Guest Post: A ridiculous burger

As you are probably aware, this is a time of transition for Veritas Health. I just completed my Master's degree from Harvard School of Public Health and am moving back to the San Francisco Bay Area to begin a new phase in my public health career.

Interviewing and packing has been taking up a lot of my time these past few weeks - so I am extremely grateful to Jessica Yen, who serendipitously offered to write a guest post for VH. Jessica is a great friend and public health colleague and I hope that you enjoy her writing and insights as much as I do!
- Katelyn Mack

A Ridiculous Burger
by Jessica Yen

The other day my roommate saw a report that Lotteria, a fast food chain restaurant in Japan, has a new ten-layered hamburger called the “Cheeseburger Tower.”  Ten slices of cheese alternating between ten beef patties, the burger will subtract ten dollars from your wallet and add ten points to your cholesterol level. 

The ad claims that they created the Cheeseburger Tower in response to customer demand, but really now – I’d like to have seen those focus groups!  And although one would hope that such a menu item could not possibly catch on among Japanese consumers, it’s the broader health implications that worry this household of self-professed public health nerds.

Task Force Releases Report on Childhood Obesity

To rollback childhood obesity in one generation.

Ambitious goal - to get the prevalence of childhood obesity down to 5% by 2030. No society has ever succeeded in undertaking such an enormous task - one that is complicated by deeply ingrained norms around diet and exercise, a well-financed commercial industry (not only fast/junk food, but also when it comes to diet and weight loss), and a general distrust of government-led initiatives.

The White House Task Force on Childhood Obesity released its report (commissioned by President Obama on February 9, 2010) and it combines the best evidence for tackling weight gain among our nation's kids.

It quickly lays out the facts: our children are fatter than ever and it is impacting their health.

Updating Nutrition Labels

It was only 20 years ago that we began seeing uniform nutrition labels on processed food products telling us how many calories, how much fat and sugar, and what nutrients are in the food we eat.

But many health groups believe it's time to update nutrition labels. I agree that it's time to give consumers information in a way that is useful and helps people make healthy choices. In this week's Time, the Center for Science in the Public Interest suggested a few updates for the Nutrition Facts label.

One suggestion was to make "unhealthy" content like sugar and fat stand out using different colored text. I think that this could be misleading, given that not all fat is bad for you and it could lead to making less healthy choices. However, I love the idea of having the calorie count (per serving and per package) displayed clearly on the packaging. This is particularly important for beverages and "snack" foods -- like those $.99 chips or peanuts that are usually 2.5-3 servings and many more calories that people probably realize!

I would make it easier to read nutrition labels by changing words such as "sodium" to "salt". Hopefully innovators will see this as an opportunity to create a change in a space that will affect millions of peoples' food choices over the next few decades and will get involved.

How would you change the nutrition label?

Remember the Food Pyramid?

Every five years the US federal government reviews the Dietary Guidelines for Americans. Remember the days of the "Food Pyramid" and then the recent 2005 edition of the "My Pyramid"? Well, if you missed my past post on the topic you should see the Harvard School of Public Health rendition - the Healthy Eating Pyramid - which has a much simpler and scientific food guide for health!

Marion Nestle noted author and public health professor said in a blog post in the Daily Green today that the new recommendations acknowledge

"The need to change the food environment to help individuals meet the Dietary Guidelines."

This is a huge step in the right direction. No longer are our food addictions being looked at simply from the perspective on the individual, but as rooted firmly in the policies and norms of the communities we live in. Our environment impacts our choices, and our food choices affect our health.

There will be an opportunity for public comment on the new guidelines early this summer.

Breastfeeding Saves Money, Saves Lives

Most parents enter labor expecting to breastfeed. Many are confronted with numerous challenges (some from the start, others as they go back to work) to continue breastfeeding throughout infancy.

A CNN news report highlights the challenges and public health importance of promoting and supporting new mothers in breastfeeding their baby throughout the first 6 months of their child's life.

This challenge makes me wonder how much of the problem is one of

• Biology - Moms physically aren't able to breastfeed their kids.
• Education - Moms don't know to breastfeed - exclusively - until their child reaches 6 months.
• Awareness - Moms don't know about the benefits/risk of breastfeeding - or not - on their child's health.
• Social - Relationships (partners, family members) and social norms interfere with moms' decision or ability to breastfeed.
• Structural/Political - Policies and structural factors like break time at work inhibit moms from being able to breastfeed or pump throughout the day.

As a quick aside: the new health care reform law makes it mandatory for employers to provide breaks to female workers who are lactating (i.e. breastfeeding). I expect that will begin to address some of the structural barriers mentioned above!

FDA May Tackle Serving Size Concerns in Food Labeling Overhaul

"Once you pop, you can't stop!"

What clever marketing. Like a self-fulfilling prophecy, really. I mean "Bet you can't eat just one!" -- that'll get you, too.

Well, it's time we faced the facts of American food culture straight up. Bigger is better, and more makes you merrier. Tell me, who eats for breakfast a bowl filled with only 1 cup of cereal or -- heaven forbid -- 1/2 cup of granola? And how many people eat 1 oz (about 6-10) of tortilla chips and stop at that?

Yet, if you look at the food labels -- that is what a typical serving size would be!

While food companies have known this (and exploited it) for years, the US Food and Drug Administration (FDA) has been slow to catch on...

Jamie Oliver (Naked Chef) Takes on Child Obesity at Ted

Jamie Oliver gives a Ted Prize speech on childhood obesity at the Ted Conference in southern California. He believes that the food reality in America is awful and that action must be taken.  Oliver is a food ambassador that commands attention, even of our nations tech leaders!

This is not a research presentation; it's a passionate, moving talk on the realities of death and the TRUE costs of a poor food culture.

Slimming Down School Milk: Did it have an impact?

Schools are getting smart and thinking more about where kids are getting their calories from in school. With childhood obesity continuing to rise (even though adult obesity seems to have slowed down), the implementation of sound school wellness policies is imperative to curbing unhealthy habit forming behaviors in kids' lives.

There is not a ton of data on how school nutrition policies have impacted student health or changed children's consumption of certain foods. (Though if you're interested, I've done a ton of research in this area on sugar-sweetened beverages). But now we have data on one common policy: switching school cafeterias over to serving kids lower-fat milk (1% or fat-free).

Update: MA School Nutrition Bill

It took a little investigating (and some decoding) to figure it out: the School Nutrition Bill passed the House!

Thanks for calling and/or writing your Legislators. It does make a difference. I know there was a lot of movement on the ground Thursday morning among advocates for school wellness and nutrition policy even though I couldn't join them.

You can access the legislative history of the newly numbered bill (HB 4441) at the Massachusetts website. Each Amendment was adopted in turn, with a few hiccups (i.e. "referred to House Rules" and "Rules Suspended") along the way.

Need a little more information about what took place yesterday?? ...

Contact Your MA Legislator for School Nutrition!

Tomorrow may be a historic day for school nutrition in Massachusetts!

This Thursday, the Massachusetts House plans to vote on House Bill 4438 (previously HB 2092), also known as the School Nutrition Bill. This would be a milestone in Massachusetts school nutrition history, as no previous bill has set standards for the types and quality of food sold in school besides the VERY minimal federal regulations.

If you want our schools to be healthier places for our kids, then contact your legislator by TOMORROW!

You can find out more about the School Nutrition Bill and the Local Farm Products Bill (HB 2017), which will *hopefully* also be incorporated in the final document, at the Massachusetts Public Health Association website.

To find out who your State Representative is and how to contact them click here.

This is what I wrote to my Representative...

Altering Our Salt Obsession: A New York City Initiative

Salt is a hot topic in health right now. For more than a decade Americans have been consuming nearly twice the recommended amount of salt in their foods, mostly due to eating out more and the increased consumption of heavily processed, heavily salted foods.

Nutritionists and doctors have been concerned about individuals' excess consumption of salt (or sodium), particularly among those with high blood pressure. The US Department of Health and Human Services recommends a maximum of 2,300 mg of sodium/day (only about 1 tsp of salt), and even less for those with high-blood pressure. But many Americans consume closer to 3 tsp of salt each day.

Eating too much salt has been shown to raise blood pressure and increase a person's risk of suffering from heart disease or stroke. That's why if you or someone you know has been diagnosed with high blood pressure, your doctor has likely advised you to cut back on your salt intake and switch to low- or no-sodium products so that you can add your own salt to taste.

This week public health professionals and politicians stirred interest in salt -- particularly the abundant use of salt and salt-laden products by restaurants, especially fast food restaurants. The New York Times reported on January 11 of Mayor Bloomberg's plan to support the reduction of salt in packaged and restaurant foods by 25% over the next 5 years.

Nourishing Traditions: A book that gets to the heart of food

There is no arguing that our food system has dramatically changed over the past half century. The American diet has been overhauled with the advent of fast-food, supermarkets, and convenience foods (read: shelf-stable products all found in the interior of your local market or in those vending machines you frequent). These changes have affected public health in unimaginable ways -- not the least of which is the rapid rise of obesity and Type 2 (preventable) diabetes among adults and children of all ages.

This Christmas, I asked my in-laws for a cookbook that could revolutionize the way I think about and interact with food. That book, Nourishing Traditions, is subtitled "The cookbook that challenges politically correct nutrition and the diet dictocrats." And if that doesn't say enough -- it's filled with recipes calling for raw, whole fat dairy, lard and numerous recipes calling for whey (the liquid part of curds and whey -- or that clear, yellowish liquid that settles when you have a tub of yogurt in your fridge).

Is "Healthier" Healthy Enough for School Vending?

Early on a Tuesday morning, while walking the halls of Winter Hill Elementary School in Somerville, Massachusetts, I was struck by the absence of an item that has become nearly ubiquitous in schools across Massachusetts: vending machines. Vending machines are the most convenient source of exactly what you tell your kids not to eat.

Debunking American Nutrition Myths

Darya Pino of Summer Tomato (an amazing blog with lots of health and nutrition information) promoted this video. It's amazing -- Dr. Lustig of UC San Francisco debunks popular nutrition myths, particularly related to sugar consumption by tying together the science of public health, nutrition, and biochemistry.



Hope you enjoy!

How Healthy is Your Breakfast Cereal?

Cereal is about as commonplace in the American home as peanut butter and jelly (unless you are allergic, I guess). At some point in our nations history, whole cereal grain breakfast that took minutes or hours to prepare were replaced by highly processed refined grain "cereals" that had loads of added sugar and went by the name of Cap'n and Lucky.

Until today's release of the Yale Rudd Center's Cereal Facts website, there was little way to know whether the cereal you were eating was healthy or all hype. Case in point: a friend posted a picture of Facebook with a Fruit Loops box reading "NOW WITH FIBER" on the front package (see yesterday's post for more on this...) which clearly illustrated food industry's widespread marketing of unhealthy food with their "healthy" components placed first, and foremost for consumers to see.

Smart Choices Labeling System Divided, Fails?

The "Smart Choices" label, which was meant to be a guide for consumers to make healthier food choices when shopping the supermarket, may be lying on its deathbed, according to a recent article in the New York Times. A few of the major food industry supporters, including PepsiCo and Kellogg's have cut its ties with the program and will phase out production of products (like Froot Loops cereal) with the Smart Choices logo prominent on the box front. Although, Kraft indicates it has no intentions to remove the logo from its foods.

How to Lose Weight in Ten Days

Gimmicks.

Losing It
Weight loss isn't easy. The following weight loss plans: Atkins, South Beach, Green Tea, Low Carb, Low Fat all have one thing in common: they focus on diet. Why do all these weight loss fads all focus on changing what you eat? The answer may be simpler than you think: results. Changing what you eat is the quickest way to lose weight. Eat fewer calories and you will lose weight, all else being equal.

What does it take to burn 300 calories through physical activity? Likely, an hour of brisk walking or a 3 mile jog. What would it take to eat 300 fewer calories? Forgo the tortilla at Chipotle or the beef in your stir-fry. For many people, changing diet is more convenient and less challenging (mentally and physically) than becoming more physically active.

Battleground School Food

It may be a fluke or it may be fortune that the New York Times has taken up the "cause" of school food and nutrition in the last week or so. First there was the article profiling the cafeteria at a popular New York City public school in Queens. Then, Saturday, they ran an article on the ban of sugary foods from public schools in New York City even for celebrations (think kids' birthdays) and bake sales or fundraising activities. Actually, the 'bake sale ban' is not something new, it was issued in June but is just beginning to be implemented.

After my Public Health in the Media class last year (take it if you get the chance...I'll be the TA!) I am sure that it is not a mere coincidence that school nutrition has landed in the newspaper several times in the past month. I think the reason that the New York Times is talking about school nutrition policy is because people are starting to care about it! People want someone to do something about childhood obesity and schools are a natural starting place.

But it is important to ask: Does the ban on sugary snacks and treats in schools go too far?

School Nutrition Policies, MA on my mind

As I mentioned on Twitter this morning, french fries appear to be the lunch food of choice for students in a popular school in Queens, New York, according to the New York Times. That probably doesn't surprise anyone who works in a school or has visited one during lunch. Unfortunately, I have not.

Nonetheless, my memories of school lunch are not much different. I remember tater tots and pepperoni hot pockets being standard fare. By the time I graduated, there was a salad bar in place; it was not very popular. Occasionally, I opted for the food served as part of the National School Lunch Program (spaghetti comes to mind) and on days of cross-country meets I habitually ate a peanut butter and jelly sandwich, which was a pretty good choice thinking back on it.

Soda Tax To Combat Obesity, Will it Work?

Cigarettes are taxed, alcohol is taxed, why aren't soft drinks taxed?

One huge reason for the dirth of legislation levied against unhealthy foods including sodas is the enormous lobby of the food industry in DC and across the country. Whenever there is serious consideration of restricting access to unhealthy foods (such as in public schools) there is enormous resistance. Big Food has lots of money to manipulate (I mean influence) public opinion so that there is not enough momentum and public support for anti-junk food policies. The sad story is that public health professionals can have nearly the same trouble improving access to healthy, nutritious foods in these same places!!

The lead story of the Business section of today's New York Times was "Tempest in a Soda Bottle: Proposed Tax on Sugary Beverages Debated." It discusses the increased political open-mindedness to the idea of a tax on soft drinks and sugar-sweetened beverages in the US and the likely resistance to such a proposal.

Here's why I think this could be a good idea.