occasion when I have a diet soda, I feel like there’s Grand Canyon-size hole in my stomach. While the brain perceives artificial sweetener like sugar when it comes to increasing sugar cravings, the brain gets confused by the calorie void that comes with the diet drink. Diet soda activates the brain’s reward center, and then when the brain can’t find the calories, it gets confused. The brain sends a memo to the stomach about the lack of calories. In response, the stomach growls and sends the body on a quest to fill the calorie void, bringing us full circle to fact that diet-soda drinkers eat more than regular soda drinkers (Yang, 2010).

On a side note, as if the weight causing effects of both diet and regular soda aren’t enough, most self-service soda machines carry nasty bacteria. The recent study found that the majority of soda fountains contained harmful bacteria like e-coli, staph, candida (yeast) or coliform (White, 2010).

Long story short, diet soda is no better than regular soda. Go water!

Sources:

Stanner, S. (2010). The science of low-calorie sweeteners—separating fact from fiction. Nutrition Bulletin. 35; 357-362.

White, A.S., et al. (2010). Beverages obtained from soda fountain machines in the US contain microorganisms, including coliform bacteria. International Journal of Food Microbiology. 137(1); 61-66.

Yang, Q. (2010). Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings. Yale Journal of Biology and Medicine. 83; 101-108.

Losing Weight is Like Falling in Love

After my last blog post, my friend, Monica, emailed to share her weight-loss story. Monica had a similar three-step experience as that which was outlined in the post: a general contemplation of change, a negative a-ha moment that served as a catalyst (seeing her college graduation photo), and then a series of positive reinforcements. In looking back at her experience, she wrote:

I found that the negative experience is very random and uncontrollable. I had plenty of equally negative experiences before this one that did not influence me to change behavior. I believe you can't stimulate such an experience any more than you can make someone have chemistry and fall in love with another person. That spark is uncontrollable. You can lay the groundwork with an openness to the experience, an examination of what works and doesn't work for you, etc., but that spark in love is the best analogy that I have to offer to the spark that stimulates weight loss. Once you have that spark, there are things you can do to keep the flame of weight loss alive, just like keeping a relationship in the healthy and happy zone takes some work and attention as well.

I am definitely not relationship-expert extraordinaire Carrie Bradshaw, but Monica’s email made me think about my dating experiences prior to meeting my husband. (Earmuffs, honey.) I remember going out on this blind date. Our matchmaker introduced us because he was a PE teacher, I worked at a gym, and (probably the number one reason) we were both short. This guy, whose name I don’t remember, insisted on meeting at the ESPN Zone, arrived 20 minutes late, and then informed me that we didn’t have time to eat dinner because we were going to meet his friends at a basketball game. I really don’t like basketball and I find dinner to be a very important part of the day, but went along with this super-boring date anyway. At the end of the date, he said, “We should do this again.” I actually burst out laughing. As much as we looked good on paper, I doubt either one of us felt anything that resembled a spark and both of us knew that we wouldn’t be going out again.

What if, like a blind date with an arrogant little PE teacher, all of the time we spend trying to force weight loss is a colossal waste of time? Could dieting without this perfect storm of readiness, an a-ha moment, and a supportive environment do more harm than good?

If losing weight is like falling in love, dieting is like dating a guy with no job, seven kids from four different women, and a drinking problem. (If that’s not an SAT-worthy analogy, I don’t know what is.) Across the board, people who weight cycle (repeatedly gain and lose weight) weigh more and carry more fat in their abdominal area (Cereda, 2011). Diet books, magazines, and websites push us to seek out new magical low-fat, low-carb, cabbage soup, cave man, blood type, raw food, baby food, French, Mediterranean diets. Sadly, this miraculous diet doesn’t exist, and our diet-du-jour society is actually causing weight gain.

Like finding a mate, living healthy needs to feel good, be enjoyable most of the time, and come together easily. Try finding enjoyment in an activity, be it running, dancing, or eating broccoli. It also helps to start contemplating and planning for long-term weight loss by figuring out how to fit healthy eating habits and exercise into almost every day for the rest of your life. At some point when you’re ready, that a-ha moment will come. If you don’t feel that you are 100% on board and that eating healthy and exercising is a struggle, take a step back and reevaluate your plan. Like a good relationship, a healthy lifestyle shouldn’t feel like a great effort.

Cereda, E., et al. (2011). Weight cycling is associated with body weight excess and abdominal fat accumulation: A cross-sectional study. Clinical Nutrition. Epub ahead of print.

Are Negative Experiences the Trick to Weight Loss?

When we first adopted our furry daughter, Nittany, she would run laps around our condo, much to the chagrin of our downstairs neighbors. We did what every overwhelmed new puppy parent does and we signed up for obedience classes. We worked with Nittany about an hour a day between classes and she learned sit, down, and target (our instructors take on come). Like many dog trainers, ours relied on positive reinforcement (treats) and warned us against using negative reinforcement (saying no). Five years later she knows all of these tricks really well, as long as I have a treat in my hand. If I don’t have a treat, she has absolutely no motivation.

A few months after our obedience class, we were still trying to calm the Energizer Puppy. We heard that biking with a dog is a phenomenal way to help them burn energy. That Sunday, we took Nitt out for a leisurely bike ride. Turns out it was leisurely for us and pure hell on wheels for her. Even though we followed the trainer’s instructions on the website and didn’t take her very far the first day, Nitt’s paws were bloody and my husband had to carry her up the stairs to our condo. Ever since this fateful day, Nitt has been terrified of bikes. She cowers if we’re on the trail and one comes up behind us. She won’t go near our bikes propped against the wall even if we put meat next to them. This one terrifying experience changed her more than countless hours of practicing tricks in exchange for treats.

Mutual of Omaha uses the a-ha moment as their marketing tag line. If you visit their website you can view a-ha moment submissions from the public by topic. A search on “weight” yields two pages of a-ha moments including a woman too embarrassed to ask for a seatbelt extender on an airplane and another woman who felt winded and had to sit down after a few minutes of playing with her kids. Every single weight related a-ha moment is sad or embarrassing.

Much professional advice on weight loss stresses positive reinforcement and rewards (e.g., When I lose 20 pounds, I’ll buy myself a new pair of jeans.) What if we’re missing a very important motivator—negative reinforcement? (Note: Negative reinforcement is different from punishment. Negative reinforcement increases a behavior by using something annoying or uncomfortable, like the buzzing that reminds us to put on a seat belt or the 110 heat index that motivates us to go indoors.)

The only issue with this theory is that plenty of people have weight-related negative experiences and don't end up making a life-long change. I think this negative experience is important, but it's only one of three important steps:

The Stages of Change by
Prochaska and DiClemente.

First, a person needs to go through a series of slow changes to his or her thinking, including contemplating weight loss and preparing to begin a weight loss journey. These steps are called the Stages of Change. This preparation is what sets apart the people who make a life change after an embarrassing situation involving an airline seat and those who drown out the negative experience with a pint of Ben and Jerry’s.

Second, at the right moment, when the person has gone through contemplation and planning stages, something embarrassing or intense happens to cause this life-changing a-ha moment. This moment jolts them into action. These triggers are often events that cause embarrassment and humiliation, and changes to self image (Tod, 2004).

Finally, and perhaps more importantly, it's the positive reinforcement and a level of enjoyment that keeps the change going. In the study discussed in the last blog post, in addition to the a-ha moment, all of the teens who lost weight also exercised vigorously 2 hours each day and had families who supported their lifestyle changes. Maintaining a 2-hour a day exercise routine really requires some enjoyment of the activity. One teen in the study got very involved in martial arts. Others found a love of basketball, track, or baseball.

According to psychologists Richard Ryan and Edward Deci (2000), we need several things to find motivation. The best and most sustainable type of motivation is finding enjoyment in a behavior. If a love of running just isn’t in the cards, three other things need to be in place: 1) a person’s environment needs to support the behavior (like the teens' families), 2) a person needs choice and autonomy, and 3) a person needs to feel capable and confident to make a change.

To answer the question initially posed, negative experiences aren't the trick; they are a catalyst to move in the right direction. It's actually the positive experiences, support, and enjoyment of an activity that keep people going.

Now, if only I could figure out a way to incorporate this into dog training…

Sources:

Ryan, R.M., Deci, E.L.(2000). Self-Determination Theory and the Facilitation of Intrinsic Motivation, Social Development, and Well-Being. American Psychologist. 55;68-78.


Tod, A.M.; & Lacey, A. (2004). Overweight and obesity: helping clients take action. British Journal of Community Nursing. 9(2);59-66.

Is Long-Term Weight Loss Possible?

I’m working on a conference presentation for health care providers on helping adolescents lose weight. I called my husband the other day a little frustrated that I didn’t have the solution to the world-wide obesity epidemic to share with the audience. Obviously, I have some delusions of grandeur. 

Throughout the week, combing through the research really depressed me. There are so many articles that talk about the obstacles to long-term weight loss and so few that provide promising solutions. No one really has the answer to this question. A lot of diet books claim to know, but the authors are just trying to make a buck. Decoding the mystery to long-term weight loss is a little like figuring out why Arnold Schwarzenegger would cheat on Maria Shriver with the housekeeper--totally baffling. 

An article that was just published by Marc-Andre Cornier (2011) adds a layer of frustration to the problem. Dr. Cornier writes about how, as people lose weight, their bodies fight to regain it. The person’s metabolic rate slows. (This makes sense as smaller people burn less calories than bigger people.) After weight loss people also feel hungrier, aren’t satisfied after a meal, and tend to fidget less. The human body doesn’t like weight loss and fights tooth and nail to get back to its previous chubby state.

Long-term weight loss is so rare that scientists are able to keep track of people who have managed this in the National Weight Control Registry (NWCR). In fact, less than 10% of people who lose weight are able to keep it off for 5 years (Cornier, 2011). The 5,000 or so people in the NWCR all have some things in common; they maintain a low-fat, low-calorie diet; eat breakfast every day; weigh themselves at least once a week; watch less than 10 hours of TV per week; and exercise about an hour a day (NWCR, 2011). All of this is well and good, but it doesn't show what motivates them to do all of these things, when 90% of weight losers aren't able to stay motivated.

Just when I was ready to throw in the towel, I had a little glimmer of hope. Researchers at the Urban Policy Institute discovered some stark differences in obese teens who lost weight over the course of time and obese teens who gained weight during the same time. They found that all of the teens who lost weight had an a-ha moment. There was a tipping point that changed their path. 

One teen had a track coach who complimented her running, but told her that she would be even faster if she ate better. Another teen had been worried about his grandmother's diabetes around the same time his doctor brought up his weight and risk of diabetes. Another teen had an a-ha moment at the neighborhood basketball court saying, “I sat there, and I watched other people play…. They sweat a lot, but they don’t get tired, and I get tired… I was like, I don’t wanna be like that for the rest of my life.” (Lieberman, 2009) After these a-ha moments, these teens made significant lifestyle changes. In contrast, there were few life-altering moments in the group of teens that continued to gain weight. 

I had a turning point like this when I quit smoking 10 years ago. I was at a drag queen Abba concert even though I had a head cold. I had been trying to quit smoking for a while and had been resisting buying packs of cigarettes. I really wanted a cigarette that night and I bummed one off some guy. The cigarette tasted awful, as any of you who have smoked a cigarette with a cold could have predicted. I had the epiphany that smoking was a disgusting habit that night and that was my last drag of a cigarette.
  
Unfortunately, none of these a-ha moments occurred during unique situations. Every smoker brakes down and has a cigarette when sick and the cigarette, no matter how much the smoker is craving it, tastes repulsive. Why don't all smokers quit when this happens? Many overweight people have a health scare or a moment where they feel bad about their weight. What was different about the teens in the article?


What do you think? Stay tuned for part two.


Cornier, M-A. (2011). Is your brain to blame for weight regain? Physiology and Behavior. E-pub ahead of print.

Lieberman, A., et al. (2009) Why some adolescents lose weight and others do not: A qualitative study. 101(5); 439-447.

High-Fructose Corn Syrup vs. Sugar (Part 2)

When something goes awry in society, be it an increase in autism or obesity, or 90s fashion trends reentering teens' closets, it is human nature to want to blame a culprit.


Researchers at George Mason University are studying parents’ decisions to immunize their children and looking at what one of the researchers calls the “Jenny McCarthy Effect.” Ms. McCarthy, of 1990s-Playboy-model-turned-TV-hostess fame, leads the campaign that claims childhood vaccines cause autism. Many people have chosen to skip immunizing their kids, even though studies show that immunizations do not lead to autism and protect children from diseases.


The researchers were surprised by who was most susceptible to the “Jenny McCarthy Effect.” People who were highly educated, intelligent, and well-off were more likely to choose to forgo immunizing their children because of concerns about autism. In fact, the more educated a person, the more likely they were to fall victim to the “Jenny McCarthy Effect.” Poorer, less educated people routinely listened to their doctor’s advice (and the literature) and immunized their kids.


I feel like high-fructose corn syrup (HFCS) has become a little like the childhood-immunization-leading-to-autism hype. Educated, intelligent people are swearing off all foods with HFCS based on pretty shaky scientific knowledge.


I really want to tell you that HFCS is the root cause of our obesity epidemic, because that would be the socially acceptable thing to do. It would also be such a simple solution to the battle of the bulge and, boy, could we use a simple solution. Unfortunately, the research out there is pretty far from this conclusion.


Nearly everything I’ve come across in reputable journals like the American Journal of Clinical Nutrition, Nutrition and Metabolism, and The Journal of Nutrition, say that sugar and HFCS work the same way metabolically. An article in The Journal of Nutrition even goes far enough to say “Misconceptions about high-fructose corn syrup abound in the scientific literature, the advice of health professionals to their patients, media reporting, product advertising, and the irrational behavior of consumers.” (White, 2009) Studies have not found that HFCS is unique in the way it leads to obesity, predicts obesity, or that eliminating HFCS from the food supply would decrease obesity (White, 2008).


It’s true that as HFCS has increased in food, the obesity epidemic has also increased. There’s more food available and people are eating more of everything, especially fat and starches (White, 2009). The two things are correlated, but it doesn’t appear that one caused the other.


There is one study out of Princeton that showed that rats that were fed HFCS overwhelmingly became obese, while those who ate sugar did not (Parker, 2010). This is interesting, but I would like to see more studies on humans in this area. If the science goes this way, I will be sure to update my blog post.


Don’t get me wrong, I’m in no way calling HFCS a health food or advocating purchasing products that contain it. It’s processed and calorie dense and has all of the makings of an unhealthy food-like substance. I just no longer think it’s a magic obesity potion. In doing this research, my view of the unhealthiness of HFCS didn’t really change, but my view of sugar did. Table sugar does all of the same bad things to blood sugar, triglycerides, and our svelte figures as HFCS, so if you’re going to rid your cabinets of HFCS, might as well throw out that sugar too.


I feel that all of those “No HFCS!” and “Now with real sugar” labels are the epitome of misleading advertising, as are most health claims on packaging. So, here’s my advice:


• Try to avoid savory foods with any kind of added sugar, be it HFCS, brown sugar, evaporated cane juice, agave nectar, or plain-old sugar. It’s just adding extra calories.
• Use HFCS on a food label as a warning sign that the product is ultra-processed, high in calories, and contains other unhealthy ingredients.
• Don’t go crazy banning HFCS. If you really like something every once in a while that contains it, have it. You will still be able to zipper your jeans tomorrow.




Sources:


Parker, H. (March 22, 2010). A sweet problem: Princeton researchers find that high-fructose corn syrup prompts considerably more weight gain. Retrieved online from http://www.princeton.edu/main/news/archive/S26/91/22K07/.


White, J.S. (2008). Straight talk about high-fructose corn syrup: What it is and what it ain’t. American Journal of Clinical Nutrition. 88(suppl):1716S-1721S.


White, J.S. (2009). Misconceptions about high-fructose corn syrup: Is it uniquely responsible for obesity, reactive dicarbonyl compounds, and advanced glycation endproducts? The Journal of Nutrition. 1219S-1227S.

Throw Down: High-Fructose Corn Syrup vs. Sugar

My husband and I were eating walnut-chocolate chip pancakes with Aunt Jemima Butter Light Syrup a few weeks ago. (I know, it’s the nutritional equivalent of supersizing a Double Whopper Meal and then ordering a Diet Coke.) During breakfast, I read the back of the syrup label and  high-fructose corn syrup (HFCS) was staring at me. If not for my husband’s pardon, Aunt Jemima would have found herself headed to a landfill that day. (Just kidding; I would have recycled her.)

HFCS has been on many of our nutritional no-no lists for a few years. I saw a blog post a few weeks ago that mentioned HFCS. In the comments, someone wrote “What’s the matter with HFCS?” She might have well of asked “What’s the matter with genocide?” The readers went crazy, citing “research” studies that gave HFCS magical obesity-causing properties.

Background

HFCS gradually began replacing sugar in beverages and processed foods during the 1970s and 80s. It was cheaper and, since corn is grown domestically, not susceptible to the pesky little episodes of civil unrest prevalent in the tropical environments where sugar cane is grown. Because it is already in liquid form and corn is highly subsidized by the government, HFCS makes producing vats of soda much, much cheaper.

Nutritional Makeup

The nutritional make up of HFCS and sugar is pretty similar. HFCS is comprised of 55% fructose, 42% glucose, and 3% “readily hydrolysable polymers of glucose” (your guess is as good as mine). Table sugar (sucrose) has a 50/50 fructose to glucose ratio. Both substances are heavily refined and striped of nearly all nutritional value. Honey has a similar ratio to the other two sweeteners (White, 2008).

 

The HFCS Hater’s Argument

HFCS haters feel that HFCS reacts differently in the body than sugar and disproportionately causes obesity, especially the dreaded abdominal obesity. They also point out that as HFCS use has increased, so have the waistbands of Americans.

 

The Defense

Much of the defense of HFCS comes from ads and “expert” testimony produced by the Corn Refiners Association that claim that HFCS is identical to sugar. It has all of the markings of a big business moneymaking conspiracy. Watch the commercial below.

Why It’s Not So Cut and Dry

I’ve been a member of the I Hate HFCS Club for a bit, but a few things recently have made me want to take a closer look at this. The first red flag came when I saw a friend drinking a Pepsi Throwback. In the midst of the HFCS controversy, Pepsi came out with a soda made with real sugar accompanied by some borderline health promoting advertising. Wait, so soda is healthy if it’s sugar and not HFCS? I don’t think so.

I’m not particularly proud of the second reason I started doubting the evilness of HFCS. I was searching for a video on youtube and came across this one produced by the Corn Refiners Association. Normally, I would write this off as a super-biased video from an association that has everything to gain from hooking Americans up to intravenous HFCS. My issue here was one of ego. One of the experts in this video was the medical director at the George Washington University. I happened to go to grad school at GW. If you know anything about GW, you know that I will be paying for my education there until my hair is completely gray and robots rule the earth. I can’t let myself think that a representative from my alma mater would flat out lie about HFCS and still send them so much money every month. Besides, we’re “the” George Washington University. That means we’re super smart.

So, the battle of HFCS vs. sugar is open. Do you think HFCS is worse than sugar? Vote here. Stay tuned for the science on both sides.

Sources:

White, J.S. (2008). Straight talk about high-fructose corn syrup:  What it is and what it ain’t. American Journal of Clinical Nutrition. 88(suppl):1716S-1721S. 

Fitting Into Those Skinny Genes (Part 3)

We are absolutely not made to
handle the toppings bar at
FroZenYo.

FroZenYo, a self-serve frozen yogurt Mecca of yumminess, opened in my neighborhood last month. You walk in, pick up an oversized cup, fill it with fro yo, add toppings, and then weigh the monstrosity to pay per the ounce. After you pay, “free” hot fudge beckons from beyond the register. With all of those options, it’s pretty hard to limit yogurt flavors and toppings. The sheer quantity of hard-to-resist treats leads me to make some pretty interesting flavor combinations. Coconut and pistachio yogurt with berries, wet nuts, Oreo pieces, and hot fudge, anyone? Oh well, guess I’ll blame my inability to resist all of these sweet, crunchy, gooey delights on my genes.

Since FTO and similar genes make food more attractive and lower a person’s ability to resist yummy, sweet, and fatty foods, these genes definitely make living in our society harder. It wasn’t always so. Hundreds of years ago, this genetic predisposition to eat large quantities of fattening foods would have helped us survive. Throughout history, humans ate when the harvest came in or when someone from the village killed a large animal. There were periods of feast and famine. The drive to chow down kept us alive through the harsh winter. Now we power through the cold weather with venti hot chocolates, big bowls of meaty chili con queso, and non-stop streaming Netflix.

Technology has created the perfect obesity storm by making food-like substances easier and cheaper to produce. Food (or something that closely resembles it) is always around us. (Ever walked past Chipotle at 3:00 in the afternoon? There’s a long line. What meal is that exactly? Linner? Or maybe dunch? Who knows, but I need that 1,100-calorie burrito the size of my head!) Technology also enables us to stay perfectly still for long periods of time, save for pressing buttons on the remote control, smart phone, computer, etc.

These changes in our society have happened really fast, and, as a society, we’ve gained weight really fast…

… and evolution happens slowly. So, on the nature vs. nurture debate, I’m going to have to side with nurture.

Genes don’t directly affect our weight; they affect how we interact with our environment. Simply, our bodies aren’t made to live in our current society and we are going to keep getting fatter unless our environment and culture change. I’m fully aware that I’m not going to solve the obesity epidemic with this blog post, but this is how I think we can set ourselves up for success in this sedentary, food-crazed culture:

Step 1: Boycott buffets and all-you-can-eat situations. FTO and similar genes don’t allow most of us to handle them. Hey, 18% of noncarriers lost control when confronted with a Chinese buffet too. Buffets are bad news. Willpower is a myth and, unless famine is imminent, stay far away.

Step 2: More importantly, cut back on eating out all together. If we’re going to change the obesity epidemic in one generation as Mrs. Obama has promised, there needs to be a return to healthy home cooking.

Step 3: Vote for policies/politicians that work to make healthier foods cheaper and more available than junk food. To make it work, healthier foods, like farmer’s market produce, would have to be subsidized and unhealthy foods, like soda, would have to be taxed. Current government policies are setting us up for fatness.* I’m personally working to create a generation of conspiracy theorists at the college where I teach health. The truth is out there. Trust no one.

Step 4: Don’t keep crappy food in your house. Just skip the chip aisle. You know you can’t avoid it if it’s in the house. Blame it on FTO.

Step 5: Exercise for at least an hour a day. FTO carriers who exercise weigh less than those who don’t exercise (Mitchell, 2010). Duh.

Step 6: Breastfeed. Some new research shows that being breastfed for at least a month may lessen the effect of FTO in childhood (Dedoussis, 2011).

How else could we change our food environment and culture? Comment!

Sources

Dedoussis, G.V., et al. (2011). Does a short breastfeeding period protect from FTO-induced adiposity in children. International Journal of Pediatric Obesity. 6(2-2):e326-335.

Mitchell, J.A., et al. (2010). FTO genotype and the weight loss benefits of moderate intensity exercise. Obesity (Silver Spring). 18(3):641-643.

*To be described in a future post.

Fitting Into Those Skinny Genes (Part 2)

As those of you who voted guessed, our genes most definitely play a part in our weight, but not for the reason most people think. Our genes don’t affect how many calories we burn. Like in the mini experiment in Part 1, the amount of calories our bodies burn at rest is dictated by sex, weight, height, and age. Our genes work in a much more interesting and kind of scary way; they change the way we look at food.

If you’ve ever scanned the websites about the secrets of “naturally” skinny people, you’ve probably noticed that a lot of the secrets have to do with the way these skinny minis behave around food. They eat small portions; they don’t treat hunger as an emergency; they fill up on fruits and vegetables. Yes, naturally skinny people all have those things in common. They also look pretty similar genetically, especially on a gene called Fat Mass and Obesity-Related Gene (FTO). (Nope, I’m not even kidding about the name of this gene.)

 

Researchers at the Bute School of Medicine in the United Kingdom screened for FTO on a group of over 2,700 4- to 10- year-old children. If a child inherits FTO from both parents, the child is described as homozygous, meaning she has two copies of the same gene. Scientists use the shorthand AA for people with two copies of the FTO gene. People who only inherent one copy of the gene are heterozygous; and are labeled with the shorthand AT. Those without the gene are labeled TT. In this study, the scientists also measured the children’s height and weight, waist and hip circumference, and body fat.

Of the children in the study, 14% inherited two copies of FTO from their parents (AA). Nearly half (49%) inherited one copy of the gene (AT). The remaining 37% did not inherent any copies of the gene (TT). Those with one (AT) or two copies (AA) of the gene were more likely to be overweight and had an average of four pounds more body fat than their counterparts. Those who carried two copies of the gene (AA) were heavier than those with just one copy (AT).

Here’s the kicker. The carriers of the gene (AA or AT) burned an average of 84 more calories per day than those who didn’t carry the gene (TT). Both those who carried the FTO gene (AA or AT) and non-carriers (TT) burned about the same amount of calories as the researchers predicted based on their basal metabolic rate; that is, the bigger kids burned more calories than the smaller kids and boys burned more calories than girls.

It all came back to food. During the second part of the study, the researchers measured the children’s food intake. The children were fed a buffet lunch with ham, cheese, carrots, cucumber, potato chips, rolls, crackers, raisins, chocolate candy, grapes, orange juice, and water. Interestingly, all of the children ate about the same amount of food; however, the gene carriers (AA and AT) consumed 16% more calories and 30% more fat than the noncarriers (TT). The carriers of the gene chose the more fattening and higher-calorie foods, like the candy and chips, while the noncarriers gravitated towards the foods with lower calories like the fruit and vegetables (Cecil, 2008).

I absolutely love Nutella and its chocolaty, hazelnutty deliciousness. At a previous job, I kept a jar of it at my desk. I was towards the bottom of the jar and alone in my shared office. I don’t know what came over me, but a few minutes later, I had my hand jammed into the jar so I could get every last morsel of goodness into my mouth. That is until a coworker walked in and said, “What the hell are you doing?” It wasn’t until then that I realized that Nutella was on my chin, shirt, and forearm up to my elbow. Researchers call this phenomenon loss of control eating. It happens to all of us, but it happens more often to FTO carriers. On a research trip to the Chinese buffet, 37% of carriers, both AA and AT, lost control with all the moo su pork in sight. Only 18% of noncarriers (TT) got to the point where they lost control (Tanofsky-Kraff, 2009).

Since FTO was first discovered in the early 2000s, data from over 80,000 people have been analyzed. The probability that FTO’s affect is due to chance is 1.2 in 1,000,000,000,000,000,000,000,000,000,000 (Frayling, 2007). Repeatedly, studies have found the same thing—those with one or two copies of the FTO gene weigh more and eat more than those who do not carry the gene and this trend has nothing to do with metabolism (Speakman, 2008). Of course, FTO isn’t the only gene that has an effect on obesity—it’s just shown the biggest effect to date (Li, 2010).

So, why are we seeing this obesity epidemic now? Has our DNA changed? Stay tuned for Part 3 for more riveting genetic information.

Cecil, J.E., Tavendale ,R., Watt, P., Hetherington, M.M., Palmer, C.N. (2008). An obesity-associated FTO gene variant and increased energy intake in children. New England Journal of Medicine. 359(24), 2558-2566.

Tanofsky-Kraff, M., Han, J.C., Anandalingam, K., Shomaker, L.B., Columbo, K.M., Wolkoff, L.E., Kozlosky, M., Elliott, C., Ranzenhofer, L.M., Roza, C.A., Yanovski, S.Z., Yanovski, J.A. (2009). The FTO gene rs9939609 obesity-risk allele and loss of control over eating. American Journal of Clinical Nutrition. 90(6), 1483-8.

Frayling TM, Timpson NJ, Weedon MN, et al. (2007). A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity. Science. 316, 889-94.

Speakman, J.R., Rance, K.A., Johnstone, A.M. Obesity (Silver Spring). (2008). Polymorphisms of the FTO gene are associated with variation in energy intake, but not energy expenditure. 16(8), 1961-5.

Li, S., Zhao, J.H., Luan, J., Luben, R.N., Rodwell, S.A., Khaw, K.T., Ong, K.K., Wareham, N.J., & Loos, R.J. (2010).  Cumulative effects and predictive value of common obesity-susceptibility variants identified by genome-wide association studies. American Journal of Clinical Nutrition. 91(1):184-90. 

Fitting Into Those Skinny Genes (Part 1)

Do our genes play a role in weight?

Some coworkers and I got into a heated discussion about whether some people draw the genetic short straw when it comes to weight or if people from heavier families are more likely to pack on the pounds because they are raised on Quarter Pounders and Häagen Dazs. We went back and forth talking about friends who ended up skinny in overweight families, friends who ended up overweight in skinny families, and, more often, people who look a whole lot like the rest of their families.

All of these stories came with the added bonus of eating up a good chunk of my morning at work (shhh, don’t tell my boss and Curtis, if you’re reading this, I’m totally making this up); however, this really didn’t get us any closer to solving the nature vs. nurture debate. Sorry, we couldn’t have been of more help, field of psychology.



So, I did what the geek-girl inside of me needed to do and set up a mini experiment. There are a couple of ways to measure metabolic rate (a.k.a. how many calories we burn a day). The more accurate way is to measure a person’s basal metabolic rate (BMR). BMR is measured in a dark room after 8 hours of sleep and 12 hours of fasting. Needless to say, we didn’t choose this option as it would have been a little awkward and cramped for us all to sleep in the conference room. My hair also works its way into a fauxhawk overnight and I really didn’t want my coworkers to see me like that. 

Instead, we had a company come in with equipment to measure our resting metabolic rates (RMR). RMR is way less cumbersome and only requires 4 hours of fasting (and no coffee!). The tech had each of us lie down in a reclining chair (one at a time, of course); she put a clothespin on our noses, and then has us breathe into a contraption for 15 minutes.

Afterwards, we all shared our results. With a few exceptions, the number of calories each of us burned a day at rest was as expected based on our sexes, weights, heights, and ages. Caloriesperhour.com provides a calculator that gave us our comparison RMRs. As a general rule, the taller, heavier, and younger a person, the more calories she burns at rest each day. Men burn more calories than women. #sonotfair

Based on RMR readings, it seems like our bodies try to compensate for extra weight by burning more calories. If a bigger person burns more calories, why are they bigger? And why do some people seem to be immune to weight gain?

The question of the week is: Do you think genetics play a role in weight? Click here to vote, or put your vote in the comments section below if you have rebelled against the facebook machine. Voting is open through Sunday, July 3^rd.

Case Closed on Whole Milk vs. Skim Milk

It's a hung jury.

Every Saturday morning from April through November, I visit my neighborhood farmer’s market primarily to pick up my week’s supply of Strawberry Yo-Light from Blue Ridge Dairy. The ingredients in this delightful creation are pasteurized low-fat milk, organic strawberries, nonfat dry milk, organic sugar, fruit pectin, citric acid, and live and active cultures. Sometimes the guy at the farmer’s market sells out before I get there and I have to go with the Honey Yo-Light. (Then I shake my fist towards the heavens and I ask myself, “Why does he only bring five containers of the good stuff? Why?!?!?!” If you’re reading this Mr. Blue Ridge Dairy, let’s get going on the strawberry this week, ‘kay?) Either with the strawberry yogurt or the somewhat inferior honey, I feel like my weekday breakfast of oatmeal, light yogurt, fruit, and a vat of coffee is super healthy. Well, maybe not so much the vat of coffee.

This week, I picked up some fresh mozzarella to make a caprese salad to accompany our pre-triathlon carb-loading pasta. The mozzarella was made with whole milk and it was delicious. I can’t imagine that a fat-free mozzarella would have complemented the farmer’s market fresh, local basil and tomatoes quite so well. So, it was light on the yogurt and the real thing on the cheese, and I felt pretty darn good about it, based on both my taste buds and the science.

That’s right, the case of whole vs. skim ended with a hung jury. Readers were split 50/50 on the case and scientists leaned towards low-fat dairy by a thin margin. Many studies gave skim milk an advantage in promoting a healthy weight with the caveat that people who take care of themselves gravitate towards lighter choices in all areas, including dairy. Some studies also found that skim or whole didn’t matter, especially in moderate amounts. There were too many other possible explanations for the results in the pro-whole milk studies.

So, in sorting through the e-confusion, we’re going with a mixed-method approach:

• Light yogurt wins. It’s just as creamy and good and is way lower in calories. Let’s face it—most of us don’t need extra calories. (Check the back of Fage Whole Milk Greek yogurt if you want a good shock to the system.)
• Non-fat cheese doesn’t melt (other than “cheese food”—yuck!) and is pretty unappetizing and ultra-processed. I would go with a 2% or part skim for extra-cheesy dishes like enchiladas, or a full-fat cheese as a treat, but in small quantities.
• I’m having the hardest time with straight-up milk, mostly because I don’t like the way milk tastes and I can’t imagine sitting down with a glass of it. I also don’t like the concept of drinking calories (unless said beverage begins with a “w” and ends with an “ine”). My recommendation here is to drink what tastes better in moderation if you love milk. If you don’t love the taste of milk, eat yogurt, or get your calcium from food sources like broccoli (my favorite food), leafy greens, or canned salmon (Sound gross? Try these salmon cakes with fiery salsa. You’ll be a believer!)

Just like anything in life, moderation is truly the way to go. After all, we don’t eat fat or calories; we eat food. And, Mr. Blue Ridge Dairy, please remember my strawberry yo-lite this weekend. Thank you very much.

Note: Some of you noticed that I didn’t touch organic vs. conventional milk, raw milk, or dairy alternatives (soy, almond, etc.) in this post. That’s a blog for another day.