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Archive for June, 2012

The Battle Against Big Soda Continues

Below is a blog post just published for Huffington Post on Mayor Bloomberg’s proposal on sugary beverages. Here is the link.

Several weeks ago, Mayor Bloomberg announced a plan to restrict the sale of sugary drinks larger than 16 ounces at restaurants, movie theaters, and food carts in an effort to help combat the obesity epidemic in New York City. The mayor’s Task Force on Obesity states that “Americans consume 200-300 more calories daily than 30 years ago, with the largest single increase due to sugary drinks.”

As both a researcher tracking the sizes of food portions (soda included — I have many oversized soda cups in my collection) and as a nutritionist counseling overweight patients, I continue to stay abreast of the latest developments in the proposed restriction on the sale of sodas and other sugar-sweetened beverages over 16 ounces.

It seems as if Mayor Bloomberg’s proposal may be contagious.

Inspired by Mayor Bloomberg, Henrietta Davis, the mayor of Cambridge, Mass. has proposed limiting the size of soda and sugar-sweetened beverages sold in city restaurants. Mayor Davis cited an increased risk of obesity and diabetes as reasoning behind the resolution.

Many of the nation’s physicians treating obesity-related illnesses also support the mayor’s proposal, citing that 46 percent of the nation’s intake of added sugars comes from beverages. The American Medical Association (AMA) also recently endorsed taxing sugar-sweetened beverages to a penny per ounce.

As I previously wrote for The Huffington Post, I support Mayor Bloomberg’s proposal for several reasons. Sugar-sweetened beverages are purely liquid calories and provide no nutrients, portion sizes of such foods have increased considerably over the last 50 years, and larger portions contain more calories than smaller portions and encourage overeating. I see it as a win-win situation.

The mayor of New York City is not banning the sale of soda. Nor is he telling consumers that they can’t drink soda. Rather, he is calling attention to how much should be considered a reasonable amount to drink at a time. And 16 ounces is certainly more than a reasonable — that is a pint-size worth of sugar water. I do not see the proposal as a ban, but rather as an attempt to reset the norm for how much drink constitutes an appropriate portion. This is a much needed proposal in an era of oversized portions.

Others, however, disagree. Some argue that Mayor Bloomberg’s proposal violates personal freedom and that the city should not dictate what size drinks people buy. The soda industry complained that soda is being singled out, and it has a website devoted to its case: www.letsclearitup.org.

At issue is just how large soda sizes have gotten. In the 1950s, McDonald’s offered just one size, 7 ounces, and Burger King offered a 12-ounce small and a 16-ounce large.

The following chart illustrates just how out of control portion sizes — and calories — of soft drinks have gotten in fast food establishments.

McDonalds

Kids 12 oz. — 120 calories
Small 16 oz. — 150 calories
Med 21 oz. — 210 calories
Large 32 oz. — 310 calories

Burger King

Value 16 oz. — 140 calories
Small 20 oz. — 190 calories
Medium 30 oz. — 290 calories
Large 40 oz. — 380 calories

KFC

Small 16 oz. — 180 calories
Medium 20 oz. — 230 calories
Large 30 oz. — 350 calories
Mega Jug 64 oz. — 780 calories

Looking at the above chart, it is clear that most sizes currently sold will not be marketed if Mayor Bloomberg gets his way. And, I will argue, for good reason. They contain mega calories. For example, the small size soda (and only size allowed according to the proposal) at KFC contains 180 calories, while the 64-ounce mega jug contains nearly 800 calories.

New Yorkers may or may not be able to purchase jumbo sodas next spring, but the mayor’s proposal has put supersized beverages on the line and is getting a dialogue going about portion size, soda consumption, and obesity. That, in and of itself, is progress. I commend Mayor Bloomberg for raising our awareness to the problem with oversized beverages. I am proud to be a New Yorker and look forward to the day when I will no longer be able to collect oversized cups.

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Healthy grains!

The post below also appears as a blog post for  Huffington Post and can be found here.

With the low-carb movement, so many clients that I counsel fear eating grains and starches altogether, and think they are better off without them. This is false!! Certain starches are not particularly healthy such as bagels and muffins; they are oversized and each are equivalent to eating around 6 slices of bread. But many grains–whole grains–are indeed healthy and should be included as part of a healthy diet. Indeed, the 2010 dietary guidelines suggest that at least half of our grains be whole grains.  Here’s why.

Including whole grains in your diet is a great way to boost your nutrient intake. They are loaded with vitamins and minerals including B vitamins, vitamin E, magnesium, selenium, and protective phytonutrients. A good source of fiber and complex carbohydrates, they are relatively low in calories and fat. It is no surprise that diets rich in whole grains may offer protection against heart disease, stroke, type 2 diabetes, hypertension, and certain cancers.

Whole grains are healthier than processed grains because they provide many more nutrients. They also offer a greater sense of fullness in people who eat them. Whole grains are made from the whole kernels of grain, including both the inside part of the grain and the outer covering. Processed grains remove the outer covering along with a lot of the nutrition and fiber. Fiber helps prevent constipation, and may cut the risk of heart disease, diverticulosis, and certain cancers.

Most Americans do not consume enough whole grains. For many of us, eating more whole grains requires learning about foods rarely seen in the traditional American diet.  As you will see below, many delicious and nutritious grains exist.  And, if you are gluten free, no need to worry, as many terrific and versatile grains are now readily available on the market.

Skip the white pasta and white rice and include healthy grains instead: brown rice, kasha, quinoa, spelt, and whole wheat pasta, to name a few.  Here are some nutritional benefits of some healthy, tasty, and versatile grains:

Amaranth is a great grain for those with gluten intolerances and wheat allergies. It also has a terrific nutritional profile.  One cup of cooked amaranth delivers lots of fiber, protein, and is rich in minerals including iron, magnesium, manganese, and phosphorus. It also contains betalains, a class of antioxidants that may help reduce inflammation.

Barley is a good source of soluble fiber which may reduce cholesterol and stabilize blood sugar levels. Barley contains B vitamins, and the minerals selenium and copper. While pearled barley is not technically a whole grain, as it is polished, and some nutrients are lost, hulled barley is healthier, and contains more fiber, vitamins, and minerals.  However, even pearled barley is a healthier alternative to refined grains such as white rice, couscous, or pastas made from white flours.

Brown rice is a much better choice than white rice. It contains fiber, B vitamins, and a variety of minerals. It contains nearly three times the fiber as white rice. A mere ½ cup serving of cooked brown rice contains nearly a half day’s worth of the mineral manganese which works with various enzymes facilitating body processes.

Buckwheat brought to America by Russian and Polish immigrants who called it “kasha,” is a good source of the minerals manganese, magnesium, and zinc, as well as flavonoids like quercetin and rutin which contain antioxidant and anti-inflammatory properties. A great choice for those following a gluten free diet.  One cup cooked Kasha contains 5 grams of fiber.

Bulgur wheat is higher in fiber than most grains. One cup cooked bulgur contains 8 grams of fiber. The insoluble fiber it contains is helpful in preventing constipation and diverticular disease. It also contains iron, magnesium, manganese, and  B vitamins. Because bulgur is made from precooked wheat berries, it can be reconstituted by soaking or by simmering. It’s wonderful nutty flavor and light texture makes it a great choice for salads and side dishes.

Millet contains manganese and phosphorus which may contribute to bone health. It is also rich in B vitamins, especially niacin, B6, and folate. Added bonus: it is gluten-free.

Oats are a good source of soluble fiber and contain beta-glucans which helps lower cholesterol and stabilize blood sugar levels. They also contain insoluble fiber which prevents constipation and promotes regular bowel movements. Moderate amounts of pure, uncontaminated oats are tolerated by most people with celiac disease, but it is important to be aware that many commercial oat products on the market have been cross-contaminated with wheat, barley and/or rye.

Quinoa is a nutrition treasure and has a protein content that is superior to that of most grains, because it contains all the essential amino acids. It is high in the amino acid, lysine, which is important for tissue growth and repair. It is also rich in the minerals iron, magnesium, manganese, phosphorus and copper, and a great choice for the gluten free.

Spelt has gained popularity as a healthy and delicious grain due to its nutty flavor, high protein and nutrition content. It is low in fat, high in fiber, and contains B vitamins and minerals including potassium, magnesium, manganese and copper. And it has gained a following for those intolerant to wheat. Many people with wheat allergies can tolerate spelt well.

Whole wheat products are not stripped of nutrients and fiber like refined products. Whole wheat foods such as whole wheat pastas, breads, and couscous contain insoluble fiber, which prevents constipation and may be protective against certain cancers. They also contain an array of vitamins and minerals.

Aim for 100% whole wheat products such as whole wheat pasta and couscous.

Wild rice is high in protein and fiber and low in fat. It also contains the minerals potassium and phosphorus and B vitamins.

Savvy shopping tip: Choose grains that are 100% whole grain. When reading food labels, look out for words such as “multigrain” or “stoneground” which do not necessarily mean whole grain. And the phrase “made from whole grain” is generally used on products that aren’t 100% whole grain.

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Size Matters, at least in NYC!

This is an invited post I wrote for Huffington Post on Mayor Bloomberg’s proposed ban on soda sizes in NYC.   http://www.huffingtonpost.com/dr-lisa-young/new-york-soda-ban_b_1563758.html

Feel free to take part in the debate: http://www.huffingtonpost.com/2012/06/04/new-york-soda-ban_n_1567816.html?ref=healthy-livi

New York City Hopes to Ban Supersize Sugary Beverages

Oversized beverages, including 7-Eleven’s Big Gulp and just about all medium and large size beverages sold at fast-food establishments, may no longer be available to consumers in New York City if Mayor Bloomberg’s ambitious proposal to limit the portion sizes of sweetened beverages is passed by the city’s board of health in June. In fact, the “small” soda at McDonald’s may soon become the largest option available. And even Burger King’s 22-ounce “small” would be banned. According to the mayor, it is time for food eateries to start shaving down their portions.

The proposed ban would restrict the sale of sodas and other sugary drinks that are larger than 16 fluid ounces in food establishments such as restaurants, movie theaters, sports arenas, delis, and street carts. It would include the popular 20-ounce soda bottle from the corner deli and, of course, oversized fountain drinks available in fast-food establishments and movie theaters. The ban would not affect diet drinks, fruit juice, dairy-based drinks such as milkshakes, or alcoholic beverages. Nor would it affect beverages sold in grocery stores.

It is no surprise that the beverage industry is up in arms about the proposal, and feels that the city’s department of health is unfairly singling out soda. Indeed, the ban would affect the sales of their product. According to the New York Times, the New York City Beverage Association criticized the city’s proposal:

“The New York City health department’s unhealthy obsession with attacking soft drinks is again pushing them over the top,” the industry spokesman, Stefan Friedman, said. “It’s time for serious health professionals to move on and seek solutions that are going to actually curb obesity.”

According to the New York City Department of Health, sugary, sweetened beverages are a major contributor to the current obesity epidemic both in New York City and in the rest of the country. In a phone interview, Dr. Thomas Farley, New York City’s health commissioner, indicated that the extra calories from sweetened beverages have indeed contributed substantially to rising obesity rates throughout our country.

This is not the first time the New York City Department of Health has tried to help us trim our portions. In January, they launched a portion-size education campaign — “Cut Your Portions. Cut Your Risk” — featuring ads on subways encouraging New Yorkers to trim their portions to reduce their risk of health problems. As I previously wrote, the city’s health department has been very proactive in fighting obesity and other public health issues.

So, what should we make of this new proposal to ban oversized sugary drinks?

This campaign makes sense at a time when food portions have increased and so have rates of obesity.

As a researcher tracking portion size trends, food portions have increased steadily over the years, and so have we. We have grown accustomed to oversized portions, and we have come to expect them. My research found that portion sizes are now two to five times larger than they were in the 1950s. When McDonald’s opened, for example, the only size soda available was 7 ounces. When Burger King first opened, the company offered a 12-ounce small and a 16-ounce large. Boy have we grown! Burger King’s small is now 22 ounces and its large is 42 ounces. I think it is time to return to those more reasonable sizes.

Large portions may contribute to obesity in several ways. Large portions contain more calories than small portions. For example, an 8-ounce soda contains 100 calories, while a 64-ounce Double Gulp without too much ice contains nearly 800 calories. Large portions also encourage us to consume more and to underestimate how much we are really eating. Sugar-sweetened beverages, in particular, provide no nutritional value whatsoever. As a registered dietitian counseling clients on healthy eating, I advise eating a small portion of foods low in nutritional value.

If food companies do not sell large sizes, consumers will not buy them. Of course, you can get around the ban by purchasing several drinks. Indeed, four 16-ounce sodas would amount to just one 64-ounce Double Gulp, but it’s going to cost a lot more money. And will consumers want to pay for them?

Part of the portion problem is that the current price structure encourages us to buy bigger sizes. All too often, the bigger the portions, the less we pay per ounce. At a local 7-Eleven, the cost of the smallest size available (20 ounces) is roughly five cents per ounce, but the largest size (64 ounces) goes down to just two cents per ounce. It is hard to resist such a bargain.

As an educator and clinician, I would absolutely continue to advocate for better education and public health campaigns. I would urge such campaigns to begin at home and continue in the schools for our children to receive training on nutrition and health — in particular, on the relationship between calories and portion sizes. But education has not proven to be the answer thus far. Research looking into the effectiveness of the posting calories on menu boards has not been very promising. The health department found that 15 percent of patrons improved their choices by looking at calorie counts on menu boards. Indeed, we need to take this a step further. And Mayor Bloomberg is taking action.

Given the health consequences and enormous cost of our country’s obesity epidemic, it is time to return eating less. And banning the large sizes of unhealthy sugar-sweetened beverages is a good place to begin. The city has unveiled other such public health campaigns, and it appears that they may actually be working. Smoking has declined and so have rates of childhood obesity in New York City. I applaud the health department for its efforts in fighting to improve the public health of New Yorkers and hope other health departments around the country follow New York’s lead.

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