Being overweight or obese is often identified as the primary cause of heart disease, diabetes, cancer, and, ultimately, premature death. As a result, Americans are waging a war on fat (we have been for years). Diet books, pills, programs, and fitness fads abound… But is fat really at fault? Meaning, is an excess amount of body fat in and of itself responsible for the increased rates of death and disease? Or are other factors like unhealthy lifestyles, lack of cardiovascular fitness, and/or fat prejudice to blame?
Consider the concept of Health at Every Size (HAES). HAES is a relatively new “movement” focused on body acceptance and healthy lifestyles instead weight loss. From the HAES website: “Fighting fat hasn’t made the fat go away. And being thinner, even if we knew how to successfully accomplish it, will not necessarily make us healthier or happier… Health at Every Size is the new peace movement. Very simply, it acknowledges that good health can best be realized independent from considerations of size. It supports people—of all sizes—in addressing health directly by adopting healthy behaviors.”
It all sounds well and good, but is there any scientific support for HAES? Indeed, there is. A 2005 study published in the Journal of Academy of Nutrition and Dietetics compared the effectiveness of a traditional diet approach and a HAES approach in a group of obese women (the approaches were randomly assigned). It’s important to note that “effectiveness” in this study was not limited to body weight; outcome measures also included metabolic fitness (blood pressure, blood lipids), energy expenditure, eating behaviors (restraint, eating disorder pathology), and psychology (self-esteem, depression, body image).
The results? The attrition rate at six months was high in the diet group (41%) compared to the HAES group (8%). The diet group lost weight and showed initial improvement in many variables at 1 year, but the weight was regained and little improvement was sustained at two years. The HAES group, on the other hand, maintained weight, improved all other outcome variables, and sustained the improvements for at least two years.
Food for thought
Do you think people can be fat and healthy at the same time? How about fat and fit? Also, do you think the stigma and fear associated with being fat in the United States contributes to the current “obesity epidemic”?
You may have seen recent headlines that heralded studies indicating that diet soda consumption was related to weight gain. A USA Today headline from a July 10, 2013 article read, “Study: Diet soda doesn’t help you lose weight” (Diet Soda Article). Another on the Reader’s Digest web site asks, “Is Diet Soda Making You Fat?” (Reader’s Digest Article). Furthermore, WebMD reports that searching “diet soda” and “weight” using a popular browser found that 49 of the top 50 hits were for stories that warned readers of the link between diet soda and weight gain (WebMD Article). Why has this issue been in the news in recent months? It turns out that a few scientific studies were published over the past several months, purporting this idea that diet soda consumption may actually lead to weight gain, rather than what most people would expect, weigh loss. Let’s have a closer look at those studies and also consider this issue in light of a larger body of scientific research on this topic.
It turns that the recent attention to this issue results from studies with laboratory rats and from observational studies in humans. In the rat studies, published by Drs. Swithers and Davidson at Purdue University (Swithers S and Davidson T – PubMed – NCBI), the researchers noted an association between non-nutritive sweetner consumption (e.g. saccharin) and weight gain. The researchers suggested that rats consuming saccharin, as opposed to rats ingesting table sugar, took in more calories and gained more weigh over time. But, will this finding hold true in humans?
Other recent epidemiological studies, consisting of large numbers of people, reported that those who drank more diet sodas gained more weight over time. One study tracked more than 5000 adults in the San Antonio Heart Study. The second (the Framingham analysis) reported an association between intake of both sugar-sweetened sodas and diet sodas and development of metabolic syndrome, which is cluster of symptoms linked to obesity. However, since both of these studies were observational, it is not possible to say with certainty whether consumption of diet sodas has a direct effect on body weight.
These studies were rapidly popularized by the media and online bloggers, and soon this message was out for all to see. Interestingly, not everyone agrees with these findings and many past studies have not identified such an association. A recent review of past studies on this topic, published in the American Journal of Nutrition (AJCN Article), came to different conclusions, namely that the purported mechanisms by which non-nutritive sweetners promote energy intake and contribute to weight gain are not supported by the current available evidence. The authors do however recommend that this possibility should be further considered in long-term, randomized controlled clinical trials.
The jury is thus still out on this issue, despite all the recent negative press regarding consumption of artificial sweetners. Importantly two respected scientific organizations support the use of no calorie sweetners to restrict calorie and sugar intake (the American diabetes Association and the American Dietetic Association). This thus leaves us as individuals with a sort of dilemma. Should we restrict intake of artificial sweetners? Which studies are correct? The best advice may be to consume these food additives in moderation and await more definitive research which will undoubtedly be undertaken very soon.
What comes to mind when you read the word “organic”? Do you picture happy cows eating lush green grass under the shade of an oak tree? Or a small family farm full of happy workers and buzzing bees? Or the bright colors and mouth-watering flavor of a freshly picked heirloom tomato? Do you associate “organic” with words like healthy, humane, and environmentally-friendly?
Unfortunately, none of those visions or associations may be true. Why? Because the United States Department of Agriculture (USDA) defines the word “organic” not by what it is, but rather by what it’s not. There are essentially six things permitted in conventional foods that are NOT allowed in organic foods (National Organic Program):
- No synthetic fertilizers
- No synthetic pesticides (herbicides or insecticides)
- No antibiotics or growth hormones (in animal products)
- No municipal sewage sludge (applied to fields)
- No irradiation
- No genetically-modified organisms (GMOs)
Some folks proclaim that the simple absence of the above items is no guarantee that organic foods are any healthier, more humane, or friendlier to the environment than conventional foods. Other folks firmly believe that the absence of any the above items makes organic food better by default.
Food for thought
What do you think? Is organic food “better” than conventional food? Why or why not?
Obviously this is not a straightforward, “apples-to-apples” comparison. The quality of your food, organic or conventional, depends on the practices of your farmer, as well as the additional processing and/or distances that the food is submitted to before it arrived on your plate. There are a host of other factors to consider as well. What factors matter most to you?
National Organic Program website. Accessed November 24, 2013. http://www.ams.usda.gov/AMSv1.0/nop
Is there gluten in your bread? Trans fat in your potato chips? High-fructose corn syrup in your cookies? The answers to all of these questions (and more!) are conveniently located on your food labels. By law. Go ahead and take a look for yourself.
How about genetically modified organisms (GMOs) – are there any of those in your food? Hmm, that one is a little harder to determine. By lack of law.
In the European Union, food products that contain GMOs or were derived from GMOs have been labeled since 1997. In the United States, despite upwards of 93% of citizens supporting similar measures (Kopicki, 2013), such food products are currently NOT labeled. Biotechnology companies claim that GMO labels would raise “unnecessary fears” among consumers and increase the price of food. Furthermore, the Food and Drug Administration (FDA) claims that genetically-modified foods are “substantially equivalent” to non-modified foods.
The battle to label genetically-modified foods has been waged and lost in two high profile state elections over the past year. Following a similar storyline, citizens in both California and Washington initially supported independent measures to label GMO foods by an overwhelming margin. Then, in the days and weeks before each election, an influx of money from pro-GMO/anti-labeling interest groups ($46 million in California and $22 million in Washington) swayed public opinion when it mattered most: at the polls. Although both measures were ultimately voted down, twenty other states are now considering similar ballot issues for GMO labels in 2014.
Food for thought
On one hand, biotechnology companies are allowed to patent foods that have been genetically modified because they represent “unique” technologies. On the other hand, the FDA claims that genetically modified foods are “substantially equivalent” to non-modified foods and thus does not support mandatory GMO labeling laws.
What are your thoughts? Regardless of your stance on GMOs, how do you feel about labeling laws for food products that contain GMOs? Do you have a right to know what’s in your food?
Kopicki, A (2013). “Strong Support for Labeling Modified Foods”. The New York Times. July 17, 2013. Accessed November 17, 2013. http://www.nytimes.com/2013/07/28/science/strong-support-for-labeling-modified-foods.html
You may have heard recent reports detailing the possible negative health consequences associated with the consumption of dairy products. This was a topic recently highlighted by the famous TV personality and self-purported nutrition expert, Dr. Oz. A recent piece authored by he and Dr. Mike Roizen from the Cleveland Clinic (see for example http://www.willitsnews.com/ci_23981339/dr-oz-heres-milk-news-thatll-shake-you) suggested that recent studies have concluded that regular consumption of milk was associated with diverse negative health outcomes. Their claims were as follows:
Claim 1: Since milk is high in sugar, it may contribute to childhood obesity
Claim 2: Milk consumption might not promote bone health or prevent bone fractures
Claim 3: Lactose (milk sugar) increases insulin-like growth factor levels and may promote ovarian cancer
Let’s however has a closer look at this issue and see what the peer-reviewed scientific literature concludes in this issue.
In contradiction to some of the negative health claims made by Drs. Oz and Roizen, a recent review article appearing in Nutrition Reviews (http://www.ncbi.nlm.nih.gov/pubmed/23550782), which performed an extensive review of the scientific literature, found numerous positive health influences associated with milk consumption. These included the following:
Regular consumption of milk:
1) Close gaps between current nutrient intakes and recommendations.
2) Leads to better nutrient status and improved bone health
3) Is associated with lower blood pressure and decreased risk of cardiovascular disease and type 2 diabetes
Despite these controversial stances on consumption of dairy products, all sides agree that adequate calcium and vitamin D are essential for good health. Milk is one of the best sources of these essential nutrients (and others), but if you can’t (or chose not to) consume milk, make sure you choose other foods that are good dietary sources of these nutrients. Good choices include fortified almond or soy milk, calcium-set tofu, fortified breakfast cereals, almonds and leafy greens.
Two differing opinions thus emerge on this issue. Who should you believe? Do you prefer to get your nutritional advice from TV personalities or from nutrition scientists working in the field? Will you continue to consume dairy products, or side with those that pick and choose the relatively fewer studies reporting negative health consequences? The choice is yours, but be properly informed before you decide. Your long term bone health and risk of osteoporosis later in life may hang in the balance.
A few weeks ago I wrote a post about two different types of fats: “good” essential fats and “bad” trans fats. To be clear, I really don’t like using the terms “good” or “bad” when it comes to food because it’s rarely so black and white (see my first post It Depends). In this case, however, I’ll go out on a limb and call trans fats horrible! Apparently the U.S. Food and Drug Administration (FDA) agrees: “Condemning artificial trans fats as a threat to public health, the FDA announced Thursday it will require the food industry to phase them out” (Associated Press, 2013).
Trans fats are a health threat for at least three specific reasons. First, they raise “bad” LDL cholesterol levels (similar to saturated fats and dietary cholesterol). Second, trans fats lower “good” HDL cholesterol levels (which help clear LDL cholesterol from your arteries). Third, trans fats are associated with increased cellular inflammation (which contributes to high blood pressure among other things). Together these factors – high LDL, low HDL, inflammation – significantly increase the risk of cardiovascular disease, heart attacks, and strokes.
Where do trans fats come from?
Artificial trans fats are created via a process called hydrogenation, when hydrogen is added to liquid oils under high pressures and/or temperatures. Hydrogenation partially solidifies the oils, alters their mouthfeel, and increases their shelf life. Common food sources of trans fats include vegetable shortening, margarine, cookies, crackers, French fries, and other foods made with partially hydrogenated oils.
In 2006 the FDA began requiring manufacturers to list trans fats on food labels alongside saturated fats and dietary cholesterol. Trans fat intake subsequently declined among Americans from an average 4.6 grams per day in 2006 to about one gram a day in 2012 (Tavernise, 2013). That’s good news, but any amount of trans fats is too much and they can still be found in many processed foods like microwave popcorn, packaged baked goods, frozen pizzas, and coffee creamers.
Food for thought
From a health perspective, how many grams of trans fats do you consume each day? What types of foods could you substitute in place of trans fats? From a philosophical perspective, do you think the government should intervene in public health matters like this? Or should the choice to consume trans fats be left to consumers?
Associated Press (2013). “No More Trans Fat: FDA Banning the Artery-Clogger.” ABC News online. November 7. Accessed November 8, 2013. http://abcnews.go.com/Health/wireStory/trans-fat-fda-banning-artery-clogger-20824813
Tavernise, Sabrina (2013). “F.D.A. Ruling Would All but Eliminate Trans Fats.” New York Times online. November 7. Accessed November 7, 2013. http://www.nytimes.com/2013/11/08/health/fda-trans-fats.html?hp&_r=0
How many folks use energy efficient light bulbs? Anybody drive a hybrid car? Who makes efforts to reduce, re-use, and recycle? Good, because we need all the help we can get! Climate change is official and we’re all responsible and/or affected to some degree (Intergovernmental Panel on Climate Change, 2013).
This topic is related is related to food in two distinct ways: crops and meat. With regard to the former, rising temperatures are expected to negatively impact global production to the tune of 2% per decade for the rest of this century (Gillis, 2013). This at a time when food prices and availability are already critical issues. The good news is that it’s not too late to take action.
That’s where meat comes in. No matter how many energy efficient light bulbs you use or hybrid cars you drive, eating less meat may be the most environmentally-friendly action you can take part in. From the inputs required to produce livestock feed (e.g., diesel fuel, fertilizer, pesticides, water, and land) to the greenhouse gases emitted from the manure that comes out the other end (e.g. methane), meat takes a significant toll on the climate. According to the Environmental Working Group (2011), here’s a summary of how eating less meat stacks up against other climate-saving actions over the course of a year:
- If you eat one less burger a week, it’s like taking your car off the road for 320 miles or line-drying your clothes half the time.
- If your four-person family skips meat and cheese one day a week, it’s like taking your car off the road for five weeks – or reducing everyone’s daily showers by 3 minutes.
- If your four-person family skips steak once a week, it’s like taking your car off the road for nearly three months.
- If everyone in the United States ate no meat or cheese just one day a week, it would be like not driving 91 billion miles – or taking 7.6 million cars off the road.
It’s not necessary to become a vegetarian in order to save the planet, although that certainly wouldn’t hurt. Other positive actions you could take part in include eating fewer meat and dairy products, eating “greener” meats, eating more plants, and wasting less meat.
Food for thought
Would you and your family consider taking part in Meatless Mondays? What types of meats are better or worse for the environment? What types of plants are considered complete and/or complementary proteins? What are some health benefits associated with eating less meat? Check out the report by the Environmental Working Group for answers to these questions and more.
Environmental Working Group (2011). “The Meat Eater’s Guide to Climate Change and Health”. Accessed November 2, 2013: http://www.ewg.org/meateatersguide
Gillis, Justin (2013). “Climate Change Seen Posing Risk to Food Supplies.” The New York Times, November 1. Accessed November 2, 2013. http://www.nytimes.com/2013/11/02/science/earth/science-panel-warns-of-risks-to-food-supply-from-climate-change.html?hp
Intergovernmental Panel on Climate Change (2013). “Fifth Assessment Report: The Physical Science Basis”. Accessed November 2, 2013. http://www.ipcc.ch/report/ar5/wg1/#.UnUHlBDAbIU
You may have seen headlines recently that provide confusing messages about taking a daily multivitamin. Observational studies performed by researchers at the Mayo Clinic found that taking multivitamins increased risk of premature death in older Midwestern women. Furthermore, the Iowa Woman’s Health study reported that those taking a daily multivitamin were 6 percent more likely to die over the 19 year study period than those that did not take one. Not all studies however support these observations.
Do multivitamins protect against disease?
Although the above referenced studies suggest increased risk of death when taking a daily multivitamin, others do not support this contention. For example, a placebo-controlled clinical trial, the Physician’s Health study, found that taking a multi did not increase (or decrease) risk for heart attack or stroke. This study asked participants to either take a multivitamin or not for a period of 11 years. Of note, prostate cancer development was slightly lower (~8%) in those taking the multi, but risk of other cancers was not different between study groups. Importantly, this study was able to link cause and effect, unlike the epidemiological studies cited above. It’s thus safe to say that the data from large-scale clinical trials and observational studies are not convincing on either side at this time. So, what’s a person to do and what should be the take home message?
Who should take a multivitamin and why?
For those who do not obtain enough of several critical nutrients, taking a multi is a good idea. The nutrients of concern, as identified by nutrition experts, are as follows: vitamin B12, vitamin D, folic acid, iron, calcium, potassium and fiber. Fiber, potassium and calcium are too bulky to fit into a pill, so these should be obtained from the diet. A daily multi however, can provide amounts of the other 4 to make up for dietary deficiencies. Many consider multivitamins as insurance against disease development, but if you consume adequate levels of these nutrients of concern, the multi will have little added benefit.
What type of product is recommended?
If you do choose to take a daily multivitamin, choose one that has no more than 100% the DV for the added nutrients. Avoid products that contain more than RDA for iron for adults (which varies depending upon gender and eating patterns). Furthermore, since the calcium content of most multivitamins is low, you might consider taking calcium supplements, particularly if you don’t consume dairy products. Also keep in mind that more expensive does not necessarily mean better. You should be able to find a suitable product for less than $10/month.
So, what do you think, do multivitamins promote health and protect against disease development? Are you going to rethink this situation for yourself and keep abreast of the latest scientific developments on this issue? What is most important is that each of us gets the daily nutrients we require for good health, and if a multivitamin allows you to accomplish this, it’s certainly not a bad idea.